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 C
Explanation
A. Expel the excess air and heparin from the syringe. While removing excess air prevents gas exchange alterations, this is not the priority when obtaining an SVO₂ sample. Excess heparin could dilute the sample, but proper blood volume collection is the first concern.
B. Place sample in arterial blood gas syringe. SVO₂ measures venous oxygen saturation, which is different from arterial blood gases (ABGs). Using an ABG syringe is incorrect because it is heparinized for arterial sampling, and arterial blood does not reflect mixed venous oxygenation.
C. Obtain a minimum of 1 mL of blood. SVO₂ is measured from the distal lumen of a pulmonary artery (PA) catheter to assess oxygen delivery and consumption. At least 1 mL of blood is required for an accurate reading, ensuring sufficient sample volume for laboratory analysis.
D. Aspirate the blood sample slowly. While slow aspiration can help prevent hemolysis, it is not the primary concern when collecting an SVO₂ sample. The priority is obtaining a sufficient volume (≥1 mL) for an accurate measurement.
Correct Answer is B
Explanation
A. Notify healthcare provider (HCP) of the symptoms and administer a PRN pain medication. While notifying the HCP is necessary, administering pain medication does not address the underlying cause of the client’s acute chest pain and difficulty breathing. These symptoms suggest a possible pulmonary embolism (PE), a life-threatening complication after orthopedic surgery. Immediate supportive interventions should be initiated before notifying the provider.
B. Increase the client's IV flow rate and start low-flow oxygen. The client is experiencing acute respiratory distress, which could indicate a pulmonary embolism (PE), a fat embolism, or another postoperative complication. Providing oxygen helps improve oxygenation and reduce hypoxia, while increasing the IV flow rate helps maintain perfusion and prevent shock. These immediate interventions support vital functions while preparing for further medical management.
C. Position the client on the left side while immobilizing the affected leg. This position is used in air embolism management, not pulmonary embolism. In suspected PE, the priority is to optimize oxygenation and circulation rather than repositioning. The affected leg should be immobilized to prevent further embolization, but this is not the first priority.
D. Take the client's vital signs and auscultate all lung sounds. While assessing the client’s vital signs and lung sounds is important, intervention should not be delayed. The priority is to support oxygenation and circulation immediately, as PE can rapidly lead to hypoxia, hemodynamic instability, or cardiac arrest. Assessment should be done concurrently with emergency interventions.
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