Dopamine hydrochloride IV at 2 mcg/kg/minute is prescribed to promote renal perfusion for a client weighing 198 lbs. The pharmacy sends a pre-mixed bag of dopamine containing 400 mg in 250 mL dextrose 5% in water (DSW). An IV pump is available that provides a precision infusion rate to a tenth of a mL. The nurse should set the IV pump to deliver how many mL/hour? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

Answer and Explanation

The Correct Answer is ["6.8"]

Converting the weight to kg:
Client weight = 198 lbs 1 lb = 0.453592 kg

Client weight in kg = 198 lbs 0.453592 kg/lb = 90.7 kg
Calculating the desired dopamine infusion rate:
Dose = 2 mcg/kg/minute Client weight = 90.7 kg
Desired infusion rate = Dose Client weight = 2 mcg/kg/minute 90.7 kg = 181.4 mcg/minute

Determining the dopamine concentration in the bag:

Dopamine amount = 400 mg Bag volume = 250 mL
Dopamine concentration = Dopamine amount / Bag volume = 400 mg / 250 mL = 1.6 mg/mL
Convert mg/mL to mcg/mL: 1.6 mg/mL 1000 mcg/mg = 1600 mcg/mL

Calculating the rate in mL/minute:

Desired infusion rate = 181.4 mcg/minute Dopamine concentration = 1600 mcg/mL
Rate (mL/minute) = Desired infusion rate (mcg/minute) / Dopamine concentration (mcg/mL)
Rate = 181.4 mcg/minute / 1600 mcg/mL = 0.1134 mL/minute

Converting the rate to mL/hour:
Rate (mL/minute) = 0.1134 mL/minute Conversion factor: 60 minutes/hour
Rate (mL/hour) = 0.1134 mL/minute 60 minutes/hour = 6.8 mL/hour (round to nearest tenth)

Therefore, the nurse should set the IV pump to deliver approximately 6.8 mL/hour.

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Correct Answer is C

Explanation

A. Encouraging the client to participate in a team sport may be overwhelming and unrealistic given the client's current level of depression and lack of activity. Starting with smaller, more achievable goals is essential in the initial stages of treatment.

B. Helping the client develop a list of daily affirmations is a positive intervention for promoting self-esteem, but it may not address the immediate need for increasing activity levels or engagement in meaningful activities.

C. Assisting the client in identifying goals for the day is the most important intervention at this stage. Setting achievable daily goals can help the client regain a sense of purpose and motivation. These goals should be realistic and tailored to the client's current abilities and interests.

D. Scheduling the client for a group focusing on self-esteem is beneficial, but it may not directly address the client's need for increased activity and engagement in meaningful daily activities.
Goals related to self-esteem can be incorporated into the client's plan of care but should be part of a comprehensive approach to treatment.

A. Instruct the UAP to notify the nurse of any changes in the client's respiratory status. B. Remind the UAP to apply a fitted respirator mask before entering the client's room. C. Review the need for the UAP to wear a face mask while in close contact with the client. D. Assign the UAP to provide care for another client and assume full care of the client.

Correct Answer is C

Explanation

A. Instruct the UAP to notify the nurse of any changes in the client's respiratory status. While important, this does not address the immediate issue of appropriate personal protective equipment (PPE).

B. Remind the UAP to apply a fitted respirator mask before entering the client's room. A fitted respirator mask is not necessary for influenza, which typically requires droplet precautions, not airborne precautions.
C. Review the need for the UAP to wear a face mask while in close contact with the client.

Influenza is spread through respiratory droplets, so a face mask is necessary for close contact to prevent transmission.
D. Assign the UAP to provide care for another client and assume full care of the client. This is not necessary if the UAP is appropriately trained and reminded to use the correct PPE.

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A client with influenza needs help in transferring to the bedside commode. The nurse observes the unlicensed assistive personnel (UAP) donning gloves and a gown to assist the client. Which action should the nurse take?

Correct Answer is C

Explanation

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