Ordered: Dopamine2mcg/kg/min In Stock: 200mg in 250mL Saline Patients weight: 60kg What rate would you set the pump to deliver the ordered medication? (Document to the nearest whole number)
The Correct Answer is ["9"]
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Dose in mcg/min=2 mcg/kg/min×60 kg=120 mcg/min
Convert this to mg/min since the concentration is in mg:
120 mcg/min=0.12 mg/min120 \text{ mcg/min} = 0.12 \text{ mg/min}120 mcg/min=0.12 mg/min
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Determine the concentration of Dopamine:
- Total amount of Dopamine: 200 mg in 250 mL of saline
- Concentration:
Concentration=200 mg250 mL=0.8 mg/mL\text{Concentration} = \frac{200 \text{ mg}}{250 \text{ mL}} = 0.8 \text{ mg/mL}Concentration=250 mL200 mg=0.8 mg/mL
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Calculate the pump rate in mL/min:
To find the rate in mL/min needed to deliver 0.12 mg/min:
Pump rate=Desired dose (mg/min)Concentration (mg/mL)\text{Pump rate} = \frac{\text{Desired dose (mg/min)}}{\text{Concentration (mg/mL)}}Pump rate=Concentration (mg/mL)Desired dose (mg/min)
Pump rate=0.12 mg/min0.8 mg/mL=0.15 mL/min\text{Pump rate} = \frac{0.12 \text{ mg/min}}{0.8 \text{ mg/mL}} = 0.15 \text{ mL/min}Pump rate=0.8 mg/mL0.12 mg/min=0.15 mL/min
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Convert the pump rate to mL/hour:
Multiply by 60 to convert from mL/min to mL/hour:
Pump rate=0.15 mL/min×60 min/hour=9 mL/hour\text{Pump rate} = 0.15 \text{ mL/min} \times 60 \text{ min/hour} = 9 \text{ mL/hour}Pump rate=0.15 mL/min×60 min/hour=9 mL/hour
So, you should set the pump to deliver Dopamine at a rate of 9 mL/hour.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Hemorrhagic shock is characterized by severe blood loss, leading to inadequate tissue perfusion and hypovolemia. The primary goal in the initial management of hemorrhagic shock is to restore intravascular volume and improve tissue perfusion. Administering intravenous fluids, such as normal saline solution, is a critical intervention to address hypovolemia and improve blood pressure.
A. Give Plasmanate 1 unit now in (option A) is incorrect because: Plasmanate is a plasma-derived product used to replace coagulation factors. While it may be necessary to address coagulation abnormalities, administering intravenous fluids to restore volume takes priority over specific blood products.
B. Prepare for endotracheal intubation in (option B) is incorrect because Endotracheal intubation may be required in cases of impending respiratory failure or compromised airway, but it should not be the first action in addressing hypovolemic shock.
D. Type and crossmatch for 4 units of packed red blood cells (PRBCs) in (option D) is incorrect because transferring packed red blood cells is an important intervention to address blood loss and improve oxygen-carrying capacity. However, before administering blood products, it is crucial to stabilize the patient's hemodynamics through fluid resuscitation.
Therefore, in a patient with hemorrhagic shock, the nurse's first priority among the given options is to give normal saline solution of 250 mL/hr to restore intravascular volume and improve tissue perfusion.
Correct Answer is A
Explanation
The ABG results show a pH of 7.50, PaCO2 of 29 mmHg, and HCO3 of 23 mEq/L, indicating respiratory alkalosis. In respiratory alkalosis, there is a decrease in PaCO2 (hypocapnia), which can be caused by excessive ventilation.
To address the respiratory alkalosis, the nurse should decrease the respiratory rate. This would help reduce the amount of ventilation provided and allow the patient to retain more carbon dioxide (CO2), thereby increasing the PaCO2 levels and restoring acid-base balance.
B. Leaving the ventilator at the current settings in (option B) is incorrect because it may exacerbate respiratory alkalosis as it would maintain the same level of ventilation.
C. Increasing the tidal volume (VT) in (option C) is incorrect because it would not address the respiratory alkalosis. Tidal volume refers to the volume of air delivered with each breath, while the issue in this case is excessive ventilation leading to hypocapnia.
D. Increasing the FiO2 (fraction of inspired oxygen) in (option D) is incorrect because it is not indicated based on the given ABG results. The oxygenation (PaO2) level is within normal limits (80 mmHg), suggesting adequate oxygenation.
It is important to consult with the healthcare provider or respiratory therapist for further guidance on adjusting the ventilator settings based on the patient's condition and response to therapy.
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