A primary healthcare provider prescribes 2 mg/kg of pyrimethamine to a child with severe drooling. A nurse finds that the child weighs 44 lbs. Upon seeing the drug label, the nurse finds that 5 mL of medication contains 1 mg of the drug.
What should the nurse do to provide safe medication to the child?

Administer 1 cup of medication to the child

Administer 1 tsp of medication to the child

Administer 0.8 mg of medication to the child

Administer 2 mL of medication to the child

Answer and Explanation

The Correct Answer is D

This answer is correct because it is based on a series of unit conversions and calculations. The nurse should follow these steps to provide safe medication to the child:

1) Convert the child's weight from pounds to kilograms by dividing by 2.2, since there are 2.2 lbs in 1 kg. The child weighs 20 kg.

2) Multiply the prescribed dose per kilogram by the child's weight in kilograms to get the total dose in milligrams. The child needs 40 mg of pyrimethamine.

3) Use the ratio given on the drug label to convert the total dose in milligrams to the volume in milliliters. The nurse can set up a proportion as follows:

1 mg / 5 mL = 40 mg / x mL

Cross-multiplying and solving for x gives:

x = 200 mL

Therefore, the nurse should administer 200 mL of medication to deliver 40 mg of pyrimethamine to the child.

4) Convert the volume in milliliters to the volume in teaspoons by dividing by 5, since there are 5 mL in 1 tsp. The nurse should administer 40 tsp of medication to the child.

5) Convert the volume in teaspoons to the volume in cups by dividing by 48, since there are 48 tsp in 1 cup. The nurse should administer 0.83 cups of medication to the child.

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Correct Answer is C

Explanation

To find the milliliters per minute, you need to calculate the following:

- The volume of Lopressor in milliliters
- The infusion rate in milliliters per minute using the formula: Infusion rate (mL/min) = Total volume (mL) / Time (min)

First, divide the dose of Lopressor by the concentration to get the volume in milliliters:

5 mg / 1 mg/mL = 5 mL

Next, use the formula for infusion rate to find how many milliliters per minute the IV pump should deliver:

Infusion rate (mL/min) = Total volume (mL) / Time (min)

Since the total volume is 5 mL and the time is 60 seconds or 1 minute, plug in these values into the formula:

Infusion rate (mL/min) = 5 mL / 1 min

Simplify and solve for the infusion rate:

Infusion rate (mL/min) = 5 mL/min

Therefore, the nurse should administer **5 mL/min** to infuse Lopressor 5 mg over 60 seconds.

A. OS B. QD C. PO D. OD

Correct Answer is B

Explanation

QD is an abbreviation for "quaque die" which means "every day" in Latin. However, QD is on the official "Do Not Use" list of the Joint Commission because it can be mistaken for QOD, which means "every other day" in Latin¹². This can lead to medication errors and patient harm. Therefore, the Joint Commission recommends writing "daily" instead of QD.

The other options are not on the official "Do Not Use" list of the Joint Commission. OS, PO, and OD are abbreviations for "oculus sinister" (left eye), "per os" (by mouth), and "oculus dexter" (right eye) respectively. They are commonly used in ophthalmology and pharmacy³. However, they should be used with caution and only when appropriate, as they can also be confused with other abbreviations or symbols.

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Naxlex Comprehensive Predictor Exams

A patient is ordered 5 mg of IV Lopressor (metoprolol tartrate) to be administered over 60 seconds. The concentration is 1 mg/1 mL. How many milliliters per minute should the nurse administer to the patient?

Correct Answer is C

Explanation

Which abbreviation is on the official "Do Not Use" list of the Joint Commission?

Correct Answer is B

Explanation

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