A client who weighs 45kg is ordered to receive 500 mg of amoxicillin every eight hours. The dosing range noted in the Davis Drug Guide is 20 to 40 mg/kg/day divided and to be given every 8 hours. True or False: the client's dose is safe and therapeutic?

A) Failed communication: While communication errors can lead to medication mistakes, in this specific scenario, there is no mention of poor communication. The prescription is clear, and the issue is more likely related to the accuracy of the prescribed dose or the nurse’s understanding of it, making "failed communication" a less likely source of error in this case.

B) Dose miscalculation: This is the most likely source of potential error. The medication is ordered as 0.9 mg of ondansetron IV, which is an unusual dosage because the typical dose of ondansetron IV for nausea is usually 4 mg or 8 mg. A dose of 0.9 mg is very specific and could easily be miscalculated, especially if the nurse is not familiar with this specific dosage form or if there’s any confusion regarding the intended dose. This could lead to an error either in preparation or administration of the medication.

C) Lack of client education: While client education is important for many aspects of treatment, it’s not directly related to the potential medication error in this scenario. The nurse’s concern should focus on the accuracy of administering the prescribed dose correctly, not the client’s understanding of the medication.

D) Poor distribution practices: Poor distribution practices may affect the availability or storage of medications, but this is not the likely source of error in this case. The concern here is more about the correct dosage and potential for miscalculation, rather than issues related to drug distribution or storage.

A) Cerebral Vascular Accident (CVA): While a history of a CVA (stroke) is important to consider when prescribing medications, ondansetron is not contraindicated for clients with a history of CVA. The nurse would need to assess the client’s overall neurological status and risk factors but this condition is not an immediate concern for ondansetron use.

B) Depression: Ondansetron is not typically contraindicated in patients with depression. However, the nurse should be mindful of the potential for interactions with other medications the client may be taking for depression, but there is no direct contraindication between ondansetron and depression itself.

C) Glaucoma: This is the most concerning finding. Ondansetron can increase the risk of complications in clients with glaucoma, particularly narrow-angle glaucoma. Ondansetron has some serotonin receptor-blocking properties that can cause dilation of the pupil, which could increase intraocular pressure in clients with glaucoma. Therefore, this condition would require careful monitoring, and the nurse would need to consult with the healthcare provider before administering ondansetron to a client with glaucoma.

D) Congestive Heart Failure (CHF): While patients with CHF need to be monitored for fluid balance, ondansetron is not contraindicated in clients with CHF. The primary concern in these patients would be potential fluid retention or electrolyte imbalances, but this is generally not a direct concern for the administration of ondansetron itself.