Patient is 32 year old female with a history of epilepsy since

 

Patient is 32 year old female with a history of epilepsy since childhood. Her seizures have been well-controlled and she takes phenytoin 100mg capsule orally two times a day. Her last phenytoin level was drawn 2 weeks ago, just before her wedding, and was 18 mcg/ml. Upon return from their honeymoon, the patient and her husband decide to start a family and the patient stops taking her phenytoin.

Three days after discontinuing her medication, the patient is brought to the emergency department in status epilepticus. Measures are taken to ensure safety and to prevent injury, an intravenous line is started. Orders per emergency department physician:

Lorazepam (Ativan) 4mg IV push STAT, may repeat dose X1 in 10 -15 minutes

1L 0.9% NS at 100ml/hr

phenytoin level STAT

continuous ECG

Seizure precautions

  1. Lorazepam is generally available in 2mg/ml or 4mg/ml vials, however, the only vial of lorazepam available in the ED pyxis is 40/10ml. how much medication will the nurse draw up into the syringe?
  2. What is the nurse’s primary concern when administering IV lorazepam?

The patient’s seizures finally stop after 2 doses of IV lorazepam and she regains consciousness several hours later. Patient’s phenytoin level results and is 7mcg/ml. What is the therapeutic range of phenytoin?

Neurology service is consulted and the neurologist orders phenytoin 15 mg/kg IV loading dose to be given STAT and start phenytoin one 100mg capsule orally 3X day in the am. What is a loading dose and why might a loading dose be ordered?

What is the maximum rate at which phenytoin can be infused intravenously?

A repeat phenytoin level 48 hours later is 24.2 mcg/ml. What is your concern with this level?

What effects may you observe with this phenytoin level?

Calculate Your Essay Price
(550 words)

Approximate price: $22

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

Read more

Free-revision policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

Read more

Privacy policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

Read more

Fair-cooperation guarantee

By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.

Read more