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

A client admitted with cardiogenic shock requires hemodynamic support. The healthcare provider prescribes a continuous intravenous infusion of dobutamine at $2.7$ mcg/kg/min. The client's most recent weight is $209$ lbs. The pharmacy dispenses a premixed IV bag containing dobutamine $500$ mg in $250$ mL of $5\%$ dextrose in water. Calculate the appropriate infusion pump rate in mL/hr. (Round the final answer to the nearest tenth.)

Answer: 7.7 mL/hr

Answer

The infusion pump should be set to 7.7 mL/hr.

The correct infusion rate is calculated by first determining the client's weight in kilograms (

209 \div 2.2 = 95

kg). The total minute dose is found by multiplying the weight by the ordered dose (

95 \times 2.7 = 256.5

mcg/min). This minute dose is then multiplied by

60

to find the hourly dose (

256.5 \times 60 = 15,390

mcg/hr). Because the supplied medication is in milligrams, the hourly dose must be converted (

15,390 \div 1,000 = 15.39

mg/hr). The concentration of the supplied IV bag is

2

mg/mL (

500

\div 250

mL). Dividing the required hourly dose by the concentration provides the pump rate (

15.39 \div 2 = 7.695

mL/hr). Finally, rounding

7.695

to the nearest tenth yields

7.7

mL/hr.

Step-by-Step Solution

Convert the client's weight from pounds to kilograms.

209 \text{ lbs} \div 2.2 \text{ lbs/kg} = 95 \text{ kg}

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

Calculate the prescribed dose per minute.

95 \text{ kg} \times 2.7 \text{ mcg/kg/min} = 256.5 \text{ mcg/min}

To determine the total amount of dobutamine the client requires each minute.

Convert the dose per minute to the dose per hour.

256.5 \text{ mcg/min} \times 60 \text{ min/hr} = 15,390 \text{ mcg/hr}

Intravenous infusion pumps are programmed in hourly rates (mL/hr).

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

15,390 \text{ mcg} \div 1,000 \text{ mcg/mg} = 15.39 \text{ mg/hr}

The medication provided by the pharmacy is measured in milligrams, so units must match.

Determine the concentration of the provided intravenous solution.

500 \text{ mg} \div 250 \text{ mL} = 2 \text{ mg/mL}

To identify how many milligrams of dobutamine are contained in each milliliter of the fluid.

Calculate the final volume to be infused per hour and round to the nearest tenth.

15.39 \text{ mg/hr} \div 2 \text{ mg/mL} = 7.695 \text{ mL/hr}

, which rounds to

7.7 \text{ mL/hr}

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

Key Concept

Weight-based continuous intravenous medication titration requires converting client weight to kilograms, establishing an hourly dosage rate, and applying the supplied medication concentration to determine the final pump setting.

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