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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

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

Answer and Explanation

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.


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Related Questions

Correct Answer is ["35"]

Explanation

Understanding the Problem

Order: Regular insulin 3.5 units/hr

Available Solution: Regular insulin 100 units in 1000 mL of 0.45% sodium chloride

Desired Rate: mL/hr

Step 1: Determine the Concentration of the Insulin Solution

Available Insulin: 100 units

Solution Volume: 1000 mL

Concentration: 100 units / 1000 mL = 0.1 units/mL

Step 2: Calculate the Infusion Rate in mL/hr

Ordered Dose: 3.5 units/hr

Concentration: 0.1 units/mL

Infusion Rate: 3.5 units/hr / 0.1 units/mL = 35 mL/hr

Step 3: Round to the Nearest Whole Number

The calculated rate is 35 mL/hr, which is already a whole number.

Answer: 35 mL/hr

Correct Answer is ["25"]

Explanation

Identify the Total Volume and Infusion Time:

Total Volume: 100 mL

Infusion Time: 4 hours

Calculate the Infusion Rate (mL/hr):

We need to find out how many mL should be infused per hour.

We can use the following formula:

Infusion Rate (mL/hr) = Total Volume (mL) / Infusion Time (hours)

Plug in the Values and Calculate:

Infusion Rate (mL/hr) = 100 mL / 4 hours

Infusion Rate (mL/hr) = 25 mL/hr

Round to the Nearest Whole Number (if necessary):

25 mL/hr

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