A client with severe acute respiratory distress syndrome (ARDS) is mechanically ventilated… — NCLEX-RN

A client with severe acute respiratory distress syndrome (ARDS) is mechanically ventilated and requires continuous sedation. The healthcare provider prescribes a propofol infusion at $30 \text{ mcg/kg/min}$ . The client weighs $209 \text{ lb}$ . The pharmacy dispenses propofol $1,000 \text{ mg}$ in a $100 \text{ mL}$ lipid emulsion. What should the nurse set the infusion pump rate to in $\text{mL/hr}$ ? Record your answer to the nearest whole number.

Answer: 17 mL/hr

Answer

To determine the correct pump rate, the nurse must first convert the client's weight to kilograms (

209 \div 2.2 = 95 \text{ kg}

). Next, calculate the total dose per minute (

30 \times 95 = 2,850 \text{ mcg/min}

) and multiply by

60

to find the hourly dose (

171,000 \text{ mcg/hr}

). Because the medication is dispensed in milligrams, convert the hourly dose from micrograms to milligrams (

171,000 \div 1,000 = 171 \text{ mg/hr}

). The concentration of the dispensed propofol is

1,000 \text{ mg} \div 100 \text{ mL} = 10 \text{ mg/mL}

. Finally, divide the required hourly dose by the concentration (

171 \div 10 = 17.1 \text{ mL/hr}

) and round to the nearest whole number, resulting in

17

Step-by-Step Solution

Convert the client's weight from pounds to kilograms.

209 \text{ lb} \div 2.2 \text{ lb/kg} = 95 \text{ kg}

Critical care continuous infusions are dosed based on the client's weight in kilograms.

Calculate the prescribed dose per minute.

30 \text{ mcg/kg/min} \times 95 \text{ kg} = 2,850 \text{ mcg/min}

This determines the total amount of medication the client needs every minute.

Convert the per-minute dose to an hourly dose.

2,850 \text{ mcg/min} \times 60 \text{ min/hr} = 171,000 \text{ mcg/hr}

Infusion pumps are programmed to deliver fluids in mL per hour.

Convert the hourly dose from micrograms to milligrams.

171,000 \text{ mcg/hr} \div 1,000 \text{ mcg/mg} = 171 \text{ mg/hr}

The dispensed medication concentration is provided in milligrams, not micrograms.

Determine the concentration of the propofol emulsion.

1,000 \text{ mg} \div 100 \text{ mL} = 10 \text{ mg/mL}

This establishes how many milligrams of propofol are in each milliliter of the fluid.

Calculate the infusion pump rate in mL/hr.

171 \text{ mg/hr} \div 10 \text{ mg/mL} = 17.1 \text{ mL/hr}

Dividing the required hourly dose by the concentration yields the required fluid volume rate.

Round the final answer to the nearest whole number.

17.1

rounds down to

17

Matches the rounding instructions provided in the question stem.

Key Concept

Weight-based continuous intravenous medication infusion calculations requiring multiple unit conversions

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