Nokea
A child will be receiving diphenhydramine (Benadryl), 5 mg/kg/day, in divided doses, every 6 hours. The child weighs 80 pounds. Identify how many milligrams of medication will the child receive with each dose.
Correct Answer: 45.5 mg
Rationale: 80 pounds ?· 2.2 = 36.36 kg, which rounds to 36.4 kg; 5 mg/kg/day ?? 36.4 kg = 182 mg/day. With doses given every 6 hours, there will be 4 total doses in a 24-hour period (24 ?· 6 = 4). To calculate milligrams per dose: 182 mg/day ?· 4 doses/day = 45.5 mg/dose.
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A patient will be receiving diphenhydramine via a PEG tube, 25 mg, every 8 hours for an allergic rash. The medication is available as a 12.5 mg/5 mL syrup. Identify how many milliliters will the nurse administer with each dose.
Correct Answer: 10 mL
Rationale: 12.5 mg : 5 mL :: 25 mg : x mL; (12.5 * x) = (5 * 25); 12.5x = 125; x = 125/12.5 = 10 mL.
A patient with a tracheostomy has difficulty removing excessive, thick mucus from the respiratory tract. The nurse expects that which drug will be ordered to aid in the removal of mucus?
- A. Guaifenesin
- B. Benzonatate
- C. Diphenhydramine
- D. Dextromethorphan
Correct Answer: A
Rationale: Expectorants such as guaifenesin work to loosen and thin sputum and the bronchial secretions, thereby indirectly diminishing the tendency to cough. The other drugs listed do not have this effect.
A patient is taking guaifenesin as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching?
- A. Increase fluid intake to help loosen and liquefy secretions.
- B. Report clear-colored sputum to the prescriber.
- C. Avoid driving a car or operating heavy machinery because of the sedating effects.
- D. Report symptoms that last longer than 2 days.
Correct Answer: A
Rationale: Increasing fluid intake helps to loosen and liquefy secretions. The patient must be fully aware that any fever, chest tightness, change in sputum from clear to colored, difficult or noisy breathing, activity intolerance, or weakness needs to be reported. The patient must also report to the prescriber a fever of higher than 100.4?°F (38?°C) or symptoms that last longer than 3 to 4 days. Decongestants do not cause sedation, and therefore the patient does not need to avoid driving a car or operating heavy machinery.
A patient has been advised to add an adrenergic decongestant nasal spray to treat a cold. The nurse will include which instruction?
- A. You won't see effects for at least 1 week.
- B. Limit use of this spray to 3 to 5 days.
- C. Continue the spray until nasal stuffiness has resolved.
- D. Avoid use of this spray if a fever develops.
Correct Answer: B
Rationale: Frequent, long-term, or excessive use of adrenergic nasal decongestants may lead to rebound congestion if used beyond the recommended time. The other instructions are incorrect.
A patient tells the nurse that she wants to start taking the herbal product goldenseal to improve her health. The nurse will assess for which potential cautions or contraindications to goldenseal?
- A. Taking a proton-pump inhibitor
- B. Nasal congestion
- C. Hypothyroidism
- D. Taking an antihypertensive drug
- E. Sinus infections
- F. Pregnancy
Correct Answer: A,D,F
Rationale: Goldenseal is contraindicated in patients with acute or chronic gastrointestinal disorders and during pregnancy (because it has uterine stimulant properties). It should be used with caution by those with cardiovascular disorders. Potential drug interactions may occur with gastric acid suppressors such as antacids, histamine H2 blockers (e.g., ranitidine), and proton-pump inhibitors (e.g., omeprazole), theoretically because of their reduced effectiveness resulting from the acid-promoting effect of the herb, and with antihypertensive drugs (because of the vasoconstrictive activity of the herb). Goldenseal is potentially useful for sinus infections and chronic nasal allergies.