The physician orders magnesium sulfate 500 mg/h. The medication is supplied in 4 g/250 mL. Calculate the flow rate in milliliters per hour.

Choice A rationale

Assessing the client's specific fears about warfarin is the best action. The client's refusal stems from their perception of the drug's danger. By understanding the underlying fear, the nurse can provide targeted, accurate education about the drug's mechanism, safety protocols, and the benefits of anticoagulation, empowering the client to make an informed decision.

Choice B rationale

While laboratory monitoring (e.g., INR) is a critical component of warfarin therapy, simply reminding the client about it does not address the underlying emotional and psychological barriers to compliance. The client must first accept the drug and its importance before they can be educated on the practical aspects of its management.

Choice C rationale

Vague assurances about drug safety are unhelpful and can erode client trust. The client's concern is specific and real to them. The nurse must provide a scientific explanation of how warfarin works, its therapeutic benefits in preventing clot propagation, and how modern monitoring has made it safer, directly addressing their fears.

Choice D rationale

Warning the client about consequences can be perceived as an intimidating or judgmental approach, which can create a negative therapeutic relationship and increase resistance. A better strategy is to use a collaborative, non-coercive approach that focuses on client education and informed consent rather than using fear as a motivator. .

Step 1 is to convert the child's weight from pounds to kilograms: 55 lb ÷ 2.2 lb/kg = 25 kg.

Step 2 is to calculate the total daily dosage in milligrams: 7 mg/kg × 25 kg = 175 mg/24h.

Step 3 is to calculate the dosage per dose: 175 mg ÷ 2 doses = 87.5 mg per dose.

Step 4 is to calculate the volume per dose in mL: 87.5 mg ÷ (125 mg/5 mL) = 87.5 mg ÷ 25 mg/mL = 3.5 mL per dose. The final calculated dosage for this child is 3.5 mL per dose.