Answer:
The most important information when administering a 1,000 mg loading dose of IV phenytoin to a client with a subarachnoid hemorrhage is:
b) Rapid phenytoin administration can cause cardiac arrhythmias.
Phenytoin is an anticonvulsant medication used to treat and prevent seizures. It is particularly useful in managing seizures associated with subarachnoid hemorrhage, which is a life-threatening type of stroke caused by bleeding into the space surrounding the brain. When administering a loading dose of IV phenytoin, it is crucial to be aware of the potential side effects and complications that may arise.
Rapid administration of phenytoin can lead to cardiac arrhythmias, which are irregular heartbeats that can be life-threatening. To minimize this risk, the infusion rate should not exceed 50 mg per minute in adults and 1-3 mg/kg/minute in children. Continuous monitoring of the patient's vital signs, including heart rate and blood pressure, is essential during the infusion process.
While therapeutic drug levels (option a) are important for ensuring the effectiveness of phenytoin treatment, they are not the most critical factor when administering the initial loading dose. The primary concern at this stage is to prevent adverse effects related to rapid infusion.
Regarding option c, phenytoin should not be mixed with dextrose in water, as this can cause precipitation of the drug. Instead, it should be diluted in normal saline (0.9% sodium chloride) before administration.
Lastly, option d suggests administering phenytoin through an IV catheter in the client's hand. While this is a possible route for administration, it is not the most important factor to consider when giving a loading dose of IV phenytoin.