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To solve this question:

We are given:
- A loading dose of **Esmolol** is **3 mcg/kg** (micrograms per kilogram).
- The patient's weight is **195 lbs**.
- The medication is diluted in **200 mL** of normal saline (NS).
- The infusion rate is to be set at **1 mcg/min**.

We need to calculate the rate the nurse should set on the pump.

### Step 1: Convert weight from pounds to kilograms.
1 kg = 2.2 lbs, so:
\[
195 \, \text{lbs} \div 2.2 = 88.64 \, \text{kg}
\]

### Step 2: Calculate the total loading dose in micrograms.
Since the loading dose is 3 mcg/kg:
\[
88.64 \, \text{kg} \times 3 \, \text{mcg/kg} = 265.92 \, \text{mcg}
\]

### Step 3: Determine the rate in mL/min to achieve this dose.
The total medication of **265.92 mcg** is diluted in **200 mL** of saline. Therefore, the concentration of the solution is:
\[
\frac{265.92 \, \text{mcg}}{200 \, \text{mL}} = 1.33 \, \text{mcg/mL}
\]

To deliver **1 mcg per minute**, we need to determine the volume in mL that corresponds to **1 mcg**:
\[
\frac{1 \, \text{mcg}}{1.33 \, \text{mcg/mL}} = 0.75 \, \text{mL/min}
\]

Thus, the nurse should set the pump to **0.75 mL per minute**.

Would you like further details or have any additional questions?

### Here are 5 follow-up questions related to the problem:
1. How do you convert drug dosages when the weight is in pounds instead of kilograms?
2. What is the significance of microgram-to-milliliter conversion in IV infusions?
3. How would the infusion rate change if the dilution volume was different?
4. Why is it important to adjust the infusion rate based on the patient's weight?
5. How does the pump's calibration ensure accurate delivery of the medication?

### Tip:
Always double-check the unit conversions, as small errors can lead to significant changes in dosage calculations, especially in medical contexts!

The MD writes an order for a loading dose of Esmolol (Breviblock®) – 3 mcg/kg to be given to a patient who weighs 195. The medication should be diluted in 200 ml of NS and infused at 1 mcg/minute. What rate will the nurse set on the pump to achieve that dose?

This problem involves calculating the infusion rate of Esmolol based on a patient's weight and dilution concentration. We walk through steps like converting weight from pounds to kilograms, determining total dose, and calculating the pump rate in mL/min. Suitable for students in Grades 10-12 or healthcare professionals.

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