During a pediatric clinic follow-up, a practical nurse is collecting data from the caregiv… — NCLEX-PN

During a pediatric clinic follow-up, a practical nurse is collecting data from the caregiver of a child who weighs 32 kg (70.5 lb). The child has an active prescription for oral ibuprofen suspension 10 mg/kg/dose every 6 hours as needed for joint inflammation. The caregiver provides the medication bottle, which is labeled 'ibuprofen 100 mg/5 mL,' and states, 'I gave a 32 mL dose about 45 minutes ago because the joints looked very swollen.' Which action should the practical nurse take first?

A
Assess the child's current pain level in the swollen joints to determine if the administered dose was effective.
B
Reassure the caregiver that 32 mL is the correct weight-based volume for a 32 kg child.
Immediately notify the supervising registered nurse and the healthcare provider regarding the medication overdose.Cevap
D
Prepare to immediately administer an intravenous push medication to reverse the pharmacological effects.

Cevap

The correct action is to immediately notify the supervising registered nurse and the healthcare provider regarding the medication overdose.

The correct action is to immediately notify the supervising registered nurse and healthcare provider. The child was prescribed

10 \text{ mg/kg}

, which equates to

320 \text{ mg}

for a

32 \text{ kg}

child. Using the concentration of

100 \text{ mg}/5 \text{ mL}

(

20 \text{ mg/mL}

), the correct volume is

16 \text{ mL}

. The caregiver administered

32 \text{ mL}

(

640 \text{ mg}

), which is exactly double the correct dose. This significant medication error requires urgent escalation for potential toxicity management, which is the priority over routine assessment, and aligns perfectly with the practical nurse's scope to report critical findings.

Adım Adım Çözüm

Calculate the prescribed target dose in milligrams based on the child's weight.

32 \text{ kg} \times 10 \text{ mg/kg} = 320 \text{ mg}

To determine exactly how much active medication the child is supposed to receive per dose.

Calculate the correct volume in milliliters based on the supplied concentration.

The concentration is

100 \text{ mg} / 5 \text{ mL}

, which simplifies to

20 \text{ mg/mL}

. Volume needed =

320 \text{ mg} \div 20 \text{ mg/mL} = 16 \text{ mL}

To compare the prescribed volume against what the caregiver actually administered.

Evaluate the caregiver's administered dose.

The caregiver administered

32 \text{ mL}

. Using the concentration of

20 \text{ mg/mL}

32 \text{ mL} \times 20 \text{ mg/mL} = 640 \text{ mg}

To determine the clinical significance of the caregiver's action.

Determine the priority clinical action based on the LPN/LVN scope of practice.

Recognize that

640 \text{ mg}

is exactly double the prescribed

320 \text{ mg}

dose. This constitutes a severe medication error and overdose, requiring immediate escalation to the RN and provider.

Practical nurses must report critical safety events and cannot independently order or perform advanced interventions (like IV push reversals) for overdoses.

Anahtar Kavram

The practical nurse must accurately calculate weight-based dosages to identify medication errors made by caregivers and immediately escalate emergent toxicity risks to the supervising RN, adhering to the established scope of practice.

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