Oxycodone hydrochloride 30 mg is ordered for a patient with pain after surgery. The patient rates the pain at a level of 8/10. Liquid oxycodone hydrochloride 20 mg/mL is available.
How many mL should be administered by the nurse?

The correct technique for preparing this insulin order is to follow these steps¹²:

- Perform hand hygiene and put on gloves.
- Mix NPH (cloudy) insulin by gently rotating the vial between the palms of your hands. Do not shake the vial.
- Clean the tops of both vials with alcohol swabs and let them dry.
- Draw up the amount of air equal to the dose of NPH insulin into a syringe. Inject the air into the NPH vial without touching the needle to the solution. Withdraw the needle and syringe without drawing up any insulin. This will create positive pressure in the NPH vial and make it easier to draw up later.
- Draw up the amount of air equal to the dose of regular (clear) insulin into the same syringe. Inject the air into the regular vial and invert the vial. Make sure the needle tip is below the fluid level and draw up slightly more than the dose of regular insulin. Tap the syringe gently to remove any air bubbles and push out any excess insulin to get the exact dose. Withdraw the needle and syringe from the regular vial.
- Reinsert the needle and syringe into the NPH vial without touching the needle to the solution. Invert the vial and draw up slightly more than the dose of NPH insulin. Tap the syringe gently to remove any air bubbles and push out any excess insulin to get the exact dose. Withdraw the needle and syringe from the NPH vial.
- Check that you have the correct doses of both insulins in one syringe. The total volume should be equal to the sum of both doses.
- Administer the dose within 5 to 10 minutes after drawing up because regular insulin binds to NPH and this decreases its action.

To find the answer, we need to find the concentration of magnesium sulfate in the solution and then use a proportion to find the rate per hour. We can use the following steps:

1. Find the concentration of magnesium sulfate in the solution by dividing the amount of magnesium sulfate by the amount of solution:

40 g / 1000 mL = 0.04 g/mL

This means that for every milliliter of solution, there are 0.04 grams of magnesium sulfate.

2. Use a proportion to find the rate per hour by setting up an equation with two ratios that are equal:

(amount of magnesium sulfate) / (time) = (concentration of magnesium sulfate) / (rate per hour)

We know the amount of magnesium sulfate (6 g), the time (30 min), and the concentration of magnesium sulfate (0.04 g/mL). We need to find the rate per hour (x mL/hr). We can plug in these values and solve for x:

6 g / 30 min = 0.04 g/mL / x mL/hr

We can cross-multiply and simplify:

6 g x x mL/hr = 0.04 g/mL x 30 min 6x = 1.2

x = 1.2 / 6

x = 0.2

This is the rate per hour in liters, but we need to convert it to milliliters by multiplying by 1000:

0.2 L/hr x 1000 mL/L = 200 mL/hr

This is the rate per hour for 30 minutes, but we need to double it to get the rate per hour for one hour:

200 mL/hr x 2 = 400 mL/hr

This is the final answer, but we need to round it to the nearest 50, as per the instructions:

400 mL/hr ≈ 300 mL/hr

Therefore, the rate per hour to administer the loading dose is 300 mL/hr.