A nurse is teaching a group of middle age adults about various types of hepatitis.
What statement by one of the group members indicates correct understanding of the differences?

An idiosyncratic drug effect is an unpredictable and uncommon reaction to a drug that is not related to the dose, the pharmacology, or the patient’s allergy or intolerance. It may be caused by genetic factors, metabolic abnormalities, or interactions with other drugs or substances. An example of an idiosyncratic drug effect is paradoxical agitation or excitement after receiving a sedative.

B. A toxic drug effect is a harmful reaction to a drug that is related to the dose or the pharmacology of the drug. It may cause symptoms such as nausea, vomiting, drowsiness, confusion, or respiratory depression. A toxic drug effect is unlikely to cause agitation after receiving a sedative unless there is an overdose or a drug interaction that increases the level of the sedative in the blood.

C. An allergic drug response is an immunological reaction to a drug that is not related to the dose or the pharmacology of the drug. It may cause symptoms such as rash, itching, swelling, fever, or anaphylaxis. An allergic drug response is unlikely to cause agitation after receiving a sedative unless there is a severe anaphylactic reaction that affects the brain or the circulation.

D. An unexpected drug interaction is a modification of the effect of one drug by another drug or substance that is not predictable based on their pharmacology. It may cause an increase or a decrease in the efficacy or toxicity of one or both drugs. An unexpected drug interaction may cause agitation after receiving a sedative if there is a synergistic effect that enhances the central nervous system stimulation of another drug or substance (such as caffeine, cocaine, or amphetamines) or if there is an antagonistic effect that reduces the central nervous system depression of the sedative (such as flumazenil, naloxone, or physostigmine). However, these interactions are usually known and avoidable by checking the patient’s history and medication list.

To find the rate of the pump in ml/hour, you need to first convert the client’s weight from pounds to kilograms. You can do this by dividing the weight by 2.2046 or multiplying it by 0.454.

For example:

297 lbs / 2.2046 = 134.72 kg or 297 lbs x 0.454 = 134.72 kg

Then, you need to multiply the client’s weight in kilograms by the ordered dose in units/kg/hour to get the total units per hour.

For example:

134.72 kg x 12 units/kg/hour = 1616.64 units/hour

Next, you need to set up a proportion to find the rate of the pump in ml/hour using the supplied medication concentration.

For example:

25,000 units / 500 ml = 1616.64 units / X ml Cross-multiply and solve for X:

25,000 x X = 808320 X = 808320 / 25000 X = 32.33 ml/hour

Finally, you need to round your answer to the nearest tenth of a ml/hour as per the medication administration guidelines.

For example:

32.33 ml/hour ≈ 32.3 ml/hour

Therefore, the rate of the pump is 32.3 ml/hour.

Choice A is wrong because it uses a different conversion factor for pounds to kilograms (1 lb = 0.5 kg) which is not accurate.

Choice C is wrong because it uses a different ordered dose (10 units/kg/hour) which is not what the provider has written.

Choice D is wrong because it uses a different supplied medication concentration (20,000 units in 500 ml) which is not what is available.