The health-care provider prescribes diltiazem (Cardizem) 0.87 mg PO four times daily for an infant who weighs 22 pounds. The recommended maximum dose is 3.5 mg/kg/day. What action should the nurse take?
Give the prescribed dosages.
Assess the child's heart rate before administration.
Clarify the calculations with the pharmacist.
Notify the health-care provider.
The Correct Answer is B
Step 1: Calculate the infant's weight in kilograms:
22 pounds x (1 kg / 2.20462 pounds) ≈ 10 kg
Step 2: Calculate the recommended maximum daily dose:
Recommended Maximum Dose = 3.5 mg/kg/day x 10 kg
Recommended Maximum Dose = 35 mg/day
Step 3: Calculate the prescribed daily dose:
Prescribed Daily Dose = 0.87 mg/dose x 4 doses/day
Prescribed Daily Dose = 3.48 mg/day
Step 4: Compare the prescribed dose to the recommended maximum dose:
The prescribed daily dose (3.48 mg/day) is slightly above the recommended maximum daily dose (35 mg/day).
Therefore, the nurse should:
B. Assess the child's heart rate before administration.
While the prescribed dose is slightly above the recommended maximum, it's important to monitor the child's heart rate to ensure there are no adverse effects. If the heart rate is within the normal range, the medication can be administered. However, if there are any concerns, the nurse should consult with the health-care provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["16.8"]
Explanation
To calculate the volume of IV solution needed to dilute the nafcillin, we'll follow these steps:
Step 1: Calculate the total volume of the diluted solution:
Desired Concentration (mg/mL) = Prescribed Dose (mg) / Total Volume (mL)
Rearranging the formula to solve for Total Volume:
Total Volume (mL) = Prescribed Dose (mg) / Desired Concentration (mg/mL)
Total Volume = 800 mg / 40 mg/mL
Total Volume = 20 mL
Step 2: Calculate the volume of nafcillin solution to be added:
Volume of Nafcillin Solution = Prescribed Dose (mg) / Concentration of Nafcillin (mg/mL)
Volume of Nafcillin Solution = 800 mg / 250 mg/mL
Volume of Nafcillin Solution = 3.2 mL
Step 3: Calculate the volume of IV solution needed to dilute:
Volume of IV Solution = Total Volume - Volume of Nafcillin Solution
Volume of IV Solution = 20 mL - 3.2 mL
Volume of IV Solution = 16.8 mL
Therefore, the nurse should add 16.8 mL of IV solution to the volume control device to dilute the nafcillin.
Correct Answer is ["22"]
Explanation
Calculating the Propofol Infusion Rate
Step 1: Convert weight to kilograms:
198 lbs x (1 kg / 2.20462 lbs) ≈ 90 kg
Step 2: Calculate the desired dose rate in mcg/minute:
8 mcg/kg/minute x 90 kg = 720 mcg/minute
Step 3: Calculate the concentration of propofol in the IV solution:
100 mg/50 mL = 2 mg/mL
Step 4: Calculate the infusion rate in mL/hour:
First, convert mcg to mg:
720 mcg x (1 mg / 1000 mcg) = 0.72 mg/minute
Then, set up a proportion:
x mL/hour / 0.72 mg/minute = 60 minutes/hour / 2 mg/mL
Cross-multiply and solve for x:
x mL/hour = 0.72 mg/minute x 60 minutes/hour / 2 mg/mL
x mL/hour ≈ 21.6 mL/hour
Therefore, the nurse should program the infusion pump to deliver approximately 22 mL/hour.
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