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Zorluk: ZorPharmacological and Parenteral Therapies

A critical care nurse is managing a client with symptomatic bradycardia who is unresponsive to standard atropine therapy. The client weighs 187 lbs187\text{ lbs}. The healthcare provider prescribes a continuous IV infusion of dopamine at 4 mcg/kg/min4\text{ mcg/kg/min}. The pharmacy supplies a premixed bag containing 250 mg250\text{ mg} of dopamine in 500 mL500\text{ mL} of 5%5\% dextrose in water (D5W). What is the correct infusion pump setting in mL/hr\text{mL/hr}? Record your answer using one decimal place.

Cevap: 40.8 mL/hr

Cevap

40.8
To find the correct pump setting in mL/hr, you must first convert the client's weight to kilograms (187 / 2.2 = 85 kg), multiply by the prescribed mcg/kg/min dosage to find the total mcg/min (85 * 4 = 340 mcg/min), and multiply by 60 to find the total mcg/hr (20,400 mcg/hr). Finally, divide this hourly requirement by the solution's concentration (500 mcg/mL) to get 40.8 mL/hr.

Adım Adım Çözüm

1
Convert the client's weight from pounds to kilograms.
187 lbs÷2.2=85 kg187\text{ lbs} \div 2.2 = 85\text{ kg}
The dopamine dosage is prescribed based on the client's weight in kilograms.
2
Calculate the required medication dose per minute.
85 kg×4 mcg/kg/min=340 mcg/min85\text{ kg} \times 4\text{ mcg/kg/min} = 340\text{ mcg/min}
This establishes the total amount of dopamine the client must receive each minute.
3
Convert the per-minute dose to an hourly dose.
340 mcg/min×60 min/hr=20,400 mcg/hr340\text{ mcg/min} \times 60\text{ min/hr} = 20,400\text{ mcg/hr}
Infusion pumps are programmed to deliver volume on an hourly basis (mL/hr).
4
Determine the concentration of the dopamine solution in mcg/mL.
250 mg=250,000 mcg250\text{ mg} = 250,000\text{ mcg}; 250,000 mcg÷500 mL=500 mcg/mL250,000\text{ mcg} \div 500\text{ mL} = 500\text{ mcg/mL}
Converting milligrams to micrograms matches the prescribed dose unit, allowing calculation of the exact fluid volume per mL.
5
Calculate the final infusion pump rate.
20,400 mcg/hr÷500 mcg/mL=40.8 mL/hr20,400\text{ mcg/hr} \div 500\text{ mcg/mL} = 40.8\text{ mL/hr}
Dividing the total hourly medication requirement by the concentration yields the fluid volume needed per hour.

Anahtar Kavram

Weight-based continuous IV infusion calculation
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Konular

Pharmacological and Parenteral Therapies

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