A client weighing 9.5 kg has an order for medication at 125 mg/kg/day by mouth every 8 hours. The medication is supplied as 250 mg/5mL. How many milliliters per dose should the nurse administer? mL (If needed, round to the nearest tenth.)

Step 1: Calculate the total daily dose
Total daily dose (mg/day) = 125 mg/kg/day × 9.5 kg
Total daily dose = 1,187.5 mg/day

Step 2: Determine the dose per administration
The medication is given every 8 hours → 3 doses/day
Dose per administration = 1,187.5 ÷ 3
Dose per administration ≈ 395.8 mg

Step 3: Calculate the volume to administer
Use the formula:
Volume (mL) = (Desired dose ÷ Dose available) × Volume available

Desired dose = 395.8 mg
Dose available = 250 mg
Volume available = 5 mL

Volume = (395.8 ÷ 250) × 5
Volume ≈ 1.583 × 5
Volume ≈ 7.915 mL

Step 4: Round to the nearest tenth
7.915 = 7.9 mL

Rationale:

A. The client chewing their enteric-coated aspirin requires follow-up. Enteric-coated medications are specially formulated to dissolve in the intestine rather than the stomach to prevent gastric irritation and protect the medication from stomach acid. Chewing or crushing enteric-coated tablets destroys the protective coating, increasing the risk of stomach irritation, ulcers, or reduced effectiveness. The nurse should intervene and provide education on alternative options, such as discussing a different formulation with the healthcare provider.

B. Waiting for sublingual nitroglycerin to dissolve in the buccal cheek does not necessarily require follow-up. Although sublingual medications are typically placed under the tongue, allowing nitroglycerin to dissolve in the buccal area can still allow absorption through the oral mucosa. The key point is that the medication is not swallowed but allowed to dissolve for mucosal absorption.

C. Reviewing new prescription bottles to verify dosages is an appropriate and safe practice. This demonstrates medication awareness and helps prevent errors. No follow-up is required for this finding.

D. Taking each pill one at a time until finished is a safe medication practice. It reduces the risk of choking and helps ensure each medication is swallowed properly. This does not require intervention.