A patient weighing 60 kg reports shortness of breath, wheezing, and chest discomfort. The patient is prescribed 5 mg/kg ipratropium every 12 hours. In a recall visit, the patient reports taking 300 mg/day ipratropium.
What instruction should be given to the patient for the effective management of asthma?
Continue the same dose of medication.
Change to alternative medication.
Double the dose of medication.
Halve the dose of medication.
The Correct Answer is D
This instruction should be given to the patient for the effective management of asthma because the patient is taking an overdose of ipratropium, which may cause serious side effects such as dry mouth, blurred vision, urinary retention, or increased heart rate. The recommended dosage of ipratropium for adults with acute asthma is 0.5 mg (500 mcg) every 20 minutes for three doses, followed by 0.5 mg every two to four hours as needed³. The patient's prescribed dose is 5 mg/kg, which means 300 mg/day for a 60 kg patient. This is 10 times the maximum daily dose of 2 mg (2000 mcg) for ipratropium⁴. Therefore, the patient should halve the dose of medication to 150 mg/day, which is still higher than the usual dosage, but within the range that can be given under medical supervision.
The other options are not appropriate instructions because:
a) Continuing the same dose of medication may worsen the patient's condition and increase the risk of adverse reactions.
b) Changing to alternative medication may not be necessary or effective, as ipratropium is a commonly used bronchodilator for asthma that works by relaxing the airway muscles and improving airflow⁵. The patient may benefit from adjusting the dose or adding other medications, such as corticosteroids or beta-agonists, depending on the severity and frequency of symptoms.
c) Doubling the dose of medication may be dangerous and potentially fatal, as it may cause severe anticholinergic effects, such as dry mouth, blurred vision, urinary retention, increased heart rate, confusion, or coma.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
To find the dose of ondansetron, you need to use the formula for weight-based dosage calculation:
Dose (mg) = Weight (kg) x Prescribed dose (mg/kg)
Since the client's weight is 70 kg and the prescribed dose is 0.34 mg/kg, plug in these values into the formula:
Dose (mg) = 70 kg x 0.34 mg/kg
Simplify and solve for the dose:
Dose (mg) = 23.8 mg
Therefore, the client should receive **23.8 mg** of ondansetron prior to chemotherapy.
Correct Answer is B
Explanation
The infusion will be completed at 3:15 p.m.
This answer is correct because it is based on a simple division and addition calculation. The nurse should follow these steps to determine when the infusion will be completed:
1) Convert the volume of the fluid from liters to milliliters by multiplying by 1000, since there are 1000 mL in 1 L. The volume of the fluid is 750 mL.
2) Divide the volume of the fluid by the infusion rate to get the duration of the infusion in hours, as follows:
750 mL / 120 mL/hr = 6.25 hr
Therefore, the infusion will take 6.25 hours to complete.
3) Add the duration of the infusion to the start time of the infusion to get the end time, as follows:
9:00 a.m. + 6:25 = 3:15 p.m.
Therefore, the infusion will be completed at 3:15 p.m.
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