A nurse is preparing to administer intravenous phenytoin (Dilantin) to a patient who has status epilepticus. Which of the following actions should the nurse take?
A.
Flush the IV line with normal saline before and after giving phenytoin
B.
Mix phenytoin with dextrose solution in a syringe
C.
Give phenytoin as a bolus over 1 minute
D.
Use an inline filter when infusing phenytoin
The correct answer and Explanation is :
The correct action to take when administering intravenous phenytoin (Dilantin) is:
A. Flush the IV line with normal saline before and after giving phenytoin
Explanation:
Phenytoin is a commonly used anticonvulsant for managing seizures, including status epilepticus. It is crucial to administer phenytoin correctly to avoid complications and ensure its effectiveness. Here’s why option A is the correct choice:
- Phenytoin and Compatibility: Phenytoin is not compatible with dextrose solutions and can precipitate, which is why it should not be mixed with dextrose solutions or administered through an infusion that includes dextrose (Option B). Using an inline filter with phenytoin is not generally recommended as it can affect the medication’s stability (Option D).
- Administration Speed: Phenytoin should be administered slowly. Rapid infusion can lead to adverse effects such as hypotension and cardiac arrhythmias. It is typically given over 20 minutes, not as a bolus over 1 minute (Option C).
- Flushing the IV Line: Flushing the IV line with normal saline before and after administering phenytoin is important to ensure that the entire dose of medication is delivered and to prevent irritation of the veins. Phenytoin is highly irritating to veins, so flushing helps to minimize local reactions and maintain patency of the IV line.
In summary, flushing the IV line with normal saline before and after administering phenytoin ensures that the medication is delivered properly and helps to reduce the risk of vein irritation and other complications. This practice is aligned with standard protocols for safe administration of phenytoin and helps in maintaining the effectiveness and safety of the medication.