A nurse is preparing to administer amoxicillin to a 5-year-old client.

The client weighs 14.5 kg (32 lb) and the prescribed dose of amoxicillin is 20 mg/kg/day for treatment of otitis media.

What is the calculated dose of amoxicillin for this client?

The nurse must apply knowledge of the pathophysiology of osteogenesis imperfecta, a genetic disorder affecting collagen synthesis. Education focuses on injury prevention, understanding bone fragility, and promoting safe physical activity to optimize quality of life while minimizing the risk of recurrent fractures.

Choice A rationale

Osteogenesis imperfecta involves defective Type 1 collagen, leading to extremely fragile bones. Gymnastics involves high-impact landings and significant bone stress, which are contraindicated regardless of physical therapy, as they present a high risk for multiple pathological fractures.

Choice B rationale

Minimal contact sports still pose a significant risk for fractures in adolescents with this condition. Even minor falls or sudden twisting motions can cause bone breakage. Weight-bearing exercises should be low-impact and supervised to prevent skeletal injury.

Choice C rationale

This statement demonstrates understanding of the primary pathophysiology of the disorder. Recognizing that bones are structurally weak due to collagen deficiency allows the client to implement necessary safety measures and environmental modifications to prevent accidental bone trauma.

Choice D rationale

Total exclusion from physical education is unnecessary and detrimental to the client's social and physical health. Adapted physical education or low-impact activities like swimming are often encouraged to maintain muscle strength without putting excessive stress on bones..

Effective pediatric asthma management focuses on optimizing drug deposition within the lower respiratory tract. This scenario requires applying knowledge of inhalation mechanics and delivery device efficacy to minimize oropharyngeal deposition and maximize the therapeutic action of corticosteroids or bronchodilators in smaller airways.

Choice A rationale

Spacers slow the speed of aerosol particles and decrease the particle size. This prevents the medication from hitting the back of the throat and improves lung deposition significantly, which is critical for pediatric patients with smaller airway diameters.

Choice B rationale

Quick inhalation causes turbulent airflow, leading to medication impaction in the upper airway and mouth. Slow, deep inhalation is required to allow the aerosol to bypass the glottis and reach the distal bronchioles for effective treatment.

Choice C rationale

Holding the breath allows for sedimentation, where gravity pulls particles onto the lung surface. While important, the spacer is the most critical step for ensuring the medication actually enters the lungs initially in children who lack coordination.

Choice D rationale

Shaking ensures the propellant and medication are mixed for a consistent dose. However, without a spacer, much of that dose is wasted in the mouth, making the delivery device the priority for teaching effective clinical management.