A client admitted with cardiogenic shock requires hemodynamic support. The primary healthc… — NCLEX-RN

A client admitted with cardiogenic shock requires hemodynamic support. The primary healthcare provider orders a dopamine infusion at a rate of $5\text{ mcg/kg/min}$ . The client weighs $85\text{ kg}$ . The pharmacy dispenses a premixed intravenous bag containing dopamine $400\text{ mg}$ in $250\text{ mL}$ of $5\%$ dextrose in water (D5W).

At what rate should the electronic infusion pump be programmed? (Round the final answer to the nearest tenth.)

Answer: 15.9 mL/hr

Answer

15.9

To accurately program the electronic infusion pump, the nurse must process multiple conversions: finding the total weight-based dose per minute (

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

), expanding that to an hourly dose (

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

), matching the dose unit to the dispensed medication by converting to milligrams (

25,500 \div 1,000 = 25.5\text{ mg/hr}

), and finally dividing by the IV fluid concentration (

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

). Dividing

25.5\text{ mg/hr}

1.6\text{ mg/mL}

yields

15.9375\text{ mL/hr}

, which correctly rounds to

15.9\text{ mL/hr}

Step-by-Step Solution

Calculate the total dose required per minute in micrograms.

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

The prescription is weight-based, so the per-kilogram dose must be multiplied by the client's total body weight.

Convert the per-minute dosage to an hourly dosage.

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

Infusion pumps are programmed in milliliters per hour (mL/hr), so the total medication needed per hour must be determined.

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

25,500\text{ mcg} \div 1,000\text{ mcg/mg} = 25.5\text{ mg/hr}

The available dopamine bag is measured in milligrams, so the requested dose must match the unit of the supplied medication.

Determine the concentration of the available intravenous solution.

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

Finding the amount of medication in a single milliliter allows for direct calculation of the required fluid volume.

Calculate the final infusion rate in mL/hr and round to the nearest tenth.

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

. Rounded to the nearest tenth is

15.9\text{ mL/hr}

Dividing the required hourly dose by the concentration yields the required pump rate.

Key Concept

Weight-Based Continuous Intravenous Medication Calculations

Estimated Time:1m 30s

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