A nurse is preparing to administer morphine 8 mg IV intermittent bolus to a client. The amount available is morphine 10 mg/mL. How many mL should the nurse administer?
(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

To calculate the rate at which the IV pump should be set to deliver dopamine, we need to determine the total amount of dopamine in the infusion and divide it by the desired dose per minute.

Given:

Dopamine concentration: 400 mg in 250 mL

Desired dose: 5 mcg/kg/min

Patient weight: 220 lb

First, we need to convert the patient's weight from pounds to kilograms:

220 lb ÷ 2.2 = 100 kg

Next, we need to calculate the total amount of dopamine needed per minute:

5 mcg/kg/min × 100 kg = 500 mcg/min

Now, we need to convert the dopamine dose from mcg to mg:

500 mcg/min ÷ 1000 = 0.5 mg/min

To determine the infusion rate in mL/hr, we divide the dose in mg/min by the dopamine concentration in the infusion solution:

0.5 mg/min ÷ 250 mL = 0.002 mL/min

Finally, we convert the infusion rate from mL/min to mL/hr by multiplying by 60:

0.002 mL/min × 60 min = 0.12 mL/hr

Therefore, the nurse should set the IV pump to deliver 0.12 mL/hr.

When planning care for a client who had a myocardial infarction and is receiving thrombolytic therapy with an IV infusion of alteplase, the nurse should include the intervention of monitoring for changes in the client's level of consciousness.

Alteplase is a thrombolytic medication used to break down blood clots in certain medical emergencies, such as acute myocardial infarction (heart attack) or ischemic stroke. One of the potential complications of thrombolytic therapy, including alteplase, is bleeding. The medication's action of breaking down blood clots can also affect the body's natural clotting mechanisms, increasing the risk of bleeding.

Bleeding in the brain is a severe and potentially life-threatening complication associated with thrombolytic therapy. Therefore, it is essential for the nurse to closely monitor the client for any signs of intracranial bleeding, such as changes in the level of consciousness, confusion, severe headache, slurred speech, or weakness on one side of the body.

Let's go through the other options:

A. Administer aspirin instead of acetaminophen for fever: While aspirin is commonly used in the management of myocardial infarction, it is not specifically indicated for fever. Acetaminophen is the preferred antipyretic medication for fever management in most cases, and it does not interfere with the action of thrombolytic therapy.

B. Ambulate the client as often as tolerated: While early ambulation is beneficial for clients with myocardial infarction, it may not be appropriate during thrombolytic therapy. Thrombolytic therapy carries an increased risk of bleeding, and ambulation may be limited or contraindicated during the treatment period, depending on the client's overall condition and bleeding risk.

C. Administer a sodium phosphate enema for constipation: The administration of a sodium phosphate enema is not a specific intervention related to thrombolytic therapy or myocardial infarction. Bowel management is important for client comfort and overall well-being, but it is not a priority intervention in the immediate care of a client undergoing thrombolytic therapy.