Nitroglycerin 125 mg diluted in 500 mL of D5W (dextrose 5% in water) is infusing at a rate of 42 mcg/minute for a patient with chest pain.
What rate (in mL/hr) should the nurse program into the IV pump to deliver this dose? Round your answer to the nearest tenth.
6.5 mL/hr
9.6 mL/hr
10.1 mL/hr
14.8 mL/hr
The Correct Answer is A
To find the rate in mL/hr, you need to calculate the following:
- The concentration of nitroglycerin in the IV solution in mcg/mL
- The infusion rate in mL/hr using the formula: Infusion rate (mL/h) = (Dose (mcg/min) x 60 min/h) / Concentration (mcg/mL)
First, convert the concentration of nitroglycerin from mg to mcg by multiplying by 1000:
125 mg x 1000 = 125,000 mcg
Then, divide the amount of nitroglycerin by the volume of the IV solution to get the concentration in mcg/mL:
125,000 mcg / 500 mL = 250 mcg/mL
Next, plug in the values into the formula for infusion rate:
Infusion rate (mL/h) = (42 mcg/min x 60 min/h) / 250 mcg/mL
Simplify and solve for the infusion rate:
Infusion rate (mL/h) = 10.08 mL/h
Therefore, the nurse should program the IV pump to deliver **10.1 mL/h** to infuse nitroglycerin at 42 mcg/minute.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
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.
Correct Answer is D
Explanation
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.
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