A nurse is preparing to administer midazolam 0.2 mg/kg via IV bolus now. The client weighs 220 lb. How many mg should the nurse administer?

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

A. Pharmacists: Pharmacists are healthcare professionals who are highly knowledgeable about medications, including their indications, dosages, contraindications, interactions, and administration routes. They play a crucial role in ensuring safe medication administration by providing accurate information and counseling to both healthcare providers and patients.

B. Published journals: Published journals contain peer-reviewed articles and research studies on various aspects of medication administration, including best practices, guidelines, new developments, and evidence-based recommendations. Healthcare professionals often refer to reputable journals to stay updated on the latest information and advancements in medication administration.

C. Physicians Desk Reference (PDR): The Physicians Desk Reference is a comprehensive reference book that provides information on prescription drugs, including their indications, dosages, side effects, and interactions. It is commonly used by healthcare providers as a reliable source of medication information to support safe prescribing and administration practices.

D. Pharmaceutical sales representatives: While pharmaceutical sales representatives may provide information about specific medications, their primary role is to promote and market pharmaceutical products. While they may offer valuable information about medication characteristics, their input may be biased toward promoting specific products rather than providing comprehensive and unbiased information about medication administration. Therefore, they are not typically considered acceptable references for safe medication administration.

A. A client received gentamicin intermittent IV bolus over 1 hr:

While gentamicin is typically administered as an intermittent IV bolus, the rate of administration over 1 hour is not necessarily inappropriate. However, the specific institutional protocol or medication administration guidelines should be followed. If the rate of administration deviates significantly from the standard protocol or manufacturer's recommendations, it may warrant further investigation but may not necessarily require an incident report.

B. A nurse used a 25-gauge 3-inch needle to administer a heparin injection:

Using a 25-gauge 3-inch needle for heparin injection is not standard practice and may not be the most appropriate needle size for subcutaneous administration. However, it does not necessarily indicate a need for an incident report unless it resulted in harm to the client. It may prompt further education or clarification regarding appropriate needle selection for subcutaneous injections.

C. A nurse injected Demerol IM into the vastus lateralis site of an adult:

While Demerol (meperidine) is typically administered intramuscularly, the choice of the vastus lateralis site for injection in an adult may not be the most common practice, but it is an acceptable site for IM injections. Unless there are specific contraindications or adverse outcomes related to the site selection, this finding may not require an incident report. However, it could prompt a review of injection site selection guidelines or further education.

D. A client received a crushed bupropion XL tablet mixed with applesauce:

This finding indicates a need for an incident report. Bupropion XL (extended-release) tablets should not be crushed or chewed, as this can lead to rapid release and absorption of the medication, potentially causing adverse effects or toxicity. Administering crushed extended-release tablets is a medication error that warrants an incident report to document the event, assess potential harm to the client, and implement corrective actions to prevent recurrence.