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The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant weighing 4 pounds. The drug is diluted in 25 ml of D5W to run over 8 hours. How much Streptomycin will the infant receive?
- A. 9 mg
- B. 18 mg
- C. 27 mg
- D. 36 mg
Correct Answer: A
Rationale: To calculate the dose of Streptomycin, we first need to convert the infant's weight from pounds to kg (4 lbs = 1.81 kg). Then, we multiply the weight in kg by the prescribed dose (15 mg/kg) to get the total dose (1.81 kg * 15 mg/kg = 27.15 mg). Since the drug is diluted in 25 ml of D5W, the infant will receive 27.15 mg in 25 ml solution. To find how much Streptomycin the infant actually receives, we need to calculate the amount in 1 ml (27.15 mg / 25 ml = 1.086 mg/ml). Finally, to determine how much the infant will receive over 8 hours, we multiply the concentration by the infusion rate (1.086 mg/ml * 25 ml * 8 hours = 217.2 mg). Therefore, the correct answer is A: 9 mg, as it represents the amount
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While assessing a client with preeclampsia who is receiving magnesium sulfate, the nurse notes her deep tendon reflexes are 1+, respiratory rate is 12 breaths/minute, urinary output is 90 ml in 4 hours, and magnesium sulfate level is 9 mg/dl. What intervention should the nurse implement based on these findings?
- A. Continue the magnesium sulfate infusion as prescribed.
- B. Decrease the magnesium sulfate infusion by one-half.
- C. Stop the magnesium sulfate infusion immediately.
- D. Administer calcium gluconate immediately.
Correct Answer: C
Rationale: The correct answer is C: Stop the magnesium sulfate infusion immediately. The client is showing signs of magnesium toxicity, as evidenced by decreased deep tendon reflexes, bradypnea (respiratory rate of 12 breaths/minute), oliguria (urinary output of 90 ml in 4 hours), and elevated magnesium sulfate level of 9 mg/dl. Stopping the infusion is crucial to prevent further complications such as respiratory depression, cardiac arrest, and central nervous system depression. Continuing the infusion (choice A) would worsen the toxicity. Decreasing the infusion (choice B) may not be sufficient to address the toxicity. Administering calcium gluconate (choice D) is not the immediate priority; stopping the magnesium sulfate infusion is essential to prevent further harm.
A patient with chronic pain is prescribed a fentanyl patch. What is the most important instruction for the nurse to provide?
- A. Apply the patch to a different site each time.
- B. Change the patch every 72 hours.
- C. Avoid using additional heating pads over the patch.
- D. Remove the patch before showering.
Correct Answer: B
Rationale: The correct answer is B: Change the patch every 72 hours. Fentanyl patches are typically designed to be worn for 72 hours before being replaced to maintain consistent pain relief. Changing the patch on time helps prevent withdrawal symptoms and ensures the effectiveness of the medication.
A: Applying the patch to a different site each time is important to prevent skin irritation but is not the most crucial instruction.
C: Avoiding heating pads over the patch is important to prevent overheating and excessive absorption of the medication, but changing the patch timely is more critical.
D: Removing the patch before showering is not necessary as fentanyl patches are designed to be water-resistant.
When assessing a male client who is receiving a unit of packed red blood cells (PRBCs), the nurse notes that the infusion was started 30 minutes ago, and 50 ml of blood is left to be infused. The client's vital signs are within normal limits. He reports feeling 'out of breath' but denies any other complaints. What action should the nurse take at this time?
- A. Administer a PRN prescription for diphenhydramine (Benadryl).
- B. Start the normal saline attached to the Y-tubing at the same rate.
- C. Decrease the intravenous flow rate of the PRBC transfusion.
- D. Ask the respiratory therapist to administer PRN albuterol (Ventolin).
Correct Answer: C
Rationale: The correct action for the nurse to take in this situation is to decrease the intravenous flow rate of the PRBC transfusion. The client is showing early signs of a transfusion reaction, as evidenced by feeling 'out of breath'. By decreasing the flow rate of the transfusion, the nurse can slow down the rate at which the remaining blood is infused, potentially preventing a more severe reaction. Administering diphenhydramine or albuterol would not address the underlying issue of a potential transfusion reaction. Starting normal saline at the same rate may exacerbate the client's symptoms and is not indicated in this scenario.
A client with heart failure is prescribed digoxin (Lanoxin). Which instruction should the nurse include in the client's teaching plan?
- A. Take your pulse before each dose and hold the medication if your pulse is below 60 beats per minute.
- B. Increase your intake of foods high in potassium.
- C. Take the medication with a high-fiber meal to enhance absorption.
- D. Skip a dose if you feel dizzy or lightheaded.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Digoxin is a medication that can cause bradycardia as a side effect.
2. Instructing the client to take their pulse before each dose is crucial to monitor for bradycardia.
3. Holding the medication if the pulse is below 60 beats per minute helps prevent potential adverse effects.
4. This instruction ensures the client's safety and adherence to the prescribed regimen.
Summary:
- Choice B is incorrect because increasing potassium intake can lead to hyperkalemia when taking digoxin.
- Choice C is incorrect as taking digoxin with a high-fiber meal may affect absorption negatively.
- Choice D is incorrect because skipping a dose based on dizziness or lightheadedness may lead to suboptimal treatment outcomes.
A patient with peptic ulcer disease is prescribed omeprazole. When should the patient take this medication for optimal effectiveness?
- A. With meals
- B. At bedtime
- C. Before meals
- D. After meals
Correct Answer: C
Rationale: The correct answer is C: Before meals. Omeprazole is a proton pump inhibitor that works best when taken before meals to inhibit acid secretion before food intake. Taking it with meals (choice A) may decrease its effectiveness as it needs time to be absorbed. Taking it at bedtime (choice B) may not provide optimal coverage throughout the day. Taking it after meals (choice D) may not allow enough time for the medication to start working before the next meal.