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Zorluk: ZorPharmacological and Parenteral Therapies

A nurse is caring for a client with acute decompensated heart failure who weighs 198 lbs198 \text{ lbs}. The healthcare provider prescribes a continuous intravenous (IV) infusion of milrinone at 0.375 mcg/kg/min0.375 \text{ mcg/kg/min}. The pharmacy supplies milrinone as 20 mg20 \text{ mg} in 100 mL100 \text{ mL} of 5% Dextrose5\% \text{ Dextrose} in water (D5W). At what rate, in mL/hr\text{mL/hr}, should the nurse set the IV infusion pump? (Record answer to the nearest tenth.)

Cevap: 10.1 mL/hr

Cevap

10.1
To solve this problem, first convert the weight to kilograms (198÷2.2=90 kg198 \div 2.2 = 90 \text{ kg}). Next, find the per-minute dose (0.375 mcg×90 kg=33.75 mcg/min0.375 \text{ mcg} \times 90 \text{ kg} = 33.75 \text{ mcg/min}). Convert this to an hourly dose by multiplying by 60 (33.75×60=2025 mcg/hr33.75 \times 60 = 2025 \text{ mcg/hr}). Then, find the concentration of the supplied bag by converting mg to mcg (20 mg=20,000 mcg20 \text{ mg} = 20,000 \text{ mcg}) and dividing by the volume (20,000 mcg÷100 mL=200 mcg/mL20,000 \text{ mcg} \div 100 \text{ mL} = 200 \text{ mcg/mL}). Finally, divide the required hourly dose by the concentration (2025÷200=10.1252025 \div 200 = 10.125) and round to the nearest tenth (10.110.1).

Adım Adım Çözüm

1
Convert the client's weight from pounds (lbs) to kilograms (kg).
198 lbs÷2.2 lbs/kg=90 kg198 \text{ lbs} \div 2.2 \text{ lbs/kg} = 90 \text{ kg}
The medication is prescribed in a weight-based format using kilograms.
2
Calculate the prescribed dose per minute based on the client's weight in kilograms.
0.375 mcg/kg/min×90 kg=33.75 mcg/min0.375 \text{ mcg/kg/min} \times 90 \text{ kg} = 33.75 \text{ mcg/min}
This establishes the exact amount of medication the client needs to receive every minute.
3
Convert the dose per minute to the dose per hour.
33.75 mcg/min×60 min/hr=2025 mcg/hr33.75 \text{ mcg/min} \times 60 \text{ min/hr} = 2025 \text{ mcg/hr}
Infusion pumps are programmed in mL/hr, so the medication dose must reflect an hourly rate.
4
Convert the supplied milrinone dose from milligrams (mg) to micrograms (mcg).
20 mg×1000 mcg/mg=20,000 mcg20 \text{ mg} \times 1000 \text{ mcg/mg} = 20,000 \text{ mcg}
Standardizing units is required because the prescription is in micrograms but the supply is in milligrams.
5
Determine the concentration of the supplied medication in mcg/mL.
20,000 mcg÷100 mL=200 mcg/mL20,000 \text{ mcg} \div 100 \text{ mL} = 200 \text{ mcg/mL}
This shows how many micrograms of milrinone are contained in every 1 mL of the IV fluid.
6
Calculate the final infusion rate in mL/hr by dividing the hourly dose by the concentration.
2025 mcg/hr÷200 mcg/mL=10.125 mL/hr2025 \text{ mcg/hr} \div 200 \text{ mcg/mL} = 10.125 \text{ mL/hr}
This translates the required hourly medication dose into the fluid volume the pump must deliver.
7
Round the calculated infusion rate to the nearest tenth.
10.125 mL/hr10.125 \text{ mL/hr} rounds to 10.1 mL/hr10.1 \text{ mL/hr}
Adhering to the specific rounding instructions provided in the stem.

Anahtar Kavram

Weight-Based Continuous IV Infusion Dosage Calculations
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Konular

Pharmacological and Parenteral Therapies

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