A mechanically ventilated client in the intensive care unit requires continuous sedation. … — NCLEX-RN

A mechanically ventilated client in the intensive care unit requires continuous sedation. The healthcare provider's order reads: dexmedetomidine $0.8\text{ mcg/kg/hr}$ continuous IV infusion. The client weighs $154\text{ lb}$ . The pharmacy dispenses a pre-mixed solution containing $200\text{ mcg}$ of dexmedetomidine in $50\text{ mL}$ of $0.9\%$ sodium chloride.

At what rate, in $\text{mL/hr}$ , should the infusion pump be programmed? Record your answer using a whole number.

Answer: 14 mL/hr

Answer

To determine the correct infusion rate, first convert the client's weight to kilograms (

154 \div 2.2 = 70\text{ kg}

). Next, calculate the prescribed hourly dose by multiplying the weight by the ordered rate (

70 \times 0.8 = 56\text{ mcg/hr}

). Then, find the concentration of the supplied IV bag by dividing the total micrograms by the total milliliters (

200\text{ mcg} \div 50\text{ mL} = 4\text{ mcg/mL}

). Finally, divide the required hourly dose by the concentration to find the pump rate (

56 \div 4 = 14\text{ mL/hr}

). Since 14 is already a whole number, no rounding is necessary.

Step-by-Step Solution

Convert the client's weight from pounds to kilograms.

154\text{ lb} \div 2.2\text{ lb/kg} = 70\text{ kg}

The medication dosing is weight-based and requires the weight to be in kilograms.

Calculate the total required hourly dose of dexmedetomidine.

70\text{ kg} \times 0.8\text{ mcg/kg/hr} = 56\text{ mcg/hr}

This establishes the exact amount of medication the client needs to receive every hour.

Determine the concentration of the supplied dexmedetomidine solution.

200\text{ mcg} \div 50\text{ mL} = 4\text{ mcg/mL}

Finding the concentration is necessary to convert the ordered dose in micrograms into a liquid volume in milliliters.

Calculate the final infusion rate.

56\text{ mcg/hr} \div 4\text{ mcg/mL} = 14\text{ mL/hr}

This determines the exact volumetric rate to program into the intravenous infusion pump.

Key Concept

Weight-based continuous IV infusion calculation

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