A patient is receiving parenteral therapy. The IV orders are 400ml D5W to run over 8 hours. At what rate should the nurse maintain the infusion?

1. A

   50ml/hour

2. B

   60ml/hour

3. C

   30 ml/hour

4. D

   40 ml/hour

Appeared in: BHU NO-2019

Explanation

• 50 ml/hour.
• The formula to calculate the hourly infusion rate is: Flow Rate (mL/hr) = Total Volume (mL) / Total Time (hours).
• Applying the values from the question: 400 mL divided by 8 hours equals 50 mL/hour.
• This rate ensures the entire volume of fluid is administered evenly over the prescribed duration, which is crucial for patient safety and therapeutic effectiveness.

Why Other Options Were Wrong

• Option B: Calculating 400 mL / 8 hours does not equal 60. An infusion rate of 60 mL/hour would administer the fluid too quickly, finishing in about 6.7 hours.
• Option C: Calculating 400 mL / 8 hours does not equal 30. An infusion rate of 30 mL/hour would be too slow, taking over 13 hours to complete.
• Option D: Calculating 400 mL / 8 hours does not equal 40. An infusion rate of 40 mL/hour would be too slow, taking 10 hours to complete.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to IV Infusion Rate Calculation (mL/hr) to guide bedside assessment, documentation, and the next nursing action.
• Accurate IV infusion rate calculation is a critical nursing skill to prevent serious patient harm. Administering fluids too quickly can lead to circulatory overload, while administering them too slowly can result in inadequate treatment or dehydration.
• Nurses are the final checkpoint in medication administration. Always double-check calculations, especially for high-risk medications or vulnerable patients.
• What if? If the patient showed signs of fluid overload (like shortness of breath or new edema), the nurse's first action would be to slow the infusion rate to a minimum (KVO - keep vein open) and immediately notify the healthcare provider.

How to Approach the Question

• This is a calculation question, requiring you to determine an IV flow rate.
• First, identify the key pieces of information provided in the stem: the total volume to be infused (400 mL) and the total time for the infusion (8 hours).
• Next, determine what the question is asking for. Here, it's the rate in 'ml/hour'.
• Recall the standard formula for calculating the hourly rate: Rate = Total Volume / Total Time.
• Substitute the given values into the formula: Rate = 400 mL / 8 hours.
• Perform the division: 400 ÷ 8 = 50.

Concept Tested & Keywords

• Concept Tested: IV Infusion Rate Calculation (mL/hr)
• Stem keywords: parenteral therapy, IV orders, 400ml, 8 hours, infusion rate
• Lead-in keywords: At what rate
• Clinical cues: IV order: 400ml over 8 hours - requires precise rate calculation for safe administration.

Question ID

QMZ9IozSe2yPnHslIJ1XgE

Copy ID

Reference Book

E6 Pharmacology Nurses Shanbhag 3e p. 54-56