A nurse in a pediatric clinic is providing teaching to the guardian of an infant who has a new prescription for digoxin.
Which of the following manifestations should the nurse include as an indication of digoxin toxicity?

Choice A rationale:

Rhinorrhea (runny nose) is a common symptom of respiratory syncytial virus (RSV) infection and is not a cause for immediate concern. It is often accompanied by other upper respiratory symptoms in infants and young children.

Choice B rationale:

Tachypnea (rapid breathing) is a concerning sign in infants with RSV infection. Rapid breathing can indicate respiratory distress and difficulty in oxygen exchange, which is common in severe RSV cases. Infants with RSV may exhibit rapid, shallow breathing, flaring nostrils, and chest retractions as they struggle to breathe.

Choice C rationale:

Pharyngitis (sore throat) can be a symptom of RSV infection but is not a critical finding that requires immediate reporting to the provider. Respiratory distress and signs of respiratory failure, such as tachypnea, are more urgent concerns.

Choice D rationale:

Coughing is a common symptom of RSV infection and may not necessarily warrant immediate reporting, especially if the cough is mild and not accompanied by severe respiratory distress. However, persistent coughing, especially if it leads to difficulty in breathing, should be assessed promptly. Please note that questions 73 and 74 could not be answered accurately due to the lack of specific options and context provided. If you can provide the options for these questions, I would be happy to assist you further.

The correct answer is Choice D: 5 mL.

Choice A: 8 mL This choice suggests administering 8 mL of amoxicillin per dose. However, based on the child’s weight (10 kg) and the prescribed dosage (80 mg/kg/day divided into two doses), the correct calculation leads to a dosage of 5 mL per dose. Therefore, 8 mL would be more than the recommended dosage.

Choice B: 80 mL Administering 80 mL of amoxicillin per dose would be significantly more than the recommended dosage. This could potentially lead to an overdose, which could cause harmful side effects.

Choice C: 10 mL While 10 mL is close to the correct dosage, it is still double the recommended amount. Administering too much amoxicillin could potentially lead to an overdose and cause harmful side effects.

Choice D:

Step 1: Calculate the total amount of amoxicillin needed per day.

The total amount of amoxicillin needed per day is calculated by multiplying the weight of the child by the dosage per kg. So, 80 mg/kg/day × 10 kg = 800 mg/day.

Step 2: Divide the total amount of amoxicillin needed per day by the number of doses per day.

The total amount of amoxicillin needed per day is divided into two doses. So, 800 mg/day ÷ 2 = 400 mg/dose.

Step 3: Calculate the volume of amoxicillin suspension needed per dose.

The volume of amoxicillin suspension needed per dose is calculated by dividing the amount of amoxicillin needed per dose by the concentration of the suspension. So, 400 mg/dose ÷ (400 mg/5 mL) = 5 mL/dose.

Therefore, the nurse should administer 5 mL of amoxicillin per dose.