A child who weighs 20 kg is prescribed an intravenous (IV) aminophylline (Truphylline) loading dose of 500 mg. What is the nurse's best action?
a. Administer the drug by IV push.
b. Hold the dose and contact the prescriber immediately.
c. Administer the drug by continuous infusion over 20 to 30 minutes.
d. Assess the child's peak expiratory flow rate and then administer the drug as pre-scribed.
B
The recommended loading dose of IV aminophylline is 5 to 7 mg/kg, which is a dosage between 100 and 140 mg. The 500-mg prescription is between four and five times the recommended dose. It is possible that this is the dosage that is needed; however, because it is very far out of the rec-ommended range, the dosage should be rechecked with the prescriber (and a pharmacist). If this dosage is to be administered, the child should be in an intensive care unit.
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