To ensure medication safety, a nurse is performing an independent double-check of a milrin… — NCLEX-RN

To ensure medication safety, a nurse is performing an independent double-check of a milrinone infusion for a client with acute decompensated heart failure. The client weighs $80 \text{ kg}$ . The infusion pump is currently delivering the medication at a rate of $15 \text{ mL/hr}$ . The available medication is a premixed bag containing $20 \text{ mg}$ of milrinone in $100 \text{ mL}$ of 0.9% sodium chloride.

Calculate the dose the client is receiving in $\text{mcg/kg/min}$ . Record your answer to the nearest hundredth.

Answer: 0.63 mcg/kg/min

Answer

0.63

To determine the weight-based dosage from a known infusion rate, multiple conversions must occur. First, the concentration of the milrinone solution is

0.2 \text{ mg/mL}

, which converts to

200 \text{ mcg/mL}

. At a rate of

15 \text{ mL/hr}

, the client receives

3,000 \text{ mcg/hr}

. Dividing by

60 \text{ min/hr}

reveals the client receives

50 \text{ mcg/min}

. Finally, dividing the total minute dose by the client's

80 \text{ kg}

weight yields

0.625 \text{ mcg/kg/min}

. Standard rounding rules require rounding

0.625

up to

0.63

Step-by-Step Solution

Determine the concentration of milrinone in mg/mL.

20 \text{ mg} \div 100 \text{ mL} = 0.2 \text{ mg/mL}

Establishing the concentration is the first step to finding out how much medication is in each milliliter of fluid.

Convert the concentration from milligrams (mg) to micrograms (mcg).

0.2 \text{ mg/mL} \times 1,000 \text{ mcg/mg} = 200 \text{ mcg/mL}

The final requested unit is in micrograms, so the concentration must be converted appropriately.

Calculate the total dose delivered per hour.

15 \text{ mL/hr} \times 200 \text{ mcg/mL} = 3,000 \text{ mcg/hr}

Multiplying the pump rate by the concentration yields the total hourly dose.

Calculate the total dose delivered per minute.

3,000 \text{ mcg/hr} \div 60 \text{ min/hr} = 50 \text{ mcg/min}

The final requested unit is per minute, requiring conversion from the hourly dose.

Calculate the weight-based dose.

50 \text{ mcg/min} \div 80 \text{ kg} = 0.625 \text{ mcg/kg/min}

Dividing the total minute dose by the client's weight provides the exact dose being administered.

Round the calculated dose to the nearest hundredth.

0.63

The question specifies rounding to two decimal places (the nearest hundredth).

Key Concept

Weight-based reverse dosage calculation for continuous intravenous infusions.

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