A client is ordered 325mL of packed red blood cells over 3 hours. What is the rate to be set on the infusion pump? Round to a whole number

Given:

Desired dose: Digoxin 0.25 mg PO daily

Available concentration: Digoxin 500 mcg/10 mL

To find:

Volume to administer (in mL)

Step 1: Convert desired dose to micrograms

We know that 1 milligram (mg) is equal to 1000 micrograms (mcg). Therefore, to convert the desired dose from mg to mcg, we multiply by 1000:

Desired dose (mcg) = Desired dose (mg)x 1000

Desired dose (mcg) = 0.25 mg x 1000 = 250 mcg

Step 2: Set up the proportion

We can use the following proportion to solve the problem:

(Desired dose) / (Available concentration) = Volume to administer

Step 3: Substitute the values

Plugging in the given values, we get:

(250 mcg) / (500 mcg/10 mL) = Volume to administer

Step 4: Simplify

To simplify, we can invert the denominator and multiply:

(250 mcg) x (10 mL / 500 mcg) = Volume to administer

The "mcg" units cancel out, leaving us with:

(250 x 10 mL) / 500 = Volume to administer

Step 5: Calculate

Performing the multiplication and division, we get:

2500/ 500 = Volume to administer

5 mL = Volume to administer

Client Finding Assessment:

White blood cell count (18,000/mm³)

Expected: An elevated white blood cell count is common postpartum due to the body's inflammatory response to delivery, especially within the first few days after birth. This level is within the typical postpartum range of 5,000 to 30,000/mm³.

Blood clot size (pea-sized)

Expected: Small blood clots are common during the early postpartum period. It is normal to see some small clots in the lochia as the uterus contracts and expels blood from the uterine lining.

Uterine findings (firm and midline, 1–2 cm below the umbilicus)

Expected: A firm, midline uterus with a descent of about 1–2 cm below the umbilicus is a normal finding during the early postpartum period. This indicates appropriate uterine involution.

Lochia findings (moderate to light amount, no odor, with clots)

Expected: Lochia rubra (red blood flow) is expected during the first few days postpartum, with moderate bleeding and the presence of small clots. The absence of foul odor suggests no infection, which is a positive sign.

Calf findings (one varicose vein visible on left calf)

Expected: It is common for women to have visible varicose veins during pregnancy due to increased blood volume and pressure on the veins. These may persist postpartum, and unless associated with pain or swelling, they do not typically require intervention.

Blood pressure (145/98 mm Hg)

Unexpected: Elevated blood pressure postpartum is concerning and could indicate postpartum hypertension or preeclampsia. This needs to be addressed and monitored closely as it can be a sign of a serious condition that requires further evaluation.