A provider prescribes quetiapine 50 mg PO divided equally every 12 hr for 3 days. Available is quetiapine 25 mg tablets.
How many tablets should the nurse administer per dose on day 3? (Round the answer to the nearest whole number. Use a leading zero if it applies.
Do not use a trailing zero.)

The correct answer/s is Choice/s A, E, and G.

Choice A rationale: Administering 0.9% sodium chloride IV is a common practice in emergency departments to ensure the patient is well-hydrated. This is particularly important for patients experiencing acute mania, as they may have neglected their physical health, including hydration, during their manic episode.

Choice B rationale: Flumazenil is an antagonist for benzodiazepines and is typically used to reverse the sedative effects of benzodiazepines. It is not typically used in the treatment of bipolar disorder or acute mania.

Choice C rationale: Preparing the client for intubation is usually reserved for situations where the patient is unable to maintain their own airway or adequate ventilation. This is not typically necessary in cases of acute mania unless there are other complicating factors.

Choice D rationale: Beginning chest compressions is a response to cardiac arrest. There is no indication in the that the patient is experiencing cardiac arrest, so this would not be a typical anticipation for a patient experiencing acute mania.

Choice E rationale: Administering IV naloxone is done in cases of suspected opioid overdose. While it’s not directly related to treating acute mania, it’s possible that the patient could have comorbid substance use issues, given the high rate of comorbidity between bipolar disorder and substance use disorders.

Choice F rationale: Administering activated charcoal is done in cases of certain types of poisoning or drug overdose. It is not typically used in the treatment of bipolar disorder or acute mania.

Choice G rationale: Preparing the client for electroconvulsive therapy (ECT) could be an appropriate anticipation for a patient experiencing acute mania. ECT is considered a highly effective treatment for severe mania, particularly when other treatments have failed or when rapid stabilization is required.

The nurse should administer 2 tablets per dose.

Rationale:

Step 1: Determine the desired dose of diphenhydramine. The desired dose is 50 mg.

Step 2: Determine the available tablet strength. The available tablet strength is 25 mg.

Step 3: Divide the desired dose by the tablet strength to determine the number of tablets needed. 50 mg / 25 mg/tablet = 2 tablets

Therefore, the nurse should administer 2 tablets of diphenhydramine 25 mg per dose to achieve the desired dose of 50 mg.