A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs
44 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest
whole number. Use a leading zero if it applies. Do not use a trailing zero.)
300 mg/dose
Follow these steps for the Dimensional Analysis method of calculation:
Step 1: What is the unit of measurement the nurse should calculate? (Place the unit of measure
being calculated on the left side of the equation.)
Step 2: Determine the ratio that contains the same unit as the unit being calculated. (Place the
ratio on the right side of the equation, ensuring that the unit in the numerator matches the unit
being calculated.)
15 mgX mg/dose = 1 kg
Step 3: Place any remaining ratios that are relevant to the item on the right side of the equation,
along with any needed conversion factors, to cancel out unwanted units of measurement.
Step 6: Determine whether the amount to administer makes sense. If the prescription reads 15
mg/kg every 12 hr and the child weighs 20 kg, it makes sense to give 300 mg/dose every 12 hr.
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,A nurse is developing a teaching plan for a client who has a new prescription for simvastatin.
Which of the following instructions should the nurse include in the teaching plan? (Select all that
apply.)
a. Report muscle pain to the provider.
b. Avoid taking the medication with grapefruit juice.
c. Take the medication in the early morning.
d. Expect a flushing of the skin as a reaction to the medication.
e. Expect therapy with this medication to be lifelong.
a. b. e.
Report muscle pain to the provider is correct. Myopathy is an adverse effect of simvastatin that
can lead to rhabdomyolysis. The nurse should instruct the client to report this to the provider.
Avoid taking the medication with grapefruit juice is correct. When taken with grapefruit juice,
simvastatin increases the risk of muscle injury from elevations in creatine kinase.
Expect therapy with this medication to be lifelong is correct. If medication therapy is
discontinued, cholesterol levels will return to their pretreatment range within several weeks to
months.
Take the medication in the early morning is incorrect. This medication is most effective when
taken in the evening because cholesterol production generally increases overnight.
Expect a flushing of the skin as a reaction to the medication is incorrect. The nurse should
identify flushing of the skin as an adverse effect of the medication niacin, which can be used to
decrease the client's triglyceride levels.
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A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease.
Which of the following findings should the nurse identify as an indication that the medication has
been effective?
a. Decrease in WBC count
b. Decrease in amount of time sleeping
c. Increase in appetite
d. Increase in ability to focus
Increase in ability to focus: client who has Graves' disease can experience psychological
manifestations such as difficulty focusing, restlessness, and manic-type behaviors.
Propylthiouracil is a thyroid hormone antagonist that decreases the circulating T4 hormone,
reducing the manifestations of hyperthyroidism. An increased ability to focus indicates that the
medication has been effective.
Propylthiouracil is a thyroid hormone antagonist used in the treatment of hyperthyroidism, or
thyroid storms. A decreased WBC count is an adverse effect of propylthiouracil, which can
cause myelosuppression. Therefore, a decrease in WBC count indicates the medication has not
been effective.
Graves' disease, a form of hyperthyroidism, has neurologic manifestations, including insomnia.
Therefore, a decrease in the amount of time sleeping indicates the medication has not been
effective.
Graves' disease can result in gastrointestinal manifestations such as increased appetite, weight
loss, and increased gastrointestinal motility. Therefore, an increase in appetite indicates the
medication has not been effective.
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A nurse is preparing to administer heparin subcutaneously to a client. Which of the following
actions should the nurse plan to take?
a. Administer the medication outside the 5-cm (2-in) radius of the umbilicus.
b. Aspirate for blood return before injecting.
c. Rub vigorously after the injection to promote absorption.
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