A nurse is caring for a client who has a pulmonary embolism and has a new prescription for enoxaparin 1.5 mg/kg/dose subcutaneously every 12 hours. The client weighs 245 lbs. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
The Correct Answer is ["167 "]
To calculate the dose of enoxaparin, follow these steps:
1) Convert the client's weight from pounds to kilograms:
245 lbs / 2.2046 (kg/lb) = 111.13 kg (rounded to the nearest whole number, it's 111 kg).
2) Multiply the weight in kilograms by the prescribed dose per kilogram:
111 kg x 1.5 mg/kg = 166.5 mg.
Round the answer to the nearest whole number, so the nurse should administer 167 mg per dose of enoxaparin every 12 hours to the client with a pulmonary embolism.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is C
Explanation
Choice A Reason: This choice is incorrect because it indicates respiratory alkalosis, not AKI. Respiratory alkalosis is a condition in which the lungs eliminate too much carbon dioxide (CO2) from the blood, resulting in a low level of CO2 (PaCO2) and a high level of pH. A normal PaCO2 range is 35 to 45 mm Hg, and a normal pH range is 7.35 to 7.45, so a value of 30 mm Hg and 7.49 indicate respiratory alkalosis.
Choice B Reason: This choice is incorrect because it indicates respiratory acidosis, not AKI. Respiratory acidosis is a condition in which the lungs cannot eliminate enough CO2 from the blood, resulting in a high level of CO2 (PaCO2) and a low level of pH. A value of 46 mm Hg and 7.26 indicate respiratory acidosis.
Choice C Reason: This choice is correct because it indicates metabolic acidosis, which is a common complication of AKI. Metabolic acidosis is a condition in which the body produces too much acid or loses too much base, resulting in a low level of bicarbonate (HCO3) and a low level of pH. A normal HCO3 range is 22 to 26 mEq/L, so a value of 14 mEq/L indicates metabolic acidosis. The low PaCO2 value (30 mm Hg) is due to the respiratory compensation mechanism that tries to restore the acid-base balance by increasing the ventilation and eliminating more CO2.
Choice D Reason: This choice is incorrect because it indicates metabolic alkalosis, not AKI. Metabolic alkalosis is a condition in which the body loses too much acid or gains too much base, resulting in a high level of bicarbonate (HCO3) and a high level of pH. A value of 30 mEq/L and 7.49 indicate metabolic alkalosis.
Correct Answer is D
Explanation
Choice A Reason: This is incorrect because dextrose 5% in 0.9% sodium chloride is a hypertonic solution that can cause fluid overload and pulmonary edema in a client who has burns.
Choice B Reason: This is incorrect because dextrose 5% in water is a hypotonic solution that can cause fluid shifts from the intravascular space to the interstitial space, resulting in hypovolemia and hypotension in a client who has burns.
Choice C Reason: This is incorrect because 0.9% sodium chloride is an isotonic solution that can cause hypernatremia and hyperchloremia in a client who has burns, as the fluid loss from burns is greater than the sodium loss.
Choice D Reason: This is correct because lactated Ringer's is an isotonic solution that contains electrolytes similar to plasma, such as sodium, potassium, calcium, and chloride. It also contains lactate, which is converted to bicarbonate in the liver and helps correct the metabolic acidosis that occurs in a client who has burns.