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)
The Correct Answer is ["9"]
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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
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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
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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
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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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
In the compensatory stage of shock, the body initiates various mechanisms to maintain perfusion to vital organs and restore homeostasis. Activation of the renin-angiotensin system is one of the compensatory responses. The decreased blood flow and oxygen delivery to the kidneys stimulate the release of renin from the kidneys. Renin acts on angiotensinogen, converting it into angiotensin I, which is further converted to angiotensin II by the action of angiotensin-converting enzyme (ACE). Angiotensin II is a potent vasoconstrictor and also stimulates the release of aldosterone, leading to sodium and water retention. These mechanisms aim to increase blood pressure and cardiac output and restore fluid balance.
A. The initial stage of shock in (option A) is incorrect because it is characterized by inadequate tissue perfusion and the activation of various compensatory mechanisms, including the release of stress hormones. However, the renin-angiotensin system is not specifically mentioned as activated in this stage.
B. The progressive stage of shock in (option B) is incorrect because it occurs when compensatory mechanisms fail to maintain adequate perfusion, leading to worsening hypoperfusion and organ dysfunction. The renin-angiotensin system continues to be activated during this stage, but it is primarily associated with the compensatory stage.
C. The refractory stage of shock in (option C) is incorrect because it is the stage of severe and prolonged hypoperfusion, where organ failure becomes irreversible. The renin-angiotensin system may still be activated, but it is not the primary focus of this stage.
Therefore, the activation of the renin-angiotensin system occurs during the compensatory stage of shock.
Correct Answer is B
Explanation
Cool, clammy skin, tachycardia, and hypotension are signs of shock, indicating inadequate tissue perfusion and oxygenation. The immediate priority is to ensure adequate oxygen delivery to the tissues. Providing oxygen at 100% via a non-rebreather mask helps increase the patient's oxygen saturation and improve tissue oxygenation.
While all the options mentioned are important in the management of a patient in shock, oxygenation takes priority as it directly addresses compromised tissue perfusion and oxygenation.
A. Inserting two large-bore IV catheters in (option A) is incorrect because: Establishing intravenous access is crucial for fluid resuscitation and administration of medications, but it can be done after ensuring adequate oxygenation.
C. Drawing blood to type and crossmatch for transfusions in (option C) is incorrect because Blood typing and crossmatching are important for potential blood transfusions but should not be the first action in this critical situation.
D. Initiating continuous electrocardiogram (ECG) monitoring in (option D) is incorrect because Continuous ECG monitoring is important for assessing cardiac rhythm and detecting any dysrhythmias, but ensuring oxygenation should be the initial priority.
Therefore, in a patient presenting with cool, clammy skin, tachycardia, and hypotension, the nurse should first provide oxygen at 100% via a non-rebreather mask to address inadequate tissue perfusion and oxygenation.
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