The healthcare provider (HCP) prescribes dopamine 2 mcg/kg/min IV for client who weighs 60 kg. The IV bag contains "Dopamine 400 mg in dextrose 5% in water (DW) 500 mL." The nurse should program the infusion pump to deliver how many mL/hour? (Enter numerical value only.)

A. Notify healthcare provider (HCP) of the symptoms and administer a PRN pain medication. While notifying the HCP is necessary, administering pain medication does not address the underlying cause of the client’s acute chest pain and difficulty breathing. These symptoms suggest a possible pulmonary embolism (PE), a life-threatening complication after orthopedic surgery. Immediate supportive interventions should be initiated before notifying the provider.
B. Increase the client's IV flow rate and start low-flow oxygen. The client is experiencing acute respiratory distress, which could indicate a pulmonary embolism (PE), a fat embolism, or another postoperative complication. Providing oxygen helps improve oxygenation and reduce hypoxia, while increasing the IV flow rate helps maintain perfusion and prevent shock. These immediate interventions support vital functions while preparing for further medical management.
C. Position the client on the left side while immobilizing the affected leg. This position is used in air embolism management, not pulmonary embolism. In suspected PE, the priority is to optimize oxygenation and circulation rather than repositioning. The affected leg should be immobilized to prevent further embolization, but this is not the first priority.
D. Take the client's vital signs and auscultate all lung sounds. While assessing the client’s vital signs and lung sounds is important, intervention should not be delayed. The priority is to support oxygenation and circulation immediately, as PE can rapidly lead to hypoxia, hemodynamic instability, or cardiac arrest. Assessment should be done concurrently with emergency interventions.

A. Administer furosemide IV over ten minutes. While slow IV administration is recommended to prevent ototoxicity, the priority concern is that milrinone and furosemide are incompatible when administered in the same IV line. The nurse must first ensure separate IV access before considering the administration rate.
B. Notify the healthcare provider (HCP) of the incompatibility of the two drugs. The nurse does not need to notify the HCP but should instead use a separate IV line or flush the line thoroughly before and after administration if only one access is available. Milrinone and furosemide should never be mixed, as their combination can cause precipitation, leading to catheter occlusion or embolization.
C. Infuse furosemide through a central line to prevent extravasation. Furosemide can be given peripherally or centrally, but the concern here is drug incompatibility, not extravasation. Furosemide is not a vesicant, so central line administration is not required unless no peripheral access is available.
D. Give furosemide through a separate IV access. Milrinone is incompatible with furosemide due to pH differences, which can lead to precipitation and potential catheter occlusion. To ensure safe administration, furosemide should be given through a separate IV line or, if no secondary access is available, the line should be flushed thoroughly before and after administration.