hard · NCLEX-RN pharmacology

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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