A nurse is preparing to administer dopamine 5 mcg/kg/min by continuous IV infusion to a client who weighs 220 lb. Available is 400 mg of dopamine in 250 mL of 0.9% sodium chloride. The nurse should set the IV pump to deliver how many mi/hr? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
The Correct Answer is ["18.8"]
To calculate the rate at which the IV pump should deliver dopamine, we can follow these steps:
Step 1: Convert the weight of the client from pounds to kilograms.
220 lb ÷ 2.2 = 100 kg (rounded to the nearest whole number)
Step 2: Calculate the total dose of dopamine per minute.
5 mcg/kg/min × 100 kg = 500 mcg/min
Step 3: Convert the dose from micrograms (mcg) to milligrams (mg).
500 mcg/min ÷ 1000 = 0.5 mg/min
Step 4: Determine the infusion rate in milliliters per hour (mL/hr).
The total volume of the solution is 250 mL.
The total dose of dopamine is 400 mg.
So, the infusion rate is (0.5 mg/min ÷ 400 mg) × 250 mL = 0.3125 mL/min.
Step 5: Convert the infusion rate from mL/min to mL/hr.
0.3125 mL/min × 60 min/hr = 18.75 mL/hr (rounded to the nearest tenth).
Therefore, the nurse should set the IV pump to deliver 18.8 mL/hr (rounded to the nearest tenth).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Before administering the first dose of metformin, the nurse should evaluate the client's creatinine level. Metformin is primarily excreted by the kidneys, and its clearance from the body depends on the renal function. If the client has impaired kidney function, metformin can accumulate in the body and lead to potential adverse effects, particularly lactic acidosis.
Monitoring the creatinine level helps assess the client's kidney function and determines whether it is safe to administer metformin. If the creatinine level is elevated, indicating reduced kidney function, the nurse should consult with the healthcare provider to determine the appropriate dose adjustment or consider an alternative treatment option.
Let's go through the other options and explain why they are not the priority laboratory results to evaluate before administering metformin:
A. Potassium level: While monitoring potassium levels is important in some situations, it is not a primary concern before administering metformin. Metformin does not have a significant effect on potassium levels, and it is not a medication known for causing hypokalemia (low potassium levels).
C. Platelet count: Metformin does not have a direct impact on platelet count, and evaluating platelet count is not typically required before starting metformin therapy. Platelet count monitoring may be relevant for certain other medications or medical conditions, but it is not specific to metformin administration.
D. Liver enzymes: While it is essential to monitor liver function in clients on long-term metformin therapy, evaluating liver enzymes before the first dose of metformin is not the priority. Metformin is primarily cleared by the kidneys, and liver enzymes are not directly affected by its initial administration. However, ongoing monitoring of liver function may be necessary during long-term
Correct Answer is D
Explanation
A. Alopecia: Alopecia, or hair loss, is a common side effect of many chemotherapy drugs, including paclitaxel. While it can be distressing for the client, alopecia is not a life-threatening side effect and does not require immediate intervention. It is essential for the nurse to provide emotional support to the client experiencing hair loss and educate them about potential ways to cope with it.
B. Muscle pain: Muscle pain, also known as myalgia, is another common side effect of paclitaxel and many other chemotherapy agents. While it can cause discomfort for the client, myalgia is generally managed with pain medications and supportive care. It is not a priority finding that requires immediate reporting to the provider unless it becomes severe or debilitating.
C. Nausea: Nausea is a well-known side effect of chemotherapy, including paclitaxel. It is often managed with antiemetic medications and other supportive measures. While severe or persistent nausea can lead to dehydration and other complications, it is not an immediate life-threatening concern in most cases.
D. Bradycardia: This is the correct answer. Bradycardia (slow heart rate) is a less common but more concerning side effect of paclitaxel. It may indicate potential cardiac toxicity, which is a serious and potentially life-threatening complication. The healthcare provider should be notified promptly so that appropriate evaluation and intervention can be initiated to manage any cardiac issues and prevent further complications.
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