Question

Difficulty: MediumPharmacological and Parenteral Therapies

A healthcare provider prescribes a continuous intravenous (IV) infusion of aminophylline at a rate of 0.5 mg/kg/hr0.5 \text{ mg/kg/hr} for a client experiencing a severe exacerbation of asthma. The client weighs 75 kg75 \text{ kg}. The pharmacy supplies an IV bag containing aminophylline 500 mg500 \text{ mg} in 250 mL250 \text{ mL} of 0.9% sodium chloride0.9\% \text{ sodium chloride}. At what rate, in mL/hr\text{mL/hr}, should the nurse set the IV infusion pump? Record your answer rounding to the nearest tenth.

Answer: 18.8 mL/hr

Answer

The correct infusion rate is 18.8 mL/hr18.8 \text{ mL/hr}.
To determine the correct IV pump setting, the nurse must first calculate the total hourly dose based on the client's weight (0.5 mg/kg/hr×75 kg=37.5 mg/hr0.5 \text{ mg/kg/hr} \times 75 \text{ kg} = 37.5 \text{ mg/hr}). Next, the nurse divides this required hourly dose by the concentration of the medication provided by the pharmacy (500 mg/250 mL=2 mg/mL500 \text{ mg} / 250 \text{ mL} = 2 \text{ mg/mL}). The resulting calculation (37.5 mg/hr÷2 mg/mL=18.75 mL/hr37.5 \text{ mg/hr} \div 2 \text{ mg/mL} = 18.75 \text{ mL/hr}) is then rounded to the nearest tenth as instructed, resulting in a final programmed pump setting of 18.8 mL/hr18.8 \text{ mL/hr}.

Step-by-Step Solution

1
Calculate the required hourly dose.
37.5 mg/hr37.5 \text{ mg/hr}
The prescription is weight-based, so the client's total weight must be multiplied by the per-kg dose parameter.
2
Determine the medication concentration.
2 mg/mL2 \text{ mg/mL}
To find the volume needed per hour, the concentration of the available medication must be established.
3
Calculate the IV infusion rate.
18.75 mL/hr18.75 \text{ mL/hr}
Dividing the required hourly dose by the concentration yields the total volume to infuse per hour.
4
Round to the nearest tenth.
18.8 mL/hr18.8 \text{ mL/hr}
The question specifies rounding the final answer to the nearest tenth for programming the infusion pump.

Key Concept

Calculating weight-based continuous IV infusion rates
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