Chapter 5 PrepU

A group of students are practicing pediatric dosage calculation using Clark's rule. Which information would the students need?

Child's weight in pounds

When administering medications to an 18-month-old child, it is essential that the nurse monitor closely for adverse effects because these effects may be more severe in a child. What is the rationale for the severity of the adverse effects?

Children 2 years and younger have immature body systems and the adverse effects can be severe.

The nursing student is learning about the metric system and how it is the most commonly used system of measurement in medicine. The student demonstrates an understanding of the metric system when stating:

"In the metric system, the liter is a unit of volume."

The nurse demonstrates an understanding of the metric system when the nurse identifies which conversions as correct? (Select all that apply.)

-1 kilogram = 1000 grams -1 gram = 1000 milligrams -1 milligram = 1000 micrograms

Which are systems of measurement associated with drug dosing? (Select all that apply.)

-metric system -apothecary system -household measurements

A nurse should recognize what as a metric system unit? (Select all that apply.)

-milliliter -gram -kilogram

An 8-year-old is going home on medication after surgery. The nurse is preparing to review the discharge instructions with the mother. What basic information and/or instructions should be given to her to continue the drug therapy at home? (Select all that apply.)

-schedule and duration of administration -generic and trade names of drugs -description of the intended therapeutic drug effect

The nurse is to administer 25 mg of meperidine (Demerol). The vial states that it contains meperidine, 1.0 mL = 50.0 mg. How much medication should the nurse draw up to equal the ordered dosage?

0.50 mL

The nurse realizes that the doses given to children are usually much smaller than those given to adults. Doses for children can also be calculated based on the child's weight. Which would be correct when calculating a dose based on weight?

1 kg equals 2.2 pounds

The nurse is preparing to administer 80 mg of Solu-medrol intravenously (IV) to a client with pneumonia. The vial states that it has 120 mg per 2 mL. The nurse would correctly draw up which amount?

1.3 mL

A child is to receive 500 mg of an antibiotic suspension. The label on the bottle reads 250 mg/5 mL. The nurse should administer how much of the suspension in one dose?

10 mL

Delatsone (prednisone) has been prescribed to a client with sarcoidosis. The client is to take 20 mg/day for 1 week and then taper the dose. The medication is available in 10-mg tablets. If the client follows the drug regimen, how many tablets would be taken in the first week?

14

At 0700 (7 AM) the health care provider has ordered the nurse to begin an IV infusion and has ordered the client to receive 125 mL/hr of IV fluid. At what time will the nurse be prepared to hang the next liter of IV fluid?

1500 (3 PM)

A client consumed the 6-ounce cup of orange juice that was on the breakfast tray. The nurse should document what volume of fluid intake on the client's fluid balance sheet.

180 mL

A client is to receive 0.5 g of an analgesic. The client has 250 mg tablets on hand. The nurse should instruct the client to take how many tablets?

2

A client is being treated for congestive heart failure (CHF) and is to receive 0.5 milligrams of digoxin, which is available in 250-microgram tablets. The nurse would correctly administer how many tablets?

2 tablets

The client is to be given ascorbic acid 1 g daily by mouth. The medication comes in a container labeled, "Ascorbic Acid 250 mg." How much will the nurse give?

4 tablets

The nursing student is studying drug dosing with liquids. The student knows that a specific amount of drug will be in a given volume. A particular drug label reads "Augmentin 125 mg/5 mL." Which is correct in regards to the correct volume?

5mL

The physician orders a client to receive 1000 mL of intravenous fluid over the next 12 hours. The intravenous delivery system is a microdrip system. The nurse would set the infusion to run at which rate?

83 gtts/minute

All prescriptions are required to list the metric measure for quantity and strength of the drug.

True

Which system of measurement uses the minim as the basic unit of liquid measure?

apothecary

Which units of measure would a nurse expect to find when using the apothecary system?

drams

Which laboratory test relates most directly with the impaired drug elimination that is expected in neonates?

glomerular filtration rate

Parents of a 10-year-old child with asthma are concerned about their child's lack of growth. The parents say that the child is much shorter than anyone in the class and want to know what could have caused the problem. What medication may this child have taken that contributed to the growth suppression?

glucocorticoid

An antibiotic has been ordered for a toddler who is showing signs and symptoms of sepsis. The dose will be determined based on the child's body surface area (BSA). In addition to knowing the child's weight, the care team will also have to consider the child's:

height

A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to:

immature liver and kidney function in infants and children.

An infant's antiseizure medication has been ordered after careful consideration of the unique pharmacokinetics among this population. What characteristic of neonates has the greatest bearing on drug metabolism?

immaturity of the infant's liver

A nurse is preparing to administer a parenteral medication. Which form of the medication will be used?

liquid

A nurse is aware that a neonate is born with a highly immature liver and has low levels of the enzyme cytochrome P450 (CYP450). This physiological characteristic affects what aspect of pharmacokinetics in neonates?

metabolism

A nurse in a nutrition clinic is to give 2 cups of organic prune juice to a client every night. The nurse is to document this on the nursing chart. What unit will the nurse use to document the amount of juice according to the metric system of measurement?

milliliter

A 4-year-old boy is postoperative day one following surgery for trauma suffered in a motor vehicle accident. The boy is in pain, and the nurse is preparing to administer a dose of hydromorphone syrup as ordered. To administer this drug, the nurse should use a(n):

oral syringe.

An infant has been diagnosed with asthma and has been prescribed nebulized bronchodilators and corticosteroids for use at home. The nurse's health education for the parents should prioritize:

the technique for correct administration of the medications in the home.

A nurse is preparing to administer a nebulized bronchodilator to a young child with asthma. The nurse should be aware that this child's dosage is based primarily on what characteristic of the child?

weight

Many drugs prescribed to pediatric clients are used off label. What is the main reason that this occurs?

Drug studies do not typically involve children.

The nurse is administering a drug metabolized in the liver to an infant. Because of the immaturity of the infant liver, what does the nurse determine should be done for dosing of this drug?

Ensure that lower drug dosages or an increased interval between doses is scheduled.

Clark's rule is commonly used today to calculate pediatric drug dosages, but Young's rule is rarely used.

False

One tablespoon is equivalent to 30 milliliters.

False

A public health nurse is preparing to administer an intramuscular injection of a vaccine to an 8-year-old girl. The nurse recognizes that the child is uncharacteristically quiet and appears tense. The nurse should recognize the possibility of what nursing diagnosis?

Fear related to IM injection

The nurse is performing an assessment on a 7-year-old child in the clinic. The nurse observes the child's teeth are darkly stained. What information should the nurse obtain from the parent?

Has the child taken tetracycline for treatment?

When planning to make brownies for a department party, which measurement system would a nurse use?

Household system

After teaching a group of students about measuring systems and drug calculations, the instructor determines that the teaching was successful when the students identify which system as most widely used?

Metric system

The nurse is administering medications to a 2-year-old child with impaired renal function. What does the nurse understand about the dosage of medication for this child?

The dose should be adjusted to achieve and maintain therapeutic drug levels.

A client is to receive 150 mL of intravenous solution over the next hour using a microdrip delivery system. How much fluid would the client receive in 1 minute?

2.5 mL

A physician orders 250 mg of an antibiotic suspension. The label on the suspension reads "500 mg/5 mL." How much would the nurse administer?

2.5 mL

A child weighs 22 kilograms. The physician orders a drug as follows: "1.1 mg/kg by intramuscular injection." The nurse determines the proper dose as:

24 mg

The nurse is converting grams to milligrams. How would the nurse move the decimal point?

3 places to the right

The nurse is determining the recommended dose of medication for a child. The nursing drug handbook reads "Recommended dose is 15 mg per kg." The child's weight is 25 kg. The recommended dose for this child is:

375

According to protocol, a nursing student is required to complete metric conversions to ensure accurate administration of medication dosage. What does this indicate?

A nurse must possess a basic understanding of mathematics.

The nurse is to administer an off-label medication to a premature infant. To check for an appropriate dose for this client, the nurse refers to

A pediatric drug reference