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?

To determine if the client's dose is safe and therapeutic, we need to calculate the appropriate dosing range based on the client's weight and compare it with the ordered dose.

Client's weight: 45 kg

Ordered dose: 500 mg every 8 hours, which equals 1500 mg/day (500 mg × 3 doses).

Calculate the therapeutic range:

The dosing range in the Davis Drug Guide is 20 to 40 mg/kg/day. So, for this client, based on their weight of 45 kg:

Minimum dose: 20 mg × 45 kg = 900 mg/day

Maximum dose: 40 mg × 45 kg = 1800 mg/day

The ordered dose of 1500 mg/day falls within this range (900 mg/day to 1800 mg/day), which means it is safe and therapeutic for the client.

A) Touch the tip of the bottle to the lacrimal duct: Touching the tip of the bottle to the lacrimal duct is not a recommended practice when administering eye drops. This could introduce bacteria into the eye or nose, leading to potential infection. The goal is to administer the drops without contamination, and the tip of the bottle should never touch the eye or any part of the face.

B) Apply pressure to inner canthus for 2 minutes: Applying pressure to the inner canthus (the corner of the eye near the nose) for about 2 minutes after administering ophthalmic drops is a key step when using systemically acting eye medications like propranolol. This helps to prevent the systemic absorption of the medication through the nasolacrimal duct, reducing the risk of systemic side effects such as bradycardia or hypotension. This step ensures that the medication stays localized in the eye.

C) Have client lie down or tilt the back of their head: While lying down or tilting the head back may help the client instil the drops more comfortably, it is not a required step for the proper absorption or effectiveness of eye drops. The key to effective administration lies in positioning the drop in the correct part of the eye and minimizing systemic absorption, which is achieved by applying pressure to the inner canthus, not necessarily by tilting the head.

D) Have client pull down their lower eyelid: Pulling down the lower eyelid is a standard step in administering eye drops, as it creates a small pocket to hold the drop. However, it does not specifically address the concern for reducing systemic absorption of a medication like propranolol. The primary step for preventing systemic effects is applying pressure to the inner canthus after administration, making this less relevant for this specific question.