As the nurse caring for an infant who has been prescribed Amoxicillin (Amoxil) orally every 6 hours, you need to calculate the dose.

The recommended dosage is 50 mg/kg/day, divided into multiple doses.

If the infant weighs 6 kg, how much Amoxicillin should you administer per dose?

Choice A rationale

Difficulty feeding in infants can result from fatigue caused by inadequate oxygen delivery to tissues due to heart failure. Feeding is a demanding activity that requires energy and coordination, making it an early symptom of cardiac compromise in pediatric patients.

Choice B rationale

Wheezes or rales are caused by pulmonary congestion or edema, which occur in heart failure due to increased pulmonary venous pressure. This congestion results in fluid accumulation in the alveoli, leading to abnormal breath sounds. These findings require prompt evaluation.

Choice C rationale

Edema in the feet and legs results from systemic venous congestion caused by right-sided heart failure. Increased hydrostatic pressure in peripheral veins leads to fluid leakage into interstitial spaces, causing swelling, especially in dependent areas.

Choice D rationale

Tachypnea occurs as a compensatory mechanism in heart failure. Poor cardiac output reduces oxygen delivery, triggering the respiratory center to increase the breathing rate to improve oxygen uptake and delivery. It is an early sign of cardiopulmonary compromise in children.

Choice A rationale

Maximizing skin exposure to phototherapy lights ensures effective breakdown of bilirubin through photoisomerization, reducing serum bilirubin levels. Phototherapy converts unconjugated bilirubin to water-soluble isomers that are excreted via bile and urine. Exposing more skin enhances light absorption, increasing treatment efficacy. Normal bilirubin levels in newborns range from 1 to 12 mg/dL. This intervention aligns with standard protocols for managing hyperbilirubinemia in neonates.

Choice B rationale

Applying lotion during phototherapy can cause skin burns by altering light penetration and causing a thermal effect. It may also increase the risk of skin irritation and infections. Phototherapy lights generate heat, and lotions can exacerbate these effects, leading to complications. Effective bilirubin management depends on clean, dry skin under the lights.

Choice C rationale

While eye shields are critical to protecting the infant’s retina and cornea from potential phototoxicity, removing them during breastfeeding is necessary. This promotes bonding and facilitates feeding. Continuous shield use can obstruct parental interaction and feeding, which are vital for infant care. Shielding should only occur during phototherapy exposure.

Choice D rationale

Swaddling restricts skin exposure to the therapeutic lights, negating the benefits of phototherapy. It prevents effective breakdown of bilirubin as less skin is exposed to the treatment. Neonates under phototherapy should be minimally clothed, often only wearing a diaper, to maximize light absorption and ensure treatment success.