The healthcare provider prescribes a continuous intravenous (IV) infusion of sodium nitrop… — NCLEX-RN

The healthcare provider prescribes a continuous intravenous (IV) infusion of sodium nitroprusside at $2 \text{ mcg/kg/min}$ for a client experiencing a hypertensive emergency. The client's documented weight is $78 \text{ kg}$ . The available medication is a $250 \text{ mL}$ bag of $5\% \text{ dextrose in water}$ containing $50 \text{ mg}$ of sodium nitroprusside. At what rate, in $\text{mL/hr}$ , should the nurse set the infusion pump? Record your answer rounded to the nearest whole number.

Answer: 47 mL/hr

Answer

To find the correct pump rate, perform a sequential dimensional analysis. First, calculate the total required dose per minute based on weight:

2 \text{ mcg/kg/min} \times 78 \text{ kg} = 156 \text{ mcg/min}

. Next, convert this to an hourly dose:

156 \text{ mcg/min} \times 60 \text{ min/hr} = 9360 \text{ mcg/hr}

. Convert the dose to milligrams to match the supply:

9360 \text{ mcg/hr} / 1000 \text{ mcg/mg} = 9.36 \text{ mg/hr}

. The concentration of the supplied bag is

50 \text{ mg} / 250 \text{ mL} = 0.2 \text{ mg/mL}

. Finally, dividing the hourly dose by the concentration yields the rate:

9.36 \text{ mg/hr} / 0.2 \text{ mg/mL} = 46.8 \text{ mL/hr}

. Rounding

46.8

to the nearest whole number gives

47

Step-by-Step Solution

Calculate the required dose in

\text{mcg/min}

156 \text{ mcg/min}

Multiply the prescribed dose (

2 \text{ mcg/kg/min}

) by the client's weight (

78 \text{ kg}

) to determine the total amount of medication needed per minute.

Convert the minute dose to an hourly dose.

9360 \text{ mcg/hr}

Multiply

156 \text{ mcg/min}

60 \text{ minutes/hour}

because infusion pumps are programmed in

\text{mL/hr}

Convert the dose from micrograms (

\text{mcg}

) to milligrams (

\text{mg}

9.36 \text{ mg/hr}

Divide

9360 \text{ mcg/hr}

1000 \text{ mcg/mg}

to match the unit of the supplied medication.

Determine the concentration of the medication in the IV bag.

0.2 \text{ mg/mL}

Divide the total milligrams (

50 \text{ mg}

) by the total volume (

250 \text{ mL}

) to establish how much medication is in each milliliter of fluid.

Calculate the final volume rate in

\text{mL/hr}

46.8 \text{ mL/hr}

Divide the required hourly dose (

9.36 \text{ mg/hr}

) by the concentration (

0.2 \text{ mg/mL}

) to determine the volume of fluid needed to deliver the correct dose.

Round the final answer.

47

The question explicitly asks for the answer to be rounded to the nearest whole number.

Key Concept

Weight-based continuous intravenous medication dose calculation and pump rate programming.

Question

Answer

Step-by-Step Solution

Key Concept

Common Mistakes

Topics

More questions from this topic