Ordered: Lanoxin pediatric elixir 100 mcg PO tid loading dose, ...

[jake]

Ordered: Lanoxin pediatric elixir 100 mcg PO tid loading dose, for a child with heart failure. SDR for child over 2 years of age: loading dose 0.02-0.04 mg per kg per 24 hr in 3 divided dos-es; maintenance dose 0.006-0.
 
  012 mg per kg per 24 hr in 2 divided doses Child's weight: 12 kg Available: a. SDR for this child in milligrams:In micrograms:
 b. Decision: safe or unsafe order? State the reason.If safe to give, how many milliliters should the nurse prepare?
 c. Estimated dose:
  d. DA equation:
  e. Evaluation:
  f. What is the difference between a loading dose and a maintenance dose?

Question 2

Ordered: potassium chloride (KCl) IV 0.5 mEq per hr, for a baby with hypokalemia Pediatric SDR: up to 3 mEq per kg per 24 hr Child's weight: 16 lb Available: 10 mEq KCl in 100 mL D5W
 
  a. Child's weight in kilograms to the nearest tenth:
  b. SDR for this child:
  c. Decision: safe or unsafe order? State the reason.If safe to give, what flow rate should the nurse set on an infusion pump?
 d. DA equation:
  e. Evaluation:
  f. The IV is to be infused with a volume-control device. Agency policy states that only a 2-hour supply may be placed in the device. How many milliliters should the nurse place in the chamber?

[wuly]

Answer to Question 1

a. 0.24 mg to 0.48 mg divided in 3 doses; 240 mcg to 480 mcg per day divided in 3 doses
b. Safe. 100 mcg x 3 = 300 mcg or 0.3 mg is within the SDR
c. Estimate: 2 mL (2 x 50 mcg = 100 mcg)
d.
e. Equation is balanced. Estimate supports answer.
f. A loading dose is the first dose of a drug. It is larger than a maintenance dose. The purpose is to achieve a therapeutic level quickly when patient's condition necessitates it.

Answer to Question 2

a. 7.3 kg (16  2.2)
b. Up to 21.9 mEq per 24 hours (3 x 7.3)
c.
d.
e. Equation is balanced. Only mL per hour remains.
f. 10 mL (5 x 2 hr)