Chapter 2

c. The amount of the drug would halve every 4 hours. In 4 hours, 400 mg of the drug would be available. In 8 hours, 200 mg would be available, and in 12 hours, 100 mg of the drug would be available

d. The serum creatinine level is an indicator of kidney function.

a. An intramuscular injection in the deltoid muscle is administered approximately 1.5 inches below the acromion process in the upside-down triangle formed by the acromion process and the axilla.

c. The old patch should be removed before applying a new one to avoid a drug overdose.

a. The nurse should insert the needle at a 90-degree angle when administering enoxaparin.

b. Drugs are excreted through the kidneys, so drug toxicity can develop in the client with renal insufficiency as drug levels rise because they are not properly eliminated from the body.

d. A narrow therapeutic index indicates that it has a narrow safety margin, thus requiring frequent monitoring for drug toxicity.

c. Because a portion of an oral dose of a medication is inactivated by the first-pass effect in the liver, a drug that has been administered IV may now require a larger oral dose to achieve a therapeutic effect.

d. The best course of action is to request the pharmacy to send up a liquid form of the medicine because that does not change the route. A caplet that is not scored should not be split by the nurse.

b. IV is the fastest route because the medication is 100% bioavailable and has immediate onset.

d. The nurse determines that 0.5 mg is equal to 500 mcg and sets up the following equation: $D÷H\times <!--\; \times \; -->Q=A$. $D$ represents the desired dose (the dose ordered), $H$ the amount on hand or available, $Q$ the quantity or volume of the drug form (tablet, capsule, liquid), and $A$ the amount calculated to be administered to the client. Therefore, $500\text{mcg}÷125\text{mcg}\times <!--\; \times \; -->1\text{tablet}=4\text{tablets}$.

b. The nurse sets up the following equation: $D÷H\times <!--\; \times \; -->Q=A$. $D$ represents the desired dose (the dose ordered), $H$ the amount on hand or available, $Q$ the quantity or volume of the drug form (tablet, capsule, liquid), and $A$ the amount calculated to be administered to the client. Therefore, $150\text{mg}÷100\text{mg}\times <!--\; \times \; -->1\text{mL}=1.5\text{mL}$.

a. The nurse sets up the following equation: $D÷H\times <!--\; \times \; -->Q=A$. $D$ represents the desired dose (the dose ordered), $H$ the amount on hand or available, $Q$ the quantity or volume of the drug form (tablet, capsule, liquid), and $A$ the amount calculated to be administered to the client. Therefore, $4000\text{units}÷5000\text{units}\times <!--\; \times \; -->1\text{mL}=0.8\text{mL}$.

a. When converting metric and household units, 4.93 mL (which rounds to 5 mL) is equal to 1 teaspoon;
2 teaspoons are equivalent to 10 mL.

c. First, convert the client’s weight from pounds to kilograms ($2.2\text{lb}=1\text{kg}$ therefore, the client weighs $80\mathrm{k}\mathrm{g}$). Next, calculate the amount of drug the client should receive: $1.5\text{mg/kg}\times <!--\; \times \; -->80\text{kg}=120\text{mg}$.

b. The nurse sets up the following equation: $D÷H\times <!--\; \times \; -->Q=A$. $D$ represents the desired dose (the dose ordered), $H$ the amount on hand or available, $Q$ the quantity or volume of the drug form (tablet, capsule, liquid), and $A$ the amount calculated to be administered to the client. Therefore, $6\text{mg}÷120\text{mg}\times <!--\; \times \; -->30\text{mL}=1.5\text{mL}$.

d. The nurse sets up the following equation: $D÷H\times <!--\; \times \; -->Q=A$. $D$ represents the desired dose (the dose ordered), $H$ the amount on hand or available, $Q$ the quantity or volume of the drug form (tablet, capsule, liquid), and $A$ the amount calculated to be administered to the client. Therefore, $1250\text{units/hour}÷\mathrm{25,000}\text{units}\times <!--\; \times \; -->500\text{mL}=25\text{mL/hour}$.

a. The nurse sets up the following equation: $D÷H\times <!--\; \times \; -->Q=A$. $D$ represents the desired dose (the dose ordered), $H$ the amount on hand or available, $Q$ the quantity or volume of the drug form (tablet, capsule, liquid), and $A$ the amount calculated to be administered to the client. Therefore, $60\text{mg}÷20\text{mg}\times <!--\; \times \; -->5\text{mL}=15\text{mL}$.

c. The nurse sets up the following equation: $D÷H\times <!--\; \times \; -->Q=A$. $D$ represents the desired dose (the dose ordered), $H$ the amount on hand or available, $Q$ the quantity or volume of the drug form (tablet, capsule, liquid), and $A$ the amount calculated to be administered to the client. Therefore, $400\text{mg}÷400\text{mg}\times <!--\; \times \; -->250\text{mL}=250\text{mL}$ to be infused over 1 hour.

c. First, convert the client’s weight from pounds to kilograms ($2.2\text{lb}=1\text{kg}$). Therefore, the client weighs
60 kg.
Set the equation up in dimensional analysis:
$\frac{5\text{mcg}}{\text{kg/min}}\times <!--\; \times \; -->60\text{kg}\times <!--\; \times \; -->\frac{60min}{1\text{hour}}\times <!--\; \times \; -->\frac{1\text{mg}}{1000\text{mcg}}\times <!--\; \times \; -->\frac{250\text{mL}}{250\text{mg}}=\frac{4,500,000}{250,000}=18\text{mL/hour}$.