Dosage calculation pn maternal newborn assessment 3.2

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Question 1: View

A nurse is assisting with the care of a client who is 24 hr postoperative following a cesarean birth. Which of the following prescriptions should the nurse clarify with the charge nurse?

A. Ketorolac 10mg PO every 6hr PRN pain B. Ciprofloxacin 1000mg daily C. 0.45 % sodium chloride 1000mL-125mL/hr by continuous IV infusion D. Magnesium hydroxide 60mL PO at bedtime

Explanation

A) Ketorolac 10mg PO every 6hr PRN pain: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used for pain management after cesarean birth. However, it should not be used for more than 5 days due to potential renal side effects, gastrointestinal bleeding, and ulceration risks. A prescription for this drug 10mg every 6 hours could be appropriate if within the 5-day limit.

B) Ciprofloxacin 1000mg daily: Ciprofloxacin is an antibiotic often prescribed for certain infections. In a postoperative client, it might be prescribed for a urinary tract infection or another bacterial infection. The dose of 1000mg daily is within normal therapeutic ranges for many conditions, and there is no immediate reason to clarify it in the context of routine postoperative care.

C) 0.45% sodium chloride 1000mL-125mL/hr by continuous IV infusion: This IV fluid prescription specifies a normal saline solution at a moderate infusion rate of 125mL/hr, which is generally appropriate for postoperative fluid management. The administration of fluids is essential to prevent dehydration, maintain hydration, and promote healing in the postoperative period.

D) Magnesium hydroxide 60mL PO at bedtime: Magnesium hydroxide is commonly used as a laxative or antacid, but giving 60mL at bedtime raises a concern. Magnesium hydroxide has a significant laxative effect and can lead to dehydration, electrolyte imbalances, and excessive bowel movement. It is contraindicated in clients with impaired renal function, which is often a concern postoperatively, particularly in clients who may not be eating or drinking adequately. Additionally, in the immediate postoperative period following a cesarean, using a laxative in such a high dose could exacerbate the risk of discomfort, bloating, or diarrhea, and may not be necessary unless there is a specific indication for it.

Question 2: View

A nurse is preparing to administer morphine 8mg IM to a client who is postpartum. Available is morphine injection 10 mg/mL. How many mL should the nurse plan to administer? (Round the answer to the nearest tenth. Use leading zero if it applies.)

Explanation

Step 1: Set up the proportion:

Desired dose (mg) / Volume to administer (mL) = Concentration (mg/mL)

Step 2: Substitute the values:

8 mg / Volume = 10 mg/mL

Step 3: Solve for the unknown volume:

Volume = 8 mg / 10 mg/mL

Step 4: Calculate the volume:

Volume = 0.8 mL

Question 3: View

A nurse is preparing to administer diphenhydramine 40 mg. IM to a client who has allergies. Available is diphenhydramine injection 50 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Explanation

Step 1: Set up the proportion:

Desired dose (mg) / Volume to administer (mL) = Concentration (mg/mL)

Step 2: Substitute the values:

40 mg / Volume = 50 mg/mL

Step 3: Solve for the unknown volume:

Volume = 40 mg / 50 mg/mL

Step 4: Calculate the volume:

Volume = 0.8 mL

Question 4: View

A nurse is reviewing a client's prescription for terbutaline 0.25 mg subcutaneous every 4 hr for 24 hr PRN more than four uterine contractions per hour. How should the nurse interpret this prescription?

A. The nurse should administer terbutaline each time the client has more than four contractions in hr B. The nurse should begin administering terbutaline every 4 hr for 24 hr C. The nurse should administer terbutaline once every 24 hr to prevent the client from having more than four contractions per hour. D. The nurse should wait until the client has more than four contractions in 1 hr before administering terbutaline.

Explanation

A) The nurse should administer terbutaline each time the client has more than four contractions in an hour: This interpretation is incorrect because the prescription is for PRN (as needed) administration based on the occurrence of more than four uterine contractions per hour, not every time the client has more than four contractions. The medication should not be administered automatically at each instance of more than four contractions, but rather when it is specifically indicated as per the prescribed instructions.

B) The nurse should begin administering terbutaline every 4 hr for 24 hr: This interpretation is not accurate because the prescription does not state that terbutaline should be given regularly every 4 hours regardless of the client's condition. Instead, it specifies that terbutaline should be administered as needed (PRN) only when the client has more than four uterine contractions per hour. Routine administration every 4 hours is not appropriate unless specified in the prescription.

C) The nurse should administer terbutaline once every 24 hr to prevent the client from having more than four contractions per hour: Administering terbutaline on a fixed schedule every 24 hours is not consistent with the prescription. The prescription specifically indicates that terbutaline is only to be administered as needed (PRN) when the client is experiencing more than four contractions per hour.

D) The nurse should wait until the client has more than four contractions in 1 hr before administering terbutaline: This interpretation aligns with the prescription. Terbutaline is to be administered only when the client has more than four uterine contractions in one hour, and this should be done on a PRN basis. The medication is intended to manage excessive uterine activity, and its administration should be based on the client's current condition (i.e., the presence of more than four contractions per hour), not preemptively or on a regular schedule.

Question 5: View

A nurse is caring for a newborn who weighs 3,500 g. The nurse should record the newborn's weight as how many kg? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Explanation

Given:

Newborn's weight in grams: 3,500 g

Conversion factor:

1 kg = 1,000 g

Step 1: Set up the conversion:

Weight in kg = Weight in g / 1,000 g/kg

Step 2: Substitute the value:

Weight in kg = 3,500 g / 1,000 g/kg

Step 3: Calculate the weight in kg:

Weight in kg = 3.5 kg

Question 6: View

A nurse is assisting with the care of a client who is experiencing postpartum bleeding. The nurse is preparing to administer methylergonovine 0.4 mg PO. Available is methylergonovine 200 mcg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Explanation

1 mg = 1000 mcg

Prescribed dose: 0.4 mg Converted to mcg: 0.4 mg x 1000 = 400 mcg

Available tablets: 200 mcg each

Next, we divide the prescribed dose by the strength of the available tablets:

400 mcg / 200 mcg per tablet = 2 tablets

Question 7: View

A nurse is assisting with the care of a client who is experiencing labor pain and is preparing to administer nalbuphine 10 mg IM. Available is nalbuphine solution for injection 20 mg/mL. How many mL should the nurse plan to administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Explanation

Desired dose of nalbuphine: 10 mg

Concentration of nalbuphine solution: 20 mg/mL

Step 1: Set up the proportion:

Desired dose (mg) / Volume to administer (mL) = Concentration (mg/mL)

Step 2: Substitute the values:

10 mg / Volume = 20 mg/mL

Step 3: Solve for the unknown volume:

Volume = 10 mg / 20 mg/mL

Step 4: Calculate the volume:

Volume = 0.5 mL

Question 8: View

A nurse is preparing to administer enoxaparin 75 mg subcutaneous once daily to an antepartum client who has a clotting disorder. Available is enoxaparin injection 100 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest hundredth. Use a leading zero if it applies. Do not use a trailing zero.)

Explanation

Desired dose of enoxaparin: 75 mg

Concentration of enoxaparin injection: 100 mg/mL

Step 1: Set up the proportion:

Desired dose (mg) / Volume to administer (mL) = Concentration (mg/mL)

Step 2: Substitute the values:

75 mg / Volume = 100 mg/mL

Step 3: Solve for the unknown volume:

Volume = 75 mg / 100 mg/mL

Step 4: Calculate the volume:

Volume = 0.75 mL

Question 9: View

A nurse is assisting with the care of a newborn who has a prescription for nystatin 100,000 units PO four times each day. Available is nystatin suspension 100.000 units/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.).

Explanation

Given:

Desired dose of nystatin: 100,000 units

Concentration of nystatin suspension: 100,000 units/mL

Step 1: Set up the proportion:

Desired dose (units) / Volume to administer (mL) = Concentration (units/mL)

Step 2: Substitute the values:

100,000 units / Volume = 100,000 units/mL

Step 3: Solve for the unknown volume:

Volume = 100,000 units / 100,000 units/mL

Step 4: Calculate the volume:

Volume = 1 mL

Question 10: View

A nurse is assisting with the care of a client who is postoperative following a cesarean birth and is at risk for deep vein thrombosis. The client has a prescription for heparin 5.000 units subcutaneously. Available is heparin 10,000 units/mL. After validating the dosage with another nurse, how many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Explanation

Step 1: Set up the proportion:

Desired dose (units) / Volume to administer (mL) = Concentration (units/mL)

Step 2: Substitute the values:

5,000 units / Volume = 10,000 units/mL

Step 3: Solve for the unknown volume:

Volume = 5,000 units / 10,000 units/mL

Step 4: Calculate the volume:

Volume = 0.5 mL

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