A nurse is preparing to administer amitriptyline 150 mg PO at bedtime. The amount available is amitriptyline 75 mg tablet. How many tablets 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.)

Step 1: Determine the concentration of morphine sulfate available. = 10 mg/mL

Step 2: Determine the dose of morphine sulfate to be administered. = 2 mg

Step 3: Calculate the volume to be administered using the formula: Volume to be administered = Dose ÷ Concentration

Step 4: Perform the division. Calculation: 2 mg ÷ 10 mg/mL = 0.2 mL

Step 5: Round the answer to the nearest tenth if necessary. = 0.2 mL (no rounding needed)

The nurse should administer 0.2 mL per dose.

Choice A reason:

A sudden decrease in abdominal pain can indicate that the appendix has perforated. When the appendix bursts, the pressure is relieved, leading to a temporary reduction in pain. However, this is quickly followed by severe pain and signs of peritonitis, such as a rigid abdomen and high fever.

Choice B reason:

The absence of Rovsing’s sign is not a specific indicator of a perforated appendix. Rovsing’s sign is a clinical test used to diagnose appendicitis, where pain is elicited in the right lower quadrant when the left lower quadrant is palpated. Its absence does not necessarily indicate perforation.

Choice C reason:

A low-grade fever is a common symptom of appendicitis but does not specifically indicate perforation. A perforated appendix typically leads to a high fever due to the spread of infection within the abdomen.

Choice D reason:

A rigid abdomen is a sign of peritonitis, which can occur after the appendix has perforated. While this is an important symptom, the sudden decrease in pain followed by severe symptoms is more indicative of perforation.