A nurse is caring for a client who is taking digoxin for heart failure and develops indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer?

Calculating the IV Infusion Rate

Problem: Administer 300 mg of clindamycin IV over 30 minutes. The available solution is 300 mg in 50 mL of 0.9% NaCl.

Steps:

Convert minutes to hours:

30 minutes x (1 hour / 60 minutes) = 0.5 hours

Calculate the infusion rate:

50 mL / 0.5 hours = 100 mL/hour

Answer: The nurse should set the IV pump to deliver 100 mL/hour.

C) A client received a crushed bupropion XL tablet mixed with applesauce:
Extended-release (XL) medications like bupropion XL are designed to release their active ingredients gradually over time. Crushing these tablets can alter their release mechanism, potentially leading to an overdose or reduced efficacy. This is a significant error that should be reported through an incident report to ensure patient safety and evaluate the potential impact of the mistake.

A) A nurse injected Demerol IM into the vastus lateralis site of adult:
Injecting Demerol (meperidine) intramuscularly into the vastus lateralis site is not an error. This site is commonly used for intramuscular injections in adults, though other sites like the deltoid or gluteus maximus are also appropriate depending on the situation.

B) A client received gentamicin intermittent IV bolus over 1 hr:
Gentamicin is often administered as an intermittent IV bolus over a period of time, and administering it over 1 hour is a common practice. This does not indicate an error that would require an incident report.

D) A nurse used a 25-gauge 3/8 inch needle to administer a heparin injection:
Heparin injections are typically administered with a smaller gauge needle, but a 25-gauge needle is acceptable for subcutaneous injections. The needle size might be less than ideal but does not necessarily warrant an incident report unless it directly impacts the effectiveness of the medication or causes an issue.