Which numeric form is appropriate, according to the Joint Commission?
3.0
0.30
0.03
0.3
Calculate all drug dosages by body surface area.
The Correct Answer is D
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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Related Questions
Correct Answer is B
Explanation
Subcutaneous injection is the usual route for giving insulin because it allows the medication to be absorbed slowly and steadily into the bloodstream. Subcutaneous injection involves inserting a needle into the faty layer of tissue under the skin, usually in the abdomen, upper arm, thigh, or butock.
Intramuscular injection is not the usual route for giving insulin because it may cause rapid and unpredictable absorption of the medication, which can lead to hypoglycemia or hyperglycemia. Intramuscular injection involves inserting a needle into the muscle tissue, usually in the deltoid, vastus lateralis, or ventrogluteal area.
Intraosseous injection is not the usual route for giving insulin because it is reserved for emergency situations when intravenous access is not available. Intraosseous injection involves inserting a needle into the bone marrow, usually in the tibia or humerus.
Intradermal injection is not the usual route for giving insulin because it is mainly used for diagnostic tests, such as tuberculin skin test or allergy test. Intradermal injection involves inserting a needle into the dermis, which is the layer of skin just below the epidermis, usually in the forearm or upper back.
Correct Answer is D
Explanation
To answer this question, we need to understand the principles of pediatric dosage calculations and the factors that affect them. Pediatric dosages are usually calculated based on the child's weight or body surface area, and sometimes adjusted for age, organ function, or disease severity¹. However, not all medications that are used in adults are safe or effective in children. Some medications may have different pharmacokinetics, pharmacodynamics, adverse effects, or interactions in children than in adults².
Therefore, it is important to check the drug insert or label for any contraindications, warnings, or precautions for pediatric use before prescribing or administering a medication to a child. If the drug insert states that the medication is not for pediatric use, it means that the medication has not been tested or approved for use in children, or that it has been shown to be harmful or ineffective in children. In this case, a pediatric dose calculated from an adult dose should be avoided, as it may result in serious toxicity or therapeutic failure. The healthcare provider should consult a pediatric specialist, a pharmacist, or a reliable drug reference for alternative medications or dosing recommendations.
The other options are not correct because they do not necessarily warrant avoiding a pediatric dose calculated from an adult dose.
Option a. If the drug insert does not specify a pediatric dose, it means that there is insufficient data or evidence to support a specific pediatric dose, but it does not mean that the medication is contraindicated or unsafe in children. The healthcare provider should use clinical judgment and available resources to determine the appropriate dose for the child³.
Option b. If the child has an elevated temperature that has not responded to treatment, it means that the child may have an infection or inflammation that may affect the absorption, distribution, metabolism, or excretion of some medications. The healthcare provider should monitor the child's condition and adjust the dose accordingly, but it does not mean that the medication should be avoided altogether⁴.
Option c. If the child has gained or lost weight in the past month, it means that the child's weight may have changed significantly since the last dose calculation. The healthcare provider should weigh the child and recalculate the dose based on the current weight, but it does not mean that the medication should be avoided altogether.
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