A nurse is preparing to administer nitroglycerine 15 mcg/min by continuous IV infusion. Available is nitroglycerin 25 mg in 250 mL of dextrose 5% in water (D5W). 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) Gastric emptying time:
Gastric emptying time plays a significant role in drug absorption. The faster the stomach empties its contents into the small intestine, the quicker the drug can be absorbed. If gastric emptying is delayed, such as with certain diseases, medications, or conditions (like gastroparesis), drug absorption may be slowed. Conversely, rapid gastric emptying can lead to quicker absorption, potentially reducing the time the drug has to exert its effects.

B) Capillary walls with large spaces between cells:
Capillary permeability influences how easily a drug can pass from the bloodstream into tissues. If the capillary walls have large gaps, such as in certain areas of the body (e.g., in the liver or spleen), drugs can more easily move across the capillary membrane and be absorbed into the system.

C) Stability and solubility of the medication:
For a drug to be absorbed effectively, it must be stable in the body and soluble in bodily fluids. Drugs that are poorly soluble or unstable in the stomach may not be absorbed efficiently. For instance, medications that are lipophilic (fat-soluble) may require a carrier or special formulation (e.g., emulsions or nanoparticles) to aid in absorption, whereas hydrophilic drugs may face challenges crossing cell membranes without assistance.

D) Inspiratory effort:
Inspiratory effort does not directly affect the absorption of drugs. Inspiratory effort refers to the act of inhaling, which is more relevant to drugs administered via inhalation (e.g., inhalers or nebulizers). It affects how well the drug is delivered to the lungs but does not influence absorption in the gastrointestinal tract or other routes of administration.

E) Presence of food in the stomach or intestines:
Food in the stomach or intestines can either speed up or slow down drug absorption. Some drugs are absorbed better on an empty stomach because food can slow gastric emptying and alter the drug's solubility. On the other hand, certain medications (e.g., fat-soluble drugs) may require food for optimal absorption.

1. Convert patient weight from pounds to kilograms:

Patient weight (kg) = 152 lb x 0.453592 kg/lb = 68.94 kg

2. Calculate the desired dose in mcg/min:

Desired dose (mcg/min) = 5 mcg/kg/min x 68.94 kg = 344.7 mcg/min

3. Convert mcg/min to mg/min:

Desired dose (mg/min) = 344.7 mcg/min / 1000 mcg/mg = 0.3447 mg/min

4. Calculate the concentration of dobutamine in the solution:

Concentration (mg/mL) = 500 mg / 250 mL = 2 mg/mL

5. Calculate the flow rate in mL/min:

Flow rate (mL/min) = Desired dose (mg/min) / Concentration (mg/mL)

Flow rate (mL/min) = 0.3447 mg/min / 2 mg/mL = 0.17235 mL/min

6. Calculate the flow rate in mL/hr:

Flow rate (mL/hr) = 0.17235 mL/min x 60 min/hr = 10.341 mL/hr

7. Round to the nearest tenth:

Flow rate (mL/hr) = 10.3 mL/hr

Therefore, the correct answer is 10.4 mL/hr