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 ["1.3"]
Explanation
Order: Cefotaxime 100 mg/kg IV bolus, divided into equal doses every 8 hours
Toddler Weight: 26.4 lb
Available Solution: Cefotaxime injection 300 mg/mL
Desired Dose: mL per dose
Step 1: Convert Toddler Weight to Kilograms (kg)
1 kg = 2.2 lbs
Toddler Weight in kg: 26.4 lbs / 2.2 lbs/kg = 12 kg
Step 2: Calculate the Total Daily Dose
Ordered Dose: 100 mg/kg
Toddler Weight: 12 kg
Total Daily Dose: 100 mg/kg x 12 kg = 1200 mg
Step 3: Determine the Number of Doses per Day
Doses are given every 8 hours.
Hours in a Day: 24 hours
Number of Doses: 24 hours / 8 hours/dose = 3 doses
Step 4: Calculate the Dose per Administration
Total Daily Dose: 1200 mg
Number of Doses: 3
Dose per Administration: 1200 mg / 3 doses = 400 mg/dose
Step 5: Calculate the Volume to Administer per Dose
Dose per Administration: 400 mg
Concentration: 300 mg/mL
Volume to Administer: 400 mg / 300 mg/mL = 1.333 mL
Step 6: Round to the Nearest Tenth
The calculated volume is 1.333 mL.
Rounded to the nearest tenth: 1.3 mL
Answer: 1.3 mL
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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