A nurse is preparing to administer haloperidol 5 mg IM to a client. The amount available is haloperidol 20 mg/mL. How many mL should the nurse administer?

(Round the answer to the nearest hundredth. Use a leading zero if it applies. Do not use a trailing zero.)

To calculate the dose of midazolam to administer, we need to convert the client's weight from pounds to kilograms, and then multiply by the dose per kilogram.

Given: Client weight = 220 lb

Dose of midazolam = 0.2 mg/kg

First, let's convert the client's weight from pounds to kilograms:

1 lb ≈ 0.453592 kg (approximately 0.45 kg, for simplicity)

Client weight in kilograms ≈ 220 lb × 0.45 kg/lb ≈ 99 kg

Now, let's calculate the dose of midazolam:

Dose = Weight (in kg) × Dose per kg Dose ≈ 99 kg × 0.2 mg/kg = 19.8 mg

Rounded to the nearest whole number, the nurse should administer approximately 20 mg of midazolam.

A. Insert the needle slowly and gently.

This statement is generally true for most injection techniques, including the Z-track method. Slow and gentle insertion helps minimize discomfort for the client and allows for better control over the needle's placement. However, the specific speed of insertion may vary depending on the nurse's technique and the client's skin condition.

B. Pull the skin 1.3 cm (1/2 inch) to the side.

This statement is correct. The Z-track technique involves pulling the skin laterally (to the side) by approximately 1.3 cm (1/2 inch) before inserting the needle. This lateral displacement of the skin creates a zigzag pathway for the medication, which helps prevent leakage or tracking of the medication along the injection site.

C. Aspirate for 5 to 10 seconds.

Aspiration, or pulling back on the plunger of the syringe after needle insertion, is not typically recommended for intramuscular injections, including those using the Z-track method. Aspiration may increase the risk of tissue trauma or damage to blood vessels. Since the Z-track technique is designed to minimize medication leakage into the subcutaneous tissue, aspiration is usually unnecessary.

D. Use a 45° angle of insertion.

The angle of insertion for the Z-track technique is typically 90 degrees (perpendicular) to the skin surface rather than 45 degrees. This angle allows for proper depth penetration into the muscle and ensures adequate delivery of the medication into the muscle tissue.