ATI - DCSMA: Powdered Medications lesson

a nurse is preparing to administer pentamidine 175 mg IM. the nurse reconstitutes a vial of pentamidine to yield a final concentration of 100 mg/mL. how many mL should the nurse administer?

X mL = 175 mg x 1 ml over 100 mg X = 1.75 ===== 1.8 mL

a nurse is preparing to administer levothyroxine 200 mcg IV bolus. the nurse reconstitutes a vial of levothyroxine to yield a final concentration of 100 mcg/mL. how many mL should the nurse administer?

X mL = 200 mcg x 1 ml over 100 mcg X = 2 mL

a nurse is preparing to administer ceftriaxone 0.5 g IM. the nurse reconstitutes a vial of ceftriaxone to yield a final concentration of 350 mg/mL. how many mL should the nurse administer?

0.5 g = 500 mg X mL = 500 mg x 1 ml over 350 mg X = 1.428 ===== 1.4 mL

a nurse is preparing to administer levothroxine 0.3 mg IV bolus. the nurse reconstitutes a vial of levothroxine to yield a final concentration of 100 mcg/mL. how many mL should the nurse administer?

0.3 mg = 300 mcg X mL = 300 mcg x 1 ml over 100 mcg X = 3 mL

a nurse is preparing to administer daptomycin 360 mg IV bolus. the nurse reconstitutes a vial of daptomycin to yield a final concentration of 0.5 g / 10 mL. how many mL should the nurse administer?

0.5 g = 500 mg X mL = 360 mg x 10 ml over 500 mg X = 7.2 mL

a nurse is preparing to administer nafcillin 0.5 g IM. the nurse reconstitutes a vial of nafcillin to yield a final concentration of 250 mg/mL. how many mL should the nurse administer?

0.5 g = 500 mg X mL = 500 mg x 1 ml over 250 mg X = 2 mL

powdered medication

when reconstituting a _______, add an appropriate fluid (diluent) directly to the bottle or vial of medication.

a nurse is preparing to administer clindamycin 0.2 g PO. the nurse reconstitutes a container of clindamycin powder to yield a final concentration of 75 mg/5 mL. how many mL should the nurse administer?

0.2 g = 200 mg X mL = 200 mg x 5 ml over 75 mg X = 13.333 ===== 13.3 mL

a nurse has reconstituted a powdered medication. which of the following information should the nurse include on the written label?

- date of preparation - medication concentration - time diluent was added - expiration date and time the date of reconstitution, initials of the preparer, time of reconstitution, dosage strength of the medication after reconstitution, and expiration date are included on the written label after preparation. the diluent is printed on the vial label, and therefore not included on the written label after preparation. reconstituted medications can have varying dosages based upon the amount of diluent used

what to include when labeling a vial?

- the dosage strength of the reconstituted medication - date and time of preparation - date and time of expiration - storage method - your initials

common additives used as diluents to reconstitute medications for injection:

0.9% sodium chloride 5% dextrose in water sterile water bacteriostatic water

a nurse is preparing to administer 375 mg of cephalexin PO. the nurse reconstitutes a container of cephalexin powder to yield a final concentration of 0.25 g / 5 mL. how many mL should the nurse administer?

0.25 g = 250 mg X mL = 375 mg x 5 ml over 250 mg X = 7.5 mL

a nurse is preparing to administer clindamycin 450 mg PO. the nurse reconstitutes a container of clindamycin powder to yield a final concentration of 75 mg/5 mL. how many mL should the nurse administer?

X mL = 450 mg x 5 ml over 75 mg X = 30 mL

a nurse is preparing to administer cefazolin 1.5 g IV bolus to a client who has fluid restrictions. the nurse reconstitutes a vial of cefazolin to yield a final concentration of 138 mg/mL. how many mL should the nurse administer?

1.5 g = 1500 mg X mL = 1500 mg x 1 ml over 138 mg X = 10.869 ===== 10.9 mL

a nurse is preparing to administer ampicillin 1.5 g IV bolus. the nurse reconstitutes a vial of ampicillin to yield a final concentration of 30 mg/mL. how many mL should the nurse administer?

1.5 g = 1500 mg X mL = 1500 mg x 1 ml over 30 mg X = 50 mL

a nurse is preparing to administer nystatin 400,000 units PO. available is nystatin powder 500,000 units/ 0.125 tsp. the nurse reconstitutes a container of nystatin to yield a final concentration of 500,000 units/120 mL. how many mL should the nurse administer?

X mL = 400,000 units x 120 ml over 500,000 units X = 96 mL

a nurse is preparing to administer ampicillin 0.75 g IM every 6 hr to a client. the nurse reconstitutes a vial of ampicillin to yield a final concentration of 250 mg/mL. how many mL should the nurse administer per dose?

0.75 g = 750 mg X mL = 750 mg x 1 ml over 250 mg X = 3 mL

a nurse is preparing to administer oxacillin 375 mg IM. the nurse reconstitutes a vial of oxacillin to yield a final concentration of 250 mg/1.5 mL. how many mL should the nurse administer

X mL = 375 mg x 1.5 ml over 250 mg X = 2.25 ===== 2.3 mL

a nurse is preparing to administer nafcillin 375 mg IM to a school age child. available is nafcillin powder for injection 2 g vial. the nurse reconstitutes the powder to yield a final concentration of nafcillin 250 mg/mL should the nurse administer?

X mL = 375 mg x 1 ml over 250 mg X = 1.5 mL

a nurse is preparing to administer ampicillin 500 mg IM. how many mL should the nurse administer? resulting solution contains 250 mg ampicillin per mL.

X mL = 500 mg x 1 mL over 250 mg X = 2 mL

a nurse is preparing to administer cefazolin 500 mg IM bolus. the nurse reconstitutes a vial of cefazolin to yield a final concentration of 100 mg/mL. how many mL should the nurse administer?

X mL = 500 mg x 1 ml over 100 mg X = 5 mL

a nurse is preparing to administer oxacillin 500 mg IV bolus. the nurse reconstitutes a vial of oxacillin to yield a final concentration of 100 mg/mL. how many mL should the nurse administer?

X mL = 500 mg x 1 ml over 100 mg X = 5 mL

a nurse is preparing to administer ziprasidone 12.5 mg IM to an adolescent. the nurse reconstitutes a vial of ziprasidone to yield a final concentration of 20 mg/ mL. how many mL should the nurse administer?

X mL = 12.5 mg x 1 ml over 20 mg X = 0.625 ===== 0.6 mL

a nurse is preparing to administer methylprednisolone. the prescribed dose is 125 mg IV every 6 hr. how many mL should the nurse administer per dose? the resultant concentration is 62.5 mg/mL

X mL = 125 mg x 1 mL over 62.5 mg X = 2 mL

a nurse is preparing to administer fluconazole 200 mg PO. the nurse reconstitutes a container of fluconazole powder for oral suspension to yield a final concentration of 40 mg/mL. how many mL should the nurse administer?

X mL = 200 mg x 1 ml over 40 mg X = 5 mL

administer cefaxolin 500 mg IM every 8 hr. after reconstitution, 225 mg/mL is available. what is the appropriate dose to administer?

X mL = 500 mg x 1 mL over 225 mg. X = 2.2 mL

a nurse is preparing to administer ceftriaxone 250 mg IM. how many mL should the nurse administer? for IM administration: see package insert. each 1 mL of solution contains approximately 350 mg equivalent of ceftriaxone

X mL = 250 mg x 1 mL over 350 mg X = 0.71 mL

a nurse is preparing to administer ceftriaxone 250 mg IM. the nurse reconstitutes a vial of ceftriaxone to yield a final concentration of 350 mg/mL. how many mL should the nurse administer?

X mL = 250 mg x 1 ml over 350 mg X = 0.714 ===== 0.7 mL

a nurse is preparing to administer amoxicillin 325 mg PO. the nurse reconstitutes a container of amoxicillin powder to yield an oral suspension with a final concentration of 400 mg/ 5 mL. how many mL should the nurse administer?

X mL = 325 mg x 5 ml over 400 mg X = 4.0625 ===== 4.1 mL

a nurse is preparing to administer cefaclor 400 mg PO. the nurse reconstitutes of cefaclor powder to yield a final concentration of 187 mg / 5 mL. how many mL should the nurse administer?

X mL = 400 mg x 5 ml over 187 mg X = 10.69 ===== 10.7 mL

a nurse is preparing to administer azithromycin. the prescribed dose is 500 mg via IV bolus. how many mL should the nurse administer? each mL contains azithromycin monohydrate, USP equivalent to 100 mg of azithromycin

X mL = 500 mg x 1 mL over 100 mg X = 5 mL

a nurse is preparing to administer amoxicillin 775 mg PO. the nurse reconstitutes a container of amoxicillin powder to yield a final concentration of 400 mg / 5 mL. how many mL should the nurse administer?

X mL = 775 mg x 5 ml over 400 mg X = 9.6875 ===== 9.7 mL

a nurse is preparing to administer doxycycline oral suspension PO. the prescribed dose is 80 mg. how many mL should the nurse administer?

X mL = 80 mg x 5 ml over 25 mg X = 16 mL

supplies needed to reconstitute medication

at least two aseptic wipes and two syringes with needles that are appropriate to measure the amount of diluent to reconstitute the medication the vial of powdered medication the vial of diluent a sharps container for safe disposal of syringes

enteral + parenteral drug flow in the body

drug at site of administration 1. absorption drug in plasma 2. distribution 3. metabolism 4. elimination drug in urine, bile, or feces

how to mix powdered medication with diluent

inject the specified type and amount of diluent into the vial with the powdered medication, then roll the vial gently between the palms of the hands or gently upend and rotate it

a nurse is preparing to administer hydrocortisone 200 mg intermittent IV bolus. available is hydrocortisone powder for injection 1 g vial. the nurse reconstitutes the powder to yield a concentration of 50 mg/ mL. how many mL should the nurse administer?

X mL = 200 mg x 1 ml over 50 mg X = 4 mL

a nurse is preparing to reconstitute and administer a powdered medication in a multidose vial. which of the following actions should the nurse plan to take?

label the vial with the date and time before administering the medication the nurse should label the vial with the date, time the nurse initials, and the concentration of the medication to ensure safe medication administration

use and administer reconstituted medication:

oral IV - intravenous IM - intramuscular Subcutaneous

reconstitute

the medication from a powder to a liquid shortly before administration to make sure the medication is stable

a nurse is preparing to reconstitute a powdered medication. after gathering supplies, identifying the appropriate diluent, and performing hand hygiene, what steps should the nurse take?

1. cleanse tops of vials with an antiseptic wipe 2. withdraw diluent 3. inject diluent 4. roll vial 5. aspirate medication dose to reconstitute a powdered medication, follow the manufacturer's insert. first, gather the necessary equipment, including antiseptic swabs, syringes with needles or needless adaptors, powdered medication, and correct diluent. perform hand hygiene, and remove the sterile cap from the diluent and powdered medication vials. cleanse each vial top with a separate antiseptic swab. insert the syring into the vial of the diluent and aspirate the correct amount of fluid. once complete, remove the syringe and insert it into the powdered medication vial. inject the measured diluent into the medication. remove the syringe and gently roll. or invert the vial as directed until dissolved. finally, use a new syringe and needle to aspirate the prescribed dose of medication and administer to the client.

administer amoxicillin 300 mg PO every 12 hr. after reconstitution 400 mg/5 mL is available. what is the appropriate dose to administer?

step 1. what is the unit of measurement you need to calculate? mL step 2. what dose is desired? 300 mg step 3. what is the dose you have available? 400 mg step 4. convert the unite of measure. step 5. what quantity of the dose is available? 5 mL step 6. set up an equation. X mL = 300 mg x 5 mL over 400 mL step 7. solve for X. X=3.75 mL step 8. round if necessary step 9. determine if the amount given makes sense. if there are 400 mg / 5 mL, and the prescription read 300 mg, it makes sense to administer 3.75 mL. the nurse should administer amoxicillin 3.75 mL PO every 12 hr.

for oral medication reconstitution

use tap water bottle water