Order: diphenhydramine 25 mg PO q6h, PRN

Available: diphenhydramine 12.5 mg/5 mL.

How many mL would the nurse give?

Given:

Ordered dose of Heparin: 18 units/kg/hr

Patient weight: 123 pounds

Concentration of Heparin: 25,000 units/250 mL (100 units/mL)

Step 1: Convert patient weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Patient weight in kg = 123 lbs x 0.453592 kg/lb = 55.7923 kg

Step 2: Calculate the total dose of Heparin in units/hr:

Total dose (units/hr) = Ordered dose (units/kg/hr) x Patient weight (kg)

Total dose (units/hr) = 18 units/kg/hr x 55.7923 kg

Total dose (units/hr) = 1004.2614 units/hr

Step 3: Calculate the infusion rate in mL/hr:

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

Infusion rate (mL/hr) = 1004.2614 units/hr / 100 units/mL

Infusion rate (mL/hr) = 10.042614 mL/hr

Step 4: Round to the nearest tenths:

Infusion rate (mL/hr) ≈ 10.0 mL/hr

A) The healthcare provider's order
While the healthcare provider's order is crucial for ensuring that the correct drug and dosage are administered, it is not something that would be written on the reconstituted drug label. The reconstituted drug label is intended to communicate specific information about the reconstitution process and the product's current status, but the order itself is typically not part of this information.

B) Diluent
When reconstituting a medication, it is essential to note the diluent used. The diluent refers to the liquid used to mix the powdered medication and turn it into a solution or suspension. Including this information on the drug label ensures that anyone handling the medication can verify the proper solution used for reconstitution, which is important for both correct administration and stability of the drug.

C) Date to discard
After a medication has been reconstituted, it often has a limited shelf life, and it is important to write the date to discard on the drug label. This ensures that the medication is used within its recommended time frame to avoid potential degradation or loss of potency. The discard date is especially important in hospitals or clinics where drugs are prepared in advance.

D) Initials
The nurse should always include their initials on the reconstituted drug label. This serves as a means of accountability, allowing others to know who prepared the medication. It also helps ensure proper identification in case of questions or errors regarding the preparation.