A nurse is teaching a female client who has a new prescription for transdermal sumatriptan to treat migraine headaches. Which of the following instructions should the nurse include?

Step 1: Convert the child’s weight from pounds to kilograms.

• Weight in pounds = 28 lb
• Conversion factor = 1 kg ÷ 2.2 lb
• Weight in kilograms = 28 lb ÷ 2.2
• Result: 12.727 kg (rounded to three decimal places)

Step 2: Calculate the dose of acetaminophen in mg.

• Dose required = 10 mg × Weight in kg
• Dose required = 10 mg × 12.727 kg
• Result: 127.27 mg (rounded to two decimal places)

Step 3: Determine the volume of acetaminophen solution needed in mL.

• Concentration of acetaminophen = 120 mg ÷ 5 mL
• Volume required (mL) = Dose required (mg) ÷ Concentration (mg/mL)
• Volume required (mL) = 127.27 mg ÷ (120 mg ÷ 5 mL)
• Result: 127.27 mg ÷ 24 mg/mL
• Result: 5.303 mL (rounded to three decimal places)

Step 4: Round the volume to the nearest tenth.

• Rounded result: 5.3 mL

Final Answer: The nurse should administer 5.3 mL of acetaminophen.

Choice A reason:

Calling the lab to verify the client’s results is a reasonable step if there is any doubt about the accuracy of the lab results. However, in this scenario, the potassium level of 5.2 mEq/L is already documented, and the nurse should act on this information. Verifying the results would delay necessary actions and could potentially harm the patient if the high potassium level is not addressed promptly.

Choice B reason:

Omitting the KCL dose and documenting it as not given is a prudent action because administering potassium chloride to a patient with an elevated potassium level (5.2 mEq/L) could exacerbate hyperkalemia, which can lead to serious cardiac issues. However, this action alone is not sufficient. The nurse must also inform the prescribing physician to reassess the patient’s treatment plan.

Choice C reason:

Giving the ordered KCL as prescribed would be inappropriate in this situation. The patient’s potassium level is already elevated, and administering additional potassium could lead to hyperkalemia, which can cause dangerous cardiac arrhythmias or even cardiac arrest. Therefore, this option should be avoided.

Choice D reason:

Calling the prescribing physician and informing her of the client’s serum potassium level results is the most appropriate action. The physician needs to be aware of the elevated potassium level to make an informed decision about the patient’s treatment plan. The physician may decide to withhold the potassium chloride, order additional tests, or take other actions to manage the patient’s potassium levels safely.