A primary care provider prescribes cefazolin (Kefzol) 125 mg intramuscularly (IM) for a client. The vial contains 0.5 gm of cefazolin in powdered form. The instructions indicate to add 2 mL of sterile water to provide a solution that contains 225 mg per mL. Record your answer using one decimal place, including leading zero if applicable. ___ mL

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1. A primary care provider prescribes cefazolin (Kefzol) 125 mg intramuscularly (IM) for a client. The vial contains 0.5 gm of cefazolin in powdered form. The instructions indicate to add 2 mL of sterile water to provide a solution that contains 225 mg per mL. Record your answer using one decimal place, including leading zero if applicable. ___ mL

B!

Initially, integrity of the intravenous system should be verified to ensure that the client is receiving medication. The intravenous tubing may be kinked or compressed, or the catheter may be dislodged. Continued monitoring will result in the client experiencing unnecessary pain. The nurse may not reprogram the pump to deliver larger or more frequent doses of medication without a health care provider's prescription. The health care provider should be notified if the system is intact and the client is not obtaining relief from pain. The prescription may have to be revised; the basal dose may be increased, the length of the delay may be reduced, or another medication or mode of delivery may be prescribed.
D!

Many over-the-counter cold preparations contain acetaminophen; the amount of acetaminophen in cold preparations must be taken into consideration when the total amount of acetaminophen taken daily is calculated. A typical single dose is 650 mg a day for adults. Acetaminophen should not exceed 3 to 4 g a day, with a lower dose preferred in older adults. Taking oxycodone with the acetaminophen may result in an overdose. Oxycodone (Percocet) contains 325 to 650 mg of acetaminophen per dose, which should be calculated into the total grams of acetaminophen permitted daily. An emetic is contraindicated because it may reduce the client's ability to tolerate oral acetylcysteine, the antidote for acetaminophen toxicity.
C!

An upright position helps prevent aspiration; gravity facilitates movement of food down the esophagus and into the stomach. Metal tableware is safer than plastic tableware because it is unbreakable; a mentally challenged child could easily bite down on and break a plastic utensil and choke on the fragments. Encouraging participation, with socialization, and treating the child with dignity should be part of the meal. Although the child might assume an upright position, using a syringe is a form of forced feeding; in addition, the child should be encouraged to eat solid foods. Feeding in the supine position puts the child at risk for aspiration and choking. Solid, not chopped, food should be encouraged.
0.6

Use the 'Desire over Have' formula of ratio and proportion to solve this problem. Desire 125 mg = x mL Have 225 mg 1 mL 225x = 125 X = 125 ÷ 225 X = 0.55 mL. Round the answer up to 0.6 mL

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