A practical nurse is caring for a pediatric client who weighs 22\text{ lbs} (10\text{ kg})… — NCLEX-PN

A practical nurse is caring for a pediatric client who weighs $22\text{ lbs}$ ( $10\text{ kg}$ ) and has a tympanic temperature of $102.1^\circ\text{F}$ ( $38.9^\circ\text{C}$ ). The health care provider's prescription reads: "Ibuprofen $100\text{ mg}$ PO every $6\text{ hours}$ PRN for temperature greater than $101.5^\circ\text{F}$ ( $38.6^\circ\text{C}$ )." The pharmacy dispenses an oral suspension containing $100\text{ mg}/5\text{ mL}$ . The client's caregiver reports administering a dose of oral acetaminophen at home $2\text{ hours}$ prior to arrival. Which action by the nurse is the most appropriate?

Administer $5\text{ mL}$ of the ibuprofen suspension to the client using a calibrated oral syringe.Answer
B
Withhold the ibuprofen because it should not be administered within $4\text{ hours}$ of the caregiver's acetaminophen dose.
C
Administer $11\text{ mL}$ of the ibuprofen suspension to match a weight-based calculation using the client's weight in pounds.
D
Notify the health care provider to increase the dose because $100\text{ mg}$ is below the therapeutic range for a $22\text{ lb}$ client.

Answer

The correct action is to administer

5\text{ mL}

of the ibuprofen suspension to the client using a calibrated oral syringe.

The correct action is to administer

5\text{ mL}

of the medication. The prescribed dose of

100\text{ mg}

is safe for a

10\text{ kg}

child, as the standard pediatric dose for ibuprofen is

5

10\text{ mg/kg}

per dose (

10\text{ kg} \times 10\text{ mg/kg} = 100\text{ mg}

). To determine the correct volume, the nurse divides the desired dose by the available concentration:

(100\text{ mg} / 100\text{ mg}) \times 5\text{ mL} = 5\text{ mL}

. Acetaminophen and ibuprofen belong to different medication classes, so they can be safely administered within two hours of each other to manage a persistent high fever. A calibrated oral syringe ensures precise measurement.

Step-by-Step Solution

Verify the client's weight in kilograms.

The client weighs

10\text{ kg}

Pediatric medication dosing is strictly based on kilograms to prevent potentially fatal overdosing or underdosing.

Determine if the prescribed dose is within the safe pediatric range.

The standard dose is

5

10\text{ mg/kg}

. For a

10\text{ kg}

child, the maximum safe single dose is

100\text{ mg}

, which exactly matches the prescription.

Nurses must independently verify that a prescribed dose is safe before administration, even if the order is written clearly.

Calculate the required liquid volume to administer.

Using the formula

(\text{Desired} / \text{Have}) \times \text{Volume}

(100\text{ mg} / 100\text{ mg}) \times 5\text{ mL} = 5\text{ mL}

This calculation determines the exact physical amount of liquid to draw into the syringe.

Evaluate drug interactions and administration timing.

The administration is safe. Ibuprofen (an NSAID) and acetaminophen (a non-opioid analgesic/antipyretic) have different mechanisms of action.

Because they are metabolized differently, they can be safely alternated or given within two hours of each other for high fevers without compounding toxicity.

Key Concept

Pediatric Dosage Calculation and Antipyretic Administration

Estimated Time:2m 0s

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