A nurse starts an infusion of 1500 mL of normal saline (NS) for a client at 8:45 am at a flow rate of 2 mL/min. The tubing drop factor is 10 drops/mL.
Calculate the volume of fluid that will be left at 10:00 am.

This action should be taken by the nurse before administering the medication because the use of a trailing zero after a decimal point (5.0 mg) is a common cause of medication errors and should be avoided. A trailing zero may be misread or misinterpreted as a larger dose (50 mg) or omited altogether, resulting in a 10-fold overdose or underdose, respectively. For example, when prescriptions have been writen for "Coumadin 1.0 mg," patients have received 10 mg in error. Therefore, the nurse should clarify the intended dose with the healthcare provider and use the correct notation (5 mg) without a trailing zero.

The other options are not appropriate actions because:

a) Discussing the use of PO (by mouth) with the healthcare provider is not necessary, as PO is a standard route of administration for Haldol (haloperidol) and does not pose a risk of confusion or error.

b) Discussing the use of tid (three times a day) with the healthcare provider is not necessary, as tid is a standard frequency of administration for Haldol and does not pose a risk of confusion or error.

c) Discussing the use of Haldol with the healthcare provider is not relevant to the question, as Haldol is the prescribed medication for the patient who is agitated and does not need to be changed or questioned by the nurse.

To answer this question, the nurse needs to perform the following steps:

1) Convert the patient's weight from pounds and ounces to kilograms, using the conversion factor of 1 pound = 0.45359237 kilograms¹². To do this, first convert the ounces to a fraction of a pound by dividing by 16, then add this fraction to the pounds, and then multiply by the conversion factor. For example:

7 lb, 11.2 oz = 7 + (11.2 / 16) lb
= 7.7 lb
= 7.7 × 0.45359237 kg
= 3.492 kg

2) Calculate the dose of Garamycin in milligrams, using the prescribed dose of 4 mg/kg and the patient's weight in kilograms. To do this, simply multiply the dose per kilogram by the weight in kilograms. For example:

4 mg/kg × 3.492 kg = 13.968 mg

3) Calculate the volume of Garamycin in milliliters, using the reconstituted dosage of 20 mg/10 mL and the dose in milligrams. To do this, use a proportion to find the unknown volume that corresponds to the known dose. For example:

20 mg / 10 mL = 13.968 mg / x mL Cross-multiply and solve for x: 20x = 139.68

x = 6.984 mL
x =7 mL