After assessing a client, a primary healthcare provider prescribes diphenhydramine 25 mg IV STAT for anaphylaxis. The pharmacy supplies a vial with a concentration of 50 mg/mL.
How much and when should a nurse administer this medication?
Administer 0.5 mL of medication immediately to the client
Administer 25 mg of medication once a day to the client for two weeks
Administer 25 mg of medication every eight hours
Administer 0.5 mL of medication if the client has symptoms of allergy
Administer 0.5 mL of medication if the client has symptoms of allergy
The Correct Answer is A
To find how much medication to administer, you need to calculate the following:
- The volume of diphenhydramine in milliliters
- The infusion time in minutes
First, divide the dose of diphenhydramine by the concentration to get the volume in milliliters:
25 mg / 50 mg/mL = 0.5 mL diphenhydramine should be diluted in 10 to 20 mL of normal saline and infused over at least 2 minutes.
Therefore, the nurse should administer **0.5 mL** of diphenhydramine diluted in 10 to 20 mL of normal saline over **at least 2 minutes**.
The nurse should administer this medication **as soon as possible** after receiving the order and the medication from the pharmacy, as STAT means immediately or urgently. The nurse should also monitor the client for signs of improvement or adverse reactions.
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Related Questions
Correct Answer is C
Explanation
To find the hours to finish the infusion, you need to calculate the following:
- The volume of saline solution in milliliters
- The time in hours using the formula: Time (h) = Total volume (mL) / Infusion rate (mL/h)
First, convert the volume of saline solution from liters to milliliters by multiplying by 1000:
1.5 L x 1000 = 1500 mL
Next, use the formula for time to find how many hours it will take to infuse the saline solution at the current rate:
Time (h) = Total volume (mL) / Infusion rate (mL/h)
Since the total volume is 1500 mL and the infusion rate is 75 mL/h, plug in these values into the formula:
Time (h) = 1500 mL / 75 mL/h
Simplify and solve for the time:
Time (h) = 20 h
Therefore, it will take **20 hours** to finish the infusion at the current rate.
Correct Answer is D
Explanation
This numeric form is appropriate, according to the Joint Commission, because it does not use a trailing zero after a decimal point, which is a common cause of medication errors and should be avoided. A trailing zero may be misread or misinterpreted as a larger dose or omited altogether, resulting in a 10-fold overdose or underdose, respectively. For example, when prescriptions have been writen for "Coumadin 1.0 mg," patients have received 10 mg in error¹². Therefore, the Joint Commission requires that a trailing zero may be used only when required to demonstrate the level of precision of the value being reported, such as for laboratory results, imaging studies that report the size of lesions, or catheter/tube sizes. It may not be used in medication orders or other medication-related documentation.
The other options are not appropriate numeric forms because:
a) 3.0 uses a trailing zero after a decimal point, which poses a risk of confusion or error.
b) 0.30 uses a trailing zero after a decimal point, which poses a risk of confusion or error.
c) 0.03 is not equivalent to 0.3, as it is 10 times smaller.
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