DELIA EXAM
A nurse is preparing to administer phenytoin IV to a client who has a seizure disorder.
Which of the following actions should the nurse plan to take?
A. Hold the injection if seizure activity is present. 28%
B. Administer the medication at 100 mg/min. 8%
C. Dilute the medication with dextrose 5% in water. 0%
D. Administer a saline solution after injection. 64% Most selected
Answer and Explanation
Choice A:
Hold the injection if seizure activity is present:This is incorrect. Phenytoin is an
antiepileptic medication used to prevent seizures. If a client with a seizure disorder is
experiencing seizure activity, it is essential to administer phenytoin promptly to help
control and prevent further seizures.
Choice B:
Administer the medication at 100 mg/min:This is incorrect. Phenytoin should be
administered at a rate no faster than 50 mg/min to reduce the risk of adverse effects
such as hypotension, arrhythmias, and cardiovascular collapse. Rapid infusion can
cause adverse reactions such as hypotension, bradycardia, and cardiac arrhythmias.
Choice C:
Dilute the medication with dextrose 5% in water:This is incorrect. Phenytoin should not be
diluted with dextrose-containing solutions, as it can cause precipitation and result in
clogging of the IV line. It is typically administered undiluted or diluted with normal saline
solution.
Choice D:
Administer a saline solution after injection:This is the correct action. After administering
phenytoin IV, it is recommended to flush the IV line with normal saline solution to ensure
,that the medication is fully delivered and to prevent any remaining medication from
precipitating in the IV line, which could lead to occlusion.
A nurse is caring for a client who has bipolar disorder and a new prescription for
valproate. Which of the following instructions should the nurse give the client about the
use of this medication?
A. A pretreatment electroencephalogram (EEG) will be done. 11%
B. High serum sodium levels can cause toxic levels of valproate. 11%
C. Thyroid function tests should be performed every 6 months. 11%
D. Liver function tests must be monitored. 66% Most selected
Answer and Explanation
Choice A:
A pretreatment electroencephalogram (EEG) is not typically required before starting
valproate therapy. EEGs may be used in the diagnosis and management of seizure
disorders, but they are not a standard part of valproate therapy initiation.
Choice B:
High serum sodium levels are not associated with toxic levels of valproate. Instead,
valproate can cause hyperammonemia, especially in individuals with urea cycle
disorders.
Choice C:
Thyroid function tests are not typically required specifically for valproate therapy.
However, valproate may interfere with thyroid hormone levels, so thyroid function tests
might be ordered if there are symptoms of thyroid dysfunction.
Choice D:
, Monitoring liver function tests is essential when taking valproate because the medication
can cause hepatotoxicity. Clients should have baseline liver function tests before starting
valproate, followed by regular monitoring throughout treatment. If liver function test
results indicate liver damage, the healthcare provider may adjust the dosage or
discontinue the medication. Therefore, this is the correct instruction to provide to the
client starting valproate therapy.
A nurse is preparing to administer dextrose 5% in water (DW) 150 mL IV to infuse over 3 hr.
The drop factor of the manual IV tubing is 10 gtt/mL The nurse should set the manual IV
infusion to deliver how many gtt/min?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not
use a trailing zero.)
Answer and Explanation
Correct Answer: 8 gtt/min
Explanation
To calculate the flow rate in drops per minute (gtt/min), we first need to find the total
number of drops (gtt) that will be infused over 3 hours and then divide by the total
infusion time in minutes.
Given: Volume to infuse = 150 mL
Infusion time = 3 hours
Drop factor = 10 gtt/mL
First, let's find the total number of drops for the entire infusion:
Total drops = Volume × Drop factor
Total drops = 150 mL × 10 gtt/mL = 1500 drops
Now, let's find the infusion time in minutes: Infusion time (in minutes) = 3 hours × 60
minutes/hour = 180 minutes
Finally, let's calculate the flow rate: