A client weighing 198 lbs is prescribed Dopamine hydrochloride IV at 2 mcg/kg/minute to promote renal perfusion.

The pharmacy provides a pre-mixed bag of dopamine containing 400 mg in 250 mL dextrose 5% in water (D5W). An IV pump that provides a precision infusion rate to a tenth of a mL is available.

How many mL/hour should the IV pump be set to deliver? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

Answer and Explanation

The Correct Answer is ["6.8"]

Step 1: Convert the client’s weight from lbs to kg. 1 kg is approximately 2.2 lbs. So, 198 lbs ÷

2.2 = 90 kg (rounded to the nearest whole number).

Step 2: Calculate the total mcg of Dopamine needed per minute. The prescription is for 2 mcg/kg/minute. So, 90 kg × 2 mcg/kg/minute = 180 mcg/minute.

Step 3: Convert the total mcg of Dopamine in the bag to mcg/mL. The bag contains 400 mg of Dopamine in 250 mL. 1 mg is equal to 1000 mcg. So, 400 mg × 1000 = 400,000 mcg. Therefore, the concentration is 400,000 mcg ÷ 250 mL = 1600 mcg/mL.

Step 4: Calculate the mL of Dopamine needed per minute. So, 180 mcg/minute ÷ 1600 mcg/mL

= 0.1125 mL/minute.

Step 5: Convert mL/minute to mL/hour. There are 60 minutes in an hour. So, 0.1125 mL/minute × 60 = 6.75 mL/hour. The IV pump should be set to deliver 6.8 mL/hour (rounded to the nearest tenth).

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Free Nursing Study Resources

Correct Answer is ["D","E","F"]

Explanation

Choice D rationale
Involving the mother in the decision-making process can help alleviate some of the stress associated with caregiving. It allows the mother to maintain some control over her care and ensures that her needs and preferences are being met.
Choice E rationale
It is normal to have mixed feelings when caring for a loved one. Acknowledging these feelings can be an important part of managing caregiver stress.
Choice F rationale
Taking time for oneself and maintaining other relationships is crucial for caregiver well-being. It can help prevent burnout and improve the quality of care provided to the mother.

A. Replace the IV site with a smaller gauge. B. Apply soft bilateral wrist restraints. C. Redress the abdominal incision. D. Leave the lights on in the room at night.

Correct Answer is C

Explanation

Choice A rationale
Replacing the IV site with a smaller gauge is not the most appropriate intervention in this situation. The client’s confusion and picking at the dressing and tape are likely due to the dementia and increased confusion at night, known as “sundowning”. While a smaller gauge might be less noticeable to the client, it does not address the primary issue of the client’s confusion and restlessness at night.

Choice B rationale
Applying soft bilateral wrist restraints might be considered in some situations to prevent a confused client from removing necessary medical devices. However, restraints should be a last resort after all other interventions have been tried because they can increase agitation and confusion, and they pose a risk for injury.
Choice C rationale
Redressing the abdominal incision is the correct choice. The dressing is no longer occlusive, which means it’s not providing a proper barrier to bacteria. This could lead to an infection in the surgical site. The nurse should clean the area and apply a new sterile dressing.
Additionally, the nurse should continue to monitor the client’s behavior and implement interventions to reduce confusion and restlessness, such as reorienting the client and providing a quiet and calm environment.
Choice D rationale
Leaving the lights on in the room at night can actually increase confusion and agitation in clients with dementia. It can disrupt the client’s sleep-wake cycle and make “sundowning” worse. Therefore, this is not the most appropriate intervention.

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Naxlex Comprehensive Predictor Exams

The nurse uses the Modified Caregiver Strain Index (MCSI) and determines that the daughter is under significant stress caused by the assumption of her mother’s care.

Correct Answer is ["D","E","F"]

Explanation

Correct Answer is C

Explanation

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