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.)

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.

A. An adult client with no postoperative drainage in the Jackson-Pratt drain with the bulb compressed. This client is stable with no drainage from the Jackson-Pratt drain, indicating that there is no immediate issue that needs to be addressed. The bulb is compressed, suggesting proper function. Therefore, this client can be safely assessed last.
B. An adult client with a rectal tube draining clear, pale red liquid drainage. The presence of pale red drainage can indicate a potential issue that needs monitoring, such as bleeding or other complications, thus requiring a more timely assessment.

C. An older client with a distended abdomen and no drainage from the nasogastric tube. A distended abdomen and lack of drainage could indicate a blockage or other serious issue that needs immediate attention.
D. An older client with dark red drainage on a postoperative dressing, but no drainage in the Hemovac. Dark red drainage can indicate active bleeding, which is a critical issue that needs to be addressed promptly to prevent complications.