A nurse in the intensive care unit is caring for a client with a hypertensive emergency. T… — NCLEX-RN

A nurse in the intensive care unit is caring for a client with a hypertensive emergency. The client weighs $198\text{ lb}$ . The client is currently receiving a continuous intravenous (IV) infusion of nitroprusside at $14\text{ mL/hr}$ . The IV solution contains $50\text{ mg}$ of nitroprusside in $250\text{ mL}$ of $5\%$ dextrose in water ( $D_5W$ ). Based on the client's current blood pressure of $185/110\text{ mm Hg}$ , the healthcare provider prescribes an increase in the nitroprusside infusion rate by $0.5\text{ mcg/kg/min}$ . What is the new infusion rate in $\text{mL/hr}$ that the nurse should set on the IV pump? Record your answer using one decimal place.

Cevap: 27.5 mL/hr

Cevap

27.5

To determine the new infusion rate, calculate the volume required for the prescribed increase and add it to the current baseline rate. First, convert the weight:

198\text{ lb} \div 2.2 = 90\text{ kg}

. Calculate the increase per minute:

0.5\text{ mcg/kg/min} \times 90\text{ kg} = 45\text{ mcg/min}

. Convert to an hourly dose:

45\text{ mcg/min} \times 60\text{ min/hr} = 2700\text{ mcg/hr}

. Next, determine the concentration of the available solution:

50\text{ mg} = 50,000\text{ mcg}

;

50,000\text{ mcg} \div 250\text{ mL} = 200\text{ mcg/mL}

. Divide the hourly dose increase by the concentration:

2700\text{ mcg/hr} \div 200\text{ mcg/mL} = 13.5\text{ mL/hr}

. Finally, add this volume increase to the current rate:

14\text{ mL/hr} + 13.5\text{ mL/hr} = 27.5\text{ mL/hr}

Adım Adım Çözüm

Convert the client's weight to kilograms.

90 kg

The prescribed dose increase is weight-based (mcg/kg/min), so weight must be in kg.

Calculate the total mcg/min required for the rate increase.

45 mcg/min

Multiplies the prescribed dose increase (0.5 mcg/kg/min) by the patient's weight (90 kg).

Convert the required dose increase from mcg/min to mcg/hr.

2700 mcg/hr

The IV infusion pump is programmed in mL/hr, so the dose must be standardized to an hourly rate.

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

200 mcg/mL

Converts 50 mg to 50,000 mcg, then divides by the total volume (250 mL) to find the amount of drug per mL.

Calculate the additional infusion rate (mL/hr) required for the increase.

13.5 mL/hr

Divides the required hourly dose increase (2700 mcg/hr) by the drug concentration (200 mcg/mL).

Calculate the new total infusion rate.

27.5 mL/hr

Adds the required increase (13.5 mL/hr) to the current continuous infusion rate (14 mL/hr).

Anahtar Kavram

Complex weight-based IV medication titration and dosage calculation

Soru

Cevap

Adım Adım Çözüm

Anahtar Kavram

Sık Yapılan Hatalar

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