A client admitted with cardiogenic shock requires hemodynamic support. The healthcare prov… — NCLEX-RN

A client admitted with cardiogenic shock requires hemodynamic support. The healthcare provider orders a continuous intravenous infusion of dobutamine at a rate of $5\text{ mcg/kg/min}$ . The client's current weight is $82\text{ kg}$ . The pharmacy dispenses a premixed bag containing $500\text{ mg}$ of dobutamine in $250\text{ mL}$ of $5\%$ dextrose in water ( $D_5W$ ).

At what rate, in $\text{mL/hr}$ , should the nurse program the infusion pump? Record your answer as a number with one decimal place.

Cevap: 12.3 mL/hr

Cevap

12.3

The correct infusion rate is calculated by determining the total weight-based dose per minute, converting it to an hourly dose, aligning the units with the supplied medication, and dividing by the concentration of the IV bag. This sequential mathematical process accurately results in an infusion pump setting of 12.3 mL/hr.

Adım Adım Çözüm

Determine the total dose of dobutamine required per minute.

82\text{ kg} \times 5\text{ mcg/kg/min} = 410\text{ mcg/min}

The prescribed dose is weight-based, so the client's total weight in kilograms must be multiplied by the ordered rate.

Convert the per-minute dose to an hourly dose.

410\text{ mcg/min} \times 60\text{ min/hr} = 24,600\text{ mcg/hr}

Intravenous infusion pumps are programmed in milliliters per hour, requiring the medication dose to be calculated over a 60-minute period.

Convert the hourly dose from micrograms (mcg) to milligrams (mg).

24,600\text{ mcg} \div 1000\text{ mcg/mg} = 24.6\text{ mg/hr}

The supplied medication is measured in milligrams, so the requested dose must be converted to align with the available supply.

Determine the concentration of the supplied dobutamine.

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

Calculating the milligrams of medication per single milliliter of fluid simplifies the final volume calculation.

Calculate the required infusion pump rate.

24.6\text{ mg/hr} \div 2\text{ mg/mL} = 12.3\text{ mL/hr}

Dividing the required hourly dose by the concentration of the IV solution yields the final volume to infuse per hour.

Anahtar Kavram

Weight-Based Intravenous Dosing and Pump Rate Calculation

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