A patient is receiving an IV of esmolol 2.5 grams in 250 mL of D5W (dextrose 5% in water) infusing at 200 micrograms/kilogram/minute. The patient weighs 110 lb. What rate (in mL/hr) should the nurse program into the IV pump to deliver this dose?

The nurse should administer 4 mL to this patient.

This answer is correct because it is based on a simple ratio and proportion calculation. The nurse can set up a proportion as follows:

2 mg / 1 mL = 8 mg / x mL

Cross-multiplying and solving for x gives:

x = 4 mL

Therefore, the nurse should administer 4 mL of ondansetron to deliver 8 mg of the medication to the patient.

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.