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Difficulty: HardPharmacological and Parenteral Therapies

A nurse is caring for a client with acute decompensated heart failure who has a prescription for a continuous IV infusion of milrinone at 0.375 mcg/kg/min0.375 \text{ mcg/kg/min}. The client weighs 209 lbs209 \text{ lbs}. The pharmacy provides milrinone 20 mg20 \text{ mg} in 100 mL100 \text{ mL} of 0.9% NaCl0.9\% \text{ NaCl}. The nurse should set the IV infusion pump to deliver how many mL/hr\text{mL/hr}? (Round the final answer to the nearest tenth.)

Answer: 10.7 mL/hr

Answer

10.7
The correct infusion rate is determined by a multi-step calculation: first, converting the client's weight to kg (209÷2.2=95 kg209 \div 2.2 = 95 \text{ kg}); second, calculating the hourly dose in micrograms (95×0.375×60=2137.5 mcg/hr95 \times 0.375 \times 60 = 2137.5 \text{ mcg/hr}); third, determining the concentration of the IV bag in mcg/mL (20,000÷100=200 mcg/mL20,000 \div 100 = 200 \text{ mcg/mL}); and finally, dividing the required hourly dose by the concentration (2137.5÷200=10.68752137.5 \div 200 = 10.6875). Rounding 10.687510.6875 to the nearest tenth gives 10.7 mL/hr10.7 \text{ mL/hr}.

Step-by-Step Solution

1
Convert weight from pounds to kilograms
95 kg95 \text{ kg}
The prescription is weight-based in kg, so the client's weight must be converted first (209÷2.2209 \div 2.2).
2
Calculate the total mcg required per minute
35.625 mcg/min35.625 \text{ mcg/min}
Multiply the prescribed dose (0.375 mcg/kg/min0.375 \text{ mcg/kg/min}) by the client's weight (95 kg95 \text{ kg}).
3
Calculate the total mcg required per hour
2137.5 mcg/hr2137.5 \text{ mcg/hr}
IV pumps are programmed in mL/hr, so the per-minute dose must be multiplied by 60 minutes.
4
Determine the concentration of the IV solution in mcg/mL
200 mcg/mL200 \text{ mcg/mL}
Convert 20 mg20 \text{ mg} to 20,000 mcg20,000 \text{ mcg}, then divide by 100 mL100 \text{ mL} to match the units of the required dose.
5
Calculate the final infusion rate in mL/hr
10.6875 mL/hr10.6875 \text{ mL/hr}
Divide the total hourly dose (2137.5 mcg/hr2137.5 \text{ mcg/hr}) by the concentration (200 mcg/mL200 \text{ mcg/mL}).
6
Round the final answer to the nearest tenth
10.710.7
Rounding instructions require the answer to one decimal place.

Key Concept

Weight-based continuous IV infusion calculation
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Topics

Pharmacological and Parenteral Therapies

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