A nurse in the intensive care unit is preparing to initiate a continuous intravenous (IV) … — NCLEX-RN

A nurse in the intensive care unit is preparing to initiate a continuous intravenous (IV) infusion of norepinephrine for a client experiencing severe hypotension. The prescribed dose is $0.06\text{ mcg/kg/min}$ . The client weighs $78\text{ kg}$ . The pharmacy provides a prediluted IV bag containing $8\text{ mg}$ of norepinephrine in $250\text{ mL}$ of $5\%$ dextrose in water ( $D_5W$ ).

At what rate, in $\text{mL/hr}$ , should the nurse program the infusion pump? (Record your answer using one decimal place.)

Answer: 8.8 mL/hr

Answer

8.8

To safely administer a weight-based continuous IV infusion, the exact hourly dose must be determined (

280.8\text{ mcg/hr}

) and divided by the concentration of the supplied solution (

32\text{ mcg/mL}

). The raw quotient of

8.775\text{ mL/hr}

is then rounded to the nearest tenth, resulting in the correct pump setting of

8.8\text{ mL/hr}

Step-by-Step Solution

Calculate the required mcg per minute based on the client's weight.

4.68\text{ mcg/min}

Weight-based dosing requires multiplying the prescribed rate by the client's total body weight in kilograms.

Convert the per-minute dose to an hourly dose.

280.8\text{ mcg/hr}

Infusion pumps are programmed in mL per hour, requiring the medication dose to first be converted to an hourly rate.

Determine the concentration of the supplied IV solution in mcg/mL.

32\text{ mcg/mL}

The prescription is in micrograms, but the medication is supplied in milligrams. Converting

8\text{ mg}

8,000\text{ mcg}

and dividing by the

250\text{ mL}

volume determines the specific unit concentration.

Calculate the exact fluid volume per hour required.

8.775\text{ mL/hr}

Dividing the total hourly dose by the concentration yields the total fluid volume needed per hour.

Round the final result to one decimal place.

8.8\text{ mL/hr}

The prompt explicitly instructs to record the answer using one decimal place.

Key Concept

Weight-based continuous intravenous infusion calculations

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