A male client who weighs 175 lb (79.4 kg) is receiving aminophylline (Aminophyllin) (400 mg in 500 ml) at 50 ml/hour.. Question the order because it’s too low

A male client who weighs 175 lb (79.4 kg) is receiving aminophylline (Aminophyllin) (400 mg in 500 ml) at 50 ml/hour. The theophylline level is reported as 6 mcg/ml. The nurse calls the physician who instructs the nurse to change the dosage to 0.45 mg/kg/hour. The nurse should:
a. Question the order because it’s too low.
b. Question the order because it’s too high.
c. Set the pump at 45 ml/hour.
d. Stop the infusion and have the laboratory repeat the theophylline measurement.

Answer A.
A therapeutic theophylline level is 10 to 20 mcg/ml. The client is currently receiving 0.5 mg/kg/hour of aminophylline. Because the client’s theophylline level is sub-therapeutic, reducing the dose (which is what the physician’s order would do) would be inappropriate. Therefore, the nurse should question the order.
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