A nurse is caring for 4-year-old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child's cooperation?

A. The client drinks 2 liters of liquids daily. - This statement indicates adequate fluid intake, which is important for preventing dehydration and lithium toxicity. Increased fluid intake helps maintain normal lithium levels by promoting its excretion through urine.

B. The client eats 2 to 3 gm of sodium-containing foods daily. - This statement suggests a moderate sodium intake, which can help maintain stable lithium levels. Adequate sodium intake is important for preventing lithium toxicity because sodium depletion can increase lithium reabsorption by the kidneys, leading to higher serum levels.

C. The client runs 4 miles outdoors every afternoon. - This statement indicates excessive sweating, which can lead to dehydration and subsequent lithium toxicity. Vigorous exercise, particularly in hot environments, increases fluid loss through sweating, potentially reducing lithium excretion and increasing serum levels.

D. The client eats foods high in tyramine. - This statement is unrelated to lithium toxicity. Tyramine-containing foods are typically associated with interactions with monoamine oxidase inhibitors (MAOIs), not lithium.

To calculate the dose of midazolam to administer, we need to convert the client's weight from pounds to kilograms, and then multiply by the dose per kilogram.

Given: Client weight = 220 lb

Dose of midazolam = 0.2 mg/kg

First, let's convert the client's weight from pounds to kilograms:

1 lb ≈ 0.453592 kg (approximately 0.45 kg, for simplicity)

Client weight in kilograms ≈ 220 lb × 0.45 kg/lb ≈ 99 kg

Now, let's calculate the dose of midazolam:

Dose = Weight (in kg) × Dose per kg Dose ≈ 99 kg × 0.2 mg/kg = 19.8 mg

Rounded to the nearest whole number, the nurse should administer approximately 20 mg of midazolam.