A nurse is preparing to administer esmolel 45 mcg/kg/min by continuous IV infusion to a client who weighs $2 kg. Available is esmolol 2,500 mg in dextrose 5% in water 250 mL. The nurse should set the IV pump to deliver how many mi/hr? (Round the answer to the nearest whole number, Use a leading zero if it applies. Do not use a trailing zero.)
The Correct Answer is ["14"]
Understanding the Problem
Order: Esmolol 45 mcg/kg/min
Client Weight: 52 kg
Available Solution: Esmolol 2,500 mg in 250 mL of D5W
Desired Rate: mL/hr
Step 1: Calculate the Total Dose per Minute
Dose: 45 mcg/kg/min
Client Weight: 52 kg
Total Dose: 45 mcg/kg/min x 52 kg = 2340 mcg/min
Step 2: Convert Micrograms (mcg) to Milligrams (mg)
1 mg = 1000 mcg
Dose in mg/min: 2340 mcg/min / 1000 mcg/mg = 2.34 mg/min
Step 3: Calculate the Dose per Hour
Dose in mg/min: 2.34 mg/min
Minutes in an Hour: 60 min
Dose in mg/hr: 2.34 mg/min x 60 min/hr = 140.4 mg/hr
Step 4: Determine the Concentration of the Esmolol Solution
Available Esmolol: 2,500 mg
Solution Volume: 250 mL
Concentration: 2,500 mg / 250 mL = 10 mg/mL
Step 5: Calculate the Infusion Rate in mL/hr
Dose in mg/hr: 140.4 mg/hr
Concentration: 10 mg/mL
Infusion Rate: 140.4 mg/hr / 10 mg/mL = 14.04 mL/hr
Step 6: Round to the Nearest Whole Number
The calculated rate is 14.04 mL/hr.
Rounded to the nearest whole number: 14 mL/hr
Answer: 14 mL/hr
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is ["1.5"]
Explanation
Understanding the Problem
Order: Midazolam 0.03 mg/kg IM
Client Weight: 110 lbs
Available Solution: Midazolam 1 mg/mL
Desired Dose: mL to administer
Step 1: Convert Client Weight to Kilograms (kg)
1 kg = 2.2 lbs
Client Weight in kg: 110 lbs / 2.2 lbs/kg = 50 kg
Step 2: Calculate the Total Dose
Ordered Dose: 0.03 mg/kg
Client Weight: 50 kg
Total Dose: 0.03 mg/kg x 50 kg = 1.5 mg
Step 3: Calculate the Volume to Administer
Total Dose: 1.5 mg
Concentration: 1 mg/mL
Volume: 1.5 mg / 1 mg/mL = 1.5 mL
Step 4: Round to the Nearest Tenth
The calculated volume is 1.5 mL, which is already to the nearest tenth.
Answer: 1.5 mL
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