The nurse is caring for a client who is prescribed phenytoin (Dilantin). To most effectively administer this agent, the nurse will:
1. hold the enteral feeding two hours before and two hours after giving phenytoin (Dilantin).
2. check the client's phenytoin (Dilantin) level before administering the dose.
3. request an alternate form and route to administer the phenytoin (Dilantin).
4. dilute the liquid form of phenytoin (Dilantin) with 100 mL of water.
Correct Answer: 1
Rationale 1: When phenytoin is administered with an enteral feeding, it binds with proteins in the enteral formula, which can result in subtherapeutic levels of the drug. To avoid this, it is recommended that the feeding be held 2 hours before and 2 hours after administering the drug.
Rationale 2: It is appropriate to check a drug level prior to administering a drug. However, the drug level will not affect procedures associated with drug administration.
Rationale 3: Phenytoin (Dilantin) can be administered via a feeding tube, so it is unnecessary to request an alternate form and route.
Rationale 4: It is more common to dilute drugs with 30 mL of water. In addition, flushing before and after administering the drug is recommended.
Global Rationale: When phenytoin is administered with an enteral feeding, it binds with proteins in the enteral formula, which can result in subtherapeutic levels of the drug. To avoid this, it is recommended that the feeding be held 2 hours before and 2 hours after administering the drug. It is appropriate to check a drug level prior to administering a drug. However, the drug level will not affect procedures associated with drug administration.
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