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The nurse is preparing to administer tissue plasminogen activator (t-PA) to a patient who weighs 132 lb. The order reads 0.9 mg/kg t-PA. The nurse understands that 10% of the calculated dose is administered as an IV bolus over 1 minute, and the remaining dose (90%) is administered IV over 1 hour via an infusion pump. How many milligrams IV bolus over 1 minute will the nurse initially administer?



Answer :

ktreyb

Answer:

5.4 mg

Explanation:

The first step in calculating the amount of tissue plasminogen activator (t-PA, also known as alteplase) IV bolus to administer is to change the patient's weight to kilograms (kg) from pounds (lb). To do so, a conversion factor, a proportion of equivalency must be multiplied by the patient's weight. 1 kg is equivalent to 2.2 lb, which can be represented as 1kg / 2.2lb

132 lb × (1 kg / 2.2 lb)
lb in both numerator and denominator cancel each other out, leaving kg as the remaining units.

132 × (1 kg / 2.2)
= 132(1 kg) / 2.2
= 132 kg/ 2.2
=  60 kg

Now, patient's weight is multiplied by the ordered dose to determine how much total medication the patient is to be administered. The ordered dose as written by the provider is 0.9 mg/kg of t-PA

60 kg × (0.9 mg / kg)
kg in both numerator and denominator cancel each other out, leaving milligrams (mg) as the remaining units.

60 × (0.9 mg / 1)
= 60 × 0.9 mg
= 54 mg

The nurse will administer 54 mg total of t-PA to the patient. The first 10% of the dose will be administered within 1 minute to immediately begin lysing any potential thrombus formation that has built up prior to administration. To calculate how much of the total dose to administer over the initial one-minute bolus, convert the percentage to a decimal and multiply it by the total dose.

Drop the decimal two places left of the percentage sign; 10% = 0.10 or simply 0.1

54 mg × 0.1 = 5.4 mg

5.4 mg of t-PA IV bolus should be administered initially over 1 minute.

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