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Difficulty: HardPharmacological Therapies

A practical nurse is caring for a client with heart failure who receives enteral nutrition and medications via a percutaneous endoscopic gastrostomy (PEG) tube. The client's current weight is 73 kg73\text{ kg}. The health care provider prescribes a maintenance dose of digoxin oral solution at 6 mcg/kg6\text{ mcg/kg} daily. The pharmacy dispenses digoxin liquid with a concentration of 0.05 mg/mL0.05\text{ mg/mL}. Prior to administration, the nurse notes a regular apical pulse of 68 beats/min68\text{ beats/min} and a serum potassium level of 4.3 mEq/L4.3\text{ mEq/L}. How many milliliters will the nurse administer? Record answer to the nearest tenth. Do not include units in answer.

Answer: 8.8

Answer

8.8
To safely administer this medication, the practical nurse must first verify that the apical pulse and potassium levels are within safe parameters. After verifying safety, the weight-based dose (438 mcg438\text{ mcg}) is calculated. Because the supplied liquid is measured in mg (0.05 mg/mL0.05\text{ mg/mL}), it must be converted to mcg (50 mcg/mL50\text{ mcg/mL}). Finally, dividing the needed dose by the concentration yields 8.76 mL8.76\text{ mL}, which rounds appropriately to 8.88.8.

Step-by-Step Solution

1
Evaluate pre-administration assessment data.
The nurse determines it is safe to proceed with administration.
Digoxin requires an apical pulse of at least 60 beats/min in adults and normal potassium levels (3.5-5.0 mEq/L) to prevent toxicity.
2
Calculate the total required dose in micrograms (mcg).
73 kg×6 mcg/kg=438 mcg73\text{ kg} \times 6\text{ mcg/kg} = 438\text{ mcg}
The prescription is weight-based, requiring multiplication of the client's weight in kg by the prescribed mcg/kg dose.
3
Convert the available concentration to matching units (mcg).
0.05 mg=50 mcg0.05\text{ mg} = 50\text{ mcg}, making the concentration 50 mcg/mL50\text{ mcg/mL}.
Dosage calculations require the ordered dose and the available dose to be in the same unit of measurement before division.
4
Calculate the volume in milliliters (mL).
438 mcg÷50 mcg/mL=8.76 mL438\text{ mcg} \div 50\text{ mcg/mL} = 8.76\text{ mL}
Dividing the desired dose by the available concentration yields the required liquid volume.
5
Round to the nearest tenth.
8.8
The question specifically requests the final answer to be recorded to the nearest tenth without units.

Key Concept

Weight-based dosage calculations, unit conversions, and pre-administration safety checks for cardiac glycosides.
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Topics

Pharmacological Therapies

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