NCLEX - PHARMACOLOGY Day1

The nurse is caring for a client who has a prescription for cefdinir 80 mg/kg/day PO in 2 divided doses every 12 hours. The client weighs 16.5 lb (7.5 kg). The nurse has cefdinir 125 mg/5 ml available. How many mL should the nurse administer to the client with each dose? Record your answer using a whole number.

Answer explanation

Using dimensional analysis, perform the following steps to calculate the administration volume of cefdinir (CFDN) in mL per dose:\n1. Identify the prescribed dose, available medication, and required medication information\nPrescribed: 80 mg CFDN/kg/day\nAvailable: 125 mg CFDN/5 mL\nRequired: mL CFDN/dose\n2. Convert the prescription to the administration volume of CFDN in mL per dose:\nPrescription x available medication = mL/dose\n(80 mg CFDN × 7.5 kg/day ÷ 2 doses) × (5 mL / 125 mg CFDN) = 12 mL per dose

The nurse is admitting a client with partial-thickness burn injuries. Burned body areas include the anterior surface of the torso and anterior surfaces of both arms. The client weighs 110 kg. Following the Parkland formula, what volume of fluid should be administered to the client during the first 8 hours?

Answer explanation

The Parkland formula is a protocol used to calculate IV fluid resuscitation required during the first 24 hours after a burn injury (excluding superficial burn injuries). The calculation is based on the client's weight and the estimated percentage of total body surface area (TBSA) that has been burned. Half of the total required fluid volume is administered during the first 8 hours after the burn injury. Perform the following steps to calculate the fluid volume required during the first 8 hours: 1. Calculate an estimate of the TBSA burned using the rule of nines Addition of burned body surface areas = TBSA OR Anterior torso + anterior right arm + anterior left arm = TBSA OR 18% + 4.5% + 4.5% = 27% 2. Calculate the total volume required for infusion during the first 24 hours 4 mL x weight (kg) x TBSA (%) = total infusion volume OR 4 mL x 110 x 27 = 11880 mL 3. Calculate the volume required for infusion during the first 8 hours Half of the total infusion volume = 8 hour infusion volume OR Total infusion volume / 2 = 8 hour infusion volume OR 11880 mL / 2 =5940 mL

The nurse is caring for a client with partial-thickness (second-degree) burns to the anterior surface of the right leg and the entire anterior and posterior torso. The client weighs 198 lb (90 kg). Using the Parkland formula and the rule of nines, how many mL of IV fluid resuscitation should the nurse administer to the client during the first 24 hours?

Answer explanation

Burn injuries are caused by direct tissue damage from exposure to caustic sources (eg, thermal, chemical, electrical). This initial tissue injury, combined with the systemic inflammatory response, causes increased capillary permeability, fluid and electrolyte shifts, and decreased intravascular volume. These intravascular losses often lead to hypovolemic shock in clients with extensive burns and require emergency fluid resuscitation for client survival. The Parkland formula is an IV fluid resuscitation protocol used to calculate the fluid replacement needed in the first 24 hours after a burn injury. Half of the calculated fluid volume should be administered during the first 8 hours after the injury, when the greatest amount of intravascular volume loss usually occurs. Perform the following steps to calculate the volume needed for infusion: 1. Calculate the percent of total body surface area (% TBSA) burned (anterior torso %) + (posterior torso %) + (anterior leg %) = % TBSA burned OR 18% + 18% + 9% = 45% TBSA burned 2. Calculate the volume needed for infusion 4 mL x body weight (kg) x % TBSA = infusion volume (mL) OR 4 mL x 90 x 45 =16,200 mL

The nurse is caring for a client who has a prescription for a continuous infusion of regular insulin at 0.2 units/kg/hr IV. The client weighs 51 lb (23.2 kg). How many units/hr should the nurse administer to the client? Record your answer using 1 decimal place.

Answer explanation

Using dimensional analysis, perform the following steps to calculate the infusion rate of regular insulin in units/hr: 1. Identify the prescribed and required medication information Prescribed: 0.2 units regular insulin Required: units kg|hr hr 2. Convert the prescription to the infusion rate needed for administration Prescription x client weight = units hr OR units regular insulin (kg) units regular insulin kg|hr hr OR 0.2 units regular insulin 23.2 kg 4.64 units regular insulin kg |hr - II hr 3. Round to 1 decimal place 4.64 units regular insulin 4.6 units regular insulin hr hr

The nurse is caring for a client who has a prescription for 8 g of albumin IV per 1000 mL of fluid removed during paracentesis. The client had 5400 mL of fluid removed and the nurse has albumin 25 g/100 mL available. How many mL should the nurse administer to the client? Record your answer using 1 decimal place.

Answer explanation

Albumin may be given after paracentesis to prevent volume depletion in clients with cirrhotic ascites. Using dimensional analysis, perform the following steps to calculate the volume of albumin in mL per dose: 1. Identify the prescribed, available, and required medication information Prescribed : 8 g albumin Available : Required : dose 2. Convert prescription to the volume needed for administration mL Prescription x available data = dose OR g albumin mL peritoneal fluid g albumin - mL mL albumin 1000 mL peritoneal fluid |dose - dose OR 8-g albumin 5400 -mb peritoneal fluid 100 mL 25 -g albumin - 172.8 mL albumin 1000 mL peritoneal fluid |dose dose 25 g albumin mL 1000 mL removed peritoneal fluid |dose 100 mL

The nurse is caring for a client who has a prescription for nalbuphine 10 mg/70 kg subcutaneously once. The client weighs 187 lb (85 kg). The nurse has nalbuphine 10 mg/1 mL available. How many mL should the nurse administer to the client? Record your answer using 1 decimal place.

Answer explanation

Alternate Method Using dimensional analysis, perform the following steps to calculate the administration volume of nalbuphine in mL per dose: 1. Identify the prescribed, available, and required medication information Prescribed: 10 mg nalbuphine Available: 10 mg nalbuphine mL 70 kg|dose mL Required: dose 2. Convert the prescription to the administration volume of nalbuphine in mL per dose mL Prescription x available medication = dose OR Ing nalbuphine kg ) mL mL nalbuphine kg|dose 10 mg nalbuphine dose OR 10 mg nalbuphine 85 kg mL 1.2142 ... mL nalbuphine 70-kg dose 10-Ig nalbuphine dose 3. Round to 1 decimal place 1.2142 ... mL nalbuphine 1.2 mL dose dose