A client is prescribed a drug as 0.3 mcg, q4h. Calculate the dose of the medicine per day.

This answer is correct because BSA is the most accurate method for calculating the child's dose from the adult dose¹². BSA takes into account the child's weight and height, and reflects the physiological function and organ growth of the child beter than weight alone¹. BSA can be calculated using a nomogram or a formula based on the child's weight and height¹. The child's dose can then be calculated by multiplying the adult dose by the ratio of the child's BSA to the average adult BSA (1.73 m2)¹. For example:

Child dose by BSA = (mg/day) = Adult Dose in mg/day x BSA in m2 / 1.73

OR

Child dose by BSA = (mg/day) = Adult Dose in mg/m2 x BSA in m2

The other options are not correct because they are not accurate methods for calculating the child's dose from the adult dose. Actual body weight and ideal body weight may not account for individual variations in pharmacokinetics, pharmacodynamics, or clinical response. Actual body height is not a reliable indicator of drug dosage, as it does not reflect the body mass or organ function of the child.

First, we need to convert the patient's weight from pounds to kilograms using the conversion factor 1 kg =

2.2 lb:

154 lb / 2.2 lb/kg = 70 kg

Next, we need to calculate the dose of nitroprusside in mcg/min using the formula Dose = Weight × Dosage:

Dose = 70 kg × 3 mcg/kg/min = 210 mcg/min

Then, we need to convert the dose of nitroprusside from mcg/min to mg/hr using the conversion factor 1 mg = 1000 mcg:

210 mcg/min × 1 mg/1000 mcg × 60 min/hr = 12.6 mg/hr

Finally, we need to calculate the rate of nitroprusside in mL/hr using the formula Rate = Dose/Concentration:

Rate = 12.6 mg/hr / 100 mg/mL = 0.126 mL/hr

To round to the nearest hundredth, we get 0.13 mL/hr, which is approximately equal to 1.26 mL/hr.

Therefore, the nurse should program the IV pump to deliver nitroprusside at a rate of 1.26 mL/hr.