A gravid client at 37 weeks gestation is admitted with severe preeclampsia and requires ma… — NCLEX-RN

A gravid client at $37$ weeks gestation is admitted with severe preeclampsia and requires magnesium sulfate therapy to prevent eclampsia, along with oxytocin for labor induction. The healthcare provider's orders include:

- Strict total intravenous fluid restriction of $125\text{ mL/hour}$ .
- Magnesium sulfate maintenance infusion at $2\text{ grams/hour}$ (supplied as $20\text{ grams}$ in $500\text{ mL}$ of $0.9\%$ sodium chloride).
- Oxytocin continuous infusion at $12\text{ milliunits/minute}$ (supplied as $30\text{ units}$ in $500\text{ mL}$ of Lactated Ringer's).
- A primary intravenous line of Lactated Ringer's to run at a rate that maintains the exact total hourly fluid restriction.

What should the nurse set the infusion rate for the primary line of Lactated Ringer's to, in $\text{mL/hour}$ ? Record your answer as a whole number.

Cevap: 63 mL/hour

Cevap

63 mL/hour

To determine the primary line rate, the nurse must calculate the hourly volume of all medication infusions and subtract this total from the maximum fluid restriction. The magnesium sulfate rate is 50 mL/hour and the oxytocin rate is 12 mL/hour, totaling 62 mL/hour. Subtracting 62 from the 125 mL/hour restriction yields 63 mL/hour for the primary maintenance line.

Adım Adım Çözüm

Calculate the magnesium sulfate infusion rate in mL/hour.

Concentration:

20\text{ g} / 500\text{ mL} = 1\text{ g} / 25\text{ mL}

. Dose:

2\text{ g/hour} \times 25\text{ mL/g} = 50\text{ mL/hour}

The infusion pump must be programmed in mL/hour to deliver the prescribed 2 grams per hour.

Convert the oxytocin concentration from units to milliunits.

30\text{ units} \times 1,000\text{ milliunits/unit} = 30,000\text{ milliunits}

. Concentration:

30,000\text{ milliunits} / 500\text{ mL} = 60\text{ milliunits/mL}

Oxytocin dosing is ordered in milliunits, so the bag concentration must match the ordered unit of measure.

Calculate the oxytocin infusion rate in mL/hour.

Dose:

12\text{ milliunits/minute} \times 60\text{ minutes/hour} = 720\text{ milliunits/hour}

. Rate:

720\text{ milliunits/hour} \div 60\text{ milliunits/mL} = 12\text{ mL/hour}

Converting the per-minute dose to a per-hour dose allows calculation of the mL/hour pump setting.

Determine the total volume of continuous medication infusions per hour.

50\text{ mL/hour (magnesium sulfate)} + 12\text{ mL/hour (oxytocin)} = 62\text{ mL/hour}

All intravenous fluids, including medications, count toward the strict fluid restriction in preeclampsia to prevent pulmonary edema.

Calculate the primary Lactated Ringer's infusion rate.

125\text{ mL/hour (total restriction)} - 62\text{ mL/hour (medications)} = 63\text{ mL/hour}

The primary line makes up the difference between the total fluid restriction and the required medication volumes.

Anahtar Kavram

Calculation of concurrent medication infusions and fluid restriction management in severe preeclampsia.

Soru

Cevap

Adım Adım Çözüm

Anahtar Kavram

Sık Yapılan Hatalar

Konular

Bu konudan daha fazla soru