A client on the cardiac step-down unit requires a continuous intravenous infusion of proca… — NCLEX-RN

A client on the cardiac step-down unit requires a continuous intravenous infusion of procainamide to manage ventricular ectopy. The healthcare provider's prescription is for $2 \text{ mg/min}$ . The available premixed solution contains $2 \text{ g}$ of procainamide in $500 \text{ mL}$ of $5\%$ dextrose in water. Calculate the required infusion rate in $\text{mL/hr}$ .

Answer: 30 mL/hr

Answer

The correct infusion rate is 30 mL/hr.

To determine the correct infusion rate, the nurse must first align all units of measurement. The provided medication is in grams (

2 \text{ g}

), which converts to

2000 \text{ mg}

. The concentration is then found by dividing

2000 \text{ mg}

by the volume of

500 \text{ mL}

, yielding

4 \text{ mg/mL}

. Next, the prescribed dose of

2 \text{ mg/min}

is multiplied by

60 \text{ minutes}

to determine the hourly requirement of

120 \text{ mg/hr}

. Finally, dividing the hourly requirement (

120 \text{ mg/hr}

) by the concentration (

4 \text{ mg/mL}

) gives the correct infusion rate of

30 \text{ mL/hr}

Step-by-Step Solution

Convert the total drug amount from grams to milligrams.

2 \text{ g} \times 1000 \text{ mg/g} = 2000 \text{ mg}

The prescribed dose is in milligrams, so the available medication must be converted to the same unit before calculating.

Calculate the concentration of the available intravenous solution.

2000 \text{ mg} / 500 \text{ mL} = 4 \text{ mg/mL}

Determining how many milligrams are in each milliliter is necessary to find the fluid volume needed per dose.

Convert the prescribed per-minute dose to an hourly dose.

2 \text{ mg/min} \times 60 \text{ min/hr} = 120 \text{ mg/hr}

The final pump rate must be programmed in hours (mL/hr), so the hourly medication requirement must be found.

Calculate the final infusion rate by dividing the hourly dose by the concentration.

120 \text{ mg/hr} / 4 \text{ mg/mL} = 30 \text{ mL/hr}

This yields the total volume of fluid that must be infused over one hour to deliver the prescribed milligrams.

Key Concept

Calculating continuous intravenous infusion rates (mL/hr) based on weight-independent dosage (mg/min).

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