A nurse is caring for a client who weighs 68 kg and has a new prescription for nitroprusside 0.3 mcg/kg/min by continuous IV infusion. The prescription says to increase the dose by 0.3 mcg every 5 min to maintain systolic UP at 100 to 200 mm Hg. Available is nitroprusside 50 mg in dextrose 5% in water 250 mL. Five min after starting the infusion, the client's 8P is 208/150 mm Hg. How many mute should the nurse administer now? (Round the to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
The Correct Answer is ["12.2"]
Understanding the Problem
Initial Order: Nitroprusside 0.3 mcg/kg/min
Client Weight: 68 kg
Dose Increase: 0.3 mcg/kg/min every 5 minutes
Current BP: 208/150 mmHg (Indicates need for dose increase)
Available Solution: Nitroprusside 50 mg in 250 mL of D5W
Desired Rate: mL/hr
Step 1: Calculate the Initial Dose
Initial Dose: 0.3 mcg/kg/min
Client Weight: 68 kg
Initial Total Dose: 0.3 mcg/kg/min x 68 kg = 20.4 mcg/min
Step 2: Determine the New Dose After Increase
Increase: 0.3 mcg/kg/min
Client Weight: 68 kg
Total Increase: 0.3 mcg/kg/min x 68 kg = 20.4 mcg/min
New Total Dose: 20.4 mcg/min (initial) + 20.4 mcg/min (increase) = 40.8 mcg/min
Step 3: Convert the New Dose to Milligrams (mg)
1 mg = 1000 mcg
New Dose in mg/min: 40.8 mcg/min / 1000 mcg/mg = 0.0408 mg/min
Step 4: Calculate the New Dose in mg/hr
New Dose in mg/min: 0.0408 mg/min
Minutes in an Hour: 60 min
New Dose in mg/hr: 0.0408 mg/min x 60 min/hr = 2.448 mg/hr
Step 5: Determine the Concentration of the Nitroprusside Solution
Available Nitroprusside: 50 mg
Solution Volume: 250 mL
Concentration: 50 mg / 250 mL = 0.2 mg/mL
Step 6: Calculate the Infusion Rate in mL/hr
New Dose in mg/hr: 2.448 mg/hr
Concentration: 0.2 mg/mL
Infusion Rate: 2.448 mg/hr / 0.2 mg/mL = 12.24 mL/hr
Step 7: Round to the Nearest Tenth
The calculated rate is 12.24 mL/hr.
Rounded to the nearest tenth: 12.2 mL/hr
Answer: 12.2 mL/hr
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["35"]
Explanation
Understanding the Problem
Order: Regular insulin 3.5 units/hr
Available Solution: Regular insulin 100 units in 1000 mL of 0.45% sodium chloride
Desired Rate: mL/hr
Step 1: Determine the Concentration of the Insulin Solution
Available Insulin: 100 units
Solution Volume: 1000 mL
Concentration: 100 units / 1000 mL = 0.1 units/mL
Step 2: Calculate the Infusion Rate in mL/hr
Ordered Dose: 3.5 units/hr
Concentration: 0.1 units/mL
Infusion Rate: 3.5 units/hr / 0.1 units/mL = 35 mL/hr
Step 3: Round to the Nearest Whole Number
The calculated rate is 35 mL/hr, which is already a whole number.
Answer: 35 mL/hr
Correct Answer is ["34"]
Explanation
Convert the Client's Weight from Pounds to Kilograms:
1 kg = 2.205 lbs
Weight in kg = 250 lbs / 2.205 lbs/kg
Weight in kg ≈ 113.38 kg
Calculate the Dobutamine Dose in mcg/min:
Dose = 5 mcg/kg/min x 113.38 kg
Dose ≈ 566.9 mcg/min
Convert the Dobutamine Dose from mcg/min to mg/min:
1 mg = 1000 mcg
Dose in mg/min = 566.9 mcg/min / 1000 mcg/mg
Dose in mg/min ≈ 0.5669 mg/min
Calculate the Dobutamine Dose in mg/hr:
Dose in mg/hr = 0.5669 mg/min x 60 min/hr
Dose in mg/hr ≈ 34.014 mg/hr
Calculate the Infusion Rate in mL/hr:
Available concentration = 250 mg / 250 mL = 1 mg/mL
Infusion Rate (mL/hr) = Dose in mg/hr / Concentration (mg/mL)
Infusion Rate (mL/hr) = 34.014 mg/hr / 1 mg/mL
Infusion Rate (mL/hr) ≈ 34.014 mL/hr
Round to the Nearest Whole Number:
34 mL/hr
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