A practical nurse (PN) is preparing to administer a scheduled dose of amoxicillin/clavulan… — NCLEX-PN

A practical nurse (PN) is preparing to administer a scheduled dose of amoxicillin/clavulanate to a pediatric client diagnosed with acute otitis media. The client's current weight is $41.8\text{ lbs}$ .

The primary health care provider's prescription reads: "Amoxicillin/clavulanate $45\text{ mg/kg/day}$ PO divided in equal doses every 12 hours."

The pharmacy dispenses a bottle of amoxicillin/clavulanate powder for oral suspension. The reconstitution instructions on the label state: "Add $67\text{ mL}$ of purified water to the bottle in two parts to yield $100\text{ mL}$ of suspension. Each $5\text{ mL}$ of the reconstituted suspension contains $250\text{ mg}$ of amoxicillin."

How many mL should the PN administer for the morning dose? (Record your answer to the nearest tenth. Do not include units in your answer.)

Answer: 8.6 mL

Answer

8.6

To safely administer a weight-based pediatric medication, the practical nurse must systematically convert the weight to kilograms, determine the daily dose, divide by the frequency to find the single dose, calculate the volume based on the correct final concentration, and round appropriately. The total daily dose is

855\text{ mg}

, meaning each of the two doses is

427.5\text{ mg}

. Using the concentration of

250\text{ mg}

5\text{ mL}

, the exact calculated volume is

8.55\text{ mL}

, which rounds to

8.6\text{ mL}

Step-by-Step Solution

Convert the client's weight from pounds (lbs) to kilograms (kg).

41.8\text{ lbs} \div 2.2\text{ lbs/kg} = 19\text{ kg}

The medication dosage is prescribed based on the client's weight in kilograms.

Calculate the total daily dose in milligrams (mg).

19\text{ kg} \times 45\text{ mg/kg/day} = 855\text{ mg/day}

This establishes the total amount of medication the client needs to receive over a 24-hour period.

Determine the amount required for a single dose.

855\text{ mg/day} \div 2\text{ doses} = 427.5\text{ mg/dose}

The prescription states the medication is divided into equal doses every 12 hours, which means 2 doses per day.

Calculate the volume of the reconstituted suspension needed for one dose.

Using dimensional analysis:

427.5\text{ mg} \times \frac{5\text{ mL}}{250\text{ mg}} = 8.55\text{ mL}

The label indicates the final concentration is

250\text{ mg}

per

5\text{ mL}

. The diluent volume (

67\text{ mL}

) and total bottle volume (

100\text{ mL}

) are distractors and not used in this step.

Round the final volume to the nearest tenth as instructed.

8.55\text{ mL}

rounds to

8.6\text{ mL}

Standard medical rounding rules dictate that when the hundredths digit is 5 or greater, the tenths digit is rounded up.

Key Concept

Weight-based pediatric dosage calculation with reconstitution

Estimated Time:3m 0s

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