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Difficulty: MediumPharmacological Therapies

A 44-lb44\text{-lb} pediatric client is receiving care for a respiratory tract infection. The client's pharmacological plan includes scheduled oral amoxicillin at 20 mg/kg20\text{ mg/kg} per dose and an as-needed intravenous (IV) push antiemetic for nausea. The unit stocks the amoxicillin oral suspension in a concentration of 250 mg/5 mL250\text{ mg}/5\text{ mL}. To maintain safety and adhere to the scope of practice, which action is correct for the practical nurse to perform?

  1. Prepare 8 mL8\text{ mL} of the oral amoxicillin suspension and verify two unique client identifiers prior to administration.Answer
  2. B
    Prepare 17.6 mL17.6\text{ mL} of the oral amoxicillin suspension by calculating the dose directly using the client's weight in pounds.
  3. C
    Administer the prepared oral amoxicillin after using the client's room number and parent's visual recognition as the primary identifiers.
  4. D
    Accept delegation from the registered nurse to administer the intravenous (IV) push antiemetic if the client develops acute nausea.

Answer

The correct action is to accurately calculate the amoxicillin dose as 8 mL and ensure two unique client identifiers are verified before administering the medication.
This action demonstrates correct dosage calculation by first converting the client's weight to kilograms (44÷2.2=20 kg44 \div 2.2 = 20\text{ kg}), finding the proper milligram dose (20×20=400 mg20 \times 20 = 400\text{ mg}), and accurately calculating the volume (400÷250×5=8 mL400 \div 250 \times 5 = 8\text{ mL}). Furthermore, it adheres to essential medication safety protocols by appropriately requiring two unique client identifiers prior to oral administration.

Step-by-Step Solution

1
Convert the client's weight from pounds to kilograms.
44 lb÷2.2=20 kg44\text{ lb} \div 2.2 = 20\text{ kg}
Weight-based medication dosages must be calculated using kilograms to ensure therapeutic accuracy.
2
Calculate the required dose in milligrams.
20 kg×20 mg/kg=400 mg20\text{ kg} \times 20\text{ mg/kg} = 400\text{ mg}
This determines the exact total milligram dose prescribed by the provider.
3
Calculate the required fluid volume using the supplied concentration.
(400 mg÷250 mg)×5 mL=8 mL(400\text{ mg} \div 250\text{ mg}) \times 5\text{ mL} = 8\text{ mL}
This converts the milligram requirement into the correct volume to draw up into the oral syringe.
4
Identify the correct scope of practice and safety protocols.
The nurse administers the oral medication after checking two identifiers and refuses the IV push delegation.
Practical nurses can safely administer oral medications with proper identification, but administering IV push medications is strictly outside their scope of practice.

Key Concept

Medication Safety, Weight-Based Dosage Calculation, and Practical Nurse Scope of Practice
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Topics

Pharmacological Therapies

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