A nurse is to administer Dobutamine (Dobutrex) 2.5 mcg/kg/min IV to a patient with severe heart failure who weighs 130 pounds. The pharmacy prepares a solution of 250 mg of Dobutrex in 500 mL D5W. How many mL of the medication should be administered to the patient per hour? Round your answer to the nearest whole number.

Answer and Explanation

The Correct Answer is ["18"]

Step 1: Convert the patient's weight from pounds to kilograms. 130 pounds ÷ 2.205 (1 pound = 0.453592 kilograms) ≈ 58.97 kilograms

Step 2: Calculate the total dosage of Dobutamine required per hour based on the weight-specific dose. 2.5 mcg/kg/min × 58.97 kg = 147.425 mcg/min

Step 3: Calculate the infusion rate (mL/hr) using the concentration of Dobutamine in the prepared solution. The solution contains 250 mg of Dobutamine in 500 mL, which means there are 250,000 mcg of Dobutamine in 500 mL. To determine the mL/hr, divide the required dosage (147.425 mcg/min) by the amount of Dobutamine in 500 mL (250,000 mcg) and multiply by 500 mL (volume of the solution).

(147.425 mcg/min ÷ 250,000 mcg) × 500 mL ≈ 0.295 mL/min

To get the mL/hr, we convert the rate from minutes to hours (60 minutes = 1 hour):

0.295 mL/min × 60 min/hr ≈ 17.7 mL/hr

Round the answer to the nearest whole number:

Approximately 18 mL/hr of Dobutamine should be administered to the patient.

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Correct Answer is C

Explanation

The sepsis resuscitation bundle typically includes the administration of intravenous fluids to restore adequate perfusion and address hypovolemia. The initial fluid of choice is often the crystalloid solution, such as Lactated Ringers (LR), and the recommended initial fluid bolus is 30 ml/kg. This intervention aims to optimize intravascular volume and improve tissue perfusion.

A. Cooling baths in (option A) is incorrect because they may be used in the management of hyperthermia or fever, but they are not specific interventions in the sepsis resuscitation bundle.

B. Blood transfusion in (option B) is incorrect it may be necessary in certain cases of sepsis, such as severe anemia or hypovolemia, but it is not a routine intervention in the sepsis resuscitation bundle based solely on the provided information.

D. NPO status (nothing by mouth) in (option D) is incorrect because it is not a specific intervention in the sepsis resuscitation bundle. It may be indicated in certain cases, such as when surgery is required or if there is a risk of aspiration, but it does not directly address the sepsis-related variables mentioned.

It is important to note that the specific management of sepsis may vary based on the patient's individual condition, clinical presentation, and healthcare provider's orders.

A. Allen's test is positive. B. The mean arterial pressure (MAP) is 90 mm Hg. C. The dicrotic notch is visible in the waveform. D. The right hand is numb.

Correct Answer is D

Explanation

Arterial pressure monitoring involves the insertion of an arterial catheter, typically in the radial artery, to directly measure blood pressure. Complications can arise from this invasive procedure, and one potential complication is inadequate blood flow to the hand, leading to numbness or ischemia.
A. The Allen's test is positive in (option A) is incorrect because The Allen's test is performed before arterial catheter insertion to assess the collateral circulation of the hand. A positive Allen test indicates adequate collateral circulation, which is desirable before performing the procedure. However, it does not directly indicate a complication during or after arterial pressure monitoring.
B. The mean arterial pressure (MAP) is 90 mm Hg in (option B) is incorrect because The mean arterial pressure (MAP) represents the average pressure in the arterial system during one cardiac cycle. While changes in MAP can be significant for patient management, it does not specifically indicate a complication of arterial pressure monitoring.
C. The dicrotic notch visible in the waveform in (option C) is incorrect because The dicrotic notch represents the closure of the aortic valve and is a normal finding in arterial waveforms. Its presence does not indicate a complication.

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Naxlex Comprehensive Predictor Exams

A 30-year-old female patient is admitted to the emergency department with two systemic inflammatory response syndrome variables: temperature of 100.2°F (35°C) and high blood sugar. Which intervention from the sepsis resuscitation bundle does the nurse initiate?

Correct Answer is C

Explanation

An arterial catheter is inserted in the right radial artery to monitor a patient's blood pressure. Which information obtained by the nurse indicates that a complication of arterial pressure monitoring may be occurring?

Correct Answer is D

Explanation

The emergency department nurse is assessing a patient who is in the compensatory stage of hypovolemic shock. Which manifestations does the nurse expect? Select all that apply.

Which assessment information obtained by the nurse when caring for a COPD patient receiving mechanical ventilation indicates the need for suctioning?

A patient who has been involved in a motor vehicle crash arrives in the emergency department (ED) with cool, clammy skin; tachycardia; and hypotension. ordered by the health care provider should the nurse implement first?

The emergency department nurse evaluates that fluid resuscitation for a 70 kg patient in shock is effective by finding which one of the following?

Which action should the nurse take when the low-pressure alarm sounds for a patient who has an arterial line in the right radial artery?

The nurse is caring for a patient receiving a continuous norepinephrine (Levophed) IV infusion. Which patient assessment information indicates that the infusion rate may be too high?

Which of the following findings is most consistent with disseminated intravascular coagulation (DIC)?

A 29-year-old female patient is admitted to the emergency department with two of the systemic inflammatory response syndrome variables: temperature of 101.2 °F and 14,000 per μL white blood cell count. Which intervention from the sepsis resuscitation bundle does the nurse initiate?