A charge nurse is reviewing the electronic health record of a pregnant client undergoing l… — NCLEX-RN

A charge nurse is reviewing the electronic health record of a pregnant client undergoing labor induction. The prescribed oxytocin protocol dictates a starting dose of $2$ milliunits/min, with increases of $2$ milliunits/min every $30$ minutes until an adequate contraction pattern is established. The IV bag contains $20$ units of oxytocin mixed in $1,000$ mL of $0.9\%$ sodium chloride. If the protocol has been strictly followed without any pauses or decelerations requiring dose reduction, how many mL/hr should the infusion pump be delivering exactly $120$ minutes after the induction began? (Record your answer as a whole number).

Answer: 30 mL/hr

Answer

The correct infusion rate at 120 minutes is 30 mL/hr.

At 120 minutes, the client has undergone 4 titrations (at 30, 60, 90, and 120 minutes), bringing the dose from 2 milliunits/min to 10 milliunits/min. The solution concentration is 20 milliunits/mL (20,000 milliunits divided by 1,000 mL). Dividing the required 10 milliunits/min by the 20 milliunits/mL concentration yields 0.5 mL/min. Multiplying this by 60 minutes per hour gives the final required pump setting of 30 mL/hr.

Step-by-Step Solution

Determine the current dose at exactly 120 minutes.

10

milliunits/min

The infusion starts at

2

milliunits/min. Increases of

2

milliunits/min occur at

30

60

90

, and

120

minutes (a total of

4

increases). Therefore,

2 + (4 \times 2) = 10

milliunits/min.

Calculate the concentration of the oxytocin solution.

20

milliunits/mL

First, convert the total units to milliunits:

20 \text{ units} \times 1,000 = 20,000 \text{ milliunits}

. Then divide by the total volume:

\frac{20,000 \text{ milliunits}}{1,000 \text{ mL}} = 20 \text{ milliunits/mL}

Calculate the required volume to be infused per minute.

0.5

mL/min

Divide the prescribed minute dose by the concentration:

\frac{10 \text{ milliunits/min}}{20 \text{ milliunits/mL}} = 0.5 \text{ mL/min}

Convert the minute rate to an hourly pump rate.

30

mL/hr

Multiply the volume per minute by

60

minutes:

0.5 \text{ mL/min} \times 60 \text{ min/hr} = 30 \text{ mL/hr}

Key Concept

Titration of high-alert maternity medications (oxytocin) requires calculating progressive dose increases over time and converting prescribed milliunits per minute into an hourly volumetric pump rate.

Estimated Time:2m 30s

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