The healthcare provider (HCP) changes a prescription for a nitroglycerin IV infusion from 10 mcg/min to 15 mcg/min. The IV bag contains nitroglycerin 50 mg in dextrose 5% in water (DW) 250 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only. If rounding is required, round to the nearest whole number.)
The Correct Answer is ["5"]
Calculation:
Calculate the New Nitroglycerin Dose in mcg/hour
Dose (mcg/hour) = Dose (mcg/min) × 60 min/hour
=15 mcg/min × 60 min/hour = 900 mcg/hour
Convert mcg to mg
Dose (mg/hour) = Dose (mcg/hour) / 1000 mcg/mg
=900 mcg/hour / 1000 mcg/mg
= 0.9 mg/hour
Calculate the Concentration of Nitroglycerin in the IV Bag
Concentration (mg/mL) = Total mg of Nitroglycerin / Total mL of Solution
=50 mg / 250 mL
= 0.2 mg/mL
Calculate the Infusion Rate = Infusion Rate (mL/hour)
=0.9 mg/hour / 0.2 mg/mL
= 4.5 mL/hour
Round to the Nearest Whole Number
4.5 mL/hour rounded to 5 mL/hour
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Turn off the pacemaker. Turning off the pacemaker is not appropriate because the client has a third-degree heart block, which means their heart is not conducting impulses properly. Disabling the pacemaker could lead to severe bradycardia or asystole. The goal is to troubleshoot the issue rather than stopping pacing altogether.
B. Check the sensitivity control. Loss of sensing means the pacemaker is not detecting the client's intrinsic heart activity, which can lead to inappropriate pacing or failure to respond to the heart’s natural rhythm. Adjusting the sensitivity setting ensures that the pacemaker can recognize the client's heartbeats and pace appropriately. This is the first step in troubleshooting pacemaker malfunctions related to sensing issues.
C. Increase the milliamps (mA). Increasing the milliamps (mA) is used when there is failure to capture, meaning the pacemaker is delivering impulses but the heart is not responding. Since the problem here is failure to sense, adjusting the sensitivity setting is the correct first action.
D. Position the client on the left side. Repositioning the client is sometimes recommended for displacement of a transvenous pacemaker lead, but in this case, the issue is sensing failure, not lead displacement. Checking and adjusting the pacemaker settings is a more appropriate first step before considering repositioning.
Correct Answer is A
Explanation
A. Prepare for oral intubation. The client is in severe respiratory distress with oxygen saturation at 88% despite receiving 100% oxygen via a nonrebreather mask. This suggests respiratory failure, likely due to a pulmonary embolism (PE), a known complication following bariatric surgery. Immediate intubation and mechanical ventilation are necessary to prevent further hypoxia and respiratory collapse.
B. Apply leg compression hose. While deep vein thrombosis (DVT) prophylaxis is essential for postoperative bariatric patients, it is not the priority in an acute emergency. Compression devices help prevent clots but do not treat an existing life-threatening pulmonary embolism.
C. Maintain head of bed at 45°. Elevating the head of the bed can help with breathing, but it will not significantly improve oxygenation in a client already failing on 100% oxygen. The priority is to secure the airway with intubation to provide controlled ventilation.
D. Administer an anticoagulant. Anticoagulation is a key treatment for pulmonary embolism, but it does not immediately improve oxygenation or stabilize respiratory function. In a hemodynamically unstable client with severe hypoxia, securing the airway takes priority before initiating anticoagulation therapy.
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