A client admitted with severe hypotension requires a continuous intravenous (IV) infusion … — NCLEX-RN

A client admitted with severe hypotension requires a continuous intravenous (IV) infusion of dopamine. The healthcare provider's prescription is for a dose of $5 \text{ mcg/kg/min}$ . The client's current weight is $176 \text{ lbs}$ . The pharmacy provides a premixed IV bag containing $400 \text{ mg}$ of dopamine dissolved in $250 \text{ mL}$ of $5\%$ dextrose in water (D5W). At what rate, in $\text{mL/hr}$ , should the nurse program the continuous IV infusion pump?

A
24
15Answer
C
33
D
150

Answer

The correct infusion rate is

15 \text{ mL/hr}

The correct answer is

15

. To solve this complex calculation, follow these sequential steps: First, convert the client's weight to kilograms (

176 \text{ lbs} \div 2.2 = 80 \text{ kg}

). Next, find the per-minute microgram dose (

5 \text{ mcg/kg/min} \times 80 \text{ kg} = 400 \text{ mcg/min}

). Then, convert this to an hourly dose (

400 \text{ mcg} \times 60 \text{ minutes} = 24,000 \text{ mcg/hr}

). Since the drug is supplied in milligrams, convert micrograms to milligrams (

24,000 \div 1,000 = 24 \text{ mg/hr}

). Finally, determine the concentration of the IV bag (

400 \text{ mg} \div 250 \text{ mL} = 1.6 \text{ mg/mL}

) and divide the hourly dose by this concentration to get the final flow rate (

24 \text{ mg/hr} \div 1.6 \text{ mg/mL} = 15 \text{ mL/hr}

Step-by-Step Solution

Convert the client's weight from pounds to kilograms.

176 \text{ lbs} \div 2.2 \text{ lbs/kg} = 80 \text{ kg}

Weight-based dosing requires the client's weight to be precisely measured in kilograms.

Calculate the required dose in micrograms per minute.

5 \text{ mcg/kg/min} \times 80 \text{ kg} = 400 \text{ mcg/min}

This determines the total amount of medication the client requires every minute based on their body weight.

Convert the per-minute dose to an hourly dose.

400 \text{ mcg/min} \times 60 \text{ min/hr} = 24,000 \text{ mcg/hr}

Continuous IV infusion pumps are programmed in hours, not minutes.

Convert the hourly dose from micrograms to milligrams.

24,000 \text{ mcg} \div 1,000 \text{ mcg/mg} = 24 \text{ mg/hr}

The available medication is supplied in milligrams, so the units must match before final calculation.

Calculate the volume required to deliver the hourly dose based on the available concentration.

24 \text{ mg/hr} \div \left( \frac{400 \text{ mg}}{250 \text{ mL}} \right) = 24 \text{ mg/hr} \div 1.6 \text{ mg/mL} = 15 \text{ mL/hr}

This provides the final volumetric flow rate needed for the infusion pump.

Key Concept

Weight-based intravenous dosage calculation and unit conversion

Question

Answer

Step-by-Step Solution

Key Concept

Common Mistakes

Topics

More questions from this topic