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Zorluk: OrtaPharmacological and Parenteral Therapies

A nurse is preparing to administer an initial intravenous (IV) loading dose of phenytoin to a client diagnosed with a seizure disorder. The client has an existing continuous IV infusion of 5% dextrose in water (D5W) running at 75 mL/hr. Which action should the nurse take to ensure safe administration of the medication?

  1. Pause the primary infusion and flush the line with 0.9% sodium chloride before and after administering the medication.Cevap
  2. B
    Administer the medication directly via the Y-site port while the continuous 5% dextrose in water infusion is running.
  3. C
    Administer the medication via an intravenous push at a rate of 100 mg per minute to quickly achieve therapeutic serum levels.
  4. D
    Discontinue the infusion immediately and contact the healthcare provider if the client develops mild drowsiness.

Cevap

Pause the primary infusion and flush the line with 0.9% sodium chloride before and after administering the medication.
Phenytoin is strictly incompatible with dextrose solutions such as D5W. When mixed, the medication will rapidly crystallize and precipitate in the IV tubing. To administer the medication safely, the nurse must pause the dextrose infusion and flush the line thoroughly with a compatible solution, specifically 0.9% sodium chloride (normal saline), both before and after the phenytoin is given.

Adım Adım Çözüm

1
Identify the compatibility of the prescribed medication (phenytoin) with the current continuous IV fluid (5% dextrose in water).
Determine that phenytoin is highly incompatible with dextrose-containing solutions and will precipitate if mixed.
Administering incompatible medications together can cause crystallization in the IV line, creating an embolism risk and rendering the medication ineffective.
2
Determine the appropriate intervention to administer the medication safely through the existing IV access.
Decide to pause the dextrose infusion and clear the line.
The line must be completely free of dextrose before the phenytoin is introduced.
3
Select the correct flush solution to use before and after the medication administration.
Select 0.9% sodium chloride (normal saline) to flush the IV tubing.
Normal saline is the only widely accepted compatible IV fluid for phenytoin administration.

Anahtar Kavram

Phenytoin Intravenous Compatibility and Administration Principles
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Konular

Pharmacological and Parenteral Therapies

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