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The healthcare provider orders dobutamine at 12 mcg/kg/min. The client weighs 75 kg. The pharmacy provides 250 mL of D5W with 1 g of dobutamine. How many mL/hr should the IV pump be programmed for? (Round to a whole number.)

140

134

Answer and Explanation

The Correct Answer is C

A. This is an underestimation due to a miscalculation of the dose rate.

B. This is an overestimation due to a miscalculation of the dose rate.

C. 1. Calculate the desired dose of dobutamine:

Desired dose (mcg/min) = Dose per kg (mcg/kg/min) x Weight (kg)

Desired dose (mcg/min) = 12 mcg/kg/min x 75 kg = 900 mcg/min

2. Convert mcg/min to mg/hr:

900 mcg/min x 60 min/hr = 54,000 mcg/hr

54,000 mcg/hr ÷ 1000 mcg/mg = 54 mg/hr

3. Calculate the concentration of dobutamine in the solution:

Concentration (mg/mL) = Total amount of dobutamine (mg) / Total volume (mL)

Concentration (mg/mL) = 1000 mg (1 g) / 250 mL = 4 mg/mL

4. Calculate the infusion rate (mL/hr):

Infusion rate (mL/hr) = Desired dose (mg/hr) / Concentration (mg/mL)

Infusion rate (mL/hr) = 54 mg/hr / 4 mg/mL = 13.5 mL/hr

5. Round to the nearest whole number:

Infusion rate (mL/hr) = 14 mL/hr

Therefore, the IV pump should be programmed for 14 mL/hr.

D. This is an overestimation due to a miscalculation of the dose rate.

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Correct Answer is B

Explanation

A. Orthopnea: Orthopnea is difficulty breathing when lying flat, but the client's description of waking up suddenly points to paroxysmal nocturnal dyspnea.

B. Paroxysmal nocturnal dyspnea: This is the correct answer. Paroxysmal nocturnal dyspnea occurs when a client with heart failure wakes up at night feeling suffocated due to fluid redistribution and pulmonary congestion.

C. Pulsus alternans: Pulsus alternans refers to alternating strong and weak heartbeats and is not related to the client's description of nocturnal dyspnea.

D. Acute bilateral pleural effusion: While pleural effusion can cause respiratory symptoms, paroxysmal nocturnal dyspnea is more specific to heart failure.

A. Adenosine 6 mg IV push B. Immediate cardioversion C. Adenosine 12 mg IV push D. Amiodarone 150 mg bolus followed by a 24 hour drip

Correct Answer is B

Explanation

A. Adenosine 6 mg IV push: Adenosine is used for certain supraventricular tachycardias, but immediate cardioversion is the first priority for a client with atrial flutter and chest pain.

B. Immediate cardioversion: This is the correct answer. Immediate cardioversion is indicated for atrial flutter with signs of hemodynamic instability, such as chest pain and shortness of breath.

C. Adenosine 12 mg IV push: Adenosine may be used after the first dose of 6 mg if the initial dose was ineffective, but cardioversion takes precedence for unstable patients.

D. Amiodarone 150 mg bolus followed by a 24-hour drip: Amiodarone is an antiarrhythmic used for rate control or rhythm conversion but is not the first step for hemodynamically unstable clients with atrial flutter.

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The healthcare provider orders dobutamine at 12 mcg/kg/min. The client weighs 75 kg. The pharmacy provides 250 mL of D5W with 1 g of dobutamine. How many mL/hr should the IV pump be programmed for? (Round to a whole number.)

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