A nurse is caring for a client with cardiogenic shock who weighs 85 \text{ kg}. The health… — NCLEX-RN

A nurse is caring for a client with cardiogenic shock who weighs $85 \text{ kg}$ . The healthcare provider prescribes a continuous intravenous (IV) infusion of dopamine at $5 \text{ mcg/kg/min}$ . The pharmacy provides an IV bag containing $400 \text{ mg}$ of dopamine mixed in $250 \text{ mL}$ of $5\%$ Dextrose in Water (D5W). At what rate should the nurse set the IV infusion pump in $\text{mL/hr}$ ? (Record your answer to the nearest tenth.)

Answer: 15.9 mL/hr

Answer

The nurse should set the infusion pump to 15.9 mL/hr.

The correct answer is derived by calculating the weight-based dose per minute, converting it to an hourly rate, matching the units to the supplied concentration (mcg to mg), and dividing by the concentration of the dopamine bag. Finally, the value is rounded to the nearest tenth.

Step-by-Step Solution

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

85 \text{ kg} \times 5 \text{ mcg/kg/min} = 425 \text{ mcg/min}

The prescription is weight-based, requiring the nurse to multiply the ordered rate by the client's weight in kg.

Convert the per-minute dose to a per-hour dose.

425 \text{ mcg/min} \times 60 \text{ min/hr} = 25,500 \text{ mcg/hr}

Infusion pumps are programmed in mL per hour, so the minute dosage must be converted to an hourly rate.

Convert the required hourly dose from micrograms (mcg) to milligrams (mg).

25,500 \text{ mcg/hr} \div 1000 \text{ mcg/mg} = 25.5 \text{ mg/hr}

The supplied medication concentration is provided in mg, so the hourly dose must match these units.

Calculate the concentration of the supplied IV fluid.

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

Determining the concentration simplifies the final volume calculation.

Calculate the final infusion rate and round to the nearest tenth.

25.5 \text{ mg/hr} \div 1.6 \text{ mg/mL} = 15.9375 \text{ mL/hr}

, which rounds to

15.9 \text{ mL/hr}

Dividing the required hourly dose by the concentration yields the final pump setting.

Key Concept

Weight-based continuous IV infusion rate calculation (mcg/kg/min to mL/hr)

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