A nurse is preparing to administer 0/9% sodium chloride (0.9% NaCl) 20ml/kg IV tp infuse over 6 hr to a school-age child who weighs 55 lbs. The nurse should set the IV pump to deliver how many ml/hr? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A) 0.2 mg
The correct way to write the dosage is 0.2 mg. In pharmacology and medication administration, it is important to follow the guidelines set by the Institute for Safe Medication Practices (ISMP) and other standard bodies, which recommend that a leading zero be used before a decimal point. This helps to prevent errors in interpreting the dosage. Writing 0.2 mg clearly indicates two-tenths of a milligram, and the leading zero makes it easier to avoid misreading the dose as a whole number (2.0 mg) or omitting the decimal point entirely.

B) .2 mg
Writing the dosage as .2 mg (without the leading zero) is considered unsafe and is a poor practice. The absence of the leading zero before the decimal point increases the likelihood that the dose may be misread. For example, someone could confuse .2 mg with 2.0 mg or misinterpret it in a hurried situation, which could lead to a tenfold dosing error

C) 2.0 mg
Writing 2.0 mg would indicate two milligrams, which is not the correct dosage for "two-tenths of a milligram." While this format does use a decimal point, it does not represent the correct dose. This error could lead to an overdose if misread as a whole number.

D) 0.20 mg
While 0.20 mg is technically correct, it is not the preferred or necessary format. The use of two decimal places is unnecessary in this case. Since the dosage is two-tenths of a milligram, 0.2 mg is simpler and clearer. Using an unnecessary trailing zero (the second "0") can cause confusion or misinterpretation, especially in critical settings where every detail counts.

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.