A physician orders Garamycin (gentamicin) 4 mg/kg/dose IV piggyback every 12 hours for a newborn weighing 7 lb, 11.2 oz. After reconstitution, the dosage is 20 mg/10 mL.
How many milliliters should the nurse administer to the patient?
1.4 mL
14 mL
7 mL
0.7 mL
0.7 mL
The Correct Answer is C
To answer this question, the nurse needs to perform the following steps:
1) Convert the patient's weight from pounds and ounces to kilograms, using the conversion factor of 1 pound = 0.45359237 kilograms¹². To do this, first convert the ounces to a fraction of a pound by dividing by 16, then add this fraction to the pounds, and then multiply by the conversion factor. For example:
7 lb, 11.2 oz = 7 + (11.2 / 16) lb
= 7.7 lb
= 7.7 × 0.45359237 kg
= 3.492 kg
2) Calculate the dose of Garamycin in milligrams, using the prescribed dose of 4 mg/kg and the patient's weight in kilograms. To do this, simply multiply the dose per kilogram by the weight in kilograms. For example:
4 mg/kg × 3.492 kg = 13.968 mg
3) Calculate the volume of Garamycin in milliliters, using the reconstituted dosage of 20 mg/10 mL and the dose in milligrams. To do this, use a proportion to find the unknown volume that corresponds to the known dose. For example:
20 mg / 10 mL = 13.968 mg / x mL Cross-multiply and solve for x: 20x = 139.68
x = 6.984 mL
x =7 mL
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
To find the total amount of heparin, you need to calculate the following:
- The concentration of heparin in units per milliliter
- The volume of heparin infused from 9:00 am to 11:00 am and from 11:00 am to 2:00 pm
- The amount of heparin in units from each time period and the total amount
First, divide the amount of heparin by the volume of D5W to get the concentration in units per milliliter:
25,000 units / 250 mL = 100 units/mL
Next, multiply the infusion rate by the duration to get the volume infused in each time period:
From 9:00 am to 11:00 am (2 hours), the infusion rate is 12 mL/hr:
12 mL/hr x 2 hours = 24 mL
From 11:00 am to 2:00 pm (3 hours), the infusion rate is 10 mL/hr:
10 mL/hr x 3 hours = 30 mL
Then, multiply the volume infused by the concentration to get the amount of heparin in units in each time period:
From 9:00 am to 11:00 am, the volume infused is 24 mL:
24 mL x 100 units/mL = 2400 units
From 11:00 am to 2:00 pm, the volume infused is 30 mL:
30 mL x 100 units/mL = 3000 units
Finally, add the amounts of heparin from each time period to get the total amount:
2400 units + 3000 units = 5400 units
Therefore, the patient received **5400 units** of heparin from 9:00 am to 2:00 pm.
Correct Answer is D
Explanation
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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