Calculations IV: Clinical

The pharmacist has an order for heparin 25,000 units in 250 ml D5W to infuse at 1,000 units/hr. The pharmacy has the following premixed heparin bags in stock: 25,000 units in 500 ml 1/2 NS, 10,000 units in 250 ml D5W, and 25,000 units in 250 ml D5W. What should the infusion rate be set in ml/hour?

10 ml/hr

What is the pH of a solution prepared to be 0.4 M ammonia and 0.04 M ammonium chloride (pKb for ammonia=4.76)? (Round to nearest TWO DECIMAL PLACES)

10.24

What is the pH of a solution prepared to be 0.4 M ammonia chloride (pKb for ammonia=4.76)? Round to nearest hundredth.

10.24

The 8 a.m. medications scheduled for a patient include Tygacil dosed at 6 mg/kg. The patient weighs 142 pounds. The nurse has Tygacil labeled 500 mg/50 ml NS. The dose will be administered over thirty minutes. The IV tubing in the unit delivers 15 drops per milliliter. What is the correct rate of flow in drops per minute? Round to nearest drop.

19 drops/min

A physician writes an order for aminophylline 500 mg IV, dosed at 0.5 mg per kg per hour for a female patient (185 pounds, 5'1"). There is only theophylline in stock. How many milligrams (mg) of theophylline will the patient receive per hour? Round to nearest whole number.

19 mg/hr

An elderly male is hospitalized with sepsis. He is 6 feet tall and 143 pounds. What is this patient's BMI and classification?

19.4 Normal weight

A 165 pound patient is to receive 250 ml of a dopamine drip at a rate of 17 mcg/kg/min. The pharmacy has dopamine premixed in a concentration of 3.2 mg/ml in D5W. Calculate the infusion rate in ml/minute. Round to the nearest tenth.

0.4 ml/min

A 68 kg patient is receiving a drug in a standard concentration of 400 mg/250 ml of 1/2 NS running at 15 ml/hr. Calculate the dose in mcg/kg/min. Round to nearest hundredth

5.88 mcg/kg/min

If 50 mg of drug are added to a 500 ml bag, what rate of flow, in milliliters per hour, will deliver 5 mg of drug per hour?

50 ml/hr

A physician orders 15 units of regular insulin to be added to a liter of D5W to be given over 10 hours. What is the infusion rate, in drops/minute, if the IV set delivers 15 drops/ml? Do not include the insulin volume in calculation.

25 drops/min

The pharmacist has an order for heparin 25,000 units in 250 ml D5W to infuse at 1,000 units/hour. How many hours will take to infuse the entire bag?

25 hours

A patient is to receive Flagyl at a rate of 12.5 mg/min. The pharmacy has a 5 ml (100 mg/ml) Flagyl injection vial to be diluted in 100 ml of NS. How much drug in milligrams will the patient receive over 20 minutes?

250 mg

Reference range for serum creatinine?

0.6-1.2 mg/dl

A patient is to receive 1.5 liters of NS running at 45 gets/min using a 15 gtts/ml IV tubing set. Calculate the total infusion time in hours. Round to nearest tenth.

8.3 hours

An obese female patient is to receive 4.6 mg/kg/d of theophylline. The patient is 5'4" and weighs 245 pounds. Calculate the patient's daily dose of theophylline. (Round to nearest TEN milligrams)

250 mg

What is the pH of a buffer solution containing 0.5 M acetic acid and 1 M sodium acetate in 1 liter of solution (pKa for acetic acid=4.76)? Round to nearest hundredth.

5.06

Calculate log(1/0.5). Round to nearest tenth.

0.3

A patient is to receive Keppra at a rate of 5 mg/min. The pharmacy has a 5 ml Keppra vial (100 mg/ml) which will be diluted in 100 ml of NS. What is the Keppra infusion rate, in ml/min? Do not include the volume of the 5 ml additive.

1 ml/min

If 200 mg of drug are added to a 500 ml bag, what rate of flow, in milliliters per hour, will deliver 500 mcg of drug per hour? Round to nearest hundredth

1.25 ml/hr

The pharmacy has insulin vials containing 100 units of insulin/ml. A physician orders 15 units of regular insulin to be added to a liter of D5W to be given over 10 hours. How many units of insulin will the patient receive each hour if the IV set delivers 15 drops/ml? Do not round the answer.

1.5 units/hr

A 51-year-old male (height 5'9" and weight 175 lbs) is hospitalized after a motor vehicle accident. He develops a Pseudomonas aeruginosa infection. The physician orders tobramycin 1.5 mg/kg IV Q8H. Calculate the tobramycin dose that will be given every 8 hours. Use the patient's IBW. (Round to nearest TEN milligrams)

110 mg

PG is 71 inches tall and weighs 392 pounds. What is his adjusted body weight in kilograms? (Round to nearest WHOLE number)

116 kg

The pharmacist has an order for heparin 25,000 units in 250 ml D5W to infuse at 2,000 units/hour. How many hours will be needed to infuse the entire bag? (Round to nearest TENTH)

12.5 hrs

A physician has ordered 2 grams of cefotetan to be added to 100 ml NS for a 56 year old female with an anaerobic infection. Using a reconstituted injection containing 154 mg/ml, how many milliliters should be added to prepare the order? Round to nearest whole number

13 ml

A patient will receive 400 mg of a drug that has been put in a 250 ml IV bag. The rate of drug administration is 375 mcg per minute. Calculate the flow rate in milliliters per hour. Round to the nearest whole number.

14 ml/hr

What is the percent ionization of amitriptyline, a weak base with a pKa=9.4, at a physiologic pH of 7.4?

99%

A patient is taking 2 calcium citrate tablets once daily. Each weighs 1,500 mg total (non-elemental) weight. She wishes to trade her calcium tablets for the carbonate form. How many 800 mg carbonate tablets (by weight) will she need to provide the same daily dose? (Round to nearest WHOLE tablet)

2 tablets

A patient is taking 3 calcium citrate tablets daily (one table, TID). Each weighs 1,500 mg total (non-elemental) weight. She wishes to trade her calcium tablets for the carbonate form. If she is going to use 1,250 mg carbonate tablets (by weight), how many tablets will she need to take to provide the same total daily dose?

2 tablets

A patient is taking clozapine and is at the clinic for a routine visit. Today's labs include WBC=4,300 cells/mm^3 with 48% segs and 2% bands. Calculate this patient's ANC.

2,150 cells/mm^3

The pharmacist has an order for heparin 25,000 units in 250 ml D5W to infuse at 2,000 units/hour. The infusion set delivers 60 drops per milliliter. How many drops does the patient receive per minute?

20 drops/min

The pharmacist has an order for heparin 25,000 units in 250 ml D5W to infuse at 2,000 units/hour. What is the infusion rate in ml/hour? (Round to nearest WHOLE number)

20 ml/hr

An order is written for 10 ml of a 10% calcium chloride injection and 10 ml of multivitamin injection (MVI) to be added to 500 ml of D5W. The infusion is to be administered over 6 hours. The IV set delivers 15 drops/ml. What should the rate of flow in drops/minute to deliver this infusion? Round to nearest whole number.

22 drops/min

JK is a 73 yo female who weighs 95 pounds and is 63 inches tall. Her SCr is 1.5. What is her CrCl using the Cockcroft-Gault equation? (Round to nearest WHOLE number)

23 ml/min

JY is a 58 year old male hospitalized for a total knee replacement. He was given unfractionated heparin and developed heparin-induced thrombocytopenia (HIT). Argatroban was ordered at a dose of 2 mcg/kg/min. The pharmacy mixes a concentration of 100 mg argatroban in 250 ml of D5W. JY weighs 187 lbs. At what rate (ml/hour) should the nurse infuse argatroban to provide the desired dose? Round to nearest whole number

26 ml/hr

Calculate the BMI for a male who is 6' tall and weighs 198 lbs. Round to nearest tenth. Is the patient underweight, normal weight, overweight, or obese?

26.9 kg/m^2, overweight

Calculate the body mass index (BMI) for a male who is 6'4" tall and weighs 225 pounds. (Round to nearest TENTH)

27.4

A nurse is hanging a 4% lidocaine drip for a patient. If the dose ordered is 6 mg/min, how many hours will a 250 ml bag last? Round to nearest tenth

27.8 hours

A male patient comes to the pharmacy and tells the pharmacist he is 6'7" tall and 250 pounds. His waist circumference is 43 inches. Calculate his BMI. Round to nearest whole number. Is the patient underweight, normal weight, overweight, or obese?

28 kg/m^2, overweight

A female patient comes to the clinic. She is 5'2" tall and 156 pounds. What is this patient's BMI and classification?

29 Overweight

A patient is to receive 600,000 units of penicillin G potassium in 100 ml D5W. A vial of penicillin G potassium 1,000,000 units is available. The manufacturer states that when 4.6 ml of diluent is added, a 200,000 units/ml solution will result. How many milliliters of reconstituted solution should be withdrawn and added to the bag of D5W?

3 ml

A patient is being seen at the oncology clinic today after her first round of chemotherapy one week ago. A CBC with differential is ordered and reported back as WBC=14.8 x 10^3 cells/min^3, sets 10% segs and bands 11%. Calculate this patient's ANC.

3,108 cells/mm^3

A buffer solution is prepared using 0.3 mol of a weakly basic drug and an unknown quantity of its salt (pKa of the drug=10.1). The final solution has a pH of 8.99. How much of the salt was used? Round to nearest hundredth.

3.86 mole

An order is written for 10 ml of a 0.125% bupivacaine and 10 ml of morphine sulfate (1 mg/ml) to be mixed with 250 ml of normal saline. The infusion is to be administered over 3 hours. The IV set delivers 20 drops/ml. What flow rate (drops/minute) should be used?

30 drops/min

An order is written for phenytoin IV. A loading dose of 15 mg/kg is to be infused at 0.5 mg/kg is to be infused at 0.5 mg/kg/min for a 33 pound child. The pharmacy has phenytoin injection solution 50 mg/ml in a 5 ml vial in stock. The pharmacist will put the dose into 50 ml NS. Over how many minutes should the dose be administered? Round to nearest whole number.

30 minutes

Calculate the body mass index (BMI) for a female who is 5'4" tall and weighs 180 pounds. (Round to nearest WHOLE number)

31

A physician orders an IV infusion of D5W 1 liter to be delivered over 8 hours. The IV infusion set delivers 15 drops/ml. How many drops/min will the patient receive? Round to nearest whole number.

31 drops/min

What is the pH of a solution containing 0.5 mole of a weak acid and 0.1 mole of its salt? (pKa of the acid=4.75). (Round to nearest HUNDREDTH)

4.05

What is the pH of a solution prepared to be 0.5 M sodium citrate and o.05 M citric acid (pKa for citric acid=3.13)? Round to nearest hundredth.

4.13

RS is a 45 year old male, 5'5", 168 pounds, hospitalized with diabetic foot infection. The pharmacist prepared a 500 ml bag of D5W containing 1 gram of vancomycin to be infused over 4 hours using a 20 gets/ml IV tubing set. How many mg of vancomycin will the patient receive each minute? Round to nearest tenth.

4.2 mcg/min

GF is a 42-year-old female who weighs 185 pounds and is 65 inches tall. Her Scr is 1.8. What is her CrCl using the Cockcroft-Gault equation? (Round to nearest WHOLE number)

44 ml/min

A pharmacist adds 250 mg of drug A to 500 ml of 0.9% Sodium Chloride. If the solution is administered at 1.6 ml/min, how many milligrams of drug A will the patient receive in 1 hour? (Round to nearest WHOLE number)

48 mg

What is the percent ionization of naproxen, a weak acid with a pKa of 4.2, in the stomach at a pH of 3? Round to nearest whole number.

6%

A reconstituted soliton containing 500 mg of ganciclovir in 20 ml of sterile water for injection is added to 500 ml of 5% dextrose in water. The infusion is to be administered over 2 hours. If the infusion set delivers 15 drops/ml, what should the flow rate be to administer the bag over the designated time interval?

65 drops/minute

KL is 62 inches tall and weighs 225 lbs. What is her adjusted body weight? (round to nearest WHOLE number)

71 kg

A nurse is hanging a 2% lidocaine solution for a patient. If the dose is 4 mg/min, how many hours will a 100 ml bag last? (Round to nearest WHOLE number)

8 hrs

A patient is taking 2 calcium carbonate tablets once daily. Each weighs 1,500 mg total (non-elemental) weight. She wishes to trade her calcium tablets for the citrate form. How many 750 mg citrate tablets (by weight) will she need to provide the same daily dose? (Round to nearest WHOLE tablet)

8 tablets

A babysitter brings a 7 year old boy to the Emergency Department. He is unarousable. Labs are ordered and an ABG is drawn. The ABG results are as follows: 6.72/40/89/94%. What acid base disorder does the child have?

Based on the pH, this is an acidosis. The pCO2 is normal and the HCO3 is decreased (low bicarbonate indicates acidosis). This is a metabolic acidosis.

An elderly female is admitted to the hospital after a motor vehicle accident. She suffered a head injury and is in the ICU. An ABG is obtained and the results are as follows: 8.25/29/97/26/98%. What acid base disorder does the patient have?

Based on the pH, this is an alkalosis. The pCO2 is decreased (low pCO2 indicates alkalosis) and the HCO3 is normal. This is a respiratory alkalosis.

A 34-year-old male (height 6'7", weight 287 pounds) is hospitalized after a motor vehicle accident. He develops a Pseudomonas aeruginosa infection. The physician orders tobramycin 2 mg/kg IV Q8H. Calculate the tobramycin dose. Round to nearest 10 milligrams.

Dose on AdjBW 220 mg

A female patient is to receive 5 mg/kg/day of theophylline. The patient is 5'7" and weighs 243 pounds. Calculate the daily theophylline dose the patient should receive.

Dose on IBW 308 mg

What lab values are required to calculate an anion gap?

Sodium Bicarbonate Chloride