A prescriber has ordered medication for a newborn that is eliminated primarily by hepatic metabolism. What would the nurse expect the prescriber to order?

A Increase the frequency of medication dosing.

B Order a dose that is higher than an adult dose.

Discontinue the drug after one or two treatments.

D Order a dose that is lower than an adult dose.

Answer and Explanation

The Correct Answer is D

a) Increasing the frequency of medication dosing may lead to higher overall exposure and is not necessarily related to hepatic metabolism.

b) Ordering a dose that is higher than an adult dose could result in excessive drug levels, especially in a newborn with immature hepatic function.

c) Discontinuing the drug after one or two treatments may not be necessary if the dose is appropriately adjusted based on hepatic metabolism.

d) Ordering a lower dose is appropriate because hepatic metabolism in newborns is often immature, and lower doses are required to avoid toxicity.

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Correct Answer is B

Explanation

a) Levothyroxine is usually recommended to be taken 30 to 60 minutes before breakfast to enhance absorption, but this is not the answer indicated by the client's statement.

b) Taking levothyroxine at bedtime is another acceptable option and may be more convenient for some individuals. Both options (morning or bedtime) are valid.

c) Taking levothyroxine when feeling fatigued is not a specific guideline for medication administration.

d) Taking levothyroxine with an antacid may interfere with absorption and is not recommended.

A. Concurrent use of acetaminophen for pain. B. An activated partial thromboplastin time (aPTT) of 80 seconds. C. An international normalized ratio (INR) of 0.8. D. Evidence of dark, tarry stools.

Correct Answer is B

Explanation

a) Concurrent use of acetaminophen is not directly related to heparin therapy for atrial fibrillation. It may need attention but does not warrant immediate reporting.

b) An aPTT of 80 seconds is significantly prolonged and may indicate a risk of bleeding due to excessive anticoagulation. This finding requires immediate notification to the healthcare provider.

c) An INR of 0.8 is within the normal range and does not pose an immediate concern in the context of heparin infusion.

d) Dark, tarry stools could indicate gastrointestinal bleeding but may not be directly related to heparin therapy. It should be monitored and reported, but it's not an immediate concern for heparin infusion.

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A prescriber has ordered medication for a newborn that is eliminated primarily by hepatic metabolism. What would the nurse expect the prescriber to order?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse reinforces instructions regarding when to take levothyroxine and determines teaching was effective when the client states the medication should be taken in which manner?

Correct Answer is B

Explanation

A client with a new diagnosis of atrial fibrillation is receiving a continuous infusion of heparin. Which finding will the nurse report immediately?

Correct Answer is B

Explanation

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