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Zorluk: OrtaPharmacological and Parenteral Therapies

A client admitted with cardiogenic shock requires hemodynamic support. The primary healthcare provider orders a dopamine infusion at a rate of 5 mcg/kg/min5\text{ mcg/kg/min}. The client weighs 85 kg85\text{ kg}. The pharmacy dispenses a premixed intravenous bag containing dopamine 400 mg400\text{ mg} in 250 mL250\text{ mL} of 5%5\% dextrose in water (D5W).

At what rate should the electronic infusion pump be programmed? (Round the final answer to the nearest tenth.)

Cevap: 15.9 mL/hr

Cevap

15.9
To accurately program the electronic infusion pump, the nurse must process multiple conversions: finding the total weight-based dose per minute (5×85=425 mcg/min5 \times 85 = 425\text{ mcg/min}), expanding that to an hourly dose (425×60=25,500 mcg/hr425 \times 60 = 25,500\text{ mcg/hr}), matching the dose unit to the dispensed medication by converting to milligrams (25,500÷1,000=25.5 mg/hr25,500 \div 1,000 = 25.5\text{ mg/hr}), and finally dividing by the IV fluid concentration (400 mg÷250 mL=1.6 mg/mL400\text{ mg} \div 250\text{ mL} = 1.6\text{ mg/mL}). Dividing 25.5 mg/hr25.5\text{ mg/hr} by 1.6 mg/mL1.6\text{ mg/mL} yields 15.9375 mL/hr15.9375\text{ mL/hr}, which correctly rounds to 15.9 mL/hr15.9\text{ mL/hr}.

Adım Adım Çözüm

1
Calculate the total dose required per minute in micrograms.
5 mcg/kg/min×85 kg=425 mcg/min5\text{ mcg/kg/min} \times 85\text{ kg} = 425\text{ mcg/min}
The prescription is weight-based, so the per-kilogram dose must be multiplied by the client's total body weight.
2
Convert the per-minute dosage to an hourly dosage.
425 mcg/min×60 min/hr=25,500 mcg/hr425\text{ mcg/min} \times 60\text{ min/hr} = 25,500\text{ mcg/hr}
Infusion pumps are programmed in milliliters per hour (mL/hr), so the total medication needed per hour must be determined.
3
Convert the hourly dosage from micrograms (mcg) to milligrams (mg).
25,500 mcg÷1,000 mcg/mg=25.5 mg/hr25,500\text{ mcg} \div 1,000\text{ mcg/mg} = 25.5\text{ mg/hr}
The available dopamine bag is measured in milligrams, so the requested dose must match the unit of the supplied medication.
4
Determine the concentration of the available intravenous solution.
400 mg÷250 mL=1.6 mg/mL400\text{ mg} \div 250\text{ mL} = 1.6\text{ mg/mL}
Finding the amount of medication in a single milliliter allows for direct calculation of the required fluid volume.
5
Calculate the final infusion rate in mL/hr and round to the nearest tenth.
25.5 mg/hr÷1.6 mg/mL=15.9375 mL/hr25.5\text{ mg/hr} \div 1.6\text{ mg/mL} = 15.9375\text{ mL/hr}. Rounded to the nearest tenth is 15.9 mL/hr15.9\text{ mL/hr}.
Dividing the required hourly dose by the concentration yields the required pump rate.

Anahtar Kavram

Weight-Based Continuous Intravenous Medication Calculations
Tahmini Süre:1m 30s
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