A patient is receiving an IV of 500 mL of D5W (dextrose 5% in water).
How many grams (g) of dextrose are contained in this IV solution?

To find the milligrams per minute, you need to calculate the following:

- The volume of Lopressor in milliliters
- The infusion rate in milliliters per minute using the formula: Infusion rate (mL/min) = Total volume (mL) / Time (min)
- The dose of Lopressor in milligrams per minute using the formula: Dose (mg/min) = Infusion rate (mL/min) x Concentration (mg/mL)

First, divide the dose of Lopressor by the concentration to get the volume in milliliters:

5 mg / 1 mg/mL = 5 mL

Next, use the formula for infusion rate to find how many milliliters per minute the IV pump should deliver:

Infusion rate (mL/min) = Total volume (mL) / Time (min)

Since the total volume is 5 mL and the time is 2 minutes, plug in these values into the formula:

Infusion rate (mL/min) = 5 mL / 2 min

Simplify and solve for the infusion rate:

Infusion rate (mL/min) = 2.5 mL/min

Then, use the formula for dose to find how many milligrams per minute the patient should receive:

Dose (mg/min) = Infusion rate (mL/min) x Concentration (mg/mL)

Since the infusion rate is 2.5 mL/min and the concentration is 1 mg/mL, plug in these values into the formula:

Dose (mg/min) = 2.5 mL/min x 1 mg/mL

Simplify and solve for the dose:

Dose (mg/min) = 2.5 mg/min

Therefore, the patient should receive **2.5 mg/min** of Lopressor.

The correct technique for preparing this insulin order is to follow these steps¹²:

- Perform hand hygiene and put on gloves.
- Mix NPH (cloudy) insulin by gently rotating the vial between the palms of your hands. Do not shake the vial.
- Clean the tops of both vials with alcohol swabs and let them dry.
- Draw up the amount of air equal to the dose of NPH insulin into a syringe. Inject the air into the NPH vial without touching the needle to the solution. Withdraw the needle and syringe without drawing up any insulin. This will create positive pressure in the NPH vial and make it easier to draw up later.
- Draw up the amount of air equal to the dose of regular (clear) insulin into the same syringe. Inject the air into the regular vial and invert the vial. Make sure the needle tip is below the fluid level and draw up slightly more than the dose of regular insulin. Tap the syringe gently to remove any air bubbles and push out any excess insulin to get the exact dose. Withdraw the needle and syringe from the regular vial.
- Reinsert the needle and syringe into the NPH vial without touching the needle to the solution. Invert the vial and draw up slightly more than the dose of NPH insulin. Tap the syringe gently to remove any air bubbles and push out any excess insulin to get the exact dose. Withdraw the needle and syringe from the NPH vial.
- Check that you have the correct doses of both insulins in one syringe. The total volume should be equal to the sum of both doses.
- Administer the dose within 5 to 10 minutes after drawing up because regular insulin binds to NPH and this decreases its action.