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 ["6.5"]
Explanation
Convert the Client's Weight from Pounds to Kilograms:
1 kg = 2.205 lbs
Weight in kg = 143 lbs / 2.205 lbs/kg
Weight in kg ≈ 64.85 kg
Calculate the Total Dose of Cyclosporine Needed:
Dose = 5 mg/kg x 64.85 kg
Dose ≈ 324.25 mg
Calculate the Volume of Cyclosporine to Administer:
Available concentration = 50 mg/mL
Volume (mL) = Desired dose (mg) / Available concentration (mg/mL)
Volume (mL) = 324.25 mg / 50 mg/mL
Volume (mL) ≈ 6.485 mL
Round to the Nearest Tenth:
6.5 mL
Correct Answer is ["30"]
Explanation
Understanding the Problem
Order: Potassium gluconate 40 mEq PO
Available Solution: Potassium gluconate liquid 20 mEq/15 mL
Desired Dose: mL to administer
Step 1: Set Up the Calculation
We need to find the volume (in mL) that contains the ordered dose (40 mEq). We can do this by setting up a proportion or using the formula:
Volume (mL) = (Ordered Dose (mEq) / Concentration (mEq/mL))
Step 2: Determine the Concentration
Available Concentration: 20 mEq / 15 mL
Step 3: Perform the Calculation
Ordered Dose: 40 mEq
Concentration: 20 mEq / 15 mL
Volume: (40 mEq) / (20 mEq / 15 mL) = (40 mEq X 15 mL) / 20 mEq
We can simplify this by dividing 40 by 20:
Volume: (2 X 15 mL) = 30 mL
Step 4: Round to the Nearest Whole Number
The result is 30 mL, which is already a whole number.
Answer: 30 mL
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