Under which circumstance should a pediatric medication dose calculated from an adult dose be avoided?
If the drug insert does not specify a pediatric dose
If the child has an elevated temperature that has not responded to treatment
If the child has gained or lost weight in the past month
If the drug insert states that the medication is not for pediatric use
The Correct Answer is D
To answer this question, we need to understand the principles of pediatric dosage calculations and the factors that affect them. Pediatric dosages are usually calculated based on the child's weight or body surface area, and sometimes adjusted for age, organ function, or disease severity¹. However, not all medications that are used in adults are safe or effective in children. Some medications may have different pharmacokinetics, pharmacodynamics, adverse effects, or interactions in children than in adults².
Therefore, it is important to check the drug insert or label for any contraindications, warnings, or precautions for pediatric use before prescribing or administering a medication to a child. If the drug insert states that the medication is not for pediatric use, it means that the medication has not been tested or approved for use in children, or that it has been shown to be harmful or ineffective in children. In this case, a pediatric dose calculated from an adult dose should be avoided, as it may result in serious toxicity or therapeutic failure. The healthcare provider should consult a pediatric specialist, a pharmacist, or a reliable drug reference for alternative medications or dosing recommendations.
The other options are not correct because they do not necessarily warrant avoiding a pediatric dose calculated from an adult dose.
Option a. If the drug insert does not specify a pediatric dose, it means that there is insufficient data or evidence to support a specific pediatric dose, but it does not mean that the medication is contraindicated or unsafe in children. The healthcare provider should use clinical judgment and available resources to determine the appropriate dose for the child³.
Option b. If the child has an elevated temperature that has not responded to treatment, it means that the child may have an infection or inflammation that may affect the absorption, distribution, metabolism, or excretion of some medications. The healthcare provider should monitor the child's condition and adjust the dose accordingly, but it does not mean that the medication should be avoided altogether⁴.
Option c. If the child has gained or lost weight in the past month, it means that the child's weight may have changed significantly since the last dose calculation. The healthcare provider should weigh the child and recalculate the dose based on the current weight, but it does not mean that the medication should be avoided altogether.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The flow rate of infusion is 125 mL/hr.
This answer is correct because it is based on a simple division and rounding calculation. The nurse should follow these steps to determine the flow rate of infusion:
1) Subtract the start time of the infusion from the end time of the infusion to get the duration of the infusion in hours and minutes, as follows:
15:45 - 06:57 = 8:48
Therefore, the infusion lasted for 8 hours and 48 minutes.
2) Convert the duration of the infusion to hours only by dividing the minutes by 60, since there are 60 minutes in 1 hour. Add this to the hours, as follows:
8 + (48 / 60) = 8.8
Therefore, the infusion lasted for 8.8 hours.
3) Divide the volume of the infusion by the duration of the infusion to get the flow rate in milliliters per hour, as follows:
1000 mL / 8.8 hr = 113.64 mL/hr
Therefore, the flow rate is 113.64 mL/hr.
4) Round the flow rate to the nearest whole number, as follows:
113.64 mL/hr ≈ 114 mL/hr
Therefore, the flow rate is approximately 114 mL/hr.
5) Adjust the flow rate to a standard value that can be set on an IV pump or gravity drip chamber, as follows:
114 mL/hr → 125 mL/hr
Therefore, the flow rate of infusion is 125 mL/hr.
Correct Answer is C
Explanation
To answer this question, the nurse needs to perform the following steps:
1) Convert the patient's weight from pounds and ounces to kilograms, using the conversion factor of 1 pound = 0.45359237 kilograms¹². To do this, first convert the ounces to a fraction of a pound by dividing by 16, then add this fraction to the pounds, and then multiply by the conversion factor. For example:
7 lb, 11.2 oz = 7 + (11.2 / 16) lb
= 7.7 lb
= 7.7 × 0.45359237 kg
= 3.492 kg
2) Calculate the dose of Garamycin in milligrams, using the prescribed dose of 4 mg/kg and the patient's weight in kilograms. To do this, simply multiply the dose per kilogram by the weight in kilograms. For example:
4 mg/kg × 3.492 kg = 13.968 mg
3) Calculate the volume of Garamycin in milliliters, using the reconstituted dosage of 20 mg/10 mL and the dose in milligrams. To do this, use a proportion to find the unknown volume that corresponds to the known dose. For example:
20 mg / 10 mL = 13.968 mg / x mL Cross-multiply and solve for x: 20x = 139.68
x = 6.984 mL
x =7 mL
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