Dosage-Calculation-Practice-Workbook all dosage calculations PDF

Preview

Summary

Practice book with answers for all dosage calculations...

Description

Dosage Calculation Practice Packet

Intravenous Infusions and Infusion Rates……………..….2-6 Calculating Infusion and Completion Time…….....……7-10 Administering Direct IV Medications…………………….11-15

1

Develop in g C omp et en c y Work the problems and answer the questions below. 1. The IV order is as follows: Electronic Medical Record

Provider Orders

Name

D. Patient

Age

MR #

89235

Allergies

Provider

77 Gender NKDA

G. Physician, MD

Order

F DOB 7-10-xx Room 197-A

Date 4-04-xx

Which of the following applies to this IV? a. This IV can be infused by gravity or by an IV pump. b. A conversion is needed if the nurse chooses an IV pump. c. If the nurse chooses to run the IV by gravity with a tubing that has a drop factor of 10 gtt/mL, the flow rate is 75 gtt/min.

IV: 1 L D5 /0.45% NS @ 75 mL/hr

2. The doctor orders ciprofloxacin 200 mg IVPB q.12h. The pharmacy sent the following premixed IVPB of ciprofloxacin. The drug reference states that IV ciprofloxacin is to be administered over 60 min. What rate will the nurse set on the IV pump (mL/hr)?

Ciprofloxacin Injection, USP

200 mg

2 mg/mL 5% Dextrose

Copyright © 2016. F. A. Davis Company. All rights reserved.

200 mg in 100 mL 5% Dextrose

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:42:40.

2

3. The IV order is as follows: 1,000 mL D5/0.9% NaCl over 12 hr. How many mL/hr will the nurse set on the IV pump?

4. The IV order is to infuse 1 L 0.9% NaCl over 6 hr. Calculate the flow rate in mL/hr.

5. The nurse is preparing to hang a unit of blood on the patient. The unit contains 235 mL and the order is to infuse the blood over 4 hours. The nurse has the following blood tubing administration set. Calculate the flow rate in gtt/min for this infusion.

15

Copyright © 2016. F. A. Davis Company. All rights reserved.

15 drops/mL Approx.

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:42:40.

3

7. The physician orders vancomycin 1 g IVPB q.12h. The pharmacy sends the following IVPB. The vancomycin is to infuse over 90 min. How many mL/hr will the nurse set on the IV pump?

Copyright © 2016. F. A. Davis Company. All rights reserved.

8. The nurse is to infuse 1 L lactated Ringer’s over 10 hours. The IV tubing set has a drop factor of 20 gtt/min. Calculate the flow rate in gtt/min.

9. The order is to infuse 500 mL D5/0.225% NaCl over 10 hr. The nurse has the following IV tubing. Calculate flow rate in gtt/min.

.

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:42:40.

4

10. The physician orders an IV to infuse at 30 mL/hr. The nurse chooses a microdrip IV infusion set. Calculate the gravity flow rate for this IV.

11. The nurse is preparing to administer 0900 medications using the patient’s electronic medication administration record. The following IVPB is in the medication drawer: Electronic Medical Record

MAR

Name Y. Patient

Age

MR #

Allergies

Date

66531

54 Gender M DOB 1-21-xx

1-08-xx

NKDA

Time

Room 57-1

0900

Scheduled Medications Time 0900

Drug name Nafcillin

Dose 1g

Route IV

Freq. Adm. q.6h

Copyright © 2016. F. A. Davis Company. All rights reserved.

The IVPB is to be infused over 60 minutes. The nurse has an IV solution set with a drop factor of 15 gtt/mL. Calculate the flow rate in gtt/min.

12. The 1,000 mL IV is to infuse over 6 hours. The nurse has an infusion set with a drop factor of 15 gtt/mL. Calculate the flow rate in gtt/min.

13. A 1 L IV is to infuse over 8 hours. The nurse has an infusion set with a drop factor of 15 gtt/mL. Calculate the flow rate in gtt/min.

14. 500 mL D5 /0.225% NaCl is to infuse over 8 hr. Calculate the mL/hr.

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:42:40.

5

15. The physician writes the following order on the electronic medical record. The nurse has a tubing administration set with a drop factor of 15 gtt/mL. Calculate the gtt/min for this gravity IV. Electronic Medical Record

Provider Orders

Name T. Patient

Age

MR #

Allergies

39877

Provider

87 Gender F DOB 2-17-xx Ampicillin

J. Physician, MD

Room 112-A

Date 3-09-xx

Order 1 L D5LR to infuse @ 83 mL/hr.

16. The IV order is to infuse 250 mL 0.9% NaCl with 10 mEq KCl over 4 hours. How many mL/hr will the nurse set on the IV pump?

17. The patient is to receive one unit of packed cells (280 mL) over 3 hours. The blood administration set has a drop factor of 10 gtt/mL. Calculate the gravity flow rate in gtt/min.

18. The nurse is to infuse 500 mL D5/0.45% NaCl over 4 hours. Calculate the mL/hr for this IV infusion.

19. The physician writes the following order for IV therapy: Electronic Medical Record

Provider Orders

Name W. Patient

Age

MR #

Allergies

59157

Provider

J. Physician, MD

77 Gender M DOB 8-18-xx NKDA

Room 240-2

Date 3-09-xx

Copyright © 2016. F. A. Davis Company. All rights reserved.

Order Start 1 L D5W to infuse over 15 hr.

The nurse sets up the IV to infuse vial a volumetric pump. How many mL/hr will the nurse set on the pump?

20. The physician orders 3 L D5/0.45% NaCl with 20 mEq KCl to infuse over 24 hours. How many mL will the patient receive per hour?

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:42:40.

6

Develop in g C omp et en c y Answer the following IV problems using the Provider Orders. Electronic Medical Record

Provider Orders

Name

D. Patient

Age

MR #

00651

Allergies

Provider

65 Gender

T. Physician, MD

F DOB 05-26-xx

NKDA

Room 136 B

Date 8-12-xx

Order Start 1 L D5 /0.9% NaCL @ 50 mL/hr

1. What is the infusion time for this IV order? 2. The nurse starts this IV at 2300. What is the completion time? Electronic Medical Record

Provider Orders

Name

S. Patient

Age

MR #

50012

Allergies

Provider

42 Gender

S. Physician, MD

M DOB 11-03-xx

Sulfa

Room 306

Date 1-09-xx

Order Start 500 mL 0.9% NaCL @ 60 mL/hr

3. What is the infusion time for this IV order? 4. The nurse starts this IV at 0700. What is the completion time?

Copyright © 2016. F. A. Davis Company. All rights reserved.

Electronic Medical Record

Provider Orders

Name

RT. Patient

Age

MR #

42105

Allergies

Provider

M. Physician, MD

88 Gender Iodine

M DOB 10-21-xx Room 415

Date 1-09-xx

Order Start 250 mL 0.9% NaCL @ 40 mL/hr

5. What is the infusion time for this IV order? 6. The nurse starts this IV at 0230. What is the completion time? Determine the correct answer. 7. 5:30 p.m. written in military time is 8. 2145 written in clock time is

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:49:44.

7

Circle the correct answer. 9. The nurse begins 1 liter of D5W at 0900 at 125 mL/hr. By 1400, the nurse is correct to report that 575 mL, 625 mL, or 700 mL has infused into the patient. 10. The nurse hangs 1 liter of D5/0.9% NS at 1800 to infuse at 75 mL/hr. By 2200, the nurse is correct to report that 300 mL, 375 mL, or 425 mL of IV fluid has infused. 11. The nurse hangs 500 mL of D5/0.45% NS at 1500 to infuse at 50 mL/hr. By 2200, the nurse is correct to report that 250 mL, 350 mL, or 400 mL of IV fluid has infused. 12. The nurse starts1 liter of lactated Ringer’s at 2300 at 75 mL/hr. By 0600, the nurse expects the remaining amount of IV fluid to be 400 mL, 475 mL, or 525 mL. 13. The nurse hangs 1 liter of lactated Ringer’s at 0000 at 85 mL/hr. By 0500, the nurse expects the remaining amount of IV fluid to be 425 mL, 500 mL, or 575 mL. 14. The physician orders 1 liter of 0.9% NS q.10h. The nurse starts the first liter at 0700. If the IV infuses as ordered, the nurse can expect the remaining amount of IV fluid at 1400 to be 300 mL, 500 mL, or 700 mL. Evaluate the following flow meters. Select the answer that correctly identifies the error in the flow meter. 15.

Order: Infuse 500 mL at 125 mL/hr.

The flow meter is: a. missing the start time. b. missing the end time. c. incorrect hourly marking.

2300 2400

2500

2600

Copyright © 2016. F. A. Davis Company. All rights reserved.

2700

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:49:44.

8

16.

Order: Infuse 500 mL at 50 mL/hr.

The flow meter is: a. missing the start time. b. missing the end time. c. incorrect hourly marking.

0100

0200 0300 0400 0500 0600 0700

0800

17.

Order: Infuse 500 mL at 150 mL/hr.

The flow meter is: a. missing the start time. b. missing the end time. c. incorrect hourly marking.

Copyright © 2016. F. A. Davis Company. All rights reserved.

0800

0900

1000

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:49:44.

9

18. The physician orders 500 mL IV to infuse at 63 mL/hr. The nurse starts the IV at 0130 and completes the flow meter with the start time, the hourly fluid level based on the mL/hr, and end time. Select all the answers that apply to the flow meter.

0130

a. The hourly fluid level is marked correctly. b. The end time is correct. c. The infusion time is 7 hours. d. The end time should be 0826. e. By 0730, approximately 375 mL have infused.

0230 0330 0430 0530 0630

0730 0830 Ending Time:

Copyright © 2016. F. A. Davis Company. All rights reserved.

0926

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:49:44.

10

Develop in g C omp et en c y Use the information from the drug references to answer the following questions. 1. The order is for dipyridamole 40 mg IVP now. The dipyridamole is labeled 5 mg/mL. How many mL of diluent will the nurse add to the ordered dose?

dipyridamole (dye-peer-id-a-mole) Apo-Dipyridamole, Dipridacot, Novodipiradol, Persantine, Persantine IV Classification Therapeutic: antiplatelet agents, diagnostic agents (coronary vasodilators) Pharmacologic: platelet adhesion inhibitors Pregnancy Category B Dilution: Each 1 mL (5mg) must be diluted with a minimum of 2 mL D5W, D5½ NS, or D5NS... Rate of Administration Give a single dose over 4 min...

2. What is the rate of administration for the ordered dose of dipyridamole?

3. The order is for flumazenil 0.2 mg IVP now. The patient is 8 years old. What is the rate of administration for the ordered dose of flumazenil?

flumazenil (flu-maz-e-nil) Anexate, Romazicon Classification Therapeutic: antidotes Copyright © 2016. F. A. Davis Company. All rights reserved.

Pregnancy Category C IV Administration Direct IV: Rate: Administer each dose over 15–30 sec into free-flowing IV in a large vein. Do not exceed 0.2 mg/min in children or 0.5 mg/min. in adults.

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:52:06.

11

4. The patient is to receive Haldol 2 mg direct IV now. Haldol 5 mg/mL is available. What is the rate of administration for the ordered dose of Haldol?

haloperidol (ha-loe-per-i-dole) Haldol, Haldol Decanoate Classification Therapeutic: antipsychotics Pharmacologic: butyrophenones Pregnancy Category C IV Administration Direct IV: Diluent: May be administered undiluted for rapid control of acute psychosis or delirium. Concentration: 5 mg/mL. Rate: Administer at a rate of 5 mg/min.

5. The patient is to receive Methergine 0.2 mg direct IV now. Methergine 0.2 mg/mL is available. If the nurse dilutes the medication, how many mL of 0.9% NaCl will be added to the syringe?

methylergonovine (meth-ill-er-goe-noe-veen) Methergine Classification Therapeutic: oxytocic Pharmacologic: ergot alkaloids Pregnancy Category C Dilution: Give undiluted or diluted in 5 mL of NS. Rate of Administration Give 0.2 mg or fraction thereof over 60 sec.

Copyright © 2016. F. A. Davis Company. All rights reserved.

6. What is the rate of administration for the ordered dose of Methergine?

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:52:06.

12

7. The order is for morphine 1 mg IVP q.15 minutes. How many mL of diluent will the nurse add to the medication? REMS

HIGH ALERT

morphine (mor-feen) Astramorph PF, AVINza, Doloral, Duramorph PF, Embeda, Epimorph, Infumorph, Kadian, M-Eslon, Morphine H.P, M.O.S, M.O.S.-S.R, MS Contin, Statex Classification Therapeutic: opioid analgesics Pharmacologic: opioid agonists Schedule II Pregnancy Category C IV Administration Direct IV: Diluent: Dilute with at least 5 mL of sterile water or 0.9% NaCl for injection. Concentration: 0.5–5 mg/mL. Rate: High Alert: Administer 2.5–15 mg over 5 min. Rapid administration may lead to increased respiratory depression, hypotension, and circulatory collapse.

8. What is the rate of administration for the ordered dose of morphine? 9. The order is for 2.5 mg of phentolamine direct IV now. What is the rate of administration for this ordered dose?

phentolamine (fen-tole-a-meen) Oraverse, Regitine,

Rogitine

Classification Therapeutic: agents for pheochromocytoma Pharmacologic: alpha-adrenergic blockers Pregnancy Category C Rate of Administration Each 5 mg or fraction thereof over 1 min.

Copyright © 2016. F. A. Davis Company. All rights reserved.

10. What is the rate of administration for glycopyrrolate 0.3 mg direct IV?

glycopyrrolate (glye-koe-pye-roe-late) Cuvposa, Robinul, Robinul-Forte Classification Therapeutic: antispasmodics Pharmacologic: anticholinergics Pregnancy Category B (oral, parenteral), C (oral solution) Rate of Administration 0.2 mg or fraction thereof over 1 to 2 min.

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:52:06.

13

11. The patient is to receive doxorubicin 30 mg direct IV now. Doxorubicin 2 mg/mL is available. How many mL of 0.9% NaCl will be added to the syringe? HIGH ALERT

DOXOrubicin (dox-oh-roo-bi-sin) Adriamycin,

Caelyx,

Myocet

Classification Therapeutic: antineoplastics Pharmacologic: anthracyclines Pregnancy Category D IV Administration Direct IV: Diluent: Dilute each 10 mg with 5 mL 0.9% NaCl (nonbacteriostatic) for injection. Shake to dissolve completely. Concentration: 2 mg/mL Rate: Administer each dose over 3–5 min... Facial flushing and erythema along involved vein frequently occur when administration is too rapid.

12. What is the rate of administration for the ordered dose of doxorubicin? 13. The dialysis nurse is to administer epoetin 2,500 units IVP at the end of dialysis. Epoetin is available in the dosage strength of 10,000 units/mL. If the nurse chooses to dilute the medication, how many mL of 0.9% NaCl will the nurse add to the epoetin in the syringe? REMS

epoetin (e-poe-e-tin) Epogen, crit

Eprex, erythropoietin, Pro-

Classification Therapeutic: antianemics Pharmacologic: hormones, erythropoiesis stimulating agents (ESA) Pregnancy Category C

Copyright © 2016. F. A. Davis Company. All rights reserved.

IV Administration Direct IV: Diluent: Administer undiluted or dilute with an equal amount of 0.9% NaCl. Rate: May be administered as direct injection or bolus over 1–3 min into IV tubing or via venous line at end of dialysis session.

14. What is the most rapid rate of administration for the ordered dose of epoetin? 15. Should the ordered dose of Reglan be diluted? REMS

metoclopramide (met-oh-kloe-pra-mide) Metonia, Metozolv ODT, Reglan Classification Therapeutic: antiemetics Pregnancy Category B IV Administration Direct IV: Diluent: May be given undiluted if dose does not exceed 10 mg... Rate: Too rapid IV injection will cause intense anxiety, restlessness, and then drowsiness. IV injection: 10 mg or fraction thereof over 2 min. Reduce rate of injection in pediatric patients.

Electronic Medical Record

Provider Orders

Name

G. Patient

Age

MR #

99810

Allergies

Provider

O. Physician, MD

45 Gender NKDA

M DOB 12-01-xx Room 815-1

Date 11-05-xx

Order Reglan 8 mg IVP now.

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : A patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2019-05-29 10:52:06.

14

16. What is the rate of administration for the ordered dose of Reglan? 17. Should the ordered dose of ascorbic acid be diluted prior to ad...