A physician orders Garamycin (gentamicin) 4 mg/kg/dose IV piggyback every 12 hours for a newborn weighing 7 lb, 11.2 oz. After reconstitution, the dosage is 20 mg/10 mL.
How many milliliters should the nurse administer to the patient?
1.4 mL
14 mL
7 mL
0.7 mL
0.7 mL
The Correct Answer is C
To answer this question, the nurse needs to perform the following steps:
1) Convert the patient's weight from pounds and ounces to kilograms, using the conversion factor of 1 pound = 0.45359237 kilograms¹². To do this, first convert the ounces to a fraction of a pound by dividing by 16, then add this fraction to the pounds, and then multiply by the conversion factor. For example:
7 lb, 11.2 oz = 7 + (11.2 / 16) lb
= 7.7 lb
= 7.7 × 0.45359237 kg
= 3.492 kg
2) Calculate the dose of Garamycin in milligrams, using the prescribed dose of 4 mg/kg and the patient's weight in kilograms. To do this, simply multiply the dose per kilogram by the weight in kilograms. For example:
4 mg/kg × 3.492 kg = 13.968 mg
3) Calculate the volume of Garamycin in milliliters, using the reconstituted dosage of 20 mg/10 mL and the dose in milligrams. To do this, use a proportion to find the unknown volume that corresponds to the known dose. For example:
20 mg / 10 mL = 13.968 mg / x mL Cross-multiply and solve for x: 20x = 139.68
x = 6.984 mL
x =7 mL
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Related Questions
Correct Answer is B
Explanation
To find the flow rate in mL/hr, you need to use the formula for infusion rate:
Infusion rate (mL/h) = Total volume (mL) / Time (h)
Since the total volume is 2.5 L and the time is 15 hours, plug in these values into the formula:
Infusion rate (mL/h) = 2.5 L / 15 h
However, before you can simplify and solve for the infusion rate, you need to convert the volume from liters to milliliters by multiplying by 1000:
Infusion rate (mL/h) = 2500 mL / 15 h
Simplify and solve for the infusion rate:
Infusion rate (mL/h) = 166.67 mL/h
Therefore, the flow rate for continuous infusion is **166.67 mL/h**.
Correct Answer is D
Explanation
This numeric form is appropriate, according to the Joint Commission, because it does not use a trailing zero after a decimal point, which is a common cause of medication errors and should be avoided. A trailing zero may be misread or misinterpreted as a larger dose or omited altogether, resulting in a 10-fold overdose or underdose, respectively. For example, when prescriptions have been writen for "Coumadin 1.0 mg," patients have received 10 mg in error¹². Therefore, the Joint Commission requires that a trailing zero may be used only when required to demonstrate the level of precision of the value being reported, such as for laboratory results, imaging studies that report the size of lesions, or catheter/tube sizes. It may not be used in medication orders or other medication-related documentation.
The other options are not appropriate numeric forms because:
a) 3.0 uses a trailing zero after a decimal point, which poses a risk of confusion or error.
b) 0.30 uses a trailing zero after a decimal point, which poses a risk of confusion or error.
c) 0.03 is not equivalent to 0.3, as it is 10 times smaller.
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