A critical care nurse is preparing to initiate a continuous IV infusion of dobutamine for … — NCLEX-RN

A critical care nurse is preparing to initiate a continuous IV infusion of dobutamine for a client with severe heart failure. The healthcare provider has prescribed dobutamine at $5 \text{ mcg/kg/min}$ . The client weighs $198 \text{ lb}$ . The medication is supplied as dobutamine $500 \text{ mg}$ in $250 \text{ mL}$ of 5% dextrose in water (D5W). At what rate, in $\text{mL/hr}$ , should the nurse set the IV infusion pump? (Record your answer using one decimal place.)

Cevap: 13.5 mL/hr

Cevap

13.5

To determine the correct IV pump rate, first convert the weight to kilograms (

198 \text{ lb} \div 2.2 = 90 \text{ kg}

). Then, calculate the total dose in mcg/min (

5 \text{ mcg/kg/min} \times 90 \text{ kg} = 450 \text{ mcg/min}

). Next, convert to an hourly dose (

450 \text{ mcg/min} \times 60 \text{ min/hr} = 27,000 \text{ mcg/hr}

), and then to milligrams (

27,000 \text{ mcg} \div 1,000 = 27 \text{ mg/hr}

). Finally, divide the hourly dose by the concentration of the IV bag (

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

) to find the rate in mL/hr:

27 \text{ mg/hr} \div 2 \text{ mg/mL} = 13.5 \text{ mL/hr}

Adım Adım Çözüm

Convert the client's weight from pounds (lb) to kilograms (kg).

198 \text{ lb} \div 2.2 \text{ lb/kg} = 90 \text{ kg}

The prescribed dose is weight-based in kilograms, so the client's weight must first be converted into the correct unit.

Calculate the total required dose per minute.

5 \text{ mcg/kg/min} \times 90 \text{ kg} = 450 \text{ mcg/min}

Multiplying the prescribed weight-based dose by the client's weight determines the exact dose the client needs each minute.

Convert the per-minute dose to an hourly dose.

450 \text{ mcg/min} \times 60 \text{ min/hr} = 27,000 \text{ mcg/hr}

IV infusion pumps are set in milliliters per hour (mL/hr), so the required medication dose must be calculated on an hourly basis.

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

27,000 \text{ mcg/hr} \div 1,000 \text{ mcg/mg} = 27 \text{ mg/hr}

The supplied medication concentration is provided in milligrams, so the requested dose must be converted to match the supplied unit.

Calculate the required volume to infuse per hour.

27 \text{ mg/hr} \div (500 \text{ mg} / 250 \text{ mL}) = 27 \text{ mg/hr} \div 2 \text{ mg/mL} = 13.5 \text{ mL/hr}

Dividing the desired hourly dose by the medication concentration determines the final infusion pump rate in mL/hr.

Anahtar Kavram

Weight-Based Intravenous Medication Dosage Calculation

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