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.
