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A 5.6 kg patient is receiving digoxin by mouth every 8 hours. The safe dose is 0.03-0.06 mg/kg/day. What is the maximum safe dose for this patient? (Round to the nearest hundredth.)
This question is an excerpt from Nurse Dive's nursing test bank - Ati Demsn 650 Pediatrics Proctored Exam. Take the full exam now
Full Explanation
Given:
- Patient weight = 5.6 kg
- Safe dose = 0.03–0.06 mg/kg/day
Step 1: Use the formula for maximum safe dose
Maximum dose = Weight × Maximum mg/kg/day
Step 2: Substitute the values
Maximum dose = 5.6 × 0.06
Step 3: Calculate
Maximum dose = 0.336 mg/day
Step 4: Round to the nearest hundredth
Maximum dose = 0.34 mg/day
Similar Questions
Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for
A. macrosomia.
Macrosomia, defined as a birth weight greater than 4,000–4,500 grams, is the most common fetal complication associated with gestational diabetes. Hyperglycemia in the mother leads to increased glucose transfer across the placenta, stimulating fetal pancreatic insulin production. Fetal hyperinsulinemia acts as a growth-promoting hormone, resulting in excessive fat and muscle deposition and ultimately large-for-gestational-age infants. Macrosomia increases the risk of birth injuries such as shoulder dystocia, clavicle fractures, and the need for cesarean delivery.
B. preterm birth.
Preterm birth is not the primary risk associated with GDM. While poorly controlled diabetes can contribute to preterm labor, it is less common than macrosomia. The main concern in GDM is excessive fetal growth, not premature delivery.
C. low birth weight
Low birth weight is not typically associated with gestational diabetes. In fact, infants of mothers with poorly controlled GDM are often larger than average, not smaller, due to fetal hyperinsulinemia and increased nutrient availability.
D. congenital anomalies of the central nervous system.
Congenital anomalies, particularly neural tube defects or central nervous system defects, are primarily associated with pregestational diabetes rather than GDM. Gestational diabetes develops later in pregnancy (usually after 24 weeks) when organogenesis has largely occurred, so the risk for major congenital anomalies is minimal.
Full Explanation
A. Macrosomia, defined as a birth weight greater than 4,000–4,500 grams, is the most common fetal complication associated with gestational diabetes. Hyperglycemia in the mother leads to increased glucose transfer across the placenta, stimulating fetal pancreatic insulin production. Fetal hyperinsulinemia acts as a growth-promoting hormone, resulting in excessive fat and muscle deposition and ultimately large-for-gestational-age infants. Macrosomia increases the risk of birth injuries such as shoulder dystocia, clavicle fractures, and the need for cesarean delivery.
B. Preterm birth is not the primary risk associated with GDM. While poorly controlled diabetes can contribute to preterm labor, it is less common than macrosomia. The main concern in GDM is excessive fetal growth, not premature delivery.
C. Low birth weight is not typically associated with gestational diabetes. In fact, infants of mothers with poorly controlled GDM are often larger than average, not smaller, due to fetal hyperinsulinemia and increased nutrient availability.
D. Congenital anomalies, particularly neural tube defects or central nervous system defects, are primarily associated with pregestational diabetes rather than GDM. Gestational diabetes develops later in pregnancy (usually after 24 weeks) when organogenesis has largely occurred, so the risk for major congenital anomalies is minimal.
A 12-week pregnant client presents for a routine checkup. She reports no vaginal bleeding or cramping, but her last fetal heartbeat detected on ultrasound is absent. The cervix is closed, and the client feels no fetal movement. Which type of miscarriage does the nurse suspect?
A. Threatened miscarriage
A threatened miscarriage is characterized by vaginal bleeding, mild cramping, and a closed cervix, but the fetus is still viable with a detectable heartbeat. In this case, the fetal heartbeat is absent, making a threatened miscarriage unlikely.
B. Incomplete miscarriage
An incomplete miscarriage occurs when some products of conception have been expelled while others remain in the uterus. It is usually accompanied by heavy bleeding, cramping, and an open cervix. This client has a closed cervix and no bleeding, ruling out an incomplete miscarriage.
C. Missed miscarriage
A missed miscarriage occurs when the fetus has died in utero but has not been expelled. The client may have no symptoms—no bleeding or cramping—and the cervix remains closed. Ultrasound confirms the absence of fetal cardiac activity, which matches this presentation. Missed miscarriages often require medical or surgical management to prevent complications such as infection or coagulopathy.
D. Inevitable miscarriage
An inevitable miscarriage is indicated by vaginal bleeding, cramping, and cervical dilation, suggesting that miscarriage is in progress and cannot be prevented. Since this client has a closed cervix and no active bleeding, an inevitable miscarriage is unlikely.
Full Explanation
A. A threatened miscarriage is characterized by vaginal bleeding, mild cramping, and a closed cervix, but the fetus is still viable with a detectable heartbeat. In this case, the fetal heartbeat is absent, making a threatened miscarriage unlikely.
B. An incomplete miscarriage occurs when some products of conception have been expelled while others remain in the uterus. It is usually accompanied by heavy bleeding, cramping, and an open cervix. This client has a closed cervix and no bleeding, ruling out an incomplete miscarriage.
C. A missed miscarriage occurs when the fetus has died in utero but has not been expelled. The client may have no symptoms—no bleeding or cramping—and the cervix remains closed. Ultrasound confirms the absence of fetal cardiac activity, which matches this presentation. Missed miscarriages often require medical or surgical management to prevent complications such as infection or coagulopathy.
D. An inevitable miscarriage is indicated by vaginal bleeding, cramping, and cervical dilation, suggesting that miscarriage is in progress and cannot be prevented. Since this client has a closed cervix and no active bleeding, an inevitable miscarriage is unlikely.
A 2-year-old child presents to the emergency department with a barking cough, stridor, and a hoarse voice that worsens at night. The child is afebrile but appears anxious and has labored breathing. The nurse suspects croup as the diagnosis. Which of the following interventions should the nurse prioritize to manage the child's symptoms and prevent further respiratory distress?
A. Administer a dose of oral antibiotics to treat the infection
Croup is usually viral in origin (most commonly parainfluenza virus), so antibiotics are not indicated unless there is evidence of a secondary bacterial infection. Routine antibiotic administration does not improve viral croup and can contribute to antibiotic resistance.
B. Place the child in a supine position to facilitate airflow to the lungs
Placing the child in a supine position may worsen airway obstruction and increase respiratory effort. Children with croup often assume an upright or sitting position to maximize airway patency and ease breathing.
C. Encourage the child to lie down to conserve energy
Encouraging the child to lie down to conserve energy is not appropriate. Lying down can exacerbate airway obstruction in croup, increase stridor, and worsen respiratory distress.
D. Provide a cool mist humidifier or take the child outside into cool night air
Providing a cool mist humidifier or taking the child outside into cool night air helps reduce airway inflammation and swelling in the upper airway. Cool air can soothe the larynx, decrease stridor, and ease the barking cough. These noninvasive measures are first-line interventions to manage mild to moderate croup and prevent progression to severe respiratory distress. Supporting the child in an upright, calm position while monitoring oxygenation and respiratory effort is also essential.
Full Explanation
A. Croup is usually viral in origin (most commonly parainfluenza virus), so antibiotics are not indicated unless there is evidence of a secondary bacterial infection. Routine antibiotic administration does not improve viral croup and can contribute to antibiotic resistance.
B. Placing the child in a supine position may worsen airway obstruction and increase respiratory effort. Children with croup often assume an upright or sitting position to maximize airway patency and ease breathing.
C. Encouraging the child to lie down to conserve energy is not appropriate. Lying down can exacerbate airway obstruction in croup, increase stridor, and worsen respiratory distress.
D. Providing a cool mist humidifier or taking the child outside into cool night air helps reduce airway inflammation and swelling in the upper airway. Cool air can soothe the larynx, decrease stridor, and ease the barking cough. These noninvasive measures are first-line interventions to manage mild to moderate croup and prevent progression to severe respiratory distress. Supporting the child in an upright, calm position while monitoring oxygenation and respiratory effort is also essential.