The nurse is caring for a client who is in heart failure and weighs 176 pounds.

The client is to receive prescribed dobutamine 10 mcg/kg/minute.

The nurse has available 1,000 mg in 250 mL of 0.9% normal saline.

How many mL per hour should the nurse administer to the client?

Round answer to a whole number.

Choice A rationale

Medications, such as phosphodiesterase type-5 inhibitors (e.g., sildenafil), are typically the next line of treatment for erectile dysfunction (ED) after lifestyle modifications fail. These agents enhance blood flow to the penile tissues during sexual stimulation by inhibiting the breakdown of cyclic guanosine monophosphate, facilitating erectile function.

Choice B rationale

Negative-pressure devices, also known as vacuum erection devices, are considered third-line treatments and are typically used in clients for whom oral medications are contraindicated or have failed. These devices work by mechanically increasing blood flow to the penis but are less effective than pharmacological interventions.

Choice C rationale

Penile injections, such as alprostadil, are invasive and used as a later option when oral medications and devices are unsuccessful or contraindicated. These injections directly relax the smooth muscle to increase penile blood flow, but they are generally not first-line treatments.

Choice D rationale

Penis transplants are experimental and not recognized as a standard treatment for erectile dysfunction. This option is far from practical or feasible and is considered unsuitable for most clients, especially given the complexity of the condition.

Step 1 is to convert 176 pounds to kilograms. (176 ÷ 2.2) = 80 kg.

Step 2 is to calculate the drug dose. (10 mcg × 80 kg) ÷ 1000 = 0.8 mg/minute.

Step 3 is to find the hourly dose. (0.8 mg × 60 minutes) = 48 mg/hour.

Step 4 is to calculate mL/hour. (48 mg ÷ (1000 mg ÷ 250 mL)) = 12 mL/hour. The final calculated answer is 12 mL/hour.