Dosage Calc I
Medication order is for:
Ampicillin 500mg orally every 12 hours
Available:
250mg/5ml
The nurse will administer how many teaspoons?
Answer:
2 teaspoons
What amount of acetaminophen should adults and children over 12 years of age not exceed in a 24-hour period?
4 grams
A patient is taking methylphenidate for attention-deficit hyperactivity disorders. What is an important consideration the nurse should include in the teaching plan?
Answers can include:
The medication can cause high blood pressure
Instruct the client to avoid caffeine
Take medication early in the day (no later than 4pm) to avoid sleep impairment
Report increased weight loss
What are signs of acetaminophen toxicity and compare them to signs of aspirin toxicity
Tylenol toxicity is related to the liver-watch for abdominal discomfort and liver impairment.
Aspirin toxicity is called salicylism. Early signs are decreased hearing, tinnitus as well as headache and dizziness
Although not a toxicity-Aspirin is also implicated in GI bleeding. Watch for black or dark tarry stools
A 28-year-old female is taking valproic acid for a seizure disorder she has had since childhood. She is discussing with the nurse that she would like to conceive a pregnancy. What information should the nurse discuss with this patient?
The patient should avoid pregnancy when taking valproic acid because it increases the risk of neural tube defects. Consult with provider about changing this medication before attempting to conceive a pregnancy
The nurse has the following order
Administer potassium chloride 40 mEq three times daily
Available
Potassium Chloride 20 mEq per 15 mL
How many mL will the nurse administer?
Answer
30 ml
What is the rationale for stopping all NSAIDS prior to any surgical procedure?
Decrease the risk of bleeding
A nurse in the clinic is providing education on a patient who is being prescribed Carbamazepine for a newly diagnosed seizure disorder. What should be included in the teaching plan?
Answers include
1. Report fever, sore throat, and easy bruising ( due to bone marrow suppression)
2. Avoid grapefruit juice, as it interacts with the medication and increases the medication plasma levels.
A patient with chronic knee pain notes that they have been taking the maximum amount of ibuprofen daily due to knee pain. Based upon her knowledge of how ibuprofen impacts kidney function, the nurse provides the client with the following instructions to watch for any adverse effects?
Watch for fluid retention and weight gain
A nurse is working with a patient in the recovery room of an outpatient surgery center. The patient has received fentanyl as part of their anesthesia treatment. The nurse notes the patient is lethargic and somnolent, documents that the respiratory rate is 9 breathes per minute, blood pressure is 89/58 and the heart rate is 122 bpm. What is the nurses priority action?
1. Prepare to administer naloxone.
The nurse has a new order to administer 1000ml of D5LR with 30 mEq of potassium to infuse over 6 hours
The nurse will administer how many ml/hr (round to the nearest whole number)
Answer
166.666
Rounds to 167 ml/hr
A nurse is providing care in the pediatric clinic and caring for a 12-year-old with a viral illness. What is the rationale for using acetaminophen instead of aspirin in this age group?
Aspirin is avoided to prevent Reye's Syndrome which can occur in children under the age of 18
A patient recently began donepezil for Alzheimer's Disease. What are important things to include in this patient's teaching plan?
Answers include:
Monitor heart rate and call provider is below 60 beats per min and syncopal episodes
Monitor weight and notify if weight loss occurs
A nurse is working in the ED caring for a client who took an acetaminophen overdose as part of a suicide attempt. What expected order does the nurse anticipate caring for this client?
Acetylcysteine is the antidote to acetaminophen toxicity/overdose
A nurse is working in an endoscopy clinic and has administered a dose of midazolam to a patient and is asked to give a second dose 10 seconds after the first dose is administered. What is the most appropriate action by the nurse?
Wait 2 minutes after giving the initial dose before giving the second dose
Administer Gentamycin 90mg IVPB every 12 hours over 45 minutes.
Available:
Gentamycin 90mg in 150ml. The nurse notes the IV tubing gtt factor is 60 gtt/min
The nurse will administer how many gtt/min
Answer
200 gtt/min
What are important considerations in the plan of care for a patient who has been prescribed pramipexole for Parkinson's Disease.
Can cause orthostatic hypotension, ensure safe ambulation and check orthostatic blood pressures (lying, sitting then standing)
Avoid driving or performing activities that need alertness if drowsiness occurs
Avoid alcohol which will increase the risk for drowsiness
A nurse is teaching a client regarding a new prescription for levodopa/carbidopa. What are specific items the nurse should include in the teaching plan?
Answers include:
Nonharmful darkening of the urine and sweat may occur
It may take up to 6 months for a full response
Avoid high protein foods which can decrease absorption
Can cause orthostatic hypotension, ensure safe ambulation strategies
What are important discharge teaching topics to cover for a client who has a new prescription for Tramadol?
Answers include:
Report urinary retention to your provider
Avoid driving while taking medication
Increase fiber if constipation occurs
Take medication only when needed
A patient is in the endoscopy center is receiving patient education and it is planned that they will receive midazolam for the procedure. What is an important instruction to give the patient?
Amnesia is likely to occur, and they will likely not remember the procedure
A nurse has the following order
Administer Reglan 15mg in 100ml Normal Saline over 15 minutes
How many mls per hour will the nurse set the infusion pump to? (Round to a whole number)
Answer
400ml/hr
What are some safety alerts and considerations for a client who is taking phenytoin for a seizure disorder?
Medication should not be abruptly stopped as this can lead to a recurrence of seizures
Monitor for signs of rash and mouth sores as this can be a sign of epidermal necrosis or Steven's Johnson syndrome. If this is noted, the medication should be stopped immediately
Give slowly if given IV to prevent cardiac collapse
Can cause drowsiness-notify provider if CNS side effect such as difficulty staying awake occurs
A patient is being prescribed memantine for dementia. What are items that the nurse should include in the plan of care and as patient education?
Instruct and teach caregivers to report increased confusion, dizziness and headache as the client might not recognize they are experiencing these side effects
Medication is contraindicated in renal failure and dose maybe decreased in renal disorders -Lab work to check is creatinine!
A patient has been prescribed allopurinol for newly diagnosed gout of the right big toe. Based on the nurses knowledge of excretion of the drug, what lab value will the nurse assess and monitor?
1. Creatinine
Pt should be instructed to ingest at least 3 L of fluid daily to dilute the urine and prevent nephropathy
During a follow up assessment in the neurological clinic, a patient who is taking phenytoin for a seizure disorder shows the nurse a red rash and mouth sores. The nurse notifies the provider and expects what order?
To stop the phenytoin (suspect Steven's Johnson Syndrome)