A nurse is caring for a client with decompensated heart failure who weighs 187\text{ lb}. … — NCLEX-RN

A nurse is caring for a client with decompensated heart failure who weighs $187\text{ lb}$ . The healthcare provider prescribes a continuous IV infusion of dobutamine at $7.5\text{ mcg/kg/min}$ . The pharmacy dispenses a premixed IV bag containing dobutamine $500\text{ mg}$ in $250\text{ mL}$ of $5\%\text{ dextrose in water}$ . At what rate, in $\text{mL/hr}$ , should the nurse set the IV infusion pump? (Record your answer to the nearest tenth.)

Answer: 19.1 mL/hr

Answer

19.1

The correct pump rate is determined by first calculating the client's total hourly medication requirement in milligrams, and then dividing that amount by the concentration of the prepared intravenous solution to find the volume needed per hour.

Step-by-Step Solution

Convert the client's weight to kilograms

85\text{ kg}

Weight-based dosing formulas require the weight in kilograms (

187 \div 2.2 = 85

)

Calculate the total dose per minute

637.5\text{ mcg/min}

Multiply the client's weight by the prescribed dose (

85 \times 7.5 = 637.5

)

Convert the minute dose to an hourly dose

38,250\text{ mcg/hr}

Infusion pumps are programmed in mL/hr, so the dose must be per hour (

637.5 \times 60 = 38,250

)

Convert micrograms to milligrams

38.25\text{ mg/hr}

The dispensed medication is measured in milligrams, so units must match (

38,250 \div 1,000 = 38.25

)

Determine the concentration of the IV solution

2\text{ mg/mL}

Divide the total milligrams by the total volume in the bag (

500 \div 250 = 2

)

Calculate the final infusion rate

19.125\text{ mL/hr}

Divide the hourly dose by the fluid concentration (

38.25 \div 2 = 19.125

)

Round the final answer

19.1\text{ mL/hr}

The question requires rounding to the nearest tenth

Key Concept

Weight-based continuous intravenous infusion rate calculation

Estimated Time:2m 0s

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