Problem 48 - Calculate With Confidence

Question

Interpret the following orders. Use either administer or give at the beginning of the sentence. Dilantin susp \(200 \mathrm{mg}\) by NGT q AM and \(300 \mathrm{mg}\) by NGT at bedtime.

Step-by-Step Solution

Answer

Administer 200 mg of Dilantin by NGT every morning and 300 mg by NGT at bedtime.

Step 1: Identify the Medication and Dosage

The order specifies the medication Dilantin, which is to be given in different dosages: 200 mg and 300 mg.

Step 2: Determine the Route of Administration

Both dosages are to be given via NGT, which stands for Nasogastric Tube.

Step 3: Specify the Timing for Each Dosage

The order states 200 mg should be administered in the morning ('q AM') and 300 mg at bedtime.

Step 4: Construct Sentences for Administration

Using the information from the previous steps, construct sentences: 1. Administer 200 mg of Dilantin suspension by NGT every morning. 2. Administer 300 mg of Dilantin suspension by NGT at bedtime.

Key Concepts

Dosage Calculation

Understanding dosage calculation is vital for effective and safe medication administration. It begins by identifying the total amount of the drug needed. For Dilantin, the order calls for two different dosages: 200 mg and 300 mg. These amounts must be administered correctly to achieve the intended therapeutic effect. When calculating dosages, consider the concentration of the drug and if any conversions are needed (for example, changing between tablet and liquid forms). However, in this case, there is no conversion needed since the order specifies the suspension form. Good practice involves:

• Double-checking the prescribed amount.
• Ensuring you understand the units used (mg for milligrams).
• Being aware of the patient's specific needs and any potential adjustment required based on those needs.

Route of Administration

The route of administration refers to the path by which a drug is taken into the body. For Dilantin, the specified route is via a nasogastric tube (NGT). This method is used when a patient cannot take medication orally, often due to difficulty swallowing or the need for long-term medication delivery. Administering medication through an NGT involves:

• Ensuring the tube is properly placed and functioning.
• Avoiding air bubbles to prevent discomfort.
• Flushing the tube with water before and after medication to maintain tube patency and prevent interactions.

Timing of Medication

Medication timing is crucial as it can affect drug efficacy and the patient's healing process. In this context, the prescription specifies two administration times: 200 mg of Dilantin in the morning, and 300 mg at bedtime. This regimen ensures continuous therapeutic levels of the drug in the bloodstream. When following a timing schedule, consider:

• Checking the patient's daily routine to align with these times.
• Being consistent with timing to maintain steady medication levels.
• Monitor for any side effects that might influence timing adjustments.

Dilantin

Dilantin, also known as phenytoin, is an antiepileptic drug used primarily to treat seizures. It works by slowing down impulses in the brain that cause seizures. When administering Dilantin:

• Be aware of potential side effects, such as dizziness or gum overgrowth.
• Ensure proper dosage as overdosing can lead to serious complications.
• Monitor the patient for therapeutic effectiveness and adjust if needed.

Nasogastric Tube

A nasogastric tube is a medical device inserted through the nose, down the throat, and into the stomach. It allows for the direct delivery of medication, nutrients, or other fluids. Key considerations for nasogastric tubes include:

• Regularly checking the tube placement to prevent displacement.
• Keeping the tube and surrounding skin clean to avoid infections.
• Educating the patient or caregivers on the management and any signs of complications such as blockages or irritation.