A provider orders phenytoin 100 mg IV push through a non-tunneled central venous catheter. In what order should the nurse administer this prescription?

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Multiple Choice

A provider orders phenytoin 100 mg IV push through a non-tunneled central venous catheter. In what order should the nurse administer this prescription?

When giving IV phenytoin through a central venous catheter, the priorities are keeping the line sterile, confirming patency, and preventing drug incompatibilities or catheter occlusion. Phenytoin must be administered with normal saline, not dextrose, and the line should be prepared with a saline flush to ensure the medication is delivered cleanly and fully. Cleanse the access port to maintain asepsis, then prime the line with normal saline so you’re certain the pathway is open. Gently aspirate for blood to confirm the line is patent and that there’s no occlusion before you push anything through. Use a push-pause saline flush to clear the lumen and create a stable, open channel. Then administer the phenytoin, taking care to follow the drug’s appropriate rate and compatibility guidelines. After the medication is in, flush again with normal saline to clear residual drug from the line, and finally flush with heparin if your facility protocol requires it to maintain patency. This sequence minimizes infection risk, confirms the catheter is usable, prevents phenytoin precipitation by keeping the line saline-filled, and helps keep the catheter open for future use.

When giving IV phenytoin through a central venous catheter, the priorities are keeping the line sterile, confirming patency, and preventing drug incompatibilities or catheter occlusion. Phenytoin must be administered with normal saline, not dextrose, and the line should be prepared with a saline flush to ensure the medication is delivered cleanly and fully.

Cleanse the access port to maintain asepsis, then prime the line with normal saline so you’re certain the pathway is open. Gently aspirate for blood to confirm the line is patent and that there’s no occlusion before you push anything through. Use a push-pause saline flush to clear the lumen and create a stable, open channel. Then administer the phenytoin, taking care to follow the drug’s appropriate rate and compatibility guidelines. After the medication is in, flush again with normal saline to clear residual drug from the line, and finally flush with heparin if your facility protocol requires it to maintain patency.

This sequence minimizes infection risk, confirms the catheter is usable, prevents phenytoin precipitation by keeping the line saline-filled, and helps keep the catheter open for future use.

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