Order: lidocaine 2 g in 250 mL of D5W at 30 mL/h
What is the flow rate?

Given:

Ordered dose of Heparin: 18 units/kg/hr

Patient weight: 123 pounds

Concentration of Heparin: 25,000 units/250 mL (100 units/mL)

Step 1: Convert patient weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Patient weight in kg = 123 lbs x 0.453592 kg/lb = 55.7923 kg

Step 2: Calculate the total dose of Heparin in units/hr:

Total dose (units/hr) = Ordered dose (units/kg/hr) x Patient weight (kg)

Total dose (units/hr) = 18 units/kg/hr x 55.7923 kg

Total dose (units/hr) = 1004.2614 units/hr

Step 3: Calculate the infusion rate in mL/hr:

Infusion rate (mL/hr) = Total dose (units/hr) / Concentration (units/mL)

Infusion rate (mL/hr) = 1004.2614 units/hr / 100 units/mL

Infusion rate (mL/hr) = 10.042614 mL/hr

Step 4: Round to the nearest tenths:

Infusion rate (mL/hr) ≈ 10.0 mL/hr

A) Potassium level of 3.0 mEq/L:
A potassium level of 3.0 mEq/L is below the normal range (3.5-5.0 mEq/L) and indicates hypokalemia. This is a critical finding for a patient taking digoxin. Hypokalemia increases the risk of digoxin toxicity because low potassium levels enhance the action of digoxin on the heart, potentially leading to arrhythmias. Therefore, the nurse should immediately report this finding to the provider for correction of the potassium imbalance.

B) BP of 132/82 mm Hg:
A blood pressure of 132/82 mm Hg is within the normal to slightly elevated range for adults. There is no immediate cause for concern related to the administration of digoxin, as this value is not indicative of hypotension or any immediate contraindication.

C) Digoxin level of 1.2 ng/mL:
A digoxin level of 1.2 ng/mL is within the therapeutic range (0.5-2.0 ng/mL). There is no indication that this level would need to be reported, as it is appropriate for digoxin therapy and not indicative of toxicity.

D) Heart rate of 66/min:
A heart rate of 66/min is within the normal range for an adult at rest (60-100 bpm). A heart rate below 60 bpm may warrant further assessment when taking digoxin, as it can cause bradycardia. However, a heart rate of 66 is not alarming and does not necessitate reporting to the provider, as it is still within an acceptable range for most individuals.