A patient is receiving an IV of esmolol 2.5 grams in 250 mL of D5W (dextrose 5% in water) infusing at 200 micrograms/kilogram/minute. The patient weighs 110 lb. What rate (in mL/hr) should the nurse program into the IV pump to deliver this dose?
45 mL/hr
60 mL/hr
75 mL/hr
90 mL/hr
The Correct Answer is B
Step 1 is Convert pounds to kilograms 110 lb ÷ 2.2 = 50 kg
Step 2 is Calculate dose in micrograms per minute 50 kg × 200 micrograms = 10,000 micrograms/min
Step 3 is Convert micrograms to milligrams 10,000 micrograms ÷ 1000 = 10 mg/min
Step 4 is Convert mg/min to mg/hr 10 mg × 60 = 600 mg/hr
Step 5 is Determine concentration of esmolol in mg/mL 2.5 grams × 1000 = 2500 mg 2500 mg ÷ 250 mL = 10 mg/mL
Step 6 is Calculate infusion rate in mL/hr 600 mg/hr ÷ 10 mg/mL = 60 mL/hr
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct technique for preparing this insulin order is to follow these steps¹²:
- Perform hand hygiene and put on gloves.
- Mix NPH (cloudy) insulin by gently rotating the vial between the palms of your hands. Do not shake the vial.
- Clean the tops of both vials with alcohol swabs and let them dry.
- Draw up the amount of air equal to the dose of NPH insulin into a syringe. Inject the air into the NPH vial without touching the needle to the solution. Withdraw the needle and syringe without drawing up any insulin. This will create positive pressure in the NPH vial and make it easier to draw up later.
- Draw up the amount of air equal to the dose of regular (clear) insulin into the same syringe. Inject the air into the regular vial and invert the vial. Make sure the needle tip is below the fluid level and draw up slightly more than the dose of regular insulin. Tap the syringe gently to remove any air bubbles and push out any excess insulin to get the exact dose. Withdraw the needle and syringe from the regular vial.
- Reinsert the needle and syringe into the NPH vial without touching the needle to the solution. Invert the vial and draw up slightly more than the dose of NPH insulin. Tap the syringe gently to remove any air bubbles and push out any excess insulin to get the exact dose. Withdraw the needle and syringe from the NPH vial.
- Check that you have the correct doses of both insulins in one syringe. The total volume should be equal to the sum of both doses.
- Administer the dose within 5 to 10 minutes after drawing up because regular insulin binds to NPH and this decreases its action.
Correct Answer is C
Explanation
The nurse should administer 1 mL per dose to the patient.
This answer is correct because it is based on a simple ratio and proportion calculation. The nurse can set up a proportion as follows:
30 mg / 1 mL = 30 mg / x mL
Cross-multiplying and solving for x gives:
x = 1 mL
Therefore, the nurse should administer 1 mL of Toradol injection to deliver 30 mg of the medication to the patient.
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