A physician ordered 1/4 strength Isomil 12 oz via nasogastric tube over 6 hours. How much solvent (water) will be needed?

A) Antibiotics
Antibiotics are medications used to treat infections by killing or inhibiting the growth of bacteria. They do not have any direct effect on clot formation. Antibiotics work by targeting specific parts of bacterial cells, such as cell walls, proteins, or DNA, but they do not interfere with the blood coagulation system. Therefore, antibiotics are not a drug group that inhibits clot formation.

B) Analgesics
Analgesics are pain-relieving medications used to reduce pain, and they include both non-opioid (e.g., acetaminophen, NSAIDs) and opioid medications (e.g., morphine, oxycodone). While some analgesics, particularly nonsteroidal anti-inflammatory drugs (NSAIDs), can affect platelet function and may slightly influence clotting, their primary function is to relieve pain.

C) Antidepressants
Antidepressants are medications used to treat mood disorders, including depression, anxiety, and other psychiatric conditions. These drugs work by altering the balance of neurotransmitters in the brain, such as serotonin, norepinephrine, or dopamine. Antidepressants do not directly affect blood clotting mechanisms, although some classes, such as selective serotonin reuptake inhibitors (SSRIs), can have mild anticoagulant effects due to their impact on platelet aggregation.

D) Anticoagulants
Anticoagulants inhibit the coagulation cascade, a series of complex biochemical reactions that lead to the formation of a blood clot. Common examples of anticoagulants include warfarin, heparin, and the newer direct oral anticoagulants (DOACs) such as rivaroxaban and apixaban. Anticoagulants are primarily used to reduce the risk of clot formation in conditions such as deep vein thrombosis (DVT), pulmonary embolism (PE), and atrial fibrillation (AF), and they are essential in managing and preventing clot-related complications.

Given:

Ordered dose of Dopamine: 3 mcg/kg/min

Child's weight: 41.8 lbs

Concentration of Dopamine: 400 mg in 250 mL D5W

Step 1: Convert child's weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Child's weight in kg = 41.8 lbs x 0.453592 kg/lb = 18.935 kg

Step 2: Calculate the total dose of Dopamine in mcg/min:

Total dose (mcg/min) = Ordered dose (mcg/kg/min) x Child's weight (kg)

Total dose (mcg/min) = 3 mcg/kg/min x 18.935 kg

Total dose (mcg/min) = 56.805 mcg/min

Step 3: Convert mcg to mg:

Total dose (mg/min) = Total dose (mcg/min) / 1000 mcg/mg

Total dose (mg/min) = 56.805 mcg/min / 1000 mcg/mg

Total dose (mg/min) = 0.056805 mg/min

Step 4: Calculate the total dose in mg/hr:

Total dose (mg/hr) = Total dose (mg/min) x 60 min/hr

Total dose (mg/hr) = 0.056805 mg/min x 60 min/hr

Total dose (mg/hr) = 3.4083 mg/hr

Step 5: Calculate the infusion rate in mL/hr:

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

Infusion rate (mL/hr) = 3.4083 mg/hr / (400 mg/250 mL)

Infusion rate (mL/hr) = 3.4083 mg/hr x (250 mL/400 mg)

Infusion rate (mL/hr) = 2.1301875 mL/hr

Step 6: Round to the nearest tenth:

Infusion rate (mL/hr) ≈ 2.1 mL/hr