A pediatric client weighing 44\text{ lb} is prescribed oral amoxicillin 300\text{ mg} ever… — NCLEX-PN

A pediatric client weighing $44\text{ lb}$ is prescribed oral amoxicillin $300\text{ mg}$ every $8\text{ hours}$ . The established safe pediatric dosage range for amoxicillin is $20\text{ to }40\text{ mg/kg/day}$ in divided doses. The pharmacy dispenses an oral suspension concentrated at $250\text{ mg}/5\text{ mL}$ . Which action should the practical nurse take?

A
Administer $6\text{ mL}$ of the oral suspension for the scheduled dose.
B
Proceed with administration after scanning the client's identification band.
Withhold the medication and notify the registered nurse that the daily dose exceeds the safe limit.Answer
D
Administer $18\text{ mL}$ of the oral suspension for the scheduled dose.

Answer

Withhold the medication and notify the registered nurse that the daily dose exceeds the safe limit.

To ensure medication safety, the practical nurse must systematically verify pediatric orders. First, convert the weight:

44\text{ lb} \div 2.2 = 20\text{ kg}

. Next, calculate the safe daily range:

20\text{ kg} \times 20\text{ mg} = 400\text{ mg/day}

, and

20\text{ kg} \times 40\text{ mg} = 800\text{ mg/day}

. The provider prescribed

300\text{ mg}

every

8\text{ hours}

(which means

3

doses per day). Total daily dose =

300\text{ mg} \times 3 = 900\text{ mg/day}

. Because

900\text{ mg/day}

exceeds the absolute maximum safe limit of

800\text{ mg/day}

, the nurse cannot safely administer the medication. The correct action is to withhold the dose and immediately notify the RN or prescribing provider.

Step-by-Step Solution

Convert the client's weight from pounds to kilograms.

44\text{ lb} \div 2.2\text{ lb/kg} = 20\text{ kg}

Safe pediatric dosages are based on body weight in kilograms.

Calculate the safe daily dosage range for this client.

Minimum:

20\text{ kg} \times 20\text{ mg/kg/day} = 400\text{ mg/day}

. Maximum:

20\text{ kg} \times 40\text{ mg/kg/day} = 800\text{ mg/day}

This establishes the safe parameters to compare against the provider's prescription.

Calculate the total daily dose prescribed by the provider.

300\text{ mg} \times 3\text{ doses/day} (every 8 hours) = 900\text{ mg/day}

The prescribed daily amount must be determined to verify safety.

Compare the prescribed dose to the safe range and determine the appropriate action.

900\text{ mg/day}

is greater than the maximum safe limit of

800\text{ mg/day}

. The medication must be withheld.

Administering a dose that exceeds established safe limits is outside the scope of practice and risks patient harm.

Key Concept

Pediatric Dosage Verification and Medication Safety

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