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
Digoxin 25 mcg/kg via IV bolus every 8 hr x 2 doses
Dobutamine 15 mcg/kg via continuous IV infusion
Bumetanide 0.1 mg/kg via IV bolus every 12 hr
Dextrose 5% in 0.45% sodium chloride with 20 mEq KCl via continuous V Infusion at 50 mL/hr
The Correct Answer is A
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
Explanation
Understanding the Problem
Order: Propranolol 240 mg/day PO in two divided doses
Available: Propranolol 60 mg tablets
Desired Dose: Number of tablets per dose
Step 1: Calculate the Dose per Administration
Total Daily Dose: 240 mg
Number of Doses: 2
Dose per Administration: 240 mg / 2 doses = 120 mg/dose
Step 2: Calculate the Number of Tablets per Dose
Dose per Administration: 120 mg
Tablet Strength: 60 mg/tablet
Number of Tablets: 120 mg / 60 mg/tablet = 2 tablets
Step 3: Round to the Nearest Whole Number
The calculated number of tablets is 2, which is already a whole number.
Answer: 2 tablets
Correct Answer is ["0.3"]
Explanation
Calculate the Total Daily Dose:
Dose: 40 mg/kg/day
Weight: 5 kg
Total Daily Dose: 40 mg/kg/day x 5 kg = 200 mg/day
Calculate the Dose Per Administration:
The dose is divided equally every 12 hours, meaning twice a day.
Dose Per Administration: 200 mg/day / 2 doses/day = 100 mg/dose
Calculate the Volume to Administer:
Available Concentration: 330 mg/mL
Volume (mL) = Desired Dose (mg) / Available Concentration (mg/mL)
Volume (mL) = 100 mg / 330 mg/mL
Volume (mL) ≈ 0.303 mL
Round to the Nearest Tenth:
0.3 mL
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