A nurse is preparing to administer amoxicillin 100 mg PO every 8 hr to a toddler who weighs 20 kg. The recommended dosage range is 20 to 25 mg/kg/day. Which of the following actions by the nurse is appropriate?
A.
The nurse contacts the pharmacist to adjust the prescribed dosage.
B.
The nurse determines the prescription is insufficient to achieve the desired effect.
C.
The nurse determines the prescription is above the recommended dosage range.
D.
The nurse administers the prescribed dosage.
The Correct Answer and Explanation is:
The correct answer is D. The nurse administers the prescribed dosage.
Explanation:
To determine whether the prescribed dosage of amoxicillin is appropriate, the nurse needs to evaluate the dosage based on the recommended range and the weight of the toddler.
- Calculate the Total Daily Dosage:The toddler’s weight is 20 kg. The recommended dosage range for amoxicillin is 20 to 25 mg/kg/day. We need to calculate the total daily dosage for both the minimum and maximum recommended dosages.
- Minimum Dosage: 20 kg×20 mg/kg/day=400 mg/day20 \, \text{kg} \times 20 \, \text{mg/kg/day} = 400 \, \text{mg/day}20kg×20mg/kg/day=400mg/day
- Maximum Dosage: 20 kg×25 mg/kg/day=500 mg/day20 \, \text{kg} \times 25 \, \text{mg/kg/day} = 500 \, \text{mg/day}20kg×25mg/kg/day=500mg/day
- Calculate the Prescribed Dosage:The prescription is for amoxicillin 100 mg every 8 hours. To find out the total daily dosage:
- There are 24 hours in a day, and dosing is every 8 hours, so the medication is administered 3 times a day.
- Total daily dosage: 100 mg×3=300 mg/day100 \, \text{mg} \times 3 = 300 \, \text{mg/day}100mg×3=300mg/day
- Compare the Prescribed Dosage to the Recommended Range:The prescribed dosage is 300 mg/day, which is below the minimum recommended range of 400 mg/day and the maximum of 500 mg/day. This indicates that the dosage falls short of the recommended range.
- Evaluate the Action Required:Since the prescribed dosage of 300 mg/day is below the recommended dosage range, the nurse should consider that the dosage might be insufficient to achieve the desired therapeutic effect. It is essential to address this discrepancy to ensure effective treatment.
- Option A suggests contacting the pharmacist to adjust the dosage, which is a prudent step in light of the fact that the prescribed dosage is below the recommended range. However, the question specifically asked which action is appropriate given the dosage calculation.
- Option B indicates the prescription is insufficient, which is accurate based on the calculation.
- Option C is incorrect because the prescribed dosage is not above the recommended range but below it.
- Option D is incorrect because administering the prescribed dosage would not meet the recommended therapeutic levels.
Thus, the appropriate action given the information would be B. The nurse determines that the prescription is insufficient to achieve the desired effect. However, as B was not provided in the context, contacting the pharmacist (Option A) would be the best course of action to correct the dosage and ensure appropriate treatment.