Pharm - Archer Review (1/4) - Dosage Calculation and Medication Administration

Choice A is correct. This assessment findings indicate that the client is experiencing infiltration. Infiltration is when the catheter migrates out of the vein, and the fluid leaks into the surrounding tissue. The nurse must stop/pause the IV fluids and discontinue the PVAD.

The nurse is assessing a client receiving intravenous (IV) fluids via a peripheral vascular access device (PVAD). Assessment findings show swelling and tenderness at the infusion site. The nurse should perform which action? A. stop the infusion and remove the PVAD B. remove the dressing and reposition the PVAD C. instruct the client to perform range of motion activities in the affected arm D. place the arm in a dependent position

➢ The Parkland formula is (4 mL x the client's weight in kilograms x total body surface area burned) ➢ This formula will determine the 24-hour total fluid requirement ➢ Once the total has been established, divide the answer by two. The formula is divided into two phases, the amount of fluid administered within the first eight hours, followed by the amount of fluid administered over sixteen hours ➢ For this problem 4 mL x 85 kg x 27 = 9,180 mL ➢ Then, divide it by two, 4590 mL will be administered over eight hours

The nurse is caring for a client who sustained a 27% total body surface area burn. The client weighs 187 pounds. Using the Parkland formula, the nurse will administer how many mL of intravenous fluid (IVF) in the first eight hours? Fill in the blank.

Choice B is correct. The proper insertion angle for intradermal injections is between 5 and 15 degrees. Additionally, the bevel of the needle should remain side up to allow for smooth skin piercing and induction of the medication into the dermis.

The nurse is preparing to administer an intradermal injection. Which of the following would be appropriate action by the nurse? A. Displace the skin to the side and inject at a 15 degree angle B. Position the needle bevel up at 15 degrees C. Position the needle bevel up at 45 degrees D. Position the needle bevel up at 90 degrees with a dart-like motion

Choice C is correct. Ophthalmic drops should be deposited into the lower conjunctival sac to allow even distribution. It is also imperative that the nurse never make contact with the dropper and the client's eye, as this contaminates the dropper and may cause ocular irritation.

The nurse is supervising a student administering prescribed ciprofloxacin eye drops. It would indicate the correct technique if the student A. instructs the client to squeeze their eyes immediately after administering the drops. B. drops the prescribed number of drops into the cornea. C. drops the prescribed number of drops into the conjunctival sac. D. asks the client to position themselves in a left lateral position with the knees bent.

To solve this, use the formula of dose ordered / dose on hand x volume to determine the mL/hr. 1250 units / 25000 units x 500 mL = 25 mL/hr Next, take the mL/hr and multiply it by eight to determine the total volume delivered. 25 mL/hr x 8 hours = 200 mL

The nurse is caring for a client receiving a continuous infusion of heparin. The label reads 25,000 units of heparin in 500 mL of Dextrose 5% in water (D5W). The client is receiving 1,250 units per hour. How many milliliters (mL) did the client receive in an eight-hour shift? Fill in the blank.

Choice A is correct. This action requires follow-up as the dorsogluteal site is not recommended. The dorsogluteal site is not recommended because of potential damage to nearby nerves and blood vessels.

The nurse is precepting a newly hired nurse administer an intramuscular injection to an adult. Which action by the newly hired nurse requires follow-up? A. Prepares to administer the medication in the dorsogluteal. B. Prepares to insert the needle at a 90-degree angle. C. Uses isopropyl alcohol to clean the area prior to injection. D. Washes their hands before and after the procedure.

Choice D is correct. This needle size and gauge are appropriate for a neonate. When administering IM medications to a neonate or young child, the vastus lateralis is the preferred site. For the volume to be administered in an IM, it is recommended to be 0.5 mL or less for infants; up to 2 mL for children.

The nurse is preparing to administer an intramuscular (IM) injection to a neonate. Which gauge and size needle should the nurse use to administer the medication? A. 19 gauge, 1 1/2" (3.8 cm) needle B. 18 gauge, 1" (2.5 cm) needle C. 20 gauge, 1" (2.5 cm) needle D. 25 gauge, 5/8" (1.6 cm) needle

Choices A and F are correct. As people age, several physiological changes occur. Many of these changes impact the pharmacokinetics and pharmacodynamics of medications. The regular physiological changes associated with the aging process that can adversely affect the excretion and elimination of drugs in the human body are the aging population's low-functioning nephrons and diminished glomerular filtration. These changes can lead to the accumulation of medications in the body because they are not properly eliminated.

The nurse conducts a review course on older adults and medication elimination/excretion. It would be appropriate for the nurse to note which factor may impact drug elimination? Select all that apply. Diminished glomerular filtration Decreased enzyme functioning Decreased peristalsis Lower pH of the gastric secretions Increased acidity of the gastric secretions Low functioning nephrons

First, determine the total daily dose for this child 50 mg x 18.5 = 925 mg Next, determine the individual dose. The drug is given every six hours, so the child will receive four individual doses each day. Divide the daily dose by the frequency of dosing 925 mg/day / 4 doses/day = 231.25 Finally, round the dose to the nearest whole number 231.25 = 231 mg

The nurse is preparing to administer penicillin V potassium to a child with pneumonia. The child weighs 18.5 kg. The prescription is for 50 mg/kg/day PO divided doses every six hours. How many milligrams should the child receive with each dose? Round your answer to the nearest whole number. Fill in the blank.

To solve this problem, the nurse will use the formula of total volume x drop factor / time in minutes First, take the prescribed volume and multiply it by the drop factor 150 mL x 15 gtt = 2250 mL Next, divide the total volume by the minutes 2250 mL / 60 minutes = 37.5 gtts Finally, perform appropriate rounding (if needed) 37.5 gtts = 38 gtts/minute

The primary healthcare provider (PHCP) prescribes 150 mL of sterile water to be administered over one hour. The drop factor is 15 gtts/mL. The nurse sets the flow rate at how many drops per minute? Round your answer to the nearest whole number. Fill in the blank.

The primary healthcare provider (PHCP) prescribes 20 mg/kg of acetaminophen for a child weighing 29 lbs. How many milligrams should the nurse administer to the child? Fill in the blank. Round your answer to the nearest whole number. To solve this multistep problem, convert the child's weight from pounds to kilograms 29 / 2.2 = 13.18 Next, multiply the prescribed amount by the weight in kg 20 mg x 13.18 kg = 263.60 mg Finally, round the amount to the nearest whole number 263.60 mg = 264 mg

The primary healthcare provider (PHCP) prescribes 20 mg/kg of acetaminophen for a child weighing 29 lbs. How many milligrams should the nurse administer to the child? Fill in the blank. Round your answer to the nearest whole number.

To calculate the client's total intake, the nurse must recall that one cup is eight ounces, equating to approximately 240 mL. The client received a 0.9% saline infusion at 125 mL/hr for six hours → 750 mL total Three cups of cranberry juice → 720 mL One cup of coffee → 240 mL One cup of water → 240 mL When added up, the total intake was 1950 mL

The nurse is calculating intake for a client. The client received 0.9% saline at 125 mL/hr for six hours, three 8-ounce cups of cranberry juice, one 8-ounce cup of coffee, and one 8-ounce cup of water. The nurse should calculate the client's total intake as how many mL? Fill in the blank.

Choice A is correct. When preparing to administer medications, the first nursing action is identifying the correct client. The other actions, such as verifying allergies, interactions, etc., cannot occur until the client's medical record is accessed, which starts with ascertaining the client's name and date of birth.

The nurse is preparing to administer a prescribed medication to a client. The nurse should take which initial action? A. Verify the client's full name and date of birth B. Ask about any medication allergies C. Review the client's vital signs D. Review medications and potential interactions

To solve this problem, the formula of volume / time (hours) will be used. First, convert the minutes to hours 75 minutes / 60 minutes = 1.25 hrs Next, divide the prescribed total volume by the infusion time 250 mL / 1.25 hours = 200 mL/hr

The primary healthcare provider (PHCP) prescribes 250 mL of 0.9% saline to infuse over 75 minutes. How many mL per hour will be administered to the client? Fill in the blank.

Choice A is correct. The client's intake over the nurse's 12-hour shift totaled 1,817 mL. The client's intake is as follows: Three eight-ounce cups of water: One cup = 240 mL 240 mL x 3 (cups) = 720 mL 0.9% sodium chloride at 70 mL/hr: 70 mL/hr x 12 hours = 840 mL 500 mg of azithromycin reconstituted in 250 mL of 0.9% sodium chloride: 500 mg of azithromycin = 250 mL 5 mg of morphine sulfate diluted in 0.9% sodium chloride, totaling an infused volume of 7 mL: Morphine sulfate in normal saline = 7 mL Total Calculation: 720 + 840 + 250 + 7 = 1,817 mL.

The nurse reviews the client's intake and output throughout the twelve-hour shift. The client consumed three eight-ounce cups of water. The client received 0.9% sodium chloride at 70 mL/hr. The client received an infusion of 500 mg of azithromycin reconstituted in 250 mL of 0.9% sodium chloride to treat a bacterial infection. The client received 5 mg of morphine sulfate diluted in 0.9% sodium chloride, totaling an infused volume of 7 mL. When calculating the total intake for the client for the shift, the nurse would document how many milliliters? A. 1817 mL B. 1815 mL C. 1810 mL D. 1800 mL

Choice A is correct. Techniques to make an intramuscular injection less traumatizing include drawing a magic circle around the area, and after the injection, the nurse may fill in a smiley face.

The nurse is preparing to administer a scheduled intramuscular injection to an apprehensive child. Which therapeutic action should the nurse take? A. Draw a "magic circle" on the area before the injection. B. Have another nurse hold down the child. C. Apply EMLA cream to the area immediately before the injection. D. Administer the medication right after the child's nap.

To solve this problem, take the volume of the infusion divided by how many hours it will be infused 250 mL / 2 hours = 125 mL/hr

The nurse is reviewing a primary healthcare provider's prescription for 20 mEq of potassium chloride to be administered to a client with hypokalemia. The medication arrives with a label stating 20 mEq of potassium chloride in 250 mL of sodium chloride (normal saline). How many milliliters per hour (mL/hr) should the nurse set the infusion pump to when giving it over two hours? Fill in the blank.

The formula of dose ordered / dose on hand x volume will be utilized to solve this problem. Divide the prescribed amount of medication by what is on hand 100 mg / 250 mg = 0.4 mg Next, take the amount of the medication and multiply it by the volume 0.4 mg x 5 mL = 2 mL

The primary healthcare provider (PHCP) prescribes 100 mg of amoxicillin oral suspension by mouth, four times a day. The medication label reads amoxicillin 250 mg per 5 mL. The nurse prepares to administer how many milliliters per dose? Fill in the blank.

To solve this problem, the nurse will use the formula of volume / time (hours) First, convert the 30 minutes to hours 30 minutes / 60 = 0.5 hr Next, divide the volume by the hour(s) 100 mL / 0.5 = 200 mL/hr

The primary healthcare provider (PHCP) prescribes 500 mg of intravenous (IV) metronidazole to be administered over thirty minutes. The pharmacy supplies the medication in a bag labeled 500 mg of metronidazole in 100 mL of 0.9% saline. How many mL/hour should the nurse administer this medication? Fill in the blank.

The formula of dose ordered / dose on hand x volume will be utilized to solve this problem. Divide the prescribed amount of medication by what is on hand 2 units / 100 units = 0.02 units Next, take the amount of the medication and multiply it by the volume 0.02 units x 250 mL = 5 mL/hr

The primary healthcare provider (PHCP) prescribes a regular insulin infusion for a client with diabetic ketoacidosis (DKA). The prescription is for 2 units/hr. The label on the medication reads 250 mL of 0.9% saline containing 100 units of regular insulin. How many mL/hr should the client receive?

The first step to solving this problem is to convert the client's weight from pounds to kilograms (kg) 154 pounds / 2.2 = 70 kg Next, establish the dosage that the client is to receive. 15 units x 70 kg = 1050 units Next, take the ordered amount and divide it by the dose on hand and then multiply it by the volume. 1050 units / 25000 units x 250 mL = 10.5 mL/hr Finally, round the mL/hr to the nearest whole number 10.5 mL = 11 mL/hr

The nurse is caring for a client prescribed IV heparin. The client is prescribed 15 units/kg/hr. The client weighs 154 pounds. The heparin is labeled with 25,000 units in 250 mL of D5W. How many mL/hr should this client receive? Round your answer to the nearest whole number. Fill in the blank.

The formula of dose ordered / dose on hand x volume will be utilized to solve this problem. Divide the prescribed amount of medication by what is on hand 30 mg / 10 mg = 3 tablets

The primary healthcare provider (PHCP) prescribes 30 mg of phenobarbital by mouth, once daily. The medication label reads phenobarbital 10 mg tablets. The nurse prepares to administer how many tablet(s) per dose? Fill in the blank.

The formula of dose ordered / dose on hand x volume will be utilized to solve this problem. First, divide the prescribed amount of medication by what is on hand 4 mg / 10 mg = 0.4 mL Finally, multiply it by the volume. If none is listed, multiply the answer by one (1) 0.4 mL x 1 mL = 0.4 mL

The primary healthcare provider (PHCP) prescribes 4 mg of morphine intramuscular (IM). The medication vial reads morphine sulfate, 10 mg/mL. The nurse prepares how many milliliters to administer the appropriate dose? Fill in the blank.

The first step is to convert the client's weight from pounds (lbs) to kilograms (kg) 256 lbs → 116.36 kg Next, multiply the prescribed dosage by the client's weight 0.1 units x 116.36 kg = 11.6 units Finally, take the answer and round it to the nearest whole number 11.6 units = 12 units

The primary healthcare provider (PHCP) prescribes a bolus of regular insulin prior to a continuous infusion. The prescription is for 0.1 units/kg. The client weighs 256 lbs. How many units of insulin should the nurse administer to the client? Fill in the blank. Round your answer to the nearest whole number.

Choice A is correct. The air vent should not be irrigated with water or used to administer medications. The purpose of the air vent is to permit free, continuous drainage of secretions when the NGT is connected to suction. This vent is found on a Salem sump tube and is often called a blue "pigtail."

The nurse is supervising a newly hired nurse administer prescribed medications via a double-lumen nasogastric tube (NGT) with an air vent. Which action by the newly hired nurse requires follow-up? The newly-hired nurse A. irrigates the air vent before medication administration with water. B. contacts the pharmacy to obtain available medications in liquid form. C. flushes the NGT between medications with water. D. administers each medication separately through the NGT.

To calculate the client's total intake, the nurse must recall that one cup is eight ounces, equating to approximately 240 mL. The client received one 150 mL intravenous antibiotic → 150 mL One eight-ounce cup of coffee → 240 mL One eight-ounce cup of ice cream → 240 mL Three eight-ounce cups of water → 720 mL Two 10 mL sodium chloride (normal saline) flushes → 20 mL When added up, the total intake was 1370 mL

The nurse is calculating intake for a client for the prior twelve-hour shift The client received one 150 mL intravenous antibiotic One eight-ounce cup of coffee One eight-ounce cup of ice cream Three eight-ounce cups of water Two 10 mL sodium chloride (normal saline) flushes The nurse should calculate the client's total intake as how many mL? Fill in the blank.

The first step to solving this problem is to convert the client's weight from pounds to kilograms (kg) 246 pounds / 2.2 = 111.81 kg Next, establish the dosage that the client is to receive. 18 units x 111.81 kg = 2012.58 units Next, take the ordered amount and divide it by the dose on hand and then multiply it by the volume. 2012.58 units / 25000 units x 250 mL = 20.12 mL/hr Finally, round the mL/hr to the nearest whole number 20.12 mL = 20 mL/hr

The nurse is caring for a client prescribed IV heparin. The client is prescribed 18 units/kg/hr. The client weighs 246 pounds. The heparin is labeled with 25,000 units in 250 mL of D5W. How many mL/hr should this client receive? Round your answer to the nearest whole number. Fill in the blank.

Choice C is correct. This is correct because rapid-acting insulin (lispro, aspart, glulisine) should be given within 10-15 minutes before a meal or while the client is actively eating.

The nurse has attended a continuing education conference regarding medication administration and meal times. Which statement, if made by the nurse, would indicate correct understanding? A. Proton pump inhibitors (PPIs) should be given as the client eats their breakfast. B. Glucocorticoids should be given on an empty stomach to prevent gastrointestinal irritation. C. Rapid-acting insulins should be administered approximately 10-15 minutes before meals D. Levodopa-Carbidopa should be administered with a high-protein snack to enhance its absorption.

Choice A is correct. Infiltration is a complication that can occur when a non-vesicant drug, intended for subcutaneous administration, unintentionally enters the surrounding subcutaneous tissue. This may happen due to issues like catheter displacement or improper needle placement.

The nurse is discussing infiltration with a group of students. It would be appropriate for the nurse to describe this complication as A. a non-vesicant drug entering subcutaneous tissue. B. a vesicant drug entering into subcutaneous tissue. C. a non-vesicant drug entering intradermal tissue. D. a vesicant drug entering into intradermal tissue.

Choice A is correct. This technique is not appropriate and requires follow-up. Depressing the plunger during the needle insertion is inappropriate because the medication is discharged when not in the appropriate spot. Once the nurse has appropriately anchored the needle in the appropriate landmark, the nurse can then depress the plunger, ensuring that the medication is discharged in the appropriate location.

The nurse is observing a nursing student prepare to give an intramuscular (IM) injection in a client's deltoid. Which action by the student requires follow-up? A. Depresses the plunger of the syringe during the insertion of the needle B. Locates the injection site 3 finger widths below the acromion process C. Positions the client either lying or sitting position D. Dons clean gloves before administering the injection

To solve this problem, the formula of volume / time (hours) will be used. First, convert the minutes to hours 45 minutes / 60 minutes = 0.75 hrs Next, divide the prescribed total volume by the infusion time 100 mL / 0.75 hours = 133.33 Finally, take the mL/hour and round to the nearest whole number 133.33 = 133 mL/hr

The primary healthcare provider (PHCP) prescribes 100 mL of 0.9% saline to infuse over 45 minutes. How many mL per hour will be administered to the client? Fill in the blank. Round your answer to the nearest whole number.

First, the nurse must convert the prescription to the same units as the medication label (micrograms → milligrams) 125 micrograms → 0.125 mg (divide 125 micrograms by 1000) Next, take the dose ordered and divide it by the dose on hand and multiply by its volume 0.125 mg / 0.25 mg x 1 tablet = 0.5 tablet Please note answers such as .5 are incorrect because that is not safely written. When responding, it is essential to have a leading zero for any answer to the tenths.

The primary healthcare provider (PHCP) prescribes 125 mcg of digoxin by mouth daily. The medication label reads digoxin 0.25 mg per tablet. The nurse prepares to administer how many tablet(s)? Fill in the blank

The first step is to convert the client's weight from pounds (lbs) to kilograms (kg) 277 lbs → 125.90 kg Next, multiply the prescribed dosage by the client's weight 0.1 units x 125.90 kg = 12.59 units Finally, take the answer and round it to the nearest whole number 12.59 units = 13 units

The nurse is preparing to administer a regular insulin IV bolus to a client who has hyperglycemic-hyperosmolar state (HHS). The primary health care provider (PHCP) has prescribed an initial bolus dose of 0.1 unit/kg. The client weighs 277 lbs. How much regular insulin should the nurse administer to the client as an IV bolus? Fill in the blank. Round your answer to the nearest whole number.

Choices B and C are correct. It is very important to always verify the correct placement of the tube before medication administration. The initial verification method for an NGT after placement is an x-ray. Subsequent verification should be completed by aspirating gastric content and assessing its pH (normal is less than 4). It is appropriate to turn off the suction during medication administration. If the client remained on low-intermittent wall suction, it could be evacuated from the stomach via suction before it had the chance to be absorbed. The nurse should stop the suction and clamp the nasogastric tube (NG tube) for 30 minutes after administering the medications to allow them to absorb fully.

The nurse is preparing to administer prescribed medications to a client via a nasogastric tube connected to low-intermittent suction. The nurse should take which appropriate action? Select all that apply. - Position the patient in Trendelenburg position. - Verify correct placement of the tube before medication administration. - Turn off the suction during medication administration. - Resume low-intermittent wall suction immediately after medication administration. - Irrigate the nasogastric tube (NGT) with sterile water.

Choice C is correct. When administering ear drops to this client, the nurse should have the client positioned on the side with the ear to be treated facing up, or the client may sit in a chair or at the bedside. Once the client is in an appropriate position, the nurse should straighten the ear canal by pulling the pinna up and back to the 10 o'clock position.

The nurse is preparing to administer ear drops to a client who is six years old. The nurse should perform which action? A. Pull the ear pinna down and back B. Position the client on their side with the ear to be treated against a pillow C. Pull the ear pinna up and back D. Place cotton directly into the ear canal after ear drop administration

To calculate the client's total intake, the nurse must recall that one cup is eight ounces, equating to approximately 240 mL. The client received one 100 mL intravenous antibiotic → 100 mL total One cup of ice → 120 mL total When determining the total mL for a cup of ice, the nurse should divide the volume by 1/2 since the ice melts One cup of ice is 240 mL, and it would be divided by half to account for the melt = 120 mL One cup of coffee → 240 mL One cup of ice cream → 240 mL Three cups of water → 720 mL When added up, the total intake was 1420 mL

The nurse is calculating intake for a client. The client received one 100 mL intravenous antibiotic One eight-ounce cup of ice chips One eight-ounce cup of coffee One eight-ounce cup of ice cream Three eight-ounce cups of water The nurse should calculate the client's total intake as how many mL? Fill in the blank.

To calculate the client's total intake, the nurse must recall that one cup is eight ounces, equating to approximately 240 mL. The client received two 100 mL intravenous antibiotics → 200 mL total Two cups of ice → 240 mL total When determining the total mL for a cup of ice, the nurse should divide the volume by 1/2 since the ice melts One cup of ice is 240 mL, and it would be divided by half to account for the melt = 120 mL 120 mL x 2 (number of cups the client consumed) One cup of coffee → 240 mL Three cups of water → 720 mL When added up, the total intake was 1400 mL

The nurse is calculating intake for a client. The client received two 100 mL intravenous antibiotics. Two eight-ounce cups of ice One eight-ounce cup of coffee Three eight-ounce cups of water. The nurse should calculate the client's total intake as how many mL? Fill in the blank.

To calculate the client's total intake, the nurse must recall that one cup is eight ounces, equating to approximately 240 mL. The client received 0.9% saline infusion at 70 mL/hr for four hours → 280 mL total Two cups of ice chips → 240 mL total When determining the total mL for a cup of ice, the nurse should divide the volume by 1/2 since the ice melts One cup of ice is 240 mL, and it would be divided by half to account for the melt = 120 mL 120 mL x 2 (number of cups the client consumed) One cup of coffee → 240 mL Three cups of water → 720 mL When added up, the total intake was 1480 mL

The nurse is calculating intake for a client. The client received 0.9% saline at 70 mL/hr for four hours, two eight-ounce cups of ice chips, one eight-ounce cup of coffee, and three eight-ounce cups of water. The nurse should calculate the client's total intake as how many mL? Fill in the blank.

The client received 0.45% saline at 85 mL/hr x 12 hours → 1020 mL One eight-ounce cup of ice chips → 120 mL When determining the total mL for a cup of ice, the nurse should divide the volume by 1/2 since the ice melts One eight-ounce cup of coffee → 240 mL One eight-ounce cup of ice cream → 240 mL Three eight-ounce cups of water → 720 mL One eight-ounce cup of pureed vegetables → This is excluded from the intake calculation as pureed food(s) are not a liquid at room temperature Total → 2340 mL

The nurse is calculating the 12-hour intake for a client The client received 0.45% saline at 85 mL/hr via continuous infusion One eight-ounce cup of ice chips One eight-ounce cup of coffee One eight-ounce cup of ice cream Three eight-ounce cups of water One eight-ounce cup of pureed vegetables The nurse should calculate the client's total liquid intake as how many mL? Fill in the blank.

Choice B is correct. Infiltration occurs when the intravenous (IV) catheter has migrated out of the vein, and the fluid spills into the surrounding tissue. Manifestations of infiltration include swelling, coolness, tingling, or redness at the IV site. The nurse should stop the infusion, discontinue the IV catheter, elevate the affected extremity above the client's heart, apply a warm compress to the affected area, and restart the IV in the opposite extremity.

The nurse is caring for a client receiving a continuous infusion of isotonic fluids and observes infiltration at the vascular access device. The nurse should take which action? A. Reduce the infusion rate and elevate the affected extremity. B. Stop the infusion and remove the intravenous (IV) catheter. C. Stop the infusion and reposition the intravenous (IV) catheter into the vein. D. Reduce the infusion rate and apply a warm compress to the intravenous (IV) site.

Choice D is correct. When flushing a central vascular access device, such as a PICC line, the nurse should flush each lumen with 0.9% sodium chloride (normal saline) in a 10 mL syringe. This 10 mL volume of the syringe is necessary because of its pressure to remove adequate debris and any fibrin clots that could form on the tip of the catheter. A pulsatile flushing technique removes any fibrin debris on the end of the catheter, which protects the lumen from becoming occluded. Because of its isotonicity, only 0.9% saline should be used to flush vascular access devices.

The nurse is caring for a client with a peripherally inserted central catheter (PICC) in the left upper extremity. It would indicate correct nursing care if the nurse A. pulsatile flushes each lumen with 0.9% sodium chloride (normal saline) in a 5 mL syringe. B. slowly flushes each lumen with 0.9% sodium chloride (normal saline) in a 10 mL syringe. C. pulsatile flushes each lumen with sterile water in a 10 mL syringe. D. pulsatile flushes each lumen with 0.9% sodium chloride (normal saline) in a 10 mL syringe.

Choices A and D are correct. Timely medication reconciliation is fundamental in the prevention of medication errors. Medication reconciliation is when the client's medications are inventoried and assessed for interactions, duplications, or omissions. Completing a medication reconciliation at admission, a transition of care, and discharge will identify potentially dangerous drug-to-drug interactions. Verbal and telephone errors are significant sources of medication errors. The nurse should limit these types of orders to emergent situations. These methods are discouraged because accents, dialects, and drug name pronunciations may skew the order being given.

The nurse is planning a staff development conference about measures to reduce medication errors. It would be appropriate for the nurse to state which actions may help reduce medication errors? Select all that apply. - Timely medication reconciliation - Delay documentation of medication administration to the end of the shift - Delegate medication transcription to unlicensed assistive personnel (UAP) - Limit the use of verbal orders to emergent situations - Place medication dispensing systems in high-traffic areas

Choice C is correct. Medication reconciliation was designed to prevent omission and duplicate errors related to medication administration.

The nurse is planning a staff development conference about medication reconciliation. Which of the following information should the nurse include? A. Medication reconciliation should occur just at discharge to prevent omissions. B. Prescribed medications should be obtained and omit herbs and supplements. C. This process should occur at admission, client transfer, and discharge. D. Obtain a list of the medications instead of reviewing the list with the client

Choice A is correct. This is the appropriate anatomical landmark for giving an IM in the vastus lateralis. To locate the vastus lateralis, palpate to find greater trochanter and knee joints; divide vertical distance between these two landmarks into thirds; inject into the middle third.

The nurse is preparing to administer an intramuscular (IM) injection into the client's vastus lateralis. The nurse is correct in identifying the landmark by A. palpating to find greater trochanter and knee joints; divide the vertical distance between these two landmarks into thirds; inject into the middle third. B. locating the acromion process; inject only into the upper third of muscle that begins about two fingerbreadths below the acromion. C. locating the greater trochanter, iliac tubercle, and iliac crest; places palm over the greater trochanter, over iliac tubercle, along the ileum; inject into center of V formed by the fingers. D. displacing the skin by pulling the skin down or to one side about 1 inch with the non-dominant hand before administering the injection.

- Place the tourniquet 10 to 15 cm (4-6 inches) above the proposed site - Palpate vein at intended insertion site by pressing downward - Release tourniquet temporarily - Clean the selected area using an alcohol-based 2% chlorhexidine solution using friction for 30 seconds - Reapply the tourniquet 10 to 15 cm (4-6 inches) above the anticipated insertion site - Insert the intravenous catheter at a 15 to 30 degree angle - Advance the catheter until a flash of blood is seen, advance the catheter into the vein while removing the needle - Release the tourniquet and connect the Luer-Lok end of short extension tubing to the needleless connector to the catheter hub - Apply sterile dressing over the intravenous site

The nurse is preparing to insert a peripheral vascular access device. The nurse should perform which action? - Reapply the tourniquet 10 to 15 cm (4-6 inches) above the anticipated insertion site - Palpate vein at intended insertion site by pressing downward - Clean the selected area using an alcohol-based 2% chlorhexidine solution using friction for 30 seconds - Place the tourniquet 10 to 15 cm (4-6 inches) above the proposed site - Release tourniquet temporarily - Apply sterile dressing over the intravenous site - Insert the intravenous catheter at a 15 to 30 degree angle - Release the tourniquet and connect the Luer-Lok end of short extension tubing to the needleless connector to the catheter hub - Advance the catheter until a flash of blood is seen, advance the catheter into the vein while removing the needle

Choice B is correct. This statement is incorrect and requires follow-up.Enoxaparin comes in prefilled syringes that are administered to the client subcutaneously. Since this medication comes in prefilled syringes, the air bubble should not be expelled. This is designed to remain next to the plunger to ensure the full dose is administered.

The nurse is teaching a caregiver how to administer an injection of a prefilled syringe of enoxaparin. Which statement, if made by the caregiver, would require further teaching? A. "I will give this injection in the abdomen." B. "I should expel the air bubble before administering." C. "Green leafy vegetables are allowed while taking this medication." D. "This medication may increase the risk for bleeding."

Choice B is correct. This statement is incorrect and requires follow-up.Enoxaparin comes in prefilled syringes that are administered to the client subcutaneously. The appropriate angle for subcutaneous injection is 90 degrees or 45 degrees. 45 degrees would be an appropriate angle if the client did not have ample subcutaneous tissue.

The nurse is teaching a caregiver how to administer an injection of enoxaparin. Which statement, if made by the caregiver, would require further teaching? A. "I will give this injection in the abdomen." B. "I should give this injection at a 30 degree angle." C. "Acetaminophen is safe while taking this medication for any aches or pains." D. "A soft toothbrush should be used while taking this medicine."

Choice D is correct. When administering a PPD, the nurse should administer the test intradermal at an angle of 15-degrees. The appropriate gauge and length of the needle should be 25- to 27-gauge, ½- to 5⁄8-inch.

The nurse supervises a nursing student administering a purified protein derivative (PPD) skin test. Which action by the student requires follow-up by the nurse? A. Inserts the needle, bevel up at a 15-degree angle B. Instructs the client that the test will be read in 48-72 hours C. Selects a site 3 to 4 finger widths below the antecubital space D. Administers the test using a 20-gauge needle, 2 inches long

The formula of dose ordered / dose on hand x volume will be utilized to solve this multistep problem. First, convert the weight from pounds to kilograms. 40 lbs / 2.2 kg = 18.18 kg Next, determine the prescribed dose 0.15 mg x 18.18 kg = 2.72 mg Next, take the dose ordered / dose on hand x volume 2.72 mg / 2 mg x 1 mL = 1.36 mL Finally, round the final result to the nearest number 1.36 mL = 1.4 mL

The primary health care provider (PHCP) prescribes ondansetron 0.15 mg/kg IV to a pediatric client who weighs 40 lb. The medication label reads 2 mg/mL. How many milliliters will the nurse administer to the client? Fill in the blank. Round the answer to the nearest tenth.

To solve this multi-step problem, the formula of dose ordered / dose on hand x volume will be utilized. First, the nurse must convert the prescription to the same units as the medication label (grams → milligrams) 0.5 grams → 500 mg Next, take the dose ordered and divide it by the dose on hand and multiply by its volume 500 mg / 500 mg x 1 capsule = 1 capsule

The primary healthcare provider (PHCP) prescribes 0.5 grams of cefaclor by mouth, twice a day. The medication label reads cefaclor 500 mg capsule. The nurse prepares to administer how many capsules per dose?

The dose ordered / dose on hand formula x volume = will be used to solve this problem. First, convert the weight from pounds to kilograms. 132 pounds / 2.2 = 60 kilograms Next, determine the prescribed amount 1 mg x 60 kilograms = 60 mg Finally, take the dose ordered / dose on hand x volume 60 mg / 60 mg x 0.6 mL = 0.6 mL

The primary healthcare provider (PHCP) prescribes 1 mg/kg of enoxaparin for a client weighing 132 pounds. How many mL should the nurse give to the client when the prefilled syringe reads 60mg/0.6mL. Round your answer to the nearest tenth. Fill in the blank.

To solve this problem, the nurse will use the formula of volume / time (hours) First, convert the 90 minutes to hours 90 minutes / 60 minutes = 1.5 hr Next, divide the volume by the hour(s) 250 mL / 1.5 hr = 166.67 mL/hr Finally, round the answer to the nearest whole number 166.67 mL/hr =167 mL/hr

The primary healthcare provider (PHCP) prescribes 1.5 grams of vancomycin to be infused over 90 minutes. The pharmacy supplies the medication in a bag labeled 1500 mg of Vancomycin in 250 mL of 0.9% saline. How many mL/hour should the nurse administer this medication? Round your answer to the nearest whole number. Fill in the blank.

The first step is to convert the client's weight from pounds (lbs) to kilograms (kg) 17.6 lbs → 8 kg Next, multiply the prescribed dosage by the client's weight 25 mg x 8 kg = 200 mg Next, since the order is in divided doses, the nurse should divide the daily dose by 4 (four 6 hour periods in 24 hours) 200 mg / 4 = 50 mg

The primary healthcare provider (PHCP) prescribes cefdinir 25 mg/kg/day in divided doses every six hours. The infant weighs 17.6 lbs. How many milligrams should the nurse administer per dose? Fill in the blank. Round your answer to a whole number.

To solve this multistep problem, the initial step is to determine the concentration of the insulin 50 units / 100 mL = 0.5 units/mL Next, take the mL per hour that the client is receiving and multiply it by the concentration 10 mL x 0.5 unit per mL = 5 units/hour

A client is receiving 10 mL/hr of a prescribed regular insulin infusion. The label on the bag reads 50 units of regular insulin in 100 mL of 0.9% saline. How many units of insulin is the client receiving every hour? Fill in the blank. Round your answer to the nearest whole number.

The first step is to convert the client's weight from pounds (lbs) to kilograms (kg) 136 lbs → 61.81 kg Next, multiply the prescribed dosage by the client's weight 0.9 mg x 61.81 kg = units Finally, take the answer and round it to the nearest whole number 55.62 mg = 56 mg

A client with a stroke is prescribed alteplase. The prescription is for 0.9 mg/kg. The client weighs 136 pounds. What is the total dose in milligrams (mg) that the client will receive? Round your answer to the nearest whole number. Fill in the blank.

Choice D is correct. Assessing the client's serum electrolytes before administering furosemide is important in ensuring medication safety. Furosemide is a loop diuretic that increases the body's excretion of water, sodium, and potassium. It can lead to significant potassium, calcium, and sodium loss, resulting in electrolyte imbalances and adverse effects.

A nurse is preparing to administer furosemide intravenously to a client. Prior to administering this medication, the nurse should perform which action? A. Obtain the client's weight B. Administering furosemide intravenously rapidly to ensure a quick onset of action C. Verifying the client's blood pressure after administering furosemide D. Assessing the client's serum electrolytes before administering furosemide

First, convert the client's weight from pounds to kilograms 97 lbs = 44.1 kg Next, determine the total daily dose for this child 3 mg x 44.1 = 132.3 mg Next, determine the individual dose. Divide the daily dose by 3. 132.3 mg/day / 3 doses/day = 44.1 mg Finally, round the dose to the nearest whole number 44.1 mg = 44 mg

A nurse is preparing to administer gentamycin to a child. The order is for 3 mg/kg IV daily in three divided doses. The client weighs 97 lbs. How many milligrams should the nurse administer per dose? Fill in the blank. Round your answer to the nearest whole number.

When determining the output for an infant, the preweighed wet diaper is weighed on a gram scale, and the gram weight of the urine is converted directly to milliliters (e.g., 35 g = 35 ml).

After administering a bolus of intravenous fluids (IV) to an infant. The infant's diaper weighs 35 grams. How many mL of urine should the nurse record in the medical record? Fill in the blank.

Choice B is correct. Administering medication via the intravenous route provides several key advantages, including rapid onset, because it skips the pharmacokinetic absorption stage. While this route may be more costly, it would be highly recommended for a client in critical condition where medication administration is often central in promoting an optimal outcome.

The nurse is caring for a client in critical condition requiring several medications. The nurse understands which route of administration would be recommended for this client? A. Subcutaneous (subQ) B. Intravenous (IV) C. Intramuscular (IM) D. Oral (PO)

To solve this problem, the formula of dose ordered / dose on hand x volume will be used. 3 grams (ordered) / 20 grams (on hand) x 1000 mL (volume) = 150 mL/hr

The client is prescribed 3 g/hr of intravenous magnesium sulfate via continuous infusion. The label reads 20 g of magnesium sulfate in 1000 mL of normal saline. How many mL/hr should the nurse set the pump to deliver the prescribed dose? Fill in the blank.

Choice A is correct. A large-bore peripheral vascular access device (PVAD) is the clinical standard for clients requiring a large volume of fluid or individuals suffering major trauma. The essential advantage of a large bore PVAD is that the client may receive the necessary volume in an expedient amount of time. A PVAD of 20 gauge or less is considered a large-bore PVAD.

The emergency department (ED) nurse cares for a client with suspected shock and is prescribed a large volume of sodium chloride (normal saline). The nurse plans on starting which gauge peripheral vascular access device? A. 18-gauge B. 22-gauge C. 24-gauge D. 26-gauge

To solve this multistep problem, the formula of dose ordered / dose on hand x volume will be used First, convert the weight to kilograms 180 / 2.2 = 81.81 kg Next, determine the hourly dosage 5 mcg x 81.81 kg x 60 minutes = 24543 mcg Next, convert the micrograms to milligrams 24543 mcg / 1000 mg = 24.54 mg Next, divide the dose ordered by the amount on hand x the volume 24.54 mg / 200 mg x 250 mL = 30.67 mL/hr Finally, round the answer to the nearest whole number 30.67 mL/hr = 31 mL/hr

The nurse has received a prescription to administer dopamine at 5 mcg/kg/min. On hand, the nurse has a bag labeled with dopamine 200 mg in 250 mL of D5W. The client weighs 180 lbs. How many mL/hr will deliver the prescribed dose? Fill in the blank. Round to the nearest whole number.

The first step to solving this problem is to establish the dosage that the client is to receive. 12 units x 92 kg = 1104 units Next, take the ordered amount and divide it by the dose on hand and then multiply it by the volume. 1104 units / 25000 units x 250 mL = 11.04 mL/hr Finally, round the mL/hr to the nearest whole number 11.04 mL = 11 mL/hr

The nurse is caring for a client prescribed IV heparin. The client is prescribed 12 units/kg/hr. The client weighs 92 kg. The heparin is labeled with 25,000 units in 250 mL of D5W. How many mL/hr should this client receive? Round your answer to the nearest whole number. Fill in the blank.

Choice A is correct. Polypharmacy has been directly implicated in falls, confusion, hospital admissions, and adverse reactions. Older adults are highly susceptible to polypharmacy. This topic is a priority because of the broad spectrum of adverse outcomes associated with polypharmacy.

The nurse is planning a community health class for older adults. Which topic should the nurse prioritize? A. preventing polypharmacy B. strategies to stay physically active C. staying socially engaged in the community D. recommended immunizations

To solve this problem, the formula of volume / by the number of hours will be used 2350 mL / 5 hours = 470 mL/hr

The primary healthcare provider (PHCP) prescribes 2350 mL of 0.9% saline to a client with severe hypovolemia. The PHCP prescribes the infusion over five hours. How many mL/hr will deliver the prescribed dose? Fill in the blank.

To solve this multistep problem, the formula of dose ordered / dose on hand x volume will be used First, determine the hourly dosage 2 mg x 60 mins = 120 milligrams Next, convert the milligrams to grams so the units align 120 milligrams / 1000 = 0.12 grams Finally, divide the dose ordered by the amount on hand x the volume 0.12 grams / 1 gram x 500 mL = 60 mL/hr

The primary healthcare provider (PHCP) prescribes lidocaine at 2 mg/min. The medication label reads lidocaine 1 gram in 500 mL of 0.9% saline. How many mL per hour will be administered to the client? Fill in the blank.

To solve this problem, the formula of dose ordered / dose on hand x volume will be used Divide the dose ordered by the amount on hand x the volume 2 grams / 20 grams x 500 mL = 50 mL/hr

The primary healthcare provider (PHCP) prescribes magnesium sulfate at 2 grams/hour. The medication label reads magnesium sulfate 20 grams in 500 mL of 0.9% saline. How many mL per hour will administer the prescribed dose? Fill in the blank.

First, convert the prescribed liters to milliliters to determine the total volume ordered 3 liters x 1000 mL = 3000 mL Next, divide the prescribed total volume by the infusion time 3000 mL / 24 hrs = 125 mL/hr

The primary healthcare provider (PHCP) prescribes three liters of 0.9% saline to infuse over 24-hours. How many mL per hour will be administered to the client? Fill in the blank.

First, determine the total daily dose for this child (the child weights 13 kg) 50 mg x 13 kg = 650 mg per day Next, determine the individual dose. Divide the daily dose by 3. 650 mg/day / 3 doses/day = 216.66 mg Next, divide the prescribed dose by the dose on hand x volume 216.66 / 500 mg x 100 mL = 43.32 mL Finally, round your answer to the nearest whole number. 43.32 mL = 43 mL

A nurse is preparing to administer vancomycin to a child. The order is for 50 mg/kg/day in three divided doses. The client weighs 13 kg. The medication label indicates vancomycin 500 mg in 100 mL of 0.9% saline. How many mL will the nurse administer per dose? Fill in the blank. Round your answer to the nearest whole number.

To solve this problem, the formula of dose ordered / dose on hand will be utilized. 0.375 mg is ordered so that will be divided by the amount on hand of 0.25 mg/mL 1.5 mL

The nurse receives a prescription from the primary healthcare provider (PHCP) for 0.375 mg of digoxin intravenously (IV). The nurse has a vial that reads digoxin 0.25 mg/mL. How many mL will administer the appropriate dose? Fill in the blank.

The formula of dose ordered / dose on hand x volume will be utilized to solve this problem. Divide the prescribed amount of medication by what is on hand 400,000 units / 300,000 units = 1.3 mL Next, take the amount of the medication and multiply it by the volume 1.3 mL x 10 mL = 13.3 mL Finally, take the dosage and round to the nearest whole number 13.3 mL = 13 mL

The primary healthcare provider (PHCP) prescribes 400,000 units of penicillin G benzathine. The label on the medication reads penicillin G benzathine 300,000 units / 10 mL. The nurse prepares how many milliliters to administer the appropriate dose? Fill in the blank. Round your answer to the nearest whole number.

To solve this multistep problem, the formula of dose ordered / dose on hand x volume will be used First, convert the weight to kilograms 198 / 2.2 = 90 kg Next, determine the hourly dosage 2.5 mcg x 90 kg x 60 minutes = 13500 mcg Next, convert the micrograms to milligrams 13500 mcg / 1000 mg = 13.5 mg Next, divide the dose ordered by the amount on hand x the volume 13.5 mg / 800 mg x 500 mL = 8.43 mL/hr Finally, round the answer to the nearest whole number 8.43 mL/hr = 8 mL/hr

The primary healthcare provider (PHCP) prescribes dopamine at 2.5 mcg/kg/minute. The client weighs 198 lbs. The medication label reads dopamine 800 mg in 500 mL of dextrose 5% water (D5W). How many mL per hour will be administered to the client? Fill in the blank. Round your answer to the nearest whole number.

To solve this multistep problem, the formula of dose ordered / dose on hand x volume will be used First, convert the weight to kilograms 178 lbs / 2.2 = 80.9 kg Next, determine the hourly dosage 5 mcg x 80.9 kg x 60 minutes = 24270 mcg Next, convert the micrograms to milligrams 24270 mcg / 1000 mg = 24.27 mg Next, divide the dose ordered by the amount on hand x the volume 24.27 mg / 800 mg x 500 mL = 15.16 mL/hr Finally, round the answer to the nearest whole number 15.16 mL/hr = 15 mL/hr

The primary healthcare provider (PHCP) prescribes dopamine at 5 mcg/kg/minute. The client weighs 178 lbs. The medication label reads dopamine 800 mg in 500 mL of dextrose 5% water (D5W). How many mL per hour will be administered to the client? Fill in the blank. Round your answer to the nearest whole number.

Choice C is correct. When administering a medication via the buccal route, the nurse should put the medication inside the client's mouth toward their cheek.

The primary healthcare provider (PHCP) prescribes medication via the buccal route. To correctly administer this medication the nurse plans to place the medication A. in the client's ear while holding the pinna down and back. B. under the client's tongue. C. in the client's mouth toward the cheek. D. into the client's nasal passage.

To solve this problem, the formula of dose ordered / dose on hand x volume will be utilized. 6,000 units / 10,000 units x 1 mL = 0.6 mL

The primary healthcare provider prescribes 6,000 units of heparin subcutaneously. The vial reads 10,000 units/1 mL. How many milliliter(s) should the nurse administer? Fill in the blank.

The first step is to convert the client's weight from pounds (lbs) to kilograms (kg) 257 lbs → 116.81 kg Next, multiply the prescribed dosage by the client's weight 0.9 mg x 116.81 kg = 105.129 mg Finally, take the answer and round it to the nearest whole number 105.129 mg = 105 mg The maximum dosage of alteplase is 90 mg. Thus, the nurse would only deliver this prescribed amount. However, when calculating the problem, it is essential to ascertain the dose for mg/kg first.

A client with a stroke is prescribed alteplase. The prescription is for 0.9 mg/kg. The client weighs 257 pounds. How many milligrams will this equal? Round your answer to the nearest whole number. Fill in the blank.

Choice A is correct. This statement requires follow-up because insulin glargine is only administered subcutaneously. Subcutaneous injections do not have to be administered just in the abdomen as the client may self-administer in the upper outer thighs. Choice C is correct. This statement requires follow-up because insulin glargine does not need to be administered with a meal because this insulin has no peak. Therefore, the likelihood of hypoglycemia is extremely low. Corrective insulin, such as rapid and short-acting, is administered with a meal. Choice D is correct. This statement requires follow-up because glargine insulin does not require to be rolled before administration. For a client receiving NPH insulin, that vial must be rolled to resuspend it so that when it is aspirated into the syringe, the client doesn't risk hypoglycemia because of the variable pharmacodynamic and pharmacokinetic profile. By rolling the vial prior to aspirating the insulin, the medication will be stable and reduce the client's risk for hypoglycemia.

The home health nurse is discussing the administration of insulin glargine with a client. It would require follow-up if the client states that insulin glargine must be administered Select all that apply. - only in the abdomen. - using a 6 mm and 31-gauge insulin syringe. - only with a meal. - after rolling the vial of insulin. - within 28 days of opening the vial.

ventrogluteal; nerve damage; EMLA (lidocaine and prilocaine)

The nurse should administer the ceftriaxone in the client's ___ to prevent ____ The nurse should obtain a prescription for _____ cream to apply before the injection to decrease the child's pain.

To solve this multistep problem, ½ gram will need to be converted to milligrams 1 gram = 1000 mg; half of this would be 500 mg Next, multiply the number of doses by the number of milligrams adminsitered 3 doses x 500 mg = 1500 mg

The primary healthcare provider (PHCP) prescribes ½ gram of acetaminophen, by mouth, every six hours. The nurse has administered 3 doses. How many total milligrams has the client received? Fill in the blank.

This is a multistep problem. First, convert the weight to kilograms (kg) 19.2 lbs / 2.2 = 8.72 kg Next, determine the daily prescribed dosage 80 mg x 8.72 kg = 697.6 mg Further, this medication is ordered in two divided doses, so divide the daily dose by 2 697.6 mg / 2 = 348.8 mg Finally, divide the prescribed dose by the amount on hand 348.8 mg / 250 mg = 1.39 mL Complete the problem by rounding the final answer to the nearest tenth 1.39 mL = 1.4 mL

The primary healthcare provider (PHCP) prescribes amoxicillin 80 mg/kg/day to be given in two divided doses. The infant weighs 19.2 lbs. The label of the medication reads 250 mg/mL of amoxicillin. How many mL of amoxicillin should the nurse administer for one dose? Fill in the blank. Round your answer to the nearest tenth.

To solve this problem, the nurse will use the formula of total volume x drop factor / time in minutes First, take the prescribed volume and multiply it by the drop factor 500 mL x 60 gtt (micro drip tubing is always 60) = 30000 Next, calculate the time in minutes by multiplying the hours by 60 4 hours x 60 = 240 minutes Further, divide the volume by the minutes 30000 mL / 240 minutes = 125 gtt/min Finally, perform appropriate rounding

The primary healthcare provider (PHCP) prescribes 500 mL of 0.9 saline to infuse over four hours via intravenous micro drip tubing. The nurse sets the flow rate at how many drops per minute? Fill in the Blank. Round your answer to the nearest whole number.

To solve this problem, the formula of volume / time (hours) will be used. First, convert the prescribed liters to milliliters to determine the total volume ordered 1 liter x 1000 mL = 1000 mL Next, divide the prescribed total volume by the infusion time 1000 mL / 6 hours = 166.66 Finally, take the mL/hour and round to the nearest whole number 166.66 = 167 mL/hr

The primary healthcare provider (PHCP) prescribes one liter of 0.9% saline to infuse over 6 hours. How many mL per hour will be administered to the client? Fill in the blank. Round your answer to the nearest whole number.

The dose ordered / dose on hand formula x volume = will be used to solve this problem First, convert the weight from pounds to kilograms 66.8 pounds / 2.2 = 30.36 kilograms Next, determine the prescribed amount 1.6 mg x 30.36 kilograms = 48.576 mg Next, take the dose ordered / dose on hand x volume 48.576 mg / 500 mg x 4 mL = 0.38 mL Finally, round your answer to the nearest tenth 0.4 mL

The primary healthcare provider orders solu-medrol 1.6 mg/kg for a child weighing 66.8 lb. The label on the medication reads 500 mg/4 mL. How many milliliters (mL) should the nurse administer? Round your answer to the nearest tenth. Fill in the blank.

First, convert the pounds to kilograms by dividing the weight in pounds by 2.2 236 / 2.2 = 107.27 kg Next, multiply the prescribed amount of fluid by the client's weight in kilograms 30 mL x 107.27 kg = 3218.1 mL Finally, round the amount of fluid to a whole number 3218 mL

The primary healthcare provider prescribes 30 mL/kg of 0.9% saline to a client with suspected sepsis. The client weighs 236 pounds. How many mL will the nurse infuse into the client? Fill in the blank. Round your answer to the nearest whole number.

To solve this problem, the nurse will use the formula of total volume x drop factor / time in minutes First, take the prescribed volume and multiply it by the drop factor 500 mL x 10 gtt = 5000 mL Next, divide the total volume by the minutes 5000 mL / 60 minutes = 83 gtts/min Finally, perform appropriate rounding (if needed)

The primary healthcare provider (PHCP) prescribes 500 mL of 0.45% saline to be administered over one hour. The drop factor is 10 gtts/mL. The nurse sets the flow rate at how many drops per minute? Round your answer to the nearest whole number. Fill in the blank.

The value of the client's urinary output is not necessary to determine the total intake. The nurse must know the conversion of 1 ounce = 30mL. The nurse will add the intravenous fluids and the oral fluids to determine the total fluid intake: 6 ounces of water (6 ounces x 30 mL) → 180 mL of water 8 ounces of chicken broth (8 ounces x 30 mL) → 240 mL of chicken broth 650 mL IV fluid 1070 mL total fluid intake

The nurse determines the total intake for a client diagnosed with acute kidney injury. The client received 650 mL of intravenous fluid, 6 ounces of water, and 8 ounces of chicken broth during the shift. The client's urinary output for the shift is 820 mL. What is the total intake the nurse will record for this client? Fill in the blank.

To solve this problem, the nurse will use the formula of total volume x drop factor / time in minutes First, take the prescribed volume and multiply it by the drop factor 250 mL x 15 gtt = 3750 mL Next, divide the total volume by the minutes 3750 mL / 60 minutes = 62.5 gtts Finally, perform appropriate rounding (if needed) 62.5 gtts = 63 gtts

The primary healthcare provider (PHCP) prescribes azithromycin 500 mg, daily for a client with sepsis. The medication label reads 500 mg of azithromycin mixed in 250 mL of 0.9% saline. The drop factor is 15 gtts/mL and it is to be infused over 60 minutes. The nurse sets the flow rate at how many drops per minute? Round your answer to the nearest whole number. Fill in the blank.

The formula of dose ordered / dose on hand x volume will be utilized to solve this problem. Divide the prescribed amount of medication by what is on hand 4.5 units / 100 units = 0.045 units Next, take the amount of the medication and multiply it by the volume 0.045 units x 250 mL = 11.25 mL Finally, take the answer and round it to the nearest tenth. 11.25 mL = 11.3 mL

The primary healthcare provider (PHCP) prescribes a regular insulin infusion. The prescription is for 4.5 units/hr. The label on the medication reads 250 mL of 0.9% saline containing 100 units of regular insulin. How many mL/hr should the client receive? Fill in the blank. Round your answer to the nearest tenth.

Choice A is correct. When initiating a PCA, the nurse must verify the settings with another nurse to ensure accuracy. PCAs deliver high-risk medications (hydromorphone, fentanyl, morphine), and at shift change, any adjustments in settings, and when replacing the PCA syringe, the nurse should verify the settings to the physician's prescription to ensure client safety. The client's safety is the priority when dealing with a high-risk medication.

The nurse cares for a client receiving fentanyl via patient-controlled analgesia (PCA). After the client reports increased pain, the nurse obtains a physician's order to adjust the PCA settings. After making the prescribed changes on the PCA device nurse should initially A. verify the settings with a second nurse. B. educate the client about the medication's side effects. C. reposition the client for nonpharmacological pain relief. D. reassess the client's pain level.