A client who is hemodynamically unstable is admitted to the critical care unit. The client… — NCLEX-RN

A client who is hemodynamically unstable is admitted to the critical care unit. The client's body weight is recorded as $187\text{ lbs}$ . The healthcare provider prescribes a continuous intravenous infusion of norepinephrine at $0.05\text{ mcg/kg/min}$ . The pharmacy dispenses an intravenous solution containing norepinephrine $4\text{ mg}$ in $250\text{ mL}$ of $0.9\%\text{ Sodium Chloride}$ . At what rate should the nurse program the infusion pump? Record your answer in $\text{mL/hr}$ and round to the nearest tenth.

Answer: 15.9 mL/hr

Answer

15.9

To accurately program the infusion pump for a weight-based continuous drip, dimensional analysis is used to bridge the ordered dose (

0.05\text{ mcg/kg/min}

) to the pump setting (

\text{mL/hr}

). The weight is first converted to

85\text{ kg}

. The hourly dose required is

255\text{ mcg/hr}

. Because the bag contains

4\text{ mg}

(

4000\text{ mcg}

) in

250\text{ mL}

, the concentration is

16\text{ mcg/mL}

. Dividing the hourly dose by the concentration yields

15.9375

, which rounds appropriately to

15.9

Step-by-Step Solution

Convert weight from pounds to kilograms.

187\text{ lbs} \div 2.2\text{ lbs/kg} = 85\text{ kg}

Weight-based dosing requires the client's weight in kilograms.

Calculate the total dose prescribed per minute.

0.05\text{ mcg/kg/min} \times 85\text{ kg} = 4.25\text{ mcg/min}

This establishes the exact amount of medication the client needs every minute.

Calculate the total dose required per hour.

4.25\text{ mcg/min} \times 60\text{ min/hr} = 255\text{ mcg/hr}

Infusion pumps are programmed in mL per hour, so the dose must reflect an hourly rate.

Determine the medication concentration in mcg/mL.

4\text{ mg} = 4000\text{ mcg}

;

4000\text{ mcg} \div 250\text{ mL} = 16\text{ mcg/mL}

The prescribed dose is in micrograms, so the available medication must be converted to match.

Calculate the final infusion rate and round to the nearest tenth.

255\text{ mcg/hr} \div 16\text{ mcg/mL} = 15.9375\text{ mL/hr}

, which rounds to

15.9\text{ mL/hr}

Dividing the hourly dose by the concentration yields the volume required per hour.

Key Concept

Weight-based complex continuous intravenous infusions.

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