After assessing a client, a primary healthcare provider prescribes diphenhydramine 25 mg IV STAT for anaphylaxis. The pharmacy supplies a vial with a concentration of 50 mg/mL.
How much and when should a nurse administer this medication?

This numeric form is appropriate, according to the Joint Commission, because it does not use a trailing zero after a decimal point, which is a common cause of medication errors and should be avoided. A trailing zero may be misread or misinterpreted as a larger dose or omited altogether, resulting in a 10-fold overdose or underdose, respectively. For example, when prescriptions have been writen for "Coumadin 1.0 mg," patients have received 10 mg in error¹². Therefore, the Joint Commission requires that a trailing zero may be used only when required to demonstrate the level of precision of the value being reported, such as for laboratory results, imaging studies that report the size of lesions, or catheter/tube sizes. It may not be used in medication orders or other medication-related documentation.

The other options are not appropriate numeric forms because:

a) 3.0 uses a trailing zero after a decimal point, which poses a risk of confusion or error.

b) 0.30 uses a trailing zero after a decimal point, which poses a risk of confusion or error.

c) 0.03 is not equivalent to 0.3, as it is 10 times smaller.

To find the volume of fluid that will be left at 10:00 am, you need to calculate the following:

- The time elapsed in minutes from 8:45 am to 10:00 am using the formula: Time elapsed (min) = End time (min) - Start time (min)
- The volume of fluid infused in milliliters (mL) during the time elapsed using the formula: Volume infused (mL) = Flow rate (mL/min) x Time elapsed (min)
- The volume of fluid left in milliliters (mL) at 10:00 am using the formula: Volume left (mL) = Initial volume (mL) - Volume infused (mL)

First, use the formula for time elapsed to find how many minutes have passed from 8:45 am to 10:00 am:

Time elapsed (min) = End time (min) - Start time (min)

Since the end time is 10:00 am and the start time is 8:45 am, plug in these values into the formula:

Time elapsed (min) = 600 min - 525 min

Simplify and solve for the time elapsed:

Time elapsed (min) = 75 min

Next, use the formula for volume infused to find the amount of fluid infused in milliliters during the time elapsed:

Volume infused (mL) = Flow rate (mL/min) x Time elapsed (min)

Since the flow rate is 2 mL/min and the time elapsed is 75 min, plug in these values into the formula:

Volume infused (mL) = 2 mL/min x 75 min

Simplify and solve for the volume infused:

Volume infused (mL) = 150 mL

Then, use the formula for volume left to find the amount of fluid left in milliliters at 10:00 am:

Volume left (mL) = Initial volume (mL) - Volume infused (mL)

Since the initial volume is 1500 mL and the volume infused is 150 mL, plug in these values into the formula:

Volume left (mL) = 1500 mL - 150 mL

Simplify and solve for the volume left:

Volume left (mL) = 1350 mL

Therefore, the volume of fluid that will be left at 10:00 am is **1350 mL**.