Questions: The nurse is caring for a patient with seizures who was prescribed phenytoin IV. The primary health care provider has replaced this drug with fosphenytoin. Which would be the most likely reason for replacing phenytoin? Select all that apply. One, some, or all responses may be correct. Fosphenytoin is suitable with glucose solutions. Fosphenytoin has reduced allergic manifestations. Fosphenytoin can be administered at a higher push rate. Fosphenytoin can be given via the intramuscular route.

The answer is:

• Fosphenytoin is suitable with glucose solutions.
• Fosphenytoin has reduced allergic manifestations.
• Fosphenytoin can be administered at a higher push rate.
• Fosphenytoin can be given via the intramuscular route.

Explanation for each option:

1. Fosphenytoin is only suitable with saline solutions.

   • This statement is incorrect. Fosphenytoin is compatible with both saline and glucose solutions, unlike phenytoin which is only compatible with saline.

2. Fosphenytoin is suitable with glucose solutions.

   • This statement is correct. Fosphenytoin can be mixed with glucose solutions, providing more flexibility in administration compared to phenytoin.

3. Fosphenytoin has reduced allergic manifestations.

   • This statement is correct. Fosphenytoin is associated with fewer allergic reactions and side effects compared to phenytoin.

4. Fosphenytoin can be administered at a higher push rate.

   • This statement is correct. Fosphenytoin can be administered more rapidly than phenytoin, which is beneficial in acute settings.

5. Fosphenytoin can be given via the intramuscular route.

   • This statement is correct. Fosphenytoin can be administered intramuscularly, providing an alternative route of administration when intravenous access is not available.

Summary: Fosphenytoin is often preferred over phenytoin because it is compatible with glucose solutions, has reduced allergic manifestations, can be administered at a higher push rate, and can be given via the intramuscular route.