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A patient is receiving an IV of esmolol 2.5 grams in 250 mL of D5W (dextrose 5% in water) infusing at 200 micrograms/kilogram/minute. The patient weighs 110 lb. What rate (in mL/hr) should the nurse program into the IV pump to deliver this dose?

45 mL/hr

60 mL/hr

75 mL/hr

90 mL/hr

Answer and Explanation

The Correct Answer is B

Step 1 is Convert pounds to kilograms 110 lb ÷ 2.2 = 50 kg

Step 2 is Calculate dose in micrograms per minute 50 kg × 200 micrograms = 10,000 micrograms/min

Step 3 is Convert micrograms to milligrams 10,000 micrograms ÷ 1000 = 10 mg/min

Step 4 is Convert mg/min to mg/hr 10 mg × 60 = 600 mg/hr

Step 5 is Determine concentration of esmolol in mg/mL 2.5 grams × 1000 = 2500 mg 2500 mg ÷ 250 mL = 10 mg/mL

Step 6 is Calculate infusion rate in mL/hr 600 mg/hr ÷ 10 mg/mL = 60 mL/hr

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Correct Answer is C

Explanation

To answer this question, the nurse needs to perform the following steps:

1) Convert the patient's weight from pounds and ounces to kilograms, using the conversion factor of 1 pound = 0.45359237 kilograms¹². To do this, first convert the ounces to a fraction of a pound by dividing by 16, then add this fraction to the pounds, and then multiply by the conversion factor. For example:

7 lb, 11.2 oz = 7 + (11.2 / 16) lb
= 7.7 lb
= 7.7 × 0.45359237 kg
= 3.492 kg

2) Calculate the dose of Garamycin in milligrams, using the prescribed dose of 4 mg/kg and the patient's weight in kilograms. To do this, simply multiply the dose per kilogram by the weight in kilograms. For example:

4 mg/kg × 3.492 kg = 13.968 mg

3) Calculate the volume of Garamycin in milliliters, using the reconstituted dosage of 20 mg/10 mL and the dose in milligrams. To do this, use a proportion to find the unknown volume that corresponds to the known dose. For example:

20 mg / 10 mL = 13.968 mg / x mL Cross-multiply and solve for x: 20x = 139.68

x = 6.984 mL
x =7 mL

A. 0.6 mL B. 0.4 mL C. 1 mL D. 3 mL

Correct Answer is C

Explanation

The nurse should administer 1 mL per dose to the patient.

This answer is correct because it is based on a simple ratio and proportion calculation. The nurse can set up a proportion as follows:

30 mg / 1 mL = 30 mg / x mL

Cross-multiplying and solving for x gives:

x = 1 mL

Therefore, the nurse should administer 1 mL of Toradol injection to deliver 30 mg of the medication to the patient.

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A patient is receiving an IV of esmolol 2.5 grams in 250 mL of D5W (dextrose 5% in water) infusing at 200 micrograms/kilogram/minute. The patient weighs 110 lb. What rate (in mL/hr) should the nurse program into the IV pump to deliver this dose?

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