Ordered: Dopamine2mcg/kg/min In Stock: 200mg in 250mL Saline Patients weight: 60kg What rate would you set the pump to deliver the ordered medication? (Document to the nearest whole number)

Answer and Explanation

The Correct Answer is ["9"]

Dose in mcg/min=2 mcg/kg/min×60 kg=120 mcg/min

Convert this to mg/min since the concentration is in mg:

120 mcg/min=0.12 mg/min120 \text{ mcg/min} = 0.12 \text{ mg/min}120 mcg/min=0.12 mg/min
Determine the concentration of Dopamine:
- Total amount of Dopamine: 200 mg in 250 mL of saline
- Concentration:
Concentration=200 mg250 mL=0.8 mg/mL\text{Concentration} = \frac{200 \text{ mg}}{250 \text{ mL}} = 0.8 \text{ mg/mL}Concentration=250 mL200 mg=0.8 mg/mL
Calculate the pump rate in mL/min:

To find the rate in mL/min needed to deliver 0.12 mg/min:

Pump rate=Desired dose (mg/min)Concentration (mg/mL)\text{Pump rate} = \frac{\text{Desired dose (mg/min)}}{\text{Concentration (mg/mL)}}Pump rate=Concentration (mg/mL)Desired dose (mg/min)

Pump rate=0.12 mg/min0.8 mg/mL=0.15 mL/min\text{Pump rate} = \frac{0.12 \text{ mg/min}}{0.8 \text{ mg/mL}} = 0.15 \text{ mL/min}Pump rate=0.8 mg/mL0.12 mg/min=0.15 mL/min
Convert the pump rate to mL/hour:

Multiply by 60 to convert from mL/min to mL/hour:

Pump rate=0.15 mL/min×60 min/hour=9 mL/hour\text{Pump rate} = 0.15 \text{ mL/min} \times 60 \text{ min/hour} = 9 \text{ mL/hour}Pump rate=0.15 mL/min×60 min/hour=9 mL/hour

So, you should set the pump to deliver Dopamine at a rate of 9 mL/hour.

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Correct Answer is A

Explanation

Tachypnoea, which refers to an increased respiratory rate, is an early symptom of hypovolemic shock. It is the body's compensatory response to inadequate tissue perfusion and decreased oxygen delivery. The increased respiratory rate is an attempt to improve oxygenation and maintain vital organ function.
B. Heart blocks in (option B) are incorrect because Heart blocks refer to disruptions in the electrical conduction system of the heart and are not specific to hypovolemic shock.
C. Vomiting in (option C) is incorrect because: Vomiting may occur in various conditions, including shock, but it is not exclusive to hypovolemic shock and can be present in other forms of shock or illnesses.
D. Bradycardia in (option D) is incorrect because Bradycardia, or a slow heart rate, is not typically an early symptom of hypovolemic shock. Instead, tachycardia (rapid heart rate) is more commonly observed as a compensatory response to maintain cardiac output.
E. Hypotension in (option E) is incorrect because Hypotension, or low blood pressure, can occur in hypovolemic shock but is generally considered a later-stage symptom. In the early stages, compensatory mechanisms may help maintain blood pressure, so hypotension may not be present initially.
F. Bradypnea in (option F) is incorrect because: Bradypnea refers to a slow respiratory rate, which is not typically an early symptom of hypovolemic shock. Tachypnoea, as mentioned earlier, is the more common early respiratory symptom.

A. Administer hydrocortisone (Solu-Cortef) 100 mg IV. B. Give PRN furosemide (Lasix) 40 mg IV. C. Increase normal saline infusion to 250 mL/hr. D. Titrate norepinephrine (Levophed) to keep systolic BP >90 mm Hg.

Correct Answer is C

Explanation

In septic shock, one of the key goals of management is to restore and maintain adequate intravascular volume. However, in this case, the patient's urine output is low (30 mL/hr for the past 3 hours), suggesting inadequate renal perfusion and potential fluid overload.
Administering additional normal saline at an increased rate (250 mL/hr) without addressing the low urine output could potentially exacerbate fluid overload and further compromise the patient's condition.
A. Administer hydrocortisone (Solu-Cortef) 100 mg IV in (option A) is incorrect because: Hydrocortisone is commonly used in septic shock to help stabilize blood pressure and modulate the inflammatory response.
B. Giving PRN furosemide (Lasix) 40 mg IV in (option B) is incorrect because Furosemide, a loop diuretic, can be administered as needed to address fluid overload or to increase urine output if there is evidence of volume overload.
D. Titrate norepinephrine (Levophed) to keep systolic BP >90 mm Hg in (option D) is incorrect because: Norepinephrine is a vasopressor commonly used in septic shock to increase systemic vascular resistance and maintain adequate blood pressure.

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Ordered: Dopamine2mcg/kg/min In Stock: 200mg in 250mL Saline Patients weight: 60kg What rate would you set the pump to deliver the ordered medication? (Document to the nearest whole number)

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Naxlex Comprehensive Predictor Exams

The surgical ICU nurse is caring for postoperative clients at risk for hypovolemic shock. Which condition represents an early symptom of shock?

Correct Answer is A

Explanation

A 78-kg patient with septic shock has a urine output of 30 mL/hr for the past 3 hours. The pulse rate is 120/minute and the central venous pressure and pulmonary artery wed pressure are low. Which order by the health care provider will the nurse question?

Correct Answer is C

Explanation

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