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A nurse is preparing to administer diltiazem IV 0.25 mg/kg V bolus given over 2 min to client who has atrial fibrillation and weighs 154 lb. Available is diltiazem IV injection 25 mg/S mL. How many mL should the nurse administer? Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Answer and Explanation

The Correct Answer is ["3.5"]

Understanding the Problem

Order: Diltiazem 0.25 mg/kg IV bolus over 2 minutes

Client Weight: 154 lbs

Available Solution: Diltiazem IV injection 25 mg/5 mL

Desired Dose: mL to administer

Step 1: Convert Client Weight to Kilograms (kg)

1 kg = 2.2 lbs

Client Weight in kg: 154 lbs / 2.2 lbs/kg = 70 kg

Step 2: Calculate the Total Dose

Ordered Dose: 0.25 mg/kg

Client Weight: 70 kg

Total Dose: 0.25 mg/kg * 70 kg = 17.5 mg

Step 3: Determine the Concentration of the Diltiazem Solution

Available Diltiazem: 25 mg

Solution Volume: 5 mL

Concentration: 25 mg / 5 mL = 5 mg/mL

Step 4: Calculate the Volume to Administer

Total Dose: 17.5 mg

Concentration: 5 mg/mL

Volume: 17.5 mg / 5 mg/mL = 3.5 mL

Step 5: Round to the Nearest Tenth

The calculated volume is 3.5 mL, which is already to the nearest tenth.

Answer: 3.5 mL

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Free Nursing Study Resources

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.

A. Digoxin 25 mcg/kg via IV bolus every 8 hr x 2 doses B. Dobutamine 15 mcg/kg via continuous IV infusion C. Bumetanide 0.1 mg/kg via IV bolus every 12 hr D. Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous V Infusion at 50 mL/hr

Correct Answer is A

Explanation

A) Digoxin 25 mcg/kg via IV bolus every 8 hr x 2 doses: This prescription should be clarified. Digoxin is typically prescribed in micrograms (mcg), but the dose of 25 mcg/kg is very high and could lead to toxicity. For a client with heart failure, the usual dosage for digoxin is 0.125–0.25 mg daily, not 25 mcg/kg per dose, which is excessive and potentially dangerous. Therefore, this order should be clarified with the provider.

B) Dobutamine 15 mcg/kg via continuous IV infusion: This is an appropriate dose for dobutamine, which is commonly used in heart failure for its inotropic effects. Dobutamine is typically dosed between 2–20 mcg/kg/min for continuous IV infusion, so 15 mcg/kg/min is within a safe range.

C) Bumetanide 0.1 mg/kg via IV bolus every 12 hr: Bumetanide is a loop diuretic used in heart failure, and the prescribed dose of 0.1 mg/kg every 12 hours is an appropriate dosing regimen for this medication. It is within the typical dosing range, and the interval is also reasonable for managing fluid overload in heart failure.

D) Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous IV infusion at 50 mL/hr: This IV fluid prescription is generally appropriate. The combination of dextrose and sodium chloride with potassium is commonly used to maintain hydration and electrolyte balance in clients, particularly in the context of heart failure management. The infusion rate of 50 mL/hr is a typical rate for continuous IV infusions.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer methylprednisolone 250 mg IV to a client. Which of the following information should the nurse interpret from the medication label?

Correct Answer is C

Explanation

A nurse is reviewing the medication orders for a client who has heart failure. Which of the following prescriptions should the nurse clarify with the provider

Correct Answer is A

Explanation

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