The patient is receiving Phenobarbital (Luminal) for control of ...

[future617RT]

The patient is receiving Phenobarbital (Luminal) for control of seizures. The patient tells the nurse she plans to become pregnant. What is the best response of the nurse?
 
  1. Your medication dose will need to be decreased during your pregnancy.
  2. Please talk to your doctor; this drug is contraindicated in pregnancy.
  3. Your medication dose will need to be increased during your pregnancy.
  4. Please talk to your doctor; you will need a safer drug like valproic acid (Depakene).

Question 2

The physician has ordered intravenous (IV) phenytoin (Dilantin). The nurse does not read the drug label and administers the medication intramuscularly (IM). What is the most likely response in the patient?
 
  1. Local tissue damage following extravasation will most likely occur.
  2. A phenomenon known as purple gluteus syndrome will most likely occur.
  3. A marked decrease in serum glucose levels will most likely occur.
  4. Nothing adverse, the medication may be administered intravenously (IV) or intramuscularly (IM).

[kardosa007]

Answer to Question 1

Correct Answer: 2
Rationale: Phenobarbital (Luminal) falls under Pregnancy Category D, and is contraindicated in pregnancy. The medication does not need to be increased; it might need to be stopped. The medication does not need to be decreased; it might need to be stopped. Valproic acid (Depakene) is also a Pregnancy Category D drug and is contraindicated during pregnancy.

Answer to Question 2

Correct Answer: 1
Rationale: Phenytoin (Dilantin) injectable is a soft-tissue irritant that causes local tissue damage following extravasation. It should not be administered intramuscularly, but should be given intravenously into a large vein or via a central catheter. There isn't any such thing as purple gluteus syndrome; purple glove syndrome occurs when phenytoin (Dilantin) is administered in a hand vein, and causes a serious local vasoconstrictive response. Phenytoin (Dilantin) causes an increase in serum glucose.

[future617RT]

Gracias!

[Jossy]

TYSM