A nurse is preparing to administer enteral formula to a client who weighs 75 kg and has a caloric need of 2250 calories per day. The nurse finds that 1000 mL of the formula provides 2000 calories.
How much formula would the client need per day (mL/day) to meet the calorie requirements?

To find the answer, we need to convert the units of the medication order and the infusion rate to the same units. We can use the following conversions:

1 mcg = 0.001 mg 1 kg = 1000 g 1 min = 60 s 1 h = 3600 s

The medication order is 140 mcg/kg/min, which means the patient needs 140 mcg of medication per kilogram of body weight per minute. The patient weighs 60 kg, so we multiply 140 mcg by 60 kg to get the total amount of medication per minute:

140 mcg/kg/min x 60 kg = 8400 mcg/min

We then convert this to milligrams by dividing by 1000:

8400 mcg/min / 1000 = 8.4 mg/min

The infusion rate is 10 mL/h, which means the patient receives 10 mL of fluid per hour. We convert this to minutes by dividing by 60:

10 mL/h / 60 = 0.167 mL/min

We can now find the concentration of the medication in the fluid by dividing the amount of medication per minute by the amount of fluid per minute:

8.4 mg/min / 0.167 mL/min = 50.3 mg/mL

This means that for every milliliter of fluid, there are 50.3 milligrams of medication. To find how many milligrams of medication are in one hour, we multiply the concentration by the infusion rate:

50.3 mg/mL x 10 mL/h = 503 mg/h

This is the total amount of medication that the patient receives in one hour. To find how many milligrams are in one dose, we divide this by the number of doses per hour, which is one:

503 mg/h / 1 dose/h = 503 mg/dose

This is the final answer, but we need to round it to the nearest tenth, as per the instructions: 503 mg/dose ≈ 67.2 mg/dose

QD is an abbreviation for "quaque die" which means "every day" in Latin. However, QD is on the official "Do Not Use" list of the Joint Commission because it can be mistaken for QOD, which means "every other day" in Latin¹². This can lead to medication errors and patient harm. Therefore, the Joint Commission recommends writing "daily" instead of QD.

The other options are not on the official "Do Not Use" list of the Joint Commission. OS, PO, and OD are abbreviations for "oculus sinister" (left eye), "per os" (by mouth), and "oculus dexter" (right eye) respectively. They are commonly used in ophthalmology and pharmacy³. However, they should be used with caution and only when appropriate, as they can also be confused with other abbreviations or symbols.