A nurse is preparing to administer 0/9% sodium chloride (0.9% NaCl) 20ml/kg IV tp infuse over 6 hr to a school-age child who weighs 55 lbs. The nurse should set the IV pump to deliver how many ml/hr? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A) 0.2 mg
The correct way to write the dosage is 0.2 mg. In pharmacology and medication administration, it is important to follow the guidelines set by the Institute for Safe Medication Practices (ISMP) and other standard bodies, which recommend that a leading zero be used before a decimal point. This helps to prevent errors in interpreting the dosage. Writing 0.2 mg clearly indicates two-tenths of a milligram, and the leading zero makes it easier to avoid misreading the dose as a whole number (2.0 mg) or omitting the decimal point entirely.

B) .2 mg
Writing the dosage as .2 mg (without the leading zero) is considered unsafe and is a poor practice. The absence of the leading zero before the decimal point increases the likelihood that the dose may be misread. For example, someone could confuse .2 mg with 2.0 mg or misinterpret it in a hurried situation, which could lead to a tenfold dosing error

C) 2.0 mg
Writing 2.0 mg would indicate two milligrams, which is not the correct dosage for "two-tenths of a milligram." While this format does use a decimal point, it does not represent the correct dose. This error could lead to an overdose if misread as a whole number.

D) 0.20 mg
While 0.20 mg is technically correct, it is not the preferred or necessary format. The use of two decimal places is unnecessary in this case. Since the dosage is two-tenths of a milligram, 0.2 mg is simpler and clearer. Using an unnecessary trailing zero (the second "0") can cause confusion or misinterpretation, especially in critical settings where every detail counts.

Given:

Ordered dose of acetaminophen: 10 mg/kg

Child's weight: 22 lb

Concentration of acetaminophen liquid: 160 mg/5 mL

Step 1: Convert child's weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Child's weight in kg = 22 lbs x 0.453592 kg/lb = 9.976824 kg

Step 2: Calculate the total dose of acetaminophen:

Total dose (mg) = Ordered dose (mg/kg) x Child's weight (kg)

Total dose (mg) = 10 mg/kg x 9.976824 kg

Total dose (mg) = 99.76824 mg

Step 3: Calculate the volume to be administered:

Volume (mL) = Total dose (mg) / Concentration (mg/mL)

Volume (mL) = 99.76824 mg / 160 mg/5 mL

Volume (mL) = 99.76824 mg x (5 mL / 160 mg)

Volume (mL) = 3.1177575 mL

Step 4: Round to the nearest tenth:

Volume (mL) ≈ 3.1 mL