A nurse is preparing to administer somatropin 0.24 mg/kg/week subcutaneously to be divided into six daily doses to a school-age child who weighs 66 lb. How many mg should the nurse administer per dose?

(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Step 1: Convert the child's weight from pounds to kilograms.

44 pounds / 2.2 pounds/kg = 20 kg

Step 2: Calculate the child's total daily dose of gentamicin.

20 kg * 6 mg/kg/day = 120 mg/day

Step 3: Divide the child's total daily dose of gentamicin by the number of doses per day.

120 mg / 3 doses/day = 40 mg/dose

Step 4: Calculate the volume of gentamicin to be administered with each dose.

40 mg / 40 mg/mL = 1 mL/dose

Step 5: Round the answer to the nearest whole number and add a leading zero if necessary.

1 mL/dose = 1 mL/dose

Answer: 1 mL with each dose.

Choice A rationale:

Hanging the antibiotic medication bag above the level of the primary infusion is an important step in administering an antibiotic via intermittent IV bolus. However, it is not the first step. The medication bag is usually hung higher to allow the antibiotic to infuse by gravity once it’s connected.

Choice B rationale:

Wiping the connection port of the primary IV tubing with an antiseptic swab is a crucial step in preventing infection. However, this is typically done just before connecting the secondary line, not as the first step.

Choice C rationale:

Checking the IV site for signs of infiltration is indeed the first step. It’s important to ensure that the IV catheter is still properly placed in the vein and that there are no signs of infection or infiltration, which could cause complications.

Choice D rationale:

Connecting the tubing of the medication bag to the primary tubing is done after cleaning the port and before hanging the bag. It’s not the first step.