A nurse is caring for a client with cardiogenic shock who weighs 176 \text{ lbs}. The heal… — NCLEX-RN

A nurse is caring for a client with cardiogenic shock who weighs $176 \text{ lbs}$ . The healthcare provider prescribes a continuous intravenous (IV) infusion of dopamine at $5 \text{ mcg/kg/min}$ . The pharmacy dispenses a premixed dopamine solution of $400 \text{ mg}$ in $250 \text{ mL}$ of $5\% \text{ dextrose in water}$ (D5W). What rate should the nurse program the IV infusion pump to deliver the prescribed dose? Record your answer as a whole number.

Answer: 15 mL/hr

Answer

15 mL/hr

The precise infusion rate required is

15 \text{ mL/hr}

. This setting accurately delivers

5 \text{ mcg/kg/min}

of dopamine to an

80 \text{ kg}

client, given the supplied medication concentration of

1.6 \text{ mg/mL}

(

400 \text{ mg}

250 \text{ mL}

Step-by-Step Solution

Convert the client's weight from pounds to kilograms.

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

The medication dosage is prescribed based on kilograms of body weight.

Calculate the required continuous dose of dopamine per minute.

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

To determine the exact amount of medication the specific client needs every minute.

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

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

Standard IV infusion pumps are programmed in milliliters per hour, so the dose must be matched to an hourly timeframe.

Convert the hourly dose from micrograms to milligrams.

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

The dispensed IV bag concentration is provided in milligrams (

400 \text{ mg}

); matching units are required before the volume calculation.

Calculate the required fluid volume to deliver the hourly dose.

\frac{24 \text{ mg}}{400 \text{ mg}} \times 250 \text{ mL} = 15 \text{ mL/hr}

This uses the formula: (Desired Dose / Amount on Hand) × Volume to find the final pump rate.

Key Concept

Weight-based continuous intravenous medication calculations.

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