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The healthcare provider (HCP) prescribes dopamine 2 mcg/kg/min IV for client who weighs 60 kg. The IV bag contains "Dopamine 400 mg in dextrose 5% in water (DW) 500 mL." The nurse should program the infusion pump to deliver how many mL/hour? (Enter numerical value only.)

Answer and Explanation

The Correct Answer is ["9"]

Calculation:

Calculate the dopamine dose in mcg/min:

Dose = 2 mcg/kg/min

Weight = 60 kg

Dose per minute = 2 mcg/kg/min × 60 kg

= 120 mcg/min

Calculate the dopamine dose in mcg/hour:

Dose per hour = 120 mcg/min × 60 min/hour

= 7200 mcg/hour

Convert mcg to mg:

Dose per hour = 7200 mcg/hour / 1000 mcg/mg

= 7.2 mg/hour

Calculate the concentration of dopamine in the IV bag:

Dopamine: 400 mg

Solution: 500 mL

Concentration = 400 mg / 500 mL

= 0.8 mg/mL

Calculate the infusion rate in mL/hour:

Dose per hour: 7.2 mg/hour

Concentration: 0.8 mg/mL

Infusion rate = 7.2 mg/hour / 0.8 mg/mL

= 9 mL/hour

Nursing Test Bank

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Correct Answer is C

Explanation

A. Oxygenate before suctioning. Pre-oxygenation before suctioning is essential to prevent hypoxia and bradycardia, but it does not directly ensure that the ETT remains in the correct position. This is a general airway management guideline rather than a specific intervention to maintain ETT placement.
B. Auscultate bilateral breath sounds. Auscultation is important for ongoing assessment of lung sounds and oxygenation but does not physically prevent tube displacement. While listening for equal breath sounds helps detect tube migration or mainstem bronchus intubation, it does not secure the ETT in place.
C. Firmly secure the ETT in place. After proper ETT placement is confirmed with a chest x-ray, securing the tube with adhesive tape or a commercial ETT holder prevents displacement. Unintentional extubation or tube migration can lead to hypoxia, respiratory distress, or esophageal intubation, making proper tube fixation a priority intervention.
D. Suction the ETT every 2 hours. Routine suctioning is not recommended unless there are indications such as visible secretions, high airway pressures, or decreased oxygenation. Frequent, unnecessary suctioning can cause mucosal trauma, hypoxia, and bradycardia and does not help maintain ETT placement.

A. Initiate an IV bolus of 0.9% normal saline 500 mL. B. Titrate IV dopamine at 8 mcg/kg/minute. C. Administer furosemide 40 mg IV push (IVP). D. Encourage a liberal PO fluid intake.

Correct Answer is C

Explanation

A. Initiate an IV bolus of 0.9% normal saline 500 mL. The client already has elevated CVP and PAWP, which indicate fluid overload and poor cardiac function. Giving a fluid bolus would worsen pulmonary congestion, edema, and respiratory distress. Fluid restriction, rather than additional IV fluids, is usually necessary in decompensated heart failure.
B. Titrate IV dopamine at 8 mcg/kg/minute. Dopamine is a vasopressor and inotropic agent that increases blood pressure and cardiac output. However, the client has an elevated blood pressure (140/50 mm Hg) and signs of fluid overload, making dopamine unnecessary. Increasing contractility could further stress the failing heart and worsen congestion.
C. Administer furosemide 40 mg IV push (IVP). Furosemide (a loop diuretic) is the best intervention for fluid overload in heart failure. Elevated CVP and PAWP suggest pulmonary congestion and excess intravascular volume, which furosemide helps relieve by reducing preload and promoting diuresis. This intervention improves breathing, reduces blood pressure, and decreases cardiac workload.
D. Encourage a liberal PO fluid intake. Clients with heart failure often require fluid restriction to prevent worsening edema and pulmonary congestion. Encouraging excessive oral fluid intake would worsen fluid overload and should be avoided.

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The healthcare provider (HCP) prescribes dopamine 2 mcg/kg/min IV for client who weighs 60 kg. The IV bag contains "Dopamine 400 mg in dextrose 5% in water (DW) 500 mL." The nurse should program the infusion pump to deliver how many mL/hour? (Enter numerical value only.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After intubating a client, correct placement of the endotracheal tube (ETT) is confirmed with a chest x-ray. Which intervention should the nurse implement to ensure that the ETT placement is maintained?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

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