An infusion at 3 mcg/kg/min. The drug is available as 600 mg in 1000 mL of fluid. The client weighs 150 pounds. Calculate. Do not round, if applicable.

Choice A Reason:
Difficulty swallowing is a critical finding in a client with burns to the face, ears, and eyelids. This symptom can indicate airway edema or obstruction, which is a life-threatening condition. Burns in these areas can cause significant swelling, leading to compromised airways. Immediate intervention is required to secure the airway and prevent respiratory failure.

Choice B Reason:
Pain of 6 on a scale of 0 to 10 is important to manage for patient comfort and to prevent complications related to pain, such as increased heart rate and blood pressure. However, it is not the immediate priority over potential airway compromise. Pain management can be addressed once the airway is secured.

Choice C Reason:
A heart rate of 122/min indicates tachycardia, which can be a response to pain, stress, or hypovolemia. While it is important to monitor and manage, it is not as immediately life-threatening as airway obstruction. Tachycardia can be addressed after ensuring the airway is clear.

Choice D Reason:
Urinary output of 25 mL/hr is below the normal range (typically 30-50 mL/hr) and can indicate dehydration or renal impairment. While this is a concerning finding, it is not the immediate priority compared to securing the airway. Fluid resuscitation and renal function can be managed once the airway is stabilized.

Step-by-Step Calculation:

Step 1: Convert the client's weight from pounds to kilograms.

220 lbs ÷ 2.2 = 100 kg

Result = 100 kg

Step 2: Calculate the concentration of Lidocaine in mcg/mL.

750 mg × 1000 = 750,000 mcg

Result = 750,000 mcg

750,000 mcg ÷ 500 mL = 1500 mcg/mL

Result = 1500 mcg/mL

Step 3: Calculate the infusion rate in mcg/min.

5 mcg/min (prescribed dose)

Result = 5 mcg/min

Step 4: Calculate the infusion rate in mcg/hr.

5 mcg/min × 60 min/hr = 300 mcg/hr

Result = 300 mcg/hr

Step 5: Calculate the infusion rate in mL/hr.

300 mcg/hr ÷ 1500 mcg/mL = 0.2 mL/hr

Result = 0.2 mL/hr

Final Results:

- Infusion rate: 5 mcg/min

- Infusion rate: 300 mcg/hr

- Infusion rate: 0.2 mL/hr