A nurse is providing teaching to a client who wants to stop smoking and has purchased a transdermal smoking patch. Which of the following information should the nurse provide?

Step 1: Determine the Lidocaine Concentration

• The solution contains 2 grams (2000 mg) of lidocaine in 500 mL.
• To find the amount of lidocaine per mL:
  2000 mg ÷ 500 mL = 4 mg/mL

Step 2: Calculate the Total Dose per Hour

• The prescribed infusion rate is 4 mg per minute.
• In 1 hour (60 minutes), the total dose is:
  4 mg/min × 60 min = 240 mg/hr

Step 3: Determine the Infusion Rate in mL/hr

• Since each mL contains 4 mg of lidocaine:
  240 mg ÷ 4 mg/mL = 60 mL/hr

The nurse should set the IV pump to 60 mL/hr for the continuous IV infusion of lidocaine at a rate of 4 mg/min.

Choice A Reason:
Ondansetron is incorrect. Ondansetron is an anti-nausea medication commonly used in cancer patients to manage nausea and vomiting, often caused by chemotherapy. It's not typically contraindicated or known to interact significantly with morphine administered via a PCA pump. This combination is often used to manage both pain and associated symptoms in cancer patients.
Choice B Reason:
Acetaminophen is incorrect. Acetaminophen is a pain reliever and fever reducer that doesn't typically interact significantly with morphine administered via a PCA pump. It's often used concurrently with other pain medications to manage discomfort in cancer patients. There isn't a known significant interaction between acetaminophen and morphine when used appropriately.
Choice C Reason:
Nalbuphine is correct. Nalbuphine is an opioid analgesic, similar to morphine, and administering it concurrently with morphine could potentially lead to opioid overdose or increased risk of opioid-related side effects such as respiratory depression. Thus, it's crucial to clarify with the provider whether there might be a potential interaction or if both medications are indeed necessary in this specific clinical scenario.
Choice D Reason:
Insulin glargine is incorrect. Insulin glargine is a long-acting insulin used to manage blood sugar levels in individuals with diabetes. While its interaction with morphine isn't typically a concern, it's essential to monitor blood sugar levels closely in individuals receiving opioids like morphine, as opioids can affect glucose metabolism and may necessitate adjustments in insulin dosage.