A client is prescribed 25 mg/kg of a medication. The weight of the client is 42 kg.
How many milligrams (mg) of medication should be administered to achieve the total prescribed dose?

This instruction should be given to the patient for the effective management of asthma because the patient is taking an overdose of ipratropium, which may cause serious side effects such as dry mouth, blurred vision, urinary retention, or increased heart rate. The recommended dosage of ipratropium for adults with acute asthma is 0.5 mg (500 mcg) every 20 minutes for three doses, followed by 0.5 mg every two to four hours as needed³. The patient's prescribed dose is 5 mg/kg, which means 300 mg/day for a 60 kg patient. This is 10 times the maximum daily dose of 2 mg (2000 mcg) for ipratropium⁴. Therefore, the patient should halve the dose of medication to 150 mg/day, which is still higher than the usual dosage, but within the range that can be given under medical supervision.

The other options are not appropriate instructions because:

a) Continuing the same dose of medication may worsen the patient's condition and increase the risk of adverse reactions.

b) Changing to alternative medication may not be necessary or effective, as ipratropium is a commonly used bronchodilator for asthma that works by relaxing the airway muscles and improving airflow⁵. The patient may benefit from adjusting the dose or adding other medications, such as corticosteroids or beta-agonists, depending on the severity and frequency of symptoms.

c) Doubling the dose of medication may be dangerous and potentially fatal, as it may cause severe anticholinergic effects, such as dry mouth, blurred vision, urinary retention, increased heart rate, confusion, or coma.

To find the hours to finish the infusion, you need to calculate the following:

- The volume of saline solution in milliliters
- The time in hours using the formula: Time (h) = Total volume (mL) / Infusion rate (mL/h)

First, convert the volume of saline solution from liters to milliliters by multiplying by 1000:

1.5 L x 1000 = 1500 mL

Next, use the formula for time to find how many hours it will take to infuse the saline solution at the current rate:

Time (h) = Total volume (mL) / Infusion rate (mL/h)

Since the total volume is 1500 mL and the infusion rate is 75 mL/h, plug in these values into the formula:

Time (h) = 1500 mL / 75 mL/h

Simplify and solve for the time:

Time (h) = 20 h

Therefore, it will take **20 hours** to finish the infusion at the current rate.