A client diagnosed with septic shock is admitted to the intensive care unit and remains pr… — NCLEX-RN

A client diagnosed with septic shock is admitted to the intensive care unit and remains profoundly hypotensive despite adequate fluid resuscitation. The healthcare provider orders a continuous intravenous infusion of norepinephrine. The client's weight is $198\text{ lb}$ . The order indicates starting the infusion at $0.1\text{ mcg/kg/min}$ . The medication arrives from the pharmacy as a premixed solution containing $8\text{ mg}$ of norepinephrine in $250\text{ mL}$ of 5% dextrose in water ( $\text{D}_5\text{W}$ ). At what rate should the nurse program the infusion pump? Record your answer in $\text{mL/hr}$ rounded to the nearest tenth.

Answer: 16.9 mL/hr

Answer

16.9

The correct pump rate is found by converting the client's weight to kilograms, finding the total hourly dose in micrograms (

540\text{ mcg/hr}

), and dividing that by the concentration of the IV solution (

32\text{ mcg/mL}

), which yields

16.875

, rounded to

16.9\text{ mL/hr}

Step-by-Step Solution

Convert the client's weight from pounds to kilograms.

198 \div 2.2 = 90\text{ kg}

The prescribed medication dosage is based on the client's weight in kilograms.

Calculate the required medication dose per minute.

90\text{ kg} \times 0.1\text{ mcg/kg/min} = 9\text{ mcg/min}

To determine the total amount of medication the client must receive every minute based on their weight.

Convert the per-minute dose to an hourly dose.

9\text{ mcg/min} \times 60\text{ min/hr} = 540\text{ mcg/hr}

Intravenous infusion pumps are programmed in milliliters per hour, so the dose must be calculated over an hour.

Determine the concentration of the intravenous solution in micrograms per milliliter.

8\text{ mg} \times 1000 = 8000\text{ mcg}

;

8000\text{ mcg} \div 250\text{ mL} = 32\text{ mcg/mL}

To align the units of the prescribed dose (micrograms) with the available concentration.

Calculate the final infusion pump rate in milliliters per hour.

540\text{ mcg/hr} \div 32\text{ mcg/mL} = 16.875\text{ mL/hr}

Dividing the hourly dose by the concentration provides the volume of fluid to be infused per hour.

Round the final answer to the nearest tenth.

16.9\text{ mL/hr}

This is standard clinical practice and matches the specific instruction in the question.

Key Concept

Weight-based critical care intravenous medication rate calculation

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