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.

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

A) The healthcare provider's order
While the healthcare provider's order is crucial for ensuring that the correct drug and dosage are administered, it is not something that would be written on the reconstituted drug label. The reconstituted drug label is intended to communicate specific information about the reconstitution process and the product's current status, but the order itself is typically not part of this information.

B) Diluent
When reconstituting a medication, it is essential to note the diluent used. The diluent refers to the liquid used to mix the powdered medication and turn it into a solution or suspension. Including this information on the drug label ensures that anyone handling the medication can verify the proper solution used for reconstitution, which is important for both correct administration and stability of the drug.

C) Date to discard
After a medication has been reconstituted, it often has a limited shelf life, and it is important to write the date to discard on the drug label. This ensures that the medication is used within its recommended time frame to avoid potential degradation or loss of potency. The discard date is especially important in hospitals or clinics where drugs are prepared in advance.

D) Initials
The nurse should always include their initials on the reconstituted drug label. This serves as a means of accountability, allowing others to know who prepared the medication. It also helps ensure proper identification in case of questions or errors regarding the preparation.