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2.1.3: Employ various techniques to calculate quantities of medication to be compounded, dispensed, or administered

TU is a 61-year-old woman with newly diagnosed metastatic breast cancer who is scheduled to receive her first dose of trastuzumab. She is 5 ft 7 inches tall and weighs 170 lbs. You receive the following order: trastuzumab 440 mg IV infusion over 1.5 hours. What is the appropriate assessment to discuss with the prescriber?

(A) Trastuzumab causes significant nausea and vomiting, warranting premedication with a serotonin antagonist antiemetic. It would be best to call the prescriber and suggest administration of an antiemetic.

(B) Trastuzumab can safely be administered as an IV bolus injection. It would be appropriate to call the prescriber and suggest the order be changed, to be administered as an IV bolus injection.

(C) Trastuzumab has been shown to be effective as an adjuvant treatment but not for treatment of metastatic disease. It would be appropriate to call the prescriber and clarify the indication for trastuzumab for this patient.

(D) The recommended initial dose of trastuzumab is 4 mg/kg (320 mg total for this patient). It would be appropriate to call the prescriber and clarify the dosage for this patient.

(E) Trastuzumab is ordered appropriately for this patient. No clarification is indicated.

The Correct Answer is: D

The standard initial dose for this patient would be 4 mg/kg or 320 mg for this patient. It would be appropriate to clarify this patient's dose (D).

Trastuzumab is not associated with nausea and vomiting that requires pretreatment antiemetic therapy (A). Trastuzumab should not be administered as an IV bolus injection (B). Trastuzumab has been shown effective as treatment for both micrometastatic and metastatic breast cancer, characterized by overexpression of HER-2 (C). Clarification of the dose ordered for this patient is warranted (E).

Topic: Breast cancer

DR is a hospitalized man who weighs 82 kg and has a BMI of 24 kg/m 2 . What is his calculated daily fluid requirement?

(A) 2,450 mL

(B) 2,740 mL

(C) 3,160 mL

(D) 3,800 mL

The correct answer is (B).

The average adult requires 1,500 mL for the first 20 kg of body weight and 20 mL/kg of body weight over 20 kg. Therefore, the calculation for daily fluid requirement for a 82 kg adult is: 1,500 mL + [(82 kg ? 20 kg) × 20 mL) = 2,740 mL (B).

2,450 mL (A) is too low, and 3,160 mL (C) and 3,800 mL (D) are ...

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