The nurse is caring for a 6 year old child with a fractured femur. The child weighs 44lb She is preparing to medicate the child for pain. The doctor's order reads Morphine 3 mg po every 4 hours as needed for pain.
The medication book states Morphine 100-200 mcg/kg per dose.
The morphine comes in liquid form, 2mg/1ml.
What is the SDR for one dose?
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A","dropdown-group-3":"A"}
Pediatric medication administration demands absolute precision, as even minor calculation errors can lead to severe adverse outcomes. Nurses must systematically verify every prescription by converting the child's weight to kilograms, establishing the safe dosage range (SDR) based on clinical drug references, and ensuring the ordered dose falls within those parameters before calculating the fluid volume for administration.
Rationale:
• 2–4 mg per dose: The child weighs 44 lb, which converts to 20 kg (44 ÷ 2.2 = 20 kg). The safe dosage range is 100–200 mcg/kg/dose.
Minimum dose: 100 mcg × 20 kg = 2,000 mcg = 2 mg
Maximum dose: 200 mcg × 20 kg = 4,000 mcg = 4 mg
Therefore, the safe dosage range is 2–4 mg per dose.
• Yes: The prescribed dose is 3 mg orally every 4 hours as needed. Since 3 mg falls within the safe dosage range of 2–4 mg per dose, the order is considered safe for administration.
• 1.5 mL: The medication concentration is 2 mg per 1 mL. Using dimensional analysis:
3 mg ordered × (1 mL ÷ 2 mg) = 1.5 mL. The nurse should administer 1.5 mL of liquid morphine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Meningitis is an acute inflammation of the meninges typically caused by bacterial or viral infection, leading to increased intracranial pressure, cerebral irritation, and systemic toxicity. Classic pediatric signs include irritability, high-pitched cry, poor feeding, fever, and meningeal irritation due to central nervous system involvement.
Rationale:
A. Meningitis presents with meningeal inflammation causing irritability, poor feeding, and a high-pitched cry in young children due to increased intracranial pressure and cerebral irritation. These are early pediatric signs before classic neck stiffness becomes evident.
B. Lyme disease primarily causes erythema migrans, arthritis, and later neurologic complications. It does not typically present acutely with a high-pitched cry or severe irritability suggestive of intracranial infection in toddlers.
C. Reye syndrome is associated with hepatic dysfunction and cerebral edema following viral illness and aspirin use. It typically presents with vomiting and altered consciousness rather than a high-pitched cry and early irritability in this presentation.
D. Febrile seizures involve transient convulsions associated with fever but do not cause persistent irritability, poor feeding, or a shrill cry between episodes, making them inconsistent with the ongoing neurologic irritation described.
Correct Answer is C
Explanation
Live attenuated vaccines such as the Varicella vaccine rely on controlled viral replication to stimulate cell-mediated immunity and long-term antibody production. Contraindications include conditions causing significant immunosuppression, as impaired T-cell function increases risk of uncontrolled viral replication and vaccine-associated disease.
Rationale:
A. A prior mild post-vaccination fever of 101°F is not a contraindication to further doses. Low-grade febrile reactions are common and reflect normal immune activation, not hypersensitivity or vaccine failure.
B. Localized injection site pain is an expected adverse effect following vaccination. It reflects localized inflammatory response and does not indicate allergy or contraindication to future doses.
C. Steroid therapy for rheumatoid arthritis indicates immunosuppression, which is a contraindication to live attenuated vaccines like Varicella. Suppressed T-cell function increases risk of uncontrolled viral replication and vaccine-related infection.
D. Strawberry allergy is unrelated to vaccine components. Food allergies without known vaccine excipient sensitivity (such as gelatin or neomycin) do not contraindicate administration of the Varicella vaccine.
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