A nurse practitioner (NP) is preparing to prescribe a medication ...

[jCorn1234]

A nurse practitioner (NP) is preparing to prescribe a medication for a 5-year-old child. To determine the correct dose for this child, the NP should:
 
  a. calculate the dose at one third of the recommended adult dose.
  b. estimate the child's body surface area (BSA) to calculate the medication dose.
  c. divide the recommended adult dose by the child's weight in kilograms (kg).
  d. follow the drug manufacturer's recommendations for medication dosing.

Question 2

An NP orders an inhaled corticosteroid 2 puffs twice daily and an albuterol metered-dose inhaler 2 puffs every 4 hours as needed for cough or wheezing for a 65-year-old patient with recent onset of reactive airways disease who reports symptoms
 
  occurring every 1 or 2 weeks. At a follow-up appointment several months later, the patient reports no change in frequency of symptoms. The NP's initial action should be to: a. order spirometry to evaluate pulmonary function.
  b. prescribe a systemic corticosteroid to help with symptoms.
  c. ask the patient to describe how the medications are taken each day.
  d. give the patient detailed information about the use of metered-dose inhalers.

[gabrielle_lawrence]

Answer to Question 1

D
The package insert provided by the manufacturer is the best source for pediatric dose recommendations. Approximated reduction in the adult dose is not a safe or effective way of calculating pediatric doses of medications, so using a third of the adult dose may not be safe. Errors inherent in determining BSA make this method less reliable than dose based on accurate weights. Dividing the adult dose by the child's weight is incorrect.

Answer to Question 2

C
It is essential to explore with the older patient what he or she is actually doing with regard to daily medication use and compare this against the prescribed medication regimen before ordering further tests, prescribing any increase in medications, or providing further education.

[jCorn1234]

Excellent

[kilada]

Thanks for the timely response, appreciate it