An order is received for Principen (ampicillin) 25 mg/kg IV for a toddler who weighs 22 lb. The dose is to be infused over 30 minutes. The ampicillin dose arrives from the pharmacy prepared in 50 mL of solution.
How many milliliters per hour should be administered?

This answer is correct because it is based on a series of unit conversions and calculations. The nurse should follow these steps to provide safe medication to the child:

1) Convert the child's weight from pounds to kilograms by dividing by 2.2, since there are 2.2 lbs in 1 kg. The child weighs 20 kg.

2) Multiply the prescribed dose per kilogram by the child's weight in kilograms to get the total dose in milligrams. The child needs 40 mg of pyrimethamine.

3) Use the ratio given on the drug label to convert the total dose in milligrams to the volume in milliliters. The nurse can set up a proportion as follows:

1 mg / 5 mL = 40 mg / x mL

Cross-multiplying and solving for x gives:

x = 200 mL

Therefore, the nurse should administer 200 mL of medication to deliver 40 mg of pyrimethamine to the child.

4) Convert the volume in milliliters to the volume in teaspoons by dividing by 5, since there are 5 mL in 1 tsp. The nurse should administer 40 tsp of medication to the child.

5) Convert the volume in teaspoons to the volume in cups by dividing by 48, since there are 48 tsp in 1 cup. The nurse should administer 0.83 cups of medication to the child.

Insulin is a hormone that helps regulate blood sugar levels. It is usually injected into the fat layer just under the skin (subcutaneous or SubQ) using a syringe and needle or a pen-like device². Insulin syringes are marked in units of insulin, not milliliters or cubic centimeters. The most common insulin syringe holds 1 mL of fluid and has markings for 100 units of insulin². A U-100 syringe means that for every 1 mL of fluid, there are 100 units of insulin³.
To administer 14 units of insulin, you would need to draw up 0.14 mL of fluid in a U-100 syringe. You would inject the insulin into your abdomen, upper arm, butocks, hip, or the front or side of the thigh¹. You would use a different area within the site each time you inject insulin to prevent lumps, swelling, or thickened skin¹.

The other options are incorrect because:

b) There is no need to divide the dose into two injections. This would increase the risk of infection and pain.

c) A tuberculin syringe is not designed for insulin administration. It is marked in milliliters or cubic centimeters, not units of insulin. Using a tuberculin syringe could result in an incorrect dose of insulin.

d) The timing of insulin administration depends on the type and duration of insulin. Some insulins are taken before meals, some are taken after meals, and some are taken once or twice a day. The primary healthcare provider should specify when to take the insulin.