A pediatric client weighing 33 lb is prescribed ibuprofen oral suspension 250 mg every 6 h… — NCLEX-PN

A pediatric client weighing $33$ lb is prescribed ibuprofen oral suspension $250$ mg every $6$ hours for a fever. The established safe pediatric dosage range for this medication is $5$ to $10$ mg/kg/dose. The pharmacy provides ibuprofen in a concentration of $100$ mg/ $5$ mL. Based on this information, which action should the nurse perform?

Withhold the medication and clarify the prescription with the healthcare provider.Answer
B
Administer $12.5$ mL of the suspension per dose as ordered.
C
Independently recalculate and administer a reduced dose of $150$ mg to ensure client safety.
D
Administer the dose after confirming the client's identity using their room number and bed assignment.

Answer

Withhold the medication and clarify the prescription with the healthcare provider.

The correct action is to withhold the medication because the prescribed dose exceeds the safe maximum limit. The child's weight is

15

kg (

33 \div 2.2

). Based on the provided parameter of

5

10

mg/kg/dose, the safe range for this child is

75

mg to

150

mg per dose. The ordered dose of

250

mg is a significant overdose. The practical nurse must withhold the drug and immediately notify the provider.

Step-by-Step Solution

Convert the client's weight from pounds to kilograms.

33 \text{ lb} \div 2.2 \text{ lb/kg} = 15 \text{ kg}

Weight-based pediatric dosage parameters are calculated using kilograms.

Calculate the safe minimum and maximum dosage range for this specific client.

Minimum:

15 \text{ kg} \times 5 \text{ mg/kg} = 75 \text{ mg/dose}

. Maximum:

15 \text{ kg} \times 10 \text{ mg/kg} = 150 \text{ mg/dose}

This establishes the acceptable therapeutic window to evaluate the provider's order.

Compare the prescribed dose to the calculated safe range.

The prescribed dose is

250

mg. The maximum safe dose is

150

mg. The order is therefore unsafe.

Administering a dose above the calculated safe range can cause severe toxicity and adverse effects.

Determine the appropriate nursing intervention within the LPN/LVN scope of practice.

Withhold the medication and contact the healthcare provider to clarify the order.

Nurses have a legal and ethical duty to withhold unsafe orders, and only the provider can write or modify a prescription.

Key Concept

Pediatric Dosage Verification and Safe Medication Administration

Estimated Time:1m 30s

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Key Concept

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