Math Titration Exercises

1. A patient weighing 65 kg is receiving Dopamine 400 mg in 250 ml running at 20 mcg/kg/min. The

physician orders to decrease the infusion to 16 mcg/kg/min. You will set the pump at(39 ml/hr)
2. A patient weighing 105 kg is receiving Dopamine 1600 mg in 1000 ml running at 3 mcg/kg/min.
The physician orders to increase the infusion to 5 mcg/kg/min. You will set the pump at(19.7
ml/hr)
3. A patient with head trauma and ICP monitoring who weighs 75 kg is receiving Propofol 500 mg in
100 ml running at 4 mcg/kg/min. There is a standing order to increase the Propofol infusion to 10
mcg/kg/min for severe agitation or ICP greater than 15 mmHg. You are receiving report during
change of shift and the patient is moving occasionally with an ICP between 16 and 18 mmHg. You
verify that the Propofol is running at (9 ml/hr)
4. You are requested to assist a fellow nurse with a patient with head trauma and ICP monitoring who
weighs 115 kg is receiving Propofol 2 g in 250 ml running at 8 mcg/kg/min. There is a standing order
to increase the Propofol infusion to 12 mcg/kg/min for severe agitation or ICP greater than 20
mmHg. The patient is combative and agitated and the ICP catheter is malfunctioning showing no
reading. While the nurse is on the phone with the attending physician you help restraining the patient
and verify that the Propofol infusion is running at(10.4 ml/hr)
5. A patient weighing 70 kg is receiving the following IV infusions: a) TPN 12.5% at 47 ml/hr, b)
Dopamine 800 mg in 500 ml at 12 mcg/kg/min, and c) Insulin 10,000 units in 100 ml at 15 units/hr.
The physician writes the following order: "Increase Dopamine to 15 mcg/kg/min" You would set the
pump to(39 ml/hr)
6. A patient weighing 90 kg and is receiving the following IV infusions: a) TPN 20% at 15 ml/hr, b)
Dopamine 400 mg in 250 ml at 10 mcg/kg/min, and c) Insulin 25,000 units in 250 ml at 20 units/hr.
The physician writes the following order: "Increase Insulin to 10 mcg/kg/min." You would(What
would you do, and why?)
7. A patient, weighing 100 kg, and with a BP of 140/90 mmHg, receives the following order: "Start
Dobutamine 500 mg in 500 ml D5% to run at 5 mcg/kg/min. Decrease infusion to 3 mcg/kg/min for
SBP > 130 mmHg, and Increase the infusion to 7 mcg/kg/min for SBP < 80 mmHg." You wouldl set
the infusion pump at(18 ml/hr)
8. A patient, weighing 140 kg, and with a BP of 65/40 mmHg, receives the following order: "Start
Dobutamine 500 mg in 250 ml D5% to run at 6 mcg/kg/min. Decrease infusion to 4 mcg/kg/min for
SBP > 130 mmHg, and Increase the infusion to 8 mcg/kg/min for SBP < 80 mmHg." You would set
the infusion pump at(33.6 ml/hr)
9. A patient, who weighs 80 kg, is receiving norepinephrine 6 mg in 250 ml at 10 ml/hr. How many
mcg/min is this patient receiving?...(4 mcg/min)

10. The physician prescribes phenylephrine as follows: "5 mg phenylephrine in 100 ml, give 50
mcg/min bolus over 5 minutes; then set maintenance dose at 5 mcg/min. You would set the pump for
the bolus at_____ for 5 minutes, then adjust the dose at _____for maintenance. (60 ml/hr bolus, 6
ml/hr for maintenance)
11. A 85 kg patient has just received a loading dose of 6 mg of Esmolol, and is receiving a
maintenance dose of 20 mg/hr. Calculate how many mcg/kg was the loading dose and how many
mcg/kg/min is the maintenance dose. (70.6 mcg/kg loading dose and 3.9 mcg/kg/min maintenance
dose)
12. A 140 kg patient has an order for Heparin 20 units/kg/hr of a solution of 25,000 units in 250 ml of
Normal Saline. You will set the pump at(28 ml/hr)
13. A 60 kg patient is receiving Heparin 5,000 units in 100 ml of Normal Saline at 15 ml/hr. How
many units/kg/hr is this patient receiving?...(12.5 units/kg/hr)
14. A 110 kg patient with End Stage Renal Disease and strict fluid restriction is receiving Esmolol 1
g in 250 ml LR at 25 mcg/kg/min. How many ml of this medication would you chart as intake at the
end of your 8 hr shift?...(330 ml)
15. A physician orders Dopamine to be started at 5 mcg/kg/min and titrated every 15 minutes by 2
mcg to maintain the clients SBP >90mmHg. The nurse starts the Dopamine (400mg/250mL) at
1330 on a client weighting 105 kg. At 1500, the physician calls the ICU and asks the nurse what the
drip is running at in mcg/kg/min and in ml/hr. Again, the physician calls the ICU at 1645 and
inquires about the Dopamine drip. Calculate the beginning rate, the rate at 1500 and again at 1645
(started at 5mcg/kg/min and 19.69 ml/hr; at 1500 17 mcg/kg/min and 66.94 ml/hr; at 1645
31 mcg/kg/min and 122.06 ml/hr)