A nurse is caring for a client who weighs 68 kg and has a new prescription for nitroprusside 0.3 mcg/kg/min by continuous IV infusion. The prescription says to increase the dose by 0.3 mcg every 5 min to maintain systolic UP at 100 to 200 mm Hg. Available is nitroprusside 50 mg in dextrose 5% in water 250 mL. Five min after starting the infusion, the client's 8P is 208/150 mm Hg. How many mute should the nurse administer now? (Round the to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
The Correct Answer is ["12.2"]
Understanding the Problem
Initial Order: Nitroprusside 0.3 mcg/kg/min
Client Weight: 68 kg
Dose Increase: 0.3 mcg/kg/min every 5 minutes
Current BP: 208/150 mmHg (Indicates need for dose increase)
Available Solution: Nitroprusside 50 mg in 250 mL of D5W
Desired Rate: mL/hr
Step 1: Calculate the Initial Dose
Initial Dose: 0.3 mcg/kg/min
Client Weight: 68 kg
Initial Total Dose: 0.3 mcg/kg/min x 68 kg = 20.4 mcg/min
Step 2: Determine the New Dose After Increase
Increase: 0.3 mcg/kg/min
Client Weight: 68 kg
Total Increase: 0.3 mcg/kg/min x 68 kg = 20.4 mcg/min
New Total Dose: 20.4 mcg/min (initial) + 20.4 mcg/min (increase) = 40.8 mcg/min
Step 3: Convert the New Dose to Milligrams (mg)
1 mg = 1000 mcg
New Dose in mg/min: 40.8 mcg/min / 1000 mcg/mg = 0.0408 mg/min
Step 4: Calculate the New Dose in mg/hr
New Dose in mg/min: 0.0408 mg/min
Minutes in an Hour: 60 min
New Dose in mg/hr: 0.0408 mg/min x 60 min/hr = 2.448 mg/hr
Step 5: Determine the Concentration of the Nitroprusside Solution
Available Nitroprusside: 50 mg
Solution Volume: 250 mL
Concentration: 50 mg / 250 mL = 0.2 mg/mL
Step 6: Calculate the Infusion Rate in mL/hr
New Dose in mg/hr: 2.448 mg/hr
Concentration: 0.2 mg/mL
Infusion Rate: 2.448 mg/hr / 0.2 mg/mL = 12.24 mL/hr
Step 7: Round to the Nearest Tenth
The calculated rate is 12.24 mL/hr.
Rounded to the nearest tenth: 12.2 mL/hr
Answer: 12.2 mL/hr
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["667"]
Explanation
Understanding the Problem
Volume: 500 mL of 0.9% sodium chloride
Infusion Time: 45 minutes
Desired Rate: mL/hr
Step 1: Convert Infusion Time to Hours
Minutes in an Hour: 60 minutes
Infusion Time in Hours: 45 minutes / 60 minutes/hour = 0.75 hours
Step 2: Calculate the Infusion Rate in mL/hr
Volume: 500 mL
Infusion Time: 0.75 hours
Infusion Rate: 500 mL / 0.75 hours = 666.666... mL/hr
Step 3: Round to the Nearest Whole Number
The calculated rate is 666.666. mL/hr.
Rounded to the nearest whole number: 667 mL/hr
Answer: 667 mL/hr
Correct Answer is C
Explanation
A. A total 62.5 mL is available in this dose: The label states that each mL of the reconstituted solution contains 62.5 mg of methylprednisolone. However, the total volume available depends on the reconstitution process, and this option does not directly match the provided information.
B. This medication can be administered IM only: The label clearly states that the medication can be given both intramuscularly (IM) and intravenously (IV), making this option incorrect.
C. This medication should be protected from light: The label explicitly instructs to protect the medication from light, confirming this as the correct answer.
D. The medication is effective for 7 days after reconstitution: The label specifies that the medication should be used within 48 hours after reconstitution, not 7 days.
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