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Zorluk: OrtaPharmacological Therapies

A pediatric client weighing 3333 lb is prescribed ibuprofen oral suspension 250250 mg every 66 hours for a fever. The established safe pediatric dosage range for this medication is 55 to 1010 mg/kg/dose. The pharmacy provides ibuprofen in a concentration of 100100 mg/55 mL. Based on this information, which action should the nurse perform?

  1. Withhold the medication and clarify the prescription with the healthcare provider.Cevap
  2. B
    Administer 12.512.5 mL of the suspension per dose as ordered.
  3. C
    Independently recalculate and administer a reduced dose of 150150 mg to ensure client safety.
  4. D
    Administer the dose after confirming the client's identity using their room number and bed assignment.

Cevap

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 1515 kg (33÷2.233 \div 2.2). Based on the provided parameter of 55 to 1010 mg/kg/dose, the safe range for this child is 7575 mg to 150150 mg per dose. The ordered dose of 250250 mg is a significant overdose. The practical nurse must withhold the drug and immediately notify the provider.

Adım Adım Çözüm

1
Convert the client's weight from pounds to kilograms.
33 lb÷2.2 lb/kg=15 kg33 \text{ lb} \div 2.2 \text{ lb/kg} = 15 \text{ kg}
Weight-based pediatric dosage parameters are calculated using kilograms.
2
Calculate the safe minimum and maximum dosage range for this specific client.
Minimum: 15 kg×5 mg/kg=75 mg/dose15 \text{ kg} \times 5 \text{ mg/kg} = 75 \text{ mg/dose}. Maximum: 15 kg×10 mg/kg=150 mg/dose15 \text{ kg} \times 10 \text{ mg/kg} = 150 \text{ mg/dose}.
This establishes the acceptable therapeutic window to evaluate the provider's order.
3
Compare the prescribed dose to the calculated safe range.
The prescribed dose is 250250 mg. The maximum safe dose is 150150 mg. The order is therefore unsafe.
Administering a dose above the calculated safe range can cause severe toxicity and adverse effects.
4
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.

Anahtar Kavram

Pediatric Dosage Verification and Safe Medication Administration
Tahmini Süre:1m 30s
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