A nurse needs to infuse esmolol to a patient weighing 65 kg. The dose on hand is 2,500 mg esmolol in 250 mL of fluid. The patient requires a dose of 200 mcg/kg/min to control a hypertensive crisis. Which rate should the nurse calculate to infuse this medication? Round to the nearest whole number.

To calculate the infusion rate, we need to convert the patient's weight from kilograms to milligrams.

Patient's weight: 65 kg

Dose required: 200 mcg/kg/min

First, let's calculate the total dose required for the patient per minute: Dose required = 200 mcg/kg/min * 65 kg

= 13,000 mcg/min

Next, we need to convert the dose from micrograms to milligrams:

13,000 mcg/min = 13 mg/min

Now, let's determine the infusion rate. We have 2,500 mg of esmolol in 250 mL of fluid. Therefore, the concentration of esmolol in the fluid is:

Concentration = 2,500 mg / 250 mL

= 10 mg/mL

To find the infusion rate, we divide the dose required by the concentration: Infusion rate = 13 mg/min / 10 mg/mL

= 1.3 mL/mi

Since the options are in mL/hr, we need to convert the rate from mL/min to mL/hr:

1.3 mL/min * 60 min/hr = 78 mL/hr

Therefore, the correct answer is:

a. 78 mL/hr

Subcutaneous injection is the usual route for giving insulin because it allows the medication to be absorbed slowly and steadily into the bloodstream. Subcutaneous injection involves inserting a needle into the faty layer of tissue under the skin, usually in the abdomen, upper arm, thigh, or butock.

Intramuscular injection is not the usual route for giving insulin because it may cause rapid and unpredictable absorption of the medication, which can lead to hypoglycemia or hyperglycemia. Intramuscular injection involves inserting a needle into the muscle tissue, usually in the deltoid, vastus lateralis, or ventrogluteal area.

Intraosseous injection is not the usual route for giving insulin because it is reserved for emergency situations when intravenous access is not available. Intraosseous injection involves inserting a needle into the bone marrow, usually in the tibia or humerus.

Intradermal injection is not the usual route for giving insulin because it is mainly used for diagnostic tests, such as tuberculin skin test or allergy test. Intradermal injection involves inserting a needle into the dermis, which is the layer of skin just below the epidermis, usually in the forearm or upper back.