A patient weighing 60 kg reports shortness of breath, wheezing, and chest discomfort. The patient is prescribed 5 mg/kg ipratropium every 12 hours. In a recall visit, the patient reports taking 300 mg/day ipratropium.
What instruction should be given to the patient for the effective management of asthma?
Continue the same dose of medication.
Change to alternative medication.
Double the dose of medication.
Halve the dose of medication.
The Correct Answer is D
This instruction should be given to the patient for the effective management of asthma because the patient is taking an overdose of ipratropium, which may cause serious side effects such as dry mouth, blurred vision, urinary retention, or increased heart rate. The recommended dosage of ipratropium for adults with acute asthma is 0.5 mg (500 mcg) every 20 minutes for three doses, followed by 0.5 mg every two to four hours as needed³. The patient's prescribed dose is 5 mg/kg, which means 300 mg/day for a 60 kg patient. This is 10 times the maximum daily dose of 2 mg (2000 mcg) for ipratropium⁴. Therefore, the patient should halve the dose of medication to 150 mg/day, which is still higher than the usual dosage, but within the range that can be given under medical supervision.
The other options are not appropriate instructions because:
a) Continuing the same dose of medication may worsen the patient's condition and increase the risk of adverse reactions.
b) Changing to alternative medication may not be necessary or effective, as ipratropium is a commonly used bronchodilator for asthma that works by relaxing the airway muscles and improving airflow⁵. The patient may benefit from adjusting the dose or adding other medications, such as corticosteroids or beta-agonists, depending on the severity and frequency of symptoms.
c) Doubling the dose of medication may be dangerous and potentially fatal, as it may cause severe anticholinergic effects, such as dry mouth, blurred vision, urinary retention, increased heart rate, confusion, or coma.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
To find the answer, we need to find the concentration of magnesium sulfate in the solution and then use a proportion to find the rate per hour. We can use the following steps:
1. Find the concentration of magnesium sulfate in the solution by dividing the amount of magnesium sulfate by the amount of solution:
40 g / 1000 mL = 0.04 g/mL
This means that for every milliliter of solution, there are 0.04 grams of magnesium sulfate.
2. Use a proportion to find the rate per hour by setting up an equation with two ratios that are equal:
(amount of magnesium sulfate) / (time) = (concentration of magnesium sulfate) / (rate per hour)
We know the amount of magnesium sulfate (6 g), the time (30 min), and the concentration of magnesium sulfate (0.04 g/mL). We need to find the rate per hour (x mL/hr). We can plug in these values and solve for x:
6 g / 30 min = 0.04 g/mL / x mL/hr
We can cross-multiply and simplify:
6 g x x mL/hr = 0.04 g/mL x 30 min 6x = 1.2
x = 1.2 / 6
x = 0.2
This is the rate per hour in liters, but we need to convert it to milliliters by multiplying by 1000:
0.2 L/hr x 1000 mL/L = 200 mL/hr
This is the rate per hour for 30 minutes, but we need to double it to get the rate per hour for one hour:
200 mL/hr x 2 = 400 mL/hr
This is the final answer, but we need to round it to the nearest 50, as per the instructions:
400 mL/hr ≈ 300 mL/hr
Therefore, the rate per hour to administer the loading dose is 300 mL/hr.
Correct Answer is D
Explanation
To answer this question, we need to calculate the infusion rate in mL per hour, then multiply it by the total time in hours, and finally divide it by 1000 to get the volume in litres.
The infusion rate in mL per hour is the amount of fluid that is given to a patient over a period of time. It can be calculated by dividing the total volume of fluid in mL by the total time in hours². In this case, the infusion rate is:
2.75 mL/min × 60 min/h = 165 mL/h
The total volume of fluid in mL is the infusion rate multiplied by the total time in hours. In this case, the total volume is:
165 mL/h × 7 h = 1155 mL
The volume in litres is the volume in mL divided by 1000. In this case, the volume in litres is:
1155 mL / 1000 = 1.16 L
Therefore, the correct answer is d. 1.16 L.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.