Page and Header: 261, Medications Ordered in mcg/minute, meg/kg/minute, or milliunits/minute—Calculation of Rate Integrated Process: Teaching/Learning Objective: 2 29 The physician ordered 400 mg of Dobutrex (dobutamine) in 250 mL of DSW. It is to infuse at 4mcg/kg/minute per infusion pump. The patient/client weighs 70 kg. What is the correct IV rate in mulliliters per hour? Round to the nearest whole number. A) 9 B) 11 C) 13 D) 15 Ans: B Feedback: When solving any problem, first check that the order and the supply are in the same weight measure. For this problem, an equivalent is necessary. This 1s a multi-step problem. First, determme how many micrograms per minute to infuse based on the patient/client's weight. Multiply: 70 kg X 4mcg/minute = 280 mcg/minute. Next, reduce the numbers in the standard solution to milligrams per milliliter: 400 mg/250 mL = 1.6 mg/1 mL. Then, change milligrams to micrograms: 1.6 mg/mL = 1600 mcg/mL (1 mg = 1000 mcg). Divide by 60 to get micrograms per minute: 1600 mcg/60 minutes = 26.66 mcg/minute. Estimate the amount to give. Round to the nearest whole number. Formula Method: 280 mcg/minute + 26.66 mcg/minute X 1 mL = 10.5 mL/hour = 11 mL/hour. Proportion (Ratios): 1 mL : 26.66 mcg :: x mL : 280 mcg; 26.66x = 280/26.66 = 11 mL. Proportion (Fractions): 1 mL/26.66 mcg = x mL/280 mcg; 26.66X = 280/26.66 = 11 mL. Use two conversion factors for dimensional analysis. Dimensional Analysis: 250 mL/400 mg X 280 mcg/l minute X 60 minutes/1 hour X 1 mg/1000 mcg =250 mL X 280 X 60 X 1/ 400 X 1 hour X 1000 = 4,200,000/400,000 = 11 mL/hour. Format: Multiple Choice Chapter: 7 Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies Cognitive Level: Apply Difficulty: Difficult
