Heparin 10,000 units subcutaneous every 12 hours is ordered for a patient after a stent placement.

The heparin is available in a 20,000 units per 1 mL concentration.

How many milliliters would the nurse administer with each dose? (ROUND TO TENTHS; LABEL CORRECTLY TO RECEIVE CREDIT)

Step 1 is to calculate the total drops to be infused. 100 mL × 15 gtt/mL = 1500 gtt.

Step 2 is to calculate the flow rate in drops per minute. 1500 gtt ÷ 30 minutes = 50 gtt/min. The final calculated answer is 50 gtt/min

Choice A rationale

Positioning a school-aged child in the supine position with the head tilted backward during nose drop administration allows gravity to assist the medication in flowing into the nasal cavity and reaching the intended mucosal surfaces. This anatomical alignment ensures optimal distribution and absorption of the drug, maximizing its therapeutic effect on the nasal passages.

Choice B rationale

Instructing the child to breathe deeply through the nose immediately after drop insertion could cause the medication to be inhaled into the lungs or swallowed, reducing its intended topical effect on the nasal mucosa. Proper technique involves maintaining the head position for a few moments to allow absorption.

Choice C rationale

Returning unused nose drops from the dropper to the medication bottle is an unsafe practice that can lead to contamination of the entire medication supply. The dropper tip, once it has touched the patient's nostril, is no longer sterile and can introduce microbes into the sterile solution.

Choice D rationale

Positioning the tip of the medication dropper within a nostril can cause discomfort, irritation, or even injury to the delicate nasal mucosa. The dropper should be held just above the nostril, allowing the drops to fall into the nasal passage without direct contact, ensuring patient safety and comfort.