An adult client admitted with acute decompensated heart failure requires inotropic support… — NCLEX-RN

An adult client admitted with acute decompensated heart failure requires inotropic support. The healthcare provider prescribes a continuous intravenous dobutamine infusion at a dose of $5\text{ mcg/kg/min}$ . The client's current weight is $80\text{ kg}$ . The medication is supplied as a pre-mixed bag containing $500\text{ mg}$ of dobutamine in $250\text{ mL}$ of $5\%$ dextrose in water. Calculate the required infusion rate in $\text{mL/hr}$ . Record your answer as a whole number.

Cevap: 12 mL/hr

Cevap

The correct infusion rate is 12 mL/hr. The patient requires 400 mcg of dobutamine per minute (80 kg * 5 mcg/kg/min). Over one hour (60 minutes), this equals 24,000 mcg, or 24 mg. Because the IV bag contains a concentration of 2 mg per 1 mL (500 mg / 250 mL), delivering 24 mg requires an infusion rate of 12 mL/hr.

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Calculate the total dose required per minute.

80\text{ kg} \times 5\text{ mcg/kg/min} = 400\text{ mcg/min}

Weight-based dosing requires determining the individualized dose based on the client's current weight.

Convert the dose from per minute to per hour.

400\text{ mcg/min} \times 60\text{ min/hr} = 24,000\text{ mcg/hr}

IV infusion pumps are programmed in mL per hour, so the medication dose must be standardized to an hourly rate.

Convert the hourly dose from micrograms to milligrams.

24,000\text{ mcg/hr} \div 1000\text{ mcg/mg} = 24\text{ mg/hr}

The supplied medication is measured in milligrams, so the requested dose must match the provided unit of measurement.

Calculate the concentration of the supplied medication.

500\text{ mg} \div 250\text{ mL} = 2\text{ mg/mL}

Determining the amount of medication in each milliliter is required to calculate the final infusion rate.

Calculate the required infusion rate in mL/hr.

24\text{ mg/hr} \div 2\text{ mg/mL} = 12\text{ mL/hr}

Dividing the required hourly dose by the concentration yields the fluid volume needed per hour.

Anahtar Kavram

Weight-based intravenous medication dosage calculation

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