hard · NCLEX-RN Pharmacological and Parenteral Therapies

The nurse identifies cues indicating immediate adverse reactions to the phenytoin therapy. Which findings require urgent nursing intervention? Select all that apply. Apply the response specifically to this case: intravenous phenytoin therapy complicated by hypotension, dysrhythmia, purple-glove injury, protein binding, and fosphenytoin conversion.

  1. Sinus bradycardia
  2. Hypotension
  3. QRS duration of 0.14 seconds
  4. Mottled purple skin discoloration distal to the IV site
  5. Post-ictal state (GCS 14 at 08:00)
  6. Baseline total phenytoin level < 2.0 mcg/mL

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