The follow questions refer to the patient described below:
A 9 yr. old child with both hydrocephalus and a cardiac defect weighs 55 pounds. He requires digoxin by mouth once daily, the dose should be held if there are any symptoms of toxicity.
Pediatric maintenance dose is 5 mcg/kg daily given as a single dose. After listening to the apical rate for one full minute, you note it is only 50. Should you administer the digoxin as ordered?
NO
Just administer it without checking
instruct mom to give it
Yes
The Correct Answer is A
Digoxin is a medication commonly used to treat certain heart conditions, including some congenital heart defects. It's important to monitor the heart rate and other signs of toxicity when administering digoxin, especially in pediatric patients. Let's break down the information given:
The pediatric maintenance dose of digoxin is 5 mcg/kg daily.
The child weighs 55 pounds (approximately 25 kg).
Given these values, the total daily dose for this child would be:
Total daily dose = 5 mcg/kg × 25 kg = 125 mcg
This total daily dose is usually given as a single dose. However, the child's heart rate is noted to be only 50 beats per minute (bpm). A heart rate of 50 bpm in a child could potentially indicate bradycardia (slow heart rate), which can be a sign of digoxin toxicity. Bradycardia is a known adverse effect of digoxin, and it's important to assess for other signs of toxicity as well, such as nausea, vomiting, and changes in color vision.
In this case, it would be prudent to withhold the digoxin and assess the child further for signs of toxicity or bradycardia. The dose should not be administered until the healthcare provider is consulted and appropriate action is determined.
So, the correct answer is indeed NO. Administering the digoxin without considering the slow heart rate and the potential for toxicity could be unsafe for the child.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
A. The fact that the patient is male
Incorrect Explanation: The patient's gender does not directly provide important information about the history of reflux.
Explanation: Vesicoureteral reflux (VUR), which is the retrograde flow of urine from the bladder into the ureters, can affect individuals of any gender. While gender might have some implications for certain conditions, it is not a critical factor in understanding the history of reflux.
B. The fact that the patient is female.
Incorrect Explanation: The patient's gender does not directly provide important information about the history of reflux.
Explanation: Just like with the previous option, the patient's gender does not play a significant role in the history of vesicoureteral reflux. The condition can affect both males and females.
C. Developmental milestones
Correct Explanation: Developmental milestones are important in understanding the history of reflux.
Explanation: Developmental milestones are significant because VUR is more common in infants and young children. Infants and young children have a higher likelihood of developing reflux due to the immaturity of their urinary tract systems. Knowing about the patient's developmental milestones can help assess the risk and potential severity of reflux.
D. The number of urinary tract infections the patient has had
Correct Explanation: The number of urinary tract infections (UTIs) is important in understanding the history of reflux.
Explanation: Repeated urinary tract infections can be a sign of vesicoureteral reflux. The backflow of urine from the bladder into the ureters can contribute to UTIs. Monitoring the frequency of UTIs can provide insights into the presence and severity of reflux.
Correct Answer is A
Explanation
A. You do not need to lose consciousness to suffer a concussion.
This statement is true. Concussion is a type of traumatic brain injury (TBI) that can occur without loss of consciousness. Many concussions happen without the person losing consciousness at all.
B. You will suffer permanent brain damage.
This statement is not necessarily true. While some concussions can lead to lasting effects, not all cases result in permanent brain damage. The severity and long-term effects of a concussion can vary widely.
C. We encourage fluids after a concussion.
This statement is true. Adequate hydration is important after a concussion. Staying hydrated can help support the brain's recovery process.
D. Bleeding always occurs with a concussion.
This statement is not true. Concussion is defined by the disruption of normal brain function due to a blow or jolt to the head or body, and bleeding is not always a necessary component of a concussion. However, more severe head injuries could involve bleeding and would not be classified as just a concussion.
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