A nurse is titrating a continuous intravenous infusion of sodium nitroprusside for a clien… — NCLEX-RN

A nurse is titrating a continuous intravenous infusion of sodium nitroprusside for a client experiencing a hypertensive emergency. The client weighs $198 \text{ lbs}$ . The medication is supplied as $50 \text{ mg}$ of sodium nitroprusside mixed in $250 \text{ mL}$ of 5% dextrose in water ( $D_5W$ ). The client's current infusion rate is set at $15 \text{ mL/hr}$ . The healthcare provider prescribes an increase in the continuous infusion dose by $0.5 \text{ mcg/kg/min}$ . What is the new infusion pump setting in $\text{mL/hr}$ ? (Record answer to the nearest tenth.)

Cevap: 28.5 mL/hr

Cevap

28.5

The correct new infusion rate is determined by first calculating the requested dose increase based on the client's weight in kilograms. After determining the hourly microgram requirement, the nurse must convert that dose into a fluid volume using the concentration of the supplied medication. Finally, the calculated rate increase must be added to the current infusion rate to determine the new overall pump setting.

Adım Adım Çözüm

Convert the client's weight from pounds to kilograms.

198 \text{ lbs} \div 2.2 \text{ lbs/kg} = 90 \text{ kg}

Weight-based dosing requires the client's weight in kilograms to ensure accuracy.

Determine the concentration of the sodium nitroprusside solution in

\text{mcg/mL}

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

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

To convert the prescribed dose into a fluid volume, the concentration must be calculated in the same mass unit (micrograms) as the prescription.

Calculate the required dose increase in

\text{mcg/min}

and then convert to

\text{mcg/hr}

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

45 \text{ mcg/min} \times 60 \text{ min/hr} = 2,700 \text{ mcg/hr}

This calculation determines the total additional amount of active medication the client needs per hour.

Calculate the increase in the infusion rate in

\text{mL/hr}

2,700 \text{ mcg/hr} \div 200 \text{ mcg/mL} = 13.5 \text{ mL/hr}

This step determines the additional fluid volume needed per hour to deliver the extra dose of medication.

Determine the new final infusion rate by adding the calculated volume increase to the current infusion rate.

15 \text{ mL/hr} + 13.5 \text{ mL/hr} = 28.5 \text{ mL/hr}

The provider prescribed an increase to the ongoing continuous infusion, so the calculated volume must be added to the baseline rate.

Anahtar Kavram

Weight-based intravenous continuous infusion titration calculations

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