# A 70-year-old client with renal impairment has a prescription for ketorolac 30 mg IV every 6 hours. Which action should the nurse take?

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> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A 70-year-old client with renal impairment has a prescription for ketorolac 30 mg IV every 6 hours. Which action should the nurse take?

## Option

1. Give 60 mg IV now because older adults need a larger loading dose.
2. Administer 30 mg every 4 hours to improve pain control.
3. Hold and clarify the order because the labeled multiple-dose regimen is 15 mg every 6 hours with a 60-mg daily maximum for this population. **✔ Correct answer**
4. Continue the regimen indefinitely if gastrointestinal symptoms do not occur.

**Correct answer: 3**

## Explanation

Clients aged 65 years or older or with renal impairment require 15 mg every 6 hours and no more than 60 mg daily for multiple-dose IV or IM treatment.

## In-depth explanation

Quick answer
Clarify the 30-mg every-6-hour order.

Why this is correct
The ketorolac label reduces both the individual and daily dose for adults 65 years or older, renally impaired clients, and clients under 50 kg. Increasing dose or frequency raises serious adverse-event risk without improving efficacy.

Easy analogy or mental picture
A slower exit and greater sensitivity require a smaller load, not a bigger one.

Memory hook
Age 65 or renal impairment: 15 mg q6h, maximum 60 mg/day.

NCLEX decision rule
Apply the most restrictive age, weight, and renal rule before administration and count total ketorolac duration across routes.

Why the other choices are wrong
Higher or more frequent dosing increases renal, gastrointestinal, and bleeding risk; ketorolac therapy is not indefinite.References
1DailyMed: Ketorolac Tromethamine InjectionReduced older-adult or renal dose and 60-mg daily maximum

## Clinical scenario

Ketorolac dose check
Verify age, weight, renal function, route, single dose, 24-hour total, concurrent NSAIDs, bleeding risk, and total treatment duration.

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