A critical care nurse is managing a client with symptomatic bradycardia who is unresponsiv… — NCLEX-RN

A critical care nurse is managing a client with symptomatic bradycardia who is unresponsive to standard atropine therapy. The client weighs $187\text{ lbs}$ . The healthcare provider prescribes a continuous IV infusion of dopamine at $4\text{ mcg/kg/min}$ . The pharmacy supplies a premixed bag containing $250\text{ mg}$ of dopamine in $500\text{ mL}$ of $5\%$ dextrose in water (D5W). What is the correct infusion pump setting in $\text{mL/hr}$ ? Record your answer using one decimal place.

Answer: 40.8 mL/hr

Answer

40.8

To find the correct pump setting in mL/hr, you must first convert the client's weight to kilograms (187 / 2.2 = 85 kg), multiply by the prescribed mcg/kg/min dosage to find the total mcg/min (85 * 4 = 340 mcg/min), and multiply by 60 to find the total mcg/hr (20,400 mcg/hr). Finally, divide this hourly requirement by the solution's concentration (500 mcg/mL) to get 40.8 mL/hr.

Step-by-Step Solution

Convert the client's weight from pounds to kilograms.

187\text{ lbs} \div 2.2 = 85\text{ kg}

The dopamine dosage is prescribed based on the client's weight in kilograms.

Calculate the required medication dose per minute.

85\text{ kg} \times 4\text{ mcg/kg/min} = 340\text{ mcg/min}

This establishes the total amount of dopamine the client must receive each minute.

Convert the per-minute dose to an hourly dose.

340\text{ mcg/min} \times 60\text{ min/hr} = 20,400\text{ mcg/hr}

Infusion pumps are programmed to deliver volume on an hourly basis (mL/hr).

Determine the concentration of the dopamine solution in mcg/mL.

250\text{ mg} = 250,000\text{ mcg}

;

250,000\text{ mcg} \div 500\text{ mL} = 500\text{ mcg/mL}

Converting milligrams to micrograms matches the prescribed dose unit, allowing calculation of the exact fluid volume per mL.

Calculate the final infusion pump rate.

20,400\text{ mcg/hr} \div 500\text{ mcg/mL} = 40.8\text{ mL/hr}

Dividing the total hourly medication requirement by the concentration yields the fluid volume needed per hour.

Key Concept

Weight-based continuous IV infusion calculation

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