PART A: The ICU nurse prepares to administer a dobutamine (Dobutrex) drip. The patient weighs 176...

PART A: The ICU nurse prepares to administer a dobutamine (Dobutrex) drip. The patient weighs 176 lbs. The safe dose range for this medication is 2.5-10mcg/kg/min. The medication preparation delivered by pharmacy is 250mg in 500mL of D5W. What is the safe dose range for this patient? (Express your answer in mg) If the drip is started at 60mL/hr. Would this be an acceptable action? (Explain why or why not.)

PART B: The nurse is preparing to administer a 500mL 0.9% NaCl IV fluid bolus at 250mL/hr. The IV tubing contains a Micro Drip set with a drop factor of 60gtts/mL. In order to administer the fluid bolus at the correct rate, how drops per minute must the nurse observe in the chamber?

Solutions

Expert Solution

A) Weight of the patient is -176lbs = 176×0.45kg = 79.2kg

The safe dose range for this medication is 2.5-10mcg/kg/min = 0.0025mg - 0.01mg /kg /min

#. So, the safe dose for the patient would be :-

(0.0025×79.2 - 0.01×79.2/min) = 0.198mg/min - 0.792mg/min

The medication preparation delivered by pharmacy is 250mg of dobutamine in 500mL of D5W.

The drip is started at 60ml/hr

Firstly we should calculate the dose available in 60 ml by unitary method :-

500ml of D5W has 250mg of dobutamine

1ml of D5W has 250mg/500ml of dobutamine

Then 60ml of D5W has 250/500× 60mg = 30mg /60min

So in 1min, 0.5 mg of dobutamine is being given to the patient .

Yes ,this would be an acceptable action as it is the safe dose .

B) Total volume of fluid is 500ml

Flow rate is -250ml/hr

250ml in 1hr

1ml in = 1hr/250 = 0.004hr = 0.24min

Drop factor - 60gtt/ml means 60drops in 1ml

So, the nurse must observe 60drops of fluid with in 0.24 mins .

Nightingale answered 1 year ago

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