A patient is receiving an IV of 500 mL of D5W (dextrose 5% in water).
How many grams (g) of dextrose are contained in this IV solution?

The dose of the medicine per day is 1.8 mcg.

This answer is correct because it is based on a simple multiplication calculation. The nurse should follow these steps to calculate the dose of the medicine per day:

1) Divide 24 hours by the frequency of the dose to get the number of doses per day, as follows:

24 / 4 = 6

Therefore, the client will receive 6 doses of the medicine per day.

2) Multiply the number of doses per day by the amount of each dose to get the total dose per day, as follows:

6 x 0.3 mcg = 1.8 mcg

Therefore, the dose of the medicine per day is 1.8 mcg.

To answer this question, we need to understand the principles of pediatric dosage calculations and the factors that affect them. Pediatric dosages are usually calculated based on the child's weight or body surface area, and sometimes adjusted for age, organ function, or disease severity¹. However, not all medications that are used in adults are safe or effective in children. Some medications may have different pharmacokinetics, pharmacodynamics, adverse effects, or interactions in children than in adults².

Therefore, it is important to check the drug insert or label for any contraindications, warnings, or precautions for pediatric use before prescribing or administering a medication to a child. If the drug insert states that the medication is not for pediatric use, it means that the medication has not been tested or approved for use in children, or that it has been shown to be harmful or ineffective in children. In this case, a pediatric dose calculated from an adult dose should be avoided, as it may result in serious toxicity or therapeutic failure. The healthcare provider should consult a pediatric specialist, a pharmacist, or a reliable drug reference for alternative medications or dosing recommendations.

The other options are not correct because they do not necessarily warrant avoiding a pediatric dose calculated from an adult dose.

Option a. If the drug insert does not specify a pediatric dose, it means that there is insufficient data or evidence to support a specific pediatric dose, but it does not mean that the medication is contraindicated or unsafe in children. The healthcare provider should use clinical judgment and available resources to determine the appropriate dose for the child³.

Option b. If the child has an elevated temperature that has not responded to treatment, it means that the child may have an infection or inflammation that may affect the absorption, distribution, metabolism, or excretion of some medications. The healthcare provider should monitor the child's condition and adjust the dose accordingly, but it does not mean that the medication should be avoided altogether⁴.

Option c. If the child has gained or lost weight in the past month, it means that the child's weight may have changed significantly since the last dose calculation. The healthcare provider should weigh the child and recalculate the dose based on the current weight, but it does not mean that the medication should be avoided altogether.