Lifespan Considerations in Dosage Calculations

Chapter 18

1. A nurse is preparing to infuse IV fluids for an infant. If the infant’s total daily fluid need is 1,480 mL, and the infant is to receive 30% of those fluids from the IV, at what mL/hr flow rate will the nurse set the pump? Round to the nearest tenth milliliter.
2. 44.4 mL/hr
3. 440 mL/hr
4. 18.5 mL/hr
5. 185 mL/hr
6. A nurse is teaching an 85-year-old patient about medications. Which of these statements indicates that the patient needs additional teaching?
7. “I will need to have laboratory tests done occasionally to see if my kidney function is impaired, as this may affect how my body gets rid of medications.”
8. “Some of my medications may interact with each other, so I need to make sure my doctor knows about all medications that I take.”
9. “I will have my son help me with organizing my medications, because I tend to be forgetful.”
10. “I will stop taking my blood pressure medications while I take these antibiotics because it is too hard to keep track of both pills.”
11. A provider orders loracarbef (Lorabid) 30 mg/kg/day oral suspension every 12 hours for a child who weighs 14 kg. Calculate the amount (mg) of loracarbef (Lorabid) to be administered per dose. Round to the nearest milligram.
12. 105 mg
13. 210 mg
14. 420 mg
15. 840 mg
16. A provider orders cyclosporine (Sandimmune) 15 mg/kg/day, IV, divided into two doses (one every 12 hours) for a child who weighs 32 kg. Calculate the amount (mg) of cyclosporine (Sandimmune) to be administered per dose. Round to the nearest milligram.
17. 120 mg
18. 240 mg
19. 480 mg
20. 960 mg
21. A provider orders daunorubicin (Cerubidine) 25 mg/m², IV, daily. The child weighs 21 kg and is 98 cm in height. Calculate the amount (mg) of daunorubicin (Cerubidine) to be administered per dose. Round the dosage to the nearest milligram.
22. 14 mg
23. 17 mg
24. 19 mg
25. 20 mg
26. A provider orders cytarabine (Cytosar) 100 mg/m², IV, divided into two daily doses. The child weighs 18 kg and is 95 cm in height. Calculate the amount (mg) of cytarabine (Cytosar) to be administered per dose. Round the dosage to the nearest tenth milligram.
27. 34.5 mg
28. 37.5 mg
29. 69 mg
30. 75 mg
31. A nurse is calculating the daily maintenance fluid needs for an adequately hydrated child who weighs 4 kg. How many mL of IV fluid will the child need in 24 hours? Round to the nearest whole milliliter.
32. 100 mL
33. 200 mL
34. 300 mL
35. 400 mL
36. A nurse is calculating the daily maintenance fluid needs for an adequately hydrated child who weighs 30 kg. If the child is to receive 25% of the fluids by the IV route, at what mL/hr flow rate should the nurse set the pump? Round to the nearest tenth milliliter.
37. 10.4 mL/hr
38. 17.7 mL/hr
39. 50.6 mL/hr
40. 70.8 mL/hr
41. A nurse is calculating the daily maintenance fluid needs for an adequately hydrated child who weighs 12 kg. If the child is to receive 50% of the fluids by the IV route, at what mL/hr flow rate should the nurse set the pump? Round to the nearest tenth milliliter.
42. 11.5 mL/hr
43. 18.6 mL/hr
44. 22.9 mL/hr
45. 45.8 mL/hr
46. A patient asks the nurse how safe it is to take medications while breastfeeding. Which statement by the nurse is correct?
47. “Breastfeed immediately before or after the dose is taken.”
48. “Avoid all medications while breastfeeding, even prescribed drugs.”
49. “It does not matter when you take your medications. Drugs cannot pass into breastmilk.”
50. “All medications are completely safe while breastfeeding.”
51. As people age, kidney function decreases. What effect does this change have on medication metabolism, absorption, or excretion?
52. Increased metabolism of medications
53. Increased excretion of medications
54. Decreased absorption of medications
55. Decreased excretion of medications
56. Which statement is correct when considering alterations in organ function related to young age?
57. Children have thicker skin so the absorption of topically applied medications is decreased.
58. The musculature of very young children is underdeveloped, so the absorption of medications given by the intramuscular route is altered.
59. Children have decreased body water content so that serum drug levels are most likely concentrated, especially those that are water soluble.
60. Gastric emptying time is quicker due to the small gastrointestinal system. Absorption of medications is considerably shorter than in adults.
61. When administering medications to infants and children, which drug dosage calculations require double-checking by another nurse or pharmacist before administration?
62. Calcium channel blocking medications given intravenously
63. Antibiotics given in an oral syringe
64. All medications given to infants and children
65. Liquid medications containing alcohol given in a unit dose cup
66. When calculating dosages for infants and children, why are calculations using body surface area (BSA) thought to be more accurate than those that use body weight alone?
67. BSA is calculated using the square root of a number, which is more complex and therefore more accurate.
68. BSA is proportional to an individual’s metabolic rate and correlates well with organ size.
69. BSA requires rounding the answer to one decimal place, or the tenths place, so that the child does not receive too much medication.
70. BSA is based on centimeters and kilograms, which are metric measurements and are more accurate.
71. A nurse is preparing an IV infusion for a child. Which action(s) by the nurse should prevent an accidental fluid bolus? Select all that apply.
72. Ensuring that an electronic pediatric infusion pump is used to infuse the fluids
73. Using a volume control set to limit fluid volume infused
74. Infusing fluids under manual control
75. Using 60 gtt/mL tubing for IV infusion
76. Using 20 gtt/mL tubing for IV infusion
77. Why are elderly patients at increased risk for adverse medication reactions? Select all that apply.
78. The elderly tend to be on many medications at the same time.
79. The elderly tend to have declining organ function.
80. The elderly tend to have a high rate of comorbid diseases.
81. The elderly tend to frequently use commercially prepared medication organizing tools.
82. The elderly tend to have a high body mass index requiring larger doses of some medications.