Outcomes of Anticonvulsant Therapy and Seizure Management
Outcomes of Anticonvulsant Therapy and Seizure Management ( 5 Questions)
A nurse is administering intramuscular (IM) phenytoin (Dilantin) to a patient who has status epilepticus that is unresponsive to IV therapy. Which of the following actions should the nurse take?
The action that the nurse should take is choice A. Use a large-bore needle and inject the drug slowly into a large muscle mass. This is the correct action because phenytoin (Dilantin) is a poorly soluble drug that can cause tissue irritation, necrosis, and abscess formation when given intramuscularly¹³. The nurse should use a large-bore needle (at least 21 gauge) and inject the drug slowly into a large muscle mass, such as the gluteus maximus or the vastus lateralis, to minimize these complications¹³. The nurse should also avoid injecting more than 5 mL of solution per site and rotate the injection sites¹³.
The action that the nurse should take is choice A. Use a large-bore needle and inject the drug slowly into a large muscle mass. This is the correct action because phenytoin (Dilantin) is a poorly soluble drug that can cause tissue irritation, necrosis, and abscess formation when given intramuscularly¹³. The nurse should use a large-bore needle (at least 21 gauge) and inject the drug slowly into a large muscle mass, such as the gluteus maximus or the vastus lateralis, to minimize these complications¹³. The nurse should also avoid injecting more than 5 mL of solution per site and rotate the injection sites¹³.
The action that the nurse should take is choice A. Use a large-bore needle and inject the drug slowly into a large muscle mass. This is the correct action because phenytoin (Dilantin) is a poorly soluble drug that can cause tissue irritation, necrosis, and abscess formation when given intramuscularly¹³. The nurse should use a large-bore needle (at least 21 gauge) and inject the drug slowly into a large muscle mass, such as the gluteus maximus or the vastus lateralis, to minimize these complications¹³. The nurse should also avoid injecting more than 5 mL of solution per site and rotate the injection sites¹³.
The action that the nurse should take is choice A. Use a large-bore needle and inject the drug slowly into a large muscle mass. This is the correct action because phenytoin (Dilantin) is a poorly soluble drug that can cause tissue irritation, necrosis, and abscess formation when given intramuscularly¹³. The nurse should use a large-bore needle (at least 21 gauge) and inject the drug slowly into a large muscle mass, such as the gluteus maximus or the vastus lateralis, to minimize these complications¹³. The nurse should also avoid injecting more than 5 mL of solution per site and rotate the injection sites¹³.
large muscle mass. This is the correct action because phenytoin (Dilantin) is a poorly soluble drug that can cause tissue irritation, necrosis, and abscess formation when given intramuscularly¹³. The nurse should use a large-bore needle (at least 21 gauge) and inject the drug slowly into a large muscle mass, such as the gluteus maximus or the vastus lateralis, to minimize these complications¹³. The nurse should also avoid injecting more than 5 mL of solution per site and rotate the injection sites¹³.
The other actions by the nurse are incorrect and indicate a need for further education.
- Choice B is wrong because the nurse should not use a small-bore needle and inject the drug rapidly into a small muscle mass. This can increase the risk of tissue damage, pain, and infection due to the high pH and low solubility of phenytoin¹³. The nurse should use a large-bore needle and inject the drug slowly into a large muscle mass to reduce these risks¹³.
- Choice C is wrong because the nurse should not mix the drug with lidocaine or procaine to reduce pain and tissue irritation. These are local anesthetics that can interfere with the absorption and efficacy of phenytoin¹². The nurse should not mix phenytoin with any other drugs or solutions, as it is incompatible with many of them and can cause precipitation or crystallization¹².
- Choice D is wrong because the nurse should not massage the injection site after administration to enhance absorption. This can cause tissue damage, pain, and infection due to the high pH and low solubility of phenytoin¹³. The nurse should avoid touching or rubbing the injection site after administration to prevent these complications¹³.