A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

Since the client weighs 90 kg, let’s first convert their weight to pounds to determine the appropriate cefazolin dosage:

Conversion factor: 1 kg = 2.205 pounds

Client weight (pounds) = 90 kg x 2.205 pounds/kg = 198.45 pounds (rounded to two decimals)

Now, comparing the client’s weight (198.45 pounds) to the weight threshold (265.5 pounds):

Client weight is less than the threshold (198.45 pounds < 265.5 pounds).

Therefore, the appropriate dosage is:

Cefazolin 2 grams/100 mL 0.9% normal saline over 1 hour.

The pump rate is determined by the total volume of the IV fluid and the infusion time.

We are not given the specific bag size, but typically these come in 100 mL or 500 mL volumes.

Assuming a 100 mL bag (which aligns with the concentration provided):

Total volume of IV bag: 100 mL

Infusion time: 1 hour

Calculation:

Pump rate (mL/hr) = Total volume (mL) / Infusion time (hr)

Pump rate (mL/hr) = 100 mL / 1 hour = 100 mL/hr

Therefore, the nurse should program the pump to deliver 100 mL/hr.

A) Holding the dose of IV pantoprazole until the client has finished eating breakfast may delay the onset of action of the medication, as pantoprazole is typically administered before meals to maximize its effectiveness in reducing gastric acid secretion. Additionally, delaying the dose may not provide immediate relief for the client's he’rtburn symptoms.

B) Providing a PRN dose of antacid along with the scheduled medications may temporarily relieve the client's he’rtburn symptoms, but it does not address the underlying cause of peptic ulcer disease or prevent further gastric acid secretion, which is the primary goal of pantoprazole and sucralfate administration.

C) Instructing the client to take the dose of sucralfate PO while eating breakfast may interfere with the optimal absorption of the medication. Sucralfate forms a protective barrier over ulcers in the stomach and should be administered on an empty stomach to allow it to adhere to the gastric mucosa effectively.

D) Administering both of the medications before breakfast as scheduled is the most appropriate action. Pantoprazole is a proton pump inhibitor that reduces gastric acid production, and sucralfate forms a protective barrier over ulcers in the stomach. Administering these medications before breakfast allows them to work synergistically to reduce gastric acid secretion and protect the gastric mucosa, helping to alleviate the client's he’rtburn symptoms and promote ulcer healing.