A nurse is to administer Dobutamine (Dobutrex) 2.5 mcg/kg/min IV to a patient with severe heart failure who weighs 130 pounds. The pharmacy prepares a solution of 250 mg of Dobutrex in 500 mL D5W. How many mL of the medication should be administered to the patient per hour? Round your answer to the nearest whole number.
The Correct Answer is ["18"]
Step 1: Convert the patient's weight from pounds to kilograms. 130 pounds ÷ 2.205 (1 pound = 0.453592 kilograms) ≈ 58.97 kilograms
Step 2: Calculate the total dosage of Dobutamine required per hour based on the weight-specific dose. 2.5 mcg/kg/min × 58.97 kg = 147.425 mcg/min
Step 3: Calculate the infusion rate (mL/hr) using the concentration of Dobutamine in the prepared solution. The solution contains 250 mg of Dobutamine in 500 mL, which means there are 250,000 mcg of Dobutamine in 500 mL. To determine the mL/hr, divide the required dosage (147.425 mcg/min) by the amount of Dobutamine in 500 mL (250,000 mcg) and multiply by 500 mL (volume of the solution).
(147.425 mcg/min ÷ 250,000 mcg) × 500 mL ≈ 0.295 mL/min
To get the mL/hr, we convert the rate from minutes to hours (60 minutes = 1 hour):
0.295 mL/min × 60 min/hr ≈ 17.7 mL/hr
Round the answer to the nearest whole number:
Approximately 18 mL/hr of Dobutamine should be administered to the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Shock is a state of inadequate tissue perfusion, resulting in compromised oxygen and nutrient delivery to cells and impaired cellular metabolism. Regardless of the specific cause or type of shock (e.g., hypovolemic, cardiogenic, distributive), the underlying problem is the failure to supply sufficient oxygen and nutrients to the body's tissues. This inadequate tissue perfusion can lead to cellular dysfunction, organ failure, and ultimately, life-threatening consequences.
A. Inefficient metabolism resulting from inadequate nutrition in (option A) is incorrect because While inadequate nutrition can contribute to the overall health status and resilience of an individual, it is not the central mechanism underlying all shock states.
C. Vasoconstriction and reflexive vasodilation due to circulating mediators in (option C) is incorrect because Vasoconstriction and vasodilation are physiological responses that can occur in various types of shock, but they are not the fundamental common denominator. Inadequate tissue perfusion remains the core issue.
D. Hypovolemia resulting from blood loss in (option D) is incorrect because Hypovolemia, which refers to decreased blood volume, is one potential cause of shock, specifically hypovolemic shock. However, other types of shock, such as cardiogenic or distributive shock, may not be primarily characterized by hypovolemia.
Therefore, the common denominator of all shock states is inadequate tissue perfusion, resulting in impaired cellular metabolism.
Correct Answer is A
Explanation
The stages of shock are commonly described as the initial, compensatory, progressive, and refractory stages. Here is an explanation of each stage and why the patient's assessment findings correspond to the progressive stage:
B. The compensatory stage in (option B) is incorrect because, In the compensatory stage, the body continues to activate compensatory mechanisms to maintain perfusion. This includes increased heart rate, peripheral vasoconstriction, and shunting of blood to vital organs. The patient's assessment findings of decreasing cardiac output, decreased peripheral perfusion, and increased capillary permeability suggest that the body's compensatory mechanisms are no longer sufficient to maintain perfusion adequately. Therefore, the patient has progressed beyond the compensatory stage.
C. The initial stage in (option C) is incorrect because, In the initial stage, there is an initial insult or injury that triggers the shock state. The body's compensatory mechanisms are activated, such as increased heart rate and vasoconstriction, to maintain blood pressure and perfusion. However, the patient's assessment findings indicate that they have progressed beyond the initial stage.
D. The refractory stage in (option D) is incorrect because The refractory stage represents a severe and irreversible state of shock where vital organs fail, and despite interventions, the patient's condition does not improve. The patient's assessment findings do not suggest the refractory stage, as there is still potential for intervention and management.
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