The physician ordered cephalexin 4 mg/kg PO Q6 hours.

The medication is available at 250 mg/5 mL. The client weighs 245 pounds.

What is the correct dose to be administered every 6 hours? (Round the answer to the nearest whole number.

Do not use a trailing zero.)

Choice A rationale

Flush with 15-30 mL sterile water after each medication. Flushing the gastrostomy tube with sterile water ensures that the medication is fully delivered and prevents clogging of the tube, which is crucial for maintaining its patency.

Choice B rationale

Crush each immediate-release tablet and mix it in 15-30 mL sterile water. Crushing immediate-release tablets and mixing them with sterile water makes it easier to administer through the tube, ensuring that the medication can be properly absorbed by the body.

Choice C rationale

Add medications directly to the tube feeding formula. Adding medications directly to the feeding formula can cause drug-nutrient interactions and may affect the medication's efficacy and absorption, making this practice generally not recommended.

Choice D rationale

Use liquid medications when available. Liquid medications are preferred for tube feedings as they are less likely to cause blockages and are easier to administer and absorb compared to crushed tablets.

Choice E rationale

Mix all medications, dilute with water and give them together. Mixing all medications together can lead to interactions between the drugs, potentially altering their effectiveness and increasing the risk of adverse reactions, making this practice inappropriate.

Choice A rationale

Measuring abdominal girth every shift helps monitor for increased abdominal distension, which can indicate worsening bowel obstruction or potential complications such as bowel perforation or ischemia. Regular monitoring is crucial to detect changes early.

Choice B rationale

A soft diet is inappropriate for someone with a suspected bowel obstruction, as solid foods can exacerbate the blockage. The standard recommendation is usually to keep the patient NPO (nothing by mouth) to prevent further obstruction.

Choice C rationale

Administering 0.9% NSS at 125 mL/hr helps maintain adequate hydration and electrolyte balance, which is vital in a patient with a bowel obstruction who cannot take oral fluids. This intervention prevents dehydration and electrolyte imbalances.

Choice D rationale

Morphine for pain management is appropriate as it helps alleviate severe abdominal pain associated with bowel obstruction. However, its use should be monitored carefully, as opioids can reduce gastrointestinal motility and potentially worsen the obstruction.