A nurse is reviewing the medication orders for a client who has heart failure. Which of the following prescriptions should the nurse clarify with the provider
Digoxin 25 mcg/kg via IV bolus every 8 hr x 2 doses
Dobutamine 15 mcg/kg via continuous IV infusion
Bumetanide 0.1 mg/kg via IV bolus every 12 hr
Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous V Infusion at 50 mL/hr
The Correct Answer is A
A) Digoxin 25 mcg/kg via IV bolus every 8 hr x 2 doses: This prescription should be clarified. Digoxin is typically prescribed in micrograms (mcg), but the dose of 25 mcg/kg is very high and could lead to toxicity. For a client with heart failure, the usual dosage for digoxin is 0.125–0.25 mg daily, not 25 mcg/kg per dose, which is excessive and potentially dangerous. Therefore, this order should be clarified with the provider.
B) Dobutamine 15 mcg/kg via continuous IV infusion: This is an appropriate dose for dobutamine, which is commonly used in heart failure for its inotropic effects. Dobutamine is typically dosed between 2–20 mcg/kg/min for continuous IV infusion, so 15 mcg/kg/min is within a safe range.
C) Bumetanide 0.1 mg/kg via IV bolus every 12 hr: Bumetanide is a loop diuretic used in heart failure, and the prescribed dose of 0.1 mg/kg every 12 hours is an appropriate dosing regimen for this medication. It is within the typical dosing range, and the interval is also reasonable for managing fluid overload in heart failure.
D) Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous IV infusion at 50 mL/hr: This IV fluid prescription is generally appropriate. The combination of dextrose and sodium chloride with potassium is commonly used to maintain hydration and electrolyte balance in clients, particularly in the context of heart failure management. The infusion rate of 50 mL/hr is a typical rate for continuous IV infusions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["60"]
Explanation
Understanding the Problem
Order: Lidocaine 4 mg/min
Available Solution: Lidocaine 1 g in 250 mL of D5W
Desired Rate: mL/hr
Step 1: Convert Grams (g) to Milligrams (mg)
1 g = 1000 mg
Available Lidocaine: 1 g x 1000 mg/g = 1000 mg
Step 2: Determine the Concentration of the Lidocaine Solution
Available Lidocaine: 1000 mg
Solution Volume: 250 mL
Concentration: 1000 mg / 250 mL = 4 mg/mL
Step 3: Calculate the Infusion Rate in mL/min
Ordered Dose: 4 mg/min
Concentration: 4 mg/mL
Infusion Rate: 4 mg/min / 4 mg/mL = 1 mL/min
Step 4: Convert Infusion Rate to mL/hr
Infusion Rate: 1 mL/min
Minutes in an Hour: 60 min
Infusion Rate in mL/hr: 1 mL/min x 60 min/hr = 60 mL/hr
Step 5: Round to the Nearest Whole Number
The calculated rate is 60 mL/hr, which is already a whole number.
Final Answer: 60 mL/hr
Correct Answer is ["6"]
Explanation
Calculate the Total Infusion Time in Minutes:
The infusion is to be delivered over 4 hours.
There are 60 minutes in 1 hour.
Total infusion time: 4 hours x 60 minutes/hour = 240 minutes
Calculate the Drip Rate (gtt/min):
We'll use the following formula:
Drip Rate (gtt/min) = (Total Volume (mL) x Drop Factor (gtt/mL)) / Total Infusion Time (minutes)
Plug in the Values and Calculate:
Drip Rate (gtt/min) = (100 mL x 15 gtt/mL) / 240 minutes
Drip Rate (gtt/min) = 1500 gtt / 240 minutes
Drip Rate (gtt/min) = 6.25 gtt/min
Round to the Nearest Whole Number:
6 gtt/min
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