The nurse is preparing to administer phenytoin to an 80-year-old patient and notes the following order: IVP phenytoin 50 mg. The nurse will perform which action?
a. Administer the undiluted drug through a Y-tube over two minutes.
b. Contact the provider to question the route and the dose.
c. Dilute the drug in dextrose solution and infuse over 15 to 20 minutes.
d. Request an order to administer the drug intramuscularly.
ANS: A
Intravenous phenytoin should be administered undiluted through a 3-way stopcock or Y-tubing. In older patients it should be infused at a rate of 25 mcg/min. The dose and the route are appropriate. Phenytoin will precipitate in dextrose solution. Intramuscular injection is very irritating to tissues and is not used.
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