May David, a 22-year-old woman, comes to the clinic to obtain a pregnancy test. She has not had her menstrual period for the past 6 weeks but claims that infrequent menses are not unusual for her. She feels nauseous in the morning but the feeling is only temporary. You ask May, “Is it possible you might be pregnant?” May’s response is “I doubt it, since we have always used a condom during intercourse.” She goes on to explain that she has been taking an anti seizure medication for several years to control her epilepsy and is taking some herbal medicines for a feeling of well-being.

May’s vital signs are the following: Temperature = 36.7 C (98 F); Pulse = 68 beats/min; Respiration = 18 breaths/min; and blood pressure = 110/70 mmHg. She is 1.7 m (5 feet 6 inches) tall and is surprised that she has gained 2.3 kg (5 lbs) in the past 4 weeks, bringing her weight to 65.8 kg (145 lbs).

A urine specimen is sent to the laboratory for a pregnancy test. A complete physical examination is performed, followed by a vaginal examination. All physical findings were within normal limits except for her urine specimen, which confirms that she is pregnant. May smokes approximetly a half pack of cigarettes per day.

This activity contains 3 questions.

1. What education should the nurse provide for May regarding the use of medications during pregnancy?
2. While caring for May, the nurse must consider FDA pregnancy risk categories. In your own words, explain these categories.
3. What effect does May’s tobacco use possibly have on her unknown baby?

Ms Nguyen reports that Liam has not been eating well for the past 48 hours. He is a 7-month-old child. Last night he vomited3 times after drinking sips of water and also had several very loose, green foul-smelling bowel movements. He voided only once in the past 12 hours. For the past 5 days Liam has been taking amoxicillin for an ear infection. Liam lies still on the examination table but responds to his mother’s commands. The nurse prepares Liam for examination.

Liam’s preliminary diagnosis is gastroenteritis with milk dehydration. His vital signs are as follows: Temperature = 39.1. C (102.4 F); Heart rate = 160 beats/min; Respiration = 39 breaths/min; Blood pressure = 100/57 mmHg; and weight = 8.6 kg (19 lbs). His skin is dry and warm to touch, and there is slight tenting. The following laboratory studies were performed; serum electrolytes, complete blood count, blood urea nitrogen, creatine, urinalysis, and stool for culture and sensitivity.

An IV line was inserted immediately and a solution of D5W in ? NSS was started to infuse at 30ml/hr. Lima was placed on NPO (nothing by mouth).

This activity contains 2 questions.

1. What factors are seen in children that affect pharmacokinetics?
2. When starting an IV, the nurse would select from the following two sites as the best sites on a patient of this age group.