Nursing Student Asked:

A 68-year-old patient with chronic kidney disease (CKD) and hypertension has been prescribed an IV infusion of furosemide. The order is for 3 mg/kg to be administered over 1 hour. The patient weighs 85 kg. The available concentration of furosemide is 10 mg/mL. Calculate the total volume of furosemide (in mL) that should be infused over 1 hour. Then, determine the appropriate IV infusion rate (in mL/hour) to ensure the medication is administered correctly. (Enter numerical values only. If rounding is required, round to the nearest tenth.)

Step 1: Calculate the Total Dose of Furosemide Required

First, we need to calculate the total dose of furosemide that the patient should receive based on their weight:

[ \text{Total Dose (mg)} = \text{Patient's Weight (kg)} \times \text{Dose (mg/kg)} ]

Substituting the values:

[ \text{Total Dose (mg)} = 85 , \text{kg} \times 3 , \text{mg/kg} = 255 , \text{mg} ]

Step 2: Determine the Volume of Furosemide to be Administered

Next, using the concentration of the available furosemide solution ((10 , \text{mg/mL})), we calculate the volume of the medication that corresponds to the total dose:

[ \text{Volume (mL)} = \frac{\text{Total Dose (mg)}}{\text{Concentration (mg/mL)}} ]

Substituting the values:

[ \text{Volume (mL)} = \frac{255 , \text{mg}}{10 , \text{mg/mL}} = 25.5 , \text{mL} ]

Step 3: Calculate the IV Infusion Rate

The infusion needs to be administered over 1 hour. Therefore, the infusion rate is simply the volume calculated in Step 2:

[ \text{Infusion Rate (mL/hour)} = \text{Volume (mL)} ]

Substituting the values:

[ \text{Infusion Rate (mL/hour)} = 25.5 , \text{mL/hour} ]

Step 4: Double-Check Calculations for Accuracy

Let’s review:

• The total dose is correctly calculated based on the patient’s weight.
• The volume of the drug needed is calculated based on the available concentration.
• The infusion rate is set to deliver the calculated volume over the specified time period.

All calculations have been confirmed, ensuring safe and effective administration of the medication.

Conclusion

• Total Volume to Infuse: 25.5 mL
• IV Infusion Rate: 25.5 mL/hour

The nurse should administer 25.5 mL of furosemide over 1 hour at an infusion rate of 25.5 mL/hour.

GoodNurse AI Explanation:

This problem requires understanding of both dosage calculations and the setup for an IV infusion. The key steps include calculating the total dose based on the patient’s weight, determining the correct volume of the drug from the available concentration, and finally, setting up the correct infusion rate to ensure the medication is delivered within the prescribed time frame.

Remember, accuracy is critical in these calculations to avoid underdosing or overdosing, which could have serious consequences, especially in a patient with chronic conditions like CKD. Always double-check your calculations and make sure you understand each step before proceeding with administration. With practice, these types of calculations will become more intuitive. If you ever feel unsure, don't hesitate to review the basic principles or consult with a colleague.