Pharmacology Seizure meds #1

Question

Which action should the nurse perform for a client with a seizure disorder prescribed phenytoin 100 mg intravenous?

Answers

  1. 1. Administer the drug at 100 mg/min IV push
    • Rationale:

      This answer is not correct because IV phenytoin should not be given as fast as 100 mg/min and definitely not by IV push. Evidence-based practice supports IV phenytoin being administered only by IV piggyback at 50 mg/min.

  2. 2. Mix the phenytoin in a dextrose solution before administration
    • Rationale:

      This answer is not correct because if phenytoin is mixed in a dextrose solution, the drug will precipitate. It is recommended to mix phenytoin in saline solution before administration.

  3. 3. Mix the phenytoin in a saline solution before administration
    • Rationale:

      Phenytoin must be mixed only in a saline solution due to irritating the vein from its high osmolality and high pH if given direct IVP. When administering Phenytoin with saline, the nurse should be administered IV piggyback at a rate of 50 mg/minute.

  4. 4. Administer the drug at 50 mg/min IV push
    • Rationale:

      This answer is not correct because administering phenytoin by IV push can be extremely irritating to the client’s vein. This is due to the high (basic) pH of phenytoin. The rate of 50 mg/min is correct, but only if it is administered by IV piggyback.

Overview

Phenytoin is an anti-seizure medication that should be given carefully to avoid irritation to the client’s vein.

Explanation

Learning Outcomes

Evidence-based practice supports IV phenytoin being administered only by IV piggyback at 50 mg/min. This is because phenytoin has a high osmolality with a high (basic) pH can cause severe irritation to a client’s vein if given by IV push.

Test Taking Tip

Details matter with IV medication administration. Be alert to the rate, route, and if the medication should be diluted. This supports safe medication administration.

Video Rationale