Author Question: A nurse is administering medications to a patient with a history of seizures and notices that the ... (Read 58 times)

drink · **on:** Jul 23, 2018

A nurse is administering medications to a patient with a history of seizures and notices that the patient exhibits nystagmus, diplopia, and a serum phenytoin level of 25 mcg/mL.

Upon further assessment, the nurse would anticipate which additional clinical finding? a. Other signs of phenytoin toxicity
b. Signs of an impending seizure
c. Stevens-Johnson syndrome
d. Gingival hyperplasia

Question 2

Which statement is correct regarding the use of ipecac?

a. Ipecac is the drug of choice when an unknown poison has been ingested.
b. Ipecac is the safest agent to use when the patient is obtunded.
c. When used, ipecac should be administered within 1 hour of the poisoning.
d. Ipecac is useful when corrosive acids have been ingested.

janeli · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

A
A phenytoin plasma level above 20 mcg/mL may cause the patient to manifest nystagmus and diplopia, as well as other signs of toxicity. This level is toxic; the normal level is 10 to 20 mcg/mL.
Nystagmus and diplopia are not indications of an impending seizure.
No evidence suggests that Stevens-Johnson syndrome is a factor.
Gingival hyperplasia is not a result of toxicity, but rather an expected effect in about 20 of pa-tients given phenytoin.

Answer to Question 2

c