Question

The physician orders meperidine (Demerol) for a postoperative client weighing \(145 \mathrm{lb}\). If the recommended dose for meperidine (Demerol) is 6 mg/kg/24 hours, how much should be administered as a single dose four times daily? a. \(220 \mathrm{mg}\) b. \(98.8 \mathrm{mg}\) c. \(22.6 \mathrm{mg}\) d. \(65 \mathrm{mg}\)

Short answer

98.8 mg

Step-by-step solution

Convert weight from pounds to kilograms

The weight of the client needs to be converted from pounds to kilograms since the recommended dose is given in mg/kg. To convert pounds to kilograms, divide the weight in pounds by 2.2046, because there are 2.2046 pounds in a kilogram.

Calculate the total daily dose in milligrams

Using the weight in kilograms from Step 1, multiply this weight by the recommended dose of 6 mg/kg to find the total daily dose in milligrams.

Determine the single dose for four times daily administration

To determine the single dose, divide the total daily dosage by four, since the medication is to be administered four times daily.

Key concepts

Nursing Pharmacology

Understanding pharmacology is crucial for any nursing professional, especially when it comes to safe medication administration. Pharmacology encompasses the study of how drugs interact with the body, and it is divided into two main areas: pharmacokinetics, which is how the body processes a drug, and pharmacodynamics, which is how a drug affects the body.

In the context of nursing, it is not only important to know the therapeutic uses of a medication but also its side effects, contraindications, interactions with other drugs, and the correct dosages. Nurses must be familiar with drug classifications, mechanisms of action, and the body's response to drugs to provide optimal care for their patients.

For example, meperidine (Demerol), as cited in the exercise, is a type of opioid analgesic. Understanding that opioids can cause respiratory depression emphasizes the importance of correct dosage calculation to prevent overdose. Pharmacological knowledge enables nurses to educate patients about their medications and monitor for adverse reactions effectively.

Dosage Calculation

Dosage calculation is a vital skill for nurses to ensure patient safety. The process involves several critical steps: converting units, such as pounds to kilograms; determining the total daily dose based on the patient's weight and the prescribed dose; and calculating the dose per administration.

As seen in the exercise, the initial step is to convert the patient's weight from pounds to kilograms since medication dosages are typically prescribed per kilogram. The formula to convert pounds to kilograms is dividing the weight by 2.2046. Following this, the total daily dose is found using the patient's weight in kilograms and the recommended dose, which must be accurately multiplied. Lastly, to find the single dose for administration, divide the total daily dose by the number of times the medication will be administered throughout the day.

Nurses must be adept at these conversions and calculations to avoid medication errors. Regular practice and familiarity with the metric and imperial systems are key in mastering this important competency.

Medication Administration

Medication administration is a fundamental aspect of nursing care, involving various routes through which drugs can be delivered, timing, dosage, and documentation. Nurses need a clear understanding of the five rights of medication administration: the right patient, right drug, right dose, right route, and right time.

Each medication comes with specific instructions on how it should be administered. For instance, some drugs are taken orally, while others are injected intravenously or intramuscularly. Factors such as the patient's condition, the drug's pharmacokinetic and pharmacodynamic properties, and the intended effect all influence how a medication is given.

In our exercise scenario, meperidine should be administered four times daily, which means the nurse must calculate the correct dosage for each of those four doses to ensure consistent therapeutic levels in the patient's system. Clear communication, careful scheduling, and meticulous record-keeping are essential to maintain an accurate medication regimen and to track the patient's response.