vtne math practice
You are instructed to administer 12 liters of sterile isotonic IV fluids via a fluid pump over the next 24 hours. What is the appropriate fluid rate to administer this volume of IV fluids?
Answer:
A 60-kg dog needs to be sedated with dexmedetomidine and butorphanol. The doctor would like a dose of 10 ug/kg for dexmedetomidine and 0.1 mg/kg for butorphanol. Dexmedetomidine comes in a 1 mg/ml solution, and butorphanol is in a 10 mg/ml solution. How many milliliters of each medication will need to be administered for the patient's sedation?
Answer: 0.6 ml of dexmedetomidine and 0.6 ml of butorphanol For dexmedetomidine, do the following math: 60 kg x (10 ug/kg) = 600 ug Note the units and convert to work with milligrams as the solution is in milligrams per milliliter. 600 ug / (1000 mg/ug) = 0.6 mg 0.6 mg / (1 mg/ml) = 0.6 ml For butorphanol, do the following math: 60 kg x 0.1 mg/kg = 6 mg 6 mg / (10 mg/ml) = 0.6 ml
The veterinarian asks you to premedicate a 16 pound Bichon Frise that is in the hospital for a routine castration. He wants you to give hydromorphone at a dosage of 0.05 mg/kg IV. Hydromorphone comes in a concentration of 2 mg/ml. How many milliliters will you draw up into the syringe?
Answer: 0.18 mls Pounds must first be converted to kilograms by dividing 16 by 2.2 = 7.2 kg. 7.2 kg multiplied by 0.05 mg/kg = 0.36 mg. 0.36 mg divided by 2 mg/ml = 0.18 mls.
You are performing an ACTH stimulation test. You are instructed to give Cortrosyn at a dose of 5 micrograms/kg IV. The Cortrosyn has been reconstituted to a concentration of 0.25 mg/mL. Your patient weighs 27 pounds. How much Cortrosyn should you administer?
Answer: 0.24 mL 27 pounds = 12.2 kg 12.2 kg X 5 micrograms = 61 micrograms 61 micrograms/ 1000 micrograms per mg = 0.06 mg (1 mg is equal to 1000 mcg) 0.06 mg/ 0.25 mg/mL = 0.24 mL IV
A dog presents with a history of coughing and rapid breathing. Radiographs confirm congestive heart failure (see image). You are asked to administer 2 mg/kg of furosemide IV. The concentration of furosemide is 50 mg/mL. The dog weighs 25 pounds. How many milliliters should you administer to this patient?
Answer: 0.44 mL The dog is 25 pounds. 25 pounds/2.2 pounds per kg= 11.3 kg Now multiply the dog's weight in kg by the dose you need (2mg/kg): 11kg X 2mg = 22 mg The dog needs 22 mg. Now divide this dose by the concentration of furosemide (50 mg/mL): 22mg/ 50 = 0.44 mL
A 12 pound dog comes into the clinic with a history of vomiting for the last 24 hours. The doctor asks you to give an injection of Cerenia (maropitant) at a dose of 0.45mg/lb. Cerenia has a concentration of 10mg/ml. How many milliliters will be given to the dog?
Answer: 0.54 mls (12lb) X (0.45mg/lb)=5.4mg (lbs cancel) 5.4mg divided by 10mg/ml=0.54mls (the milligrams cancel)
A 45 kg Akita has been presented to your hospital for radiographs. The dog had a fracture repair 8 weeks ago and the veterinarian wants to use dexmedetomidine to sedate the dog so he is comfortable during the procedure. The dosage the veterinarian wants to use is 7 mcg/kg IV. The concentration of dexmeditomidine is 0.5 mg/ml. How much drug are you going to use?
Answer: 0.63 mls 7 mcg divided by 1000 = 0.007 mg. 0.007 mg multiplied by 45 kg = 0.32 mg. 0.32 mg divided by 0.5 mg/ml = 0.63 mls.
A patient that is currently receiving 30 ml/hr of NaCl needs a medication added to the fluid bag. The clinician would like the patient to receive a total of 3 mg/kg/day of this medication. The medication comes in a 10 mg/ml solution. How many mL should be added to the bag if it is a 250 mL bag and the patient weighs 10kg?
Answer: 1 ml A 10-kg patient will need 30 mg/day of the medication (10 kg x 3 mg/kg/day) Since the fluid is being administered at an hourly rate we need to figure out how much medication we are administering per hour. 30 mg/day / (24 hr) = 1.25 mg/hr To determine how much volume of the medication is needed the following math is performed: 1.25 mg/hr / (30 ml/hr) x (250 ml) = 10.4 mg (Notice how the units cancel out) 10.4 mg / (10 mg/ml) = 1 ml
A patient that is currently receiving 30 ml/hr of NaCl needs a medication added to the fluid bag. The clinician would like the patient to receive a total of 3 mg/kg/day of this medication. The medication comes in a 10 mg/ml solution. How many mL should be added to the bag if it is a 250 mL bag and the patient weighs 10kg?
Answer: 1 ml A 10-kg patient will need 30 mg/day of the medication (10 kg x 3 mg/kg/day) Since the fluid is being administered at an hourly rate we need to figure out how much medication we are administering per hour. 30 mg/day / (24 hr) = 1.25 mg/hr To determine how much volume of the medication is needed the following math is performed: 1.25 mg/hr / (30 ml/hr) x (250 ml) = 10.4 mg (Notice how the units cancel out) 10.4 mg / (10 mg/ml) = 1 ml
A 620-kg horse weighs how many pounds?
Answer: 1,364 pounds There are 2.2 pounds per kg. So, to convert the kg into pounds, multiply the kg by 2.2. 620 kg X 2.2 pounds/kg = 1364 pounds
A 12-pound cat needs Clavamox drops at 14 mg/kg BID. The solution is 62.5 mg/mL. How many mLs should this cat receive twice daily?
Answer: 1.2 mL 12 pounds/2.2= 5.4 kg 5.4 kg X 14 mg/kg dose = 76 mg 76 mg dose/ 62.5 mg/mL concentration = 1.2 mL
The veterinarian orders 3 mg/kg diphenhydramine IM for a 60-pound dog. The concentration is 50 mg/mL. How much should you give the dog?
Answer: 1.6 mL First convert to kilograms: 60 pounds/ 2.2= 27kg Now calculate how many miligrams you need to give: 27kg X 3mg= 81mg Finally figure out how many milliliters 81mg would be: 81mg/ 50mg/mL= 1.63 mL
"Pablo", a 66 pound Labrador mix, is in oliguric renal failure. The veterinarian has asked you to start a constant rate infusion of dopamine at 5 micrograms per kilogram per minute (ug/kg/min) and a fluid rate of 120 mL per hour. Dopamine comes in a concentration of 40 mg/mL. How much dopamine will you add to a liter of 0.9% sodium chloride solution?
Answer: 1.86 mL Constant rate infusions are not something that an entry level technician would typically perform. However, the VTNE may have some questions on CRI and it will benefit you to know how to do these calculations. To solve this problem, break down the basic parts to make it less overwhelming: 1) Convert pounds to kilograms- 66 pounds/2.2 pounds per kg = 30 kg 2) Calculate the number of hours an infusion will last by dividing the volume in the bag (1 Liter, or 1,000 mL) by the rate per hour: 1,000 mL/120mL/hr = 8.3 hours 3) Now take the number of hours (8.3) and multiply by 60 to calculate how many minutes this is: 8.3 X 60 = 498 minutes 4) Now plug into the equation: 5 ug/30kg/498min= 74,700 ug 5) Now convert the ug into mg by dividing by 1,000: 74,700/1,000 = 74.7 mg 6) Calculate the quantity of dopamine to add by now dividing the 74.7 mg by the concentration of the drug (40mg/mL) : 74.7mg/40mg/mL = 1.86 mL To be truly accurate when adding drugs to a bag like this, you should discard 1.86 mL of fluids from the bag prior to adding the 1.86 mL of dopamine.
An animal needs to be sedated with Dexmedetomidine. The patient weighs 2200, lbs and the dose that the clinician wishes to administer is 10 micrograms per kilogram. Dexmedetomidine is available as a 1 mg/ml solution. How many milliliters will be administered?
Answer: 10 ml To solve this question, it is very important to know that there are 1000 micrograms in 1 milligram. Similarly, there are 1000 milligrams in 1 gram. First, convert body weight to kilograms. 2200 lbs / (2.2 lbs/kg) = 1000kg 1000kg x (10 micrograms/kg) = 10,000 micrograms 10,000 micrograms / (1 milligram/1000 micrograms) = 10 milligrams (Notice the micrograms cancel out.) 10 mg / (1 mg/ml) = 10 ml This question is critical to understand. Not having a good grasp of the difference between a milligram vs. microgram vs. gram can result in misdosing a patient.
A patient's fluid rate is currently set at 150 ml/hr. The doctor asks you to decrease the fluid rate by 25%. What is the new rate?
Answer: 112.5 ml First, we need to determine how much 25% of 150ml is. 150 ml x 0.25 = 37.5 ml Now, subtract the answer above from the original fluid rate to determine the new rate. 150 ml - 37.5 ml = 112.5 ml
A 20-kg patient is being sent home on famotidine to help with potential esophagitis. How many 10 mg tablets should be sent home with the owner, if the patient requires 0.5 mg/kg PO BID x 7 days?
Answer: 14 To correctly answer the question, the following math should have been performed: 20 kg x (0.5 mg/kg) = 10 mg (This is the amount the patient needs per dose, which is equivalent to 1 tablet.) 1 x 2= 2 (This is the number of pills needed per day, since the dosing is BID.) 2 x 7= 14 (This is the number of pills needed for the 7 day treatment course.)
What is the minimum volume of water required by mammals to sustain life?
Answer: 2 - 4 mls/kg/hr
How many milliliters should be administered to a 100-kg patient that needs 50 mg of a 2.5% solution?
Answer: 2 ml Percent is equal to weight (in Grams) / 100 parts volume (in mLs) (This is based on water since 1 mL weighs 1 Gram): Example: A 3% solution: 3 Grams / 100 mL or 3000 mg / 100 mL or 30 mg/mL The easiest way to remember is to just add a zero onto any percentage for the milligrams (i.e. 2% solution = 20 mg/ml; 10% solution = 100 mg/ml, etc.) In this situation a 2.5% solution is equivalent to 25 mg/ml. Therefore: 50 mg / (25 mg/ml) = 2 ml
How many milliliters of 25% dextrose should be added to 1 L of 0.9% saline to make a 5% dextrose solution?
Answer: 200 ml To answer this question, the following formula should be implemented: C(1)V(1) = C(2)V(2) C is the concentration V is the volume C(1) =0.25 V(1) = x C(2) = 0.05 V(2) = 1000 ml 0.25x = 0.05(1000) x = 200 ml 200 ml of 25% dextrose should be added to one liter in order to make a 5% solution.
A 12-pound cat has presented with diabetic ketoacidosis and is currently in shock. The doctor orders that a 40 ml/kg bolus of 0.9% saline be administered. How many milliliters will this patient receive?
Answer: 220 ml The body weight needs to be converted to kilograms. 12 lb / (2.2 lb/kg) = 5.5 kg 5.5 kg x (40 ml/kg) = 220 ml
How many milligrams are in 100 ml of a 3% solution?
Answer: 3,000 mg A 3% solution is equal to 30 mg/mL. Now take 100 mL X 30 mg/mL = 3000 mg= 3 grams (since there are 1000 mg in 1 gram)
A 13.2-lb cat is being sent home with an oral solution of Tramadol for post-operative pain control. At a dose of 3 mg/kg, how many milliliters should be given if the solution comes in a 5 mg/ml concentration?
Answer: 3.6 ml First, convert pounds to kilograms. 13.2 / (2.2 lb/kg) = 6 kg Then calculate milligrams necessary. 6 kg x 3 mg/ml = 18 mg Finally, calculate milliliters necessary. 18 mg / (5 mg/ml) = 3.6 ml
An 18 pound Cocker Spaniel has been admitted to your hospital for treatment of pancreatitis. The veterinarian would like you to start Lactated Ringers IV at a rate of 1.5 times maintenance. The maintenance rate is 60 ml/kg/day. How many milliliters per hour will you set the fluid pump to administer?
Answer: 30 mls/hr First you must convert pounds to kilograms dividing 18 by 2.2= 8.18 kg. 8.18 kg multiplied by 60 ml/kg/day= 490 ml/day. 490 mls/day divided by 24 hours in a day= 20 mls/hr. This is your maintenance rate, now you must multiply that by 1.5 to get the maintenance and one half rate. 20 multiplied by 1.5= 30ml/hr.
"Zoe", a 40 kg Labrador Retriever is recovering after a liver mass resection. The doctor asks you to start "Zoe" on a fentanyl constant rate infusion at 4 micrograms per kilogram per hour (ug/kg/hr). The concentration of fentanyl is 0.05mg/mL. The fluid rate is currently set at 100 mL/hour. How much fentanyl will you add to a liter of Normosol-R?
Answer: 32 mL Constant rate infusions are not something that an entry level technician would typically perform. However, the VTNE may have some questions on CRI and it will benefit you to know how to do these calculations. To solve this problem, break down the basic parts to make it less overwhelming: 1) Convert pounds to kilograms- Note that in this problem the units are already in kg so no conversion is necessary. Make sure to pay attention to this. 2) Calculate the number of hours an infusion will last by dividing the volume in the bag (1 Liter, or 1,000 mL) by the rate per hour: 1,000 mL/100mL/hr = 10 hours (If the problem asks for a dose per minute, you will need to multiply the hours by 60 to convert to minutes, but since this problem asks for ug/kg/HOUR, you do not need to further convert) 4) Now plug into the equation: 4 ug/40kg/10 hours= 1600 ug 5) Now convert the ug into mg by dividing by 1,000: 1600/1,000 = 1.6 mg 6) Calculate the quantity of fentanyl to add by now dividing the 1.6 mg by the concentration of the drug (0.05 mg/mL) : 1.6mg/0.05mg/mL = 32 mL To be truly accurate when adding drugs to a bag like this, you should discard 32 mL of fluids from the bag prior to adding the 32 mL of fentanyl.
A 60-lb patient is to go home on Clavamox after his dental cleaning. The dose is 14 mg/kg. What size tablet should the patient be sent home with?
Answer: 375 mg After converting the body weight to kilograms the dose needs to be multiplied by the body weight. 60 lb / (2.2 lb/kg) = 27 kg (Notice the pounds cancel out) 27 kg x 14= 378 mg Many medications are available in different concentrations to accommodate different sized patients. This is particularly the case with oral medications so that owners don't have to worry about trying to halve or quarter medications.
You are helping admit a patient to the hospital. Rudy is a 5-year old female spayed Yorkie with pancreatitis. The hospital is very busy and all of the fluid pumps are currently being used by other patients. You are asked to start fluids at 24mL/hr for Rudy. Calculate the drip rate for this patient. Her body weight is 8 pounds. The drop size for your administration set is 10 drops/mL.
Answer: 4 drops/minute The body weight given in this question is irrelevant. You already know what rate you need. You would only need the body weight if you were calculating her rate. Formulas for drop sizes per mL are as follows (you may wish to memorize these): 10 drops/mL: (mL/hr) / 6 = drops/minute 15 drops/mL: (mL/hr) / 4 = drops/minute 20 drops/mL: (mL/hr) / 3 = drops/minute 60 drops/mL: (mL/hr)/ 1 = drop/minute So to calculate using these simple formulas: 24/6 = 4 drops per minute Or, If you did not know this formula, or if you forget, just convert it using what you know. First convert hours into minutes: 24 mL per hour divided by 60 minutes in an hour: 0.4 mL per minute You administration set will give 10 drops per 1 mL. So, multiply 0.4mL/min X 10 drops/1mL (the mLs cancel out) = 4 drops/minute Now check your math: 4 drops per minute X 60 minutes in a hour (minutes cancel out)= 240 drops per hour Your set gives 10 drops in 1 mL. 240 drops/10 drops/mL (drops cancel out) = 24 mL per hour (correct)
A patient has developed a severe run of ventricular premature contractions. The clinician asks you to immediately pull up a 4 mg/kg dose of lidocaine for to administer intravenously. The lidocaine in the hospital comes in a 2% solution. How many milliliters should you draw up for this 20 kg patient?
Answer: 4 ml To determine how many milligrams are need, do the following math: 20 kg x (4 mg/kg) = 80 mg. Now the difficult part is determining how to calculate how many milliliters of a 2% solution of lidocaine is equivalent to 80 mg. Percent is equal to weight (in Grams) / 100 parts volume (in mLs) (This is based on water, since 1 mL weighs 1 Gram): Example: A 2% solution: 2 Grams/100 mL or 2000 mg/100 mL or 20 mg/mL The easiest way to remember is to just add a zero onto any percentage for the milligrams (i.e. 2% solution = 20 mg; 10% solution = 100 mg; 25% solution = 250 mg). Therefore, 80 mg / (20 mg/ml) = 4 ml
A 10 kg Miniature Schnauzer is to receive 22mg/kg cefazolin intravenously following a laceration repair. If the concentration of the cefazolin is 50mg/ml, how many milliliters should be administered?
Answer: 4.4 The answer is 4.4 mL. 10kg x 22mg/kg = 220mg cefazolin. 220mg/ 50mg/ml = 4.4 mL to be administered.
A 120-pound Great Dane has presented with Gastric Dilatation Volvulus. The clinician has asked you to quickly prepare the drug protocol. As a premedication, the dog is to receive 0.08 mg/kg of Hydromorphone. How many milligrams will you administer?
Answer: 4.4 mg To calculate milligrams administered the dog's body weight should be converted to kilograms. As a general rule, the majority of medications are dosed in a milligram-per-kilogram dosing. Therefore all body weights need to be converted to kilograms so that you are working in the same units. 120 lb/2.2 = 54.5 kg (There are 2.2 lbs per kilogram) 54.5 kg x (0.08 mg/kg) = 4.4 mg (Notice the "kg" will cancel out when you do the math) If your answer was 9.6 mg, you did not convert the body weight into kilograms.
The attending veterinarian asks you to administer 120 mg of enrofloxacin (Baytril) IV slow over 20 minutes to a dog that is hospitalized in your clinic. The strength of injectable enrofloxacin is 2.27%, how many milliliters of drug will you administer?
Answer: 5.3 ml A 2.27% solution is 22.7 mg/ml. 120 mg divided by 22.7 mg/ml = 5.3 mls
How many milliliters of 50% dextrose should be added to one liter of 0.9% saline in order to make it a 2.5% dextrose solution?
Answer: 50 ml To answer this question, the following formula should be implemented: C(1)V(1) = C(2)V(2) C is the concentration V is the volume C(1) =0.5 V(1) = x C(2) = 0.025 V(2) = 1000 ml 0.5x = 0.025(1000) x = 50 ml 50 ml of 50% dextrose should be added to one liter in order to make a 2.5% solution.
You are instructed to administer 12 liters of sterile isotonic IV fluids via a fluid pump over the next 24 hours. What is the appropriate fluid rate to administer this volume of IV fluids?
Answer: 500 mL/hour 12 liters (12000 mLs) divided by 24 hours would equal 500 mLs/hour.
A 20-kg patient is currently receiving 52 ml/hr of Lactated Ringer's Solution. The clinician has requested that 2 mg/kg/day of metoclopramide be added to the bag. Metoclopramide is available as a 5 mg/ml solution. How many milliliters do you need to add to a 1 liter bag?
Answer: 6.5 ml This is definitely a more complicated calculation question, but when broken down it is not insurmountable. A 20-kg patient will need 40 mg/day of metoclopramide (20 kg x 2 mg/kg/day) Since the fluid is being administered at an hourly rate, we need to figure out how much metoclopramide we are administering per hour. 40 mg/day / (24 hr) = 1.7 mg/hr To determine how much volume of metoclopramide is needed, the following math is performed: 1.7 mg/hr / (52 ml/hr) x (1000 ml)= 32.6 mg (Notice how the units cancel out.) 32.6 mg / (5 mg/ml) = 6.5 ml
A 12 kg Springer Spaniel has been presented to your hospital for pyometra surgery. The veterinarian would like you to give 20 mls of Unasyn over 20 minutes on a syringe pump before the procedure. How many milliliters per hour will you set the pump to run for?
Answer: 60 20 mls multiplied by 60 (minutes in 1 hour)= 1200 divided by 20 minutes= 60 mls/hr.
A 60 lb Bulldog is to receive intravenous fluids at a maintenance rate. Assuming the maintenance rate can be calculated as 60 ml/kg/day, what would the fluid rate be per hour? Round answer to the closest milliliter/hour.
Answer: 68 The answer is 68. 60 lb/2.2 kg/lb = 27.27 kgs in weight. 27.27 x 60 ml/kg = 1636 ml/day. 1636 ml/day / 24hrs/day = 68 ml/hour
A 5-year old Labrador has developed hemorrhagic gastroenteritis. The clinician has instructed you to start him on Metronidazole at a dose of 10 mg/kg intravenously twice daily. Metronidazole is available in a 5 mg/ml solution. How many milliliters are necessary per dose? The dog's body weight is 80 lbs.
Answer: 73 ml First, convert the dog's body weight to kilograms. 80 lbs / (2.2 lbs/kg) = 36.4 kg Now determine how many milligrams are necessary per dose. 36.4 kg x (10 mg/kg) = 364 mg (notice the kilograms cancel out) Finally, determine how many milliliters are in 364 mg. 364 mg / (5 mg/ml) = 73 ml (notice the milligrams cancel out)
A 55-pound Pit Bull mix "Rocky" was hit by a car and is hospitalized in the emergency ward. The ECG is showing continuous runs of ventricular tachycardia. The veterinarian asks you to start a constant rate infusion of lidocaine to be given at 80 micrograms per kilogram per minute (ug/kg/min). The dog is currently on a fluid rate of 80 mL per hour. Lidocaine is a 2% solution. How much lidocaine will you add to a liter of LRS?
Answer: 75 ml Constant rate infusions are not something that an entry-level technician would typically perform. However, the VTNE may have some questions on CRI, and it will benefit you to know how to do these calculations. To solve this problem, break down the basic parts to make it less overwhelming. *Note that a 2% solution is the same as 20 mg/mL (add a zero to the % number, so 1% is 10mg/mL, 20% is 200 mg/mL, etc.) 1) Convert pounds to kilograms-55 pounds/2.2 pounds per kg = 25 kg 2) Calculate the number of hours an infusion will last by dividing the volume in the bag (1 liter, or 1,000 ml) by the rate per hour: 1,000 ml/80ml/hr = 12.5 hours 3) Now take the number of hours (12.5) and multiply by 60 to calculate how many minutes this is: 12.5 X 60 = 750 minutes 4) Plug into the equation: 80 ug/25kg/750min= 1,500,000 ug 5) Now convert the ug into mg by dividing by 1,000: 1,500,000/1,000 = 1500 mg 6) Calculate the quantity of lidocaine to add by dividing the 1500 mg by the concentration of the drug (20mg/ml): 1500mg/20mg/ml = 75 ml To be truly accurate when adding drugs to a bag like this, you should discard 75 ml of fluids from the bag prior to adding the 75 ml of lidocaine.
A 4-kg puppy is in need of subcutaneous fluids due to dehydration. The doctor prescribed a dose of 20 ml/kg. How many milliliters should this patient receive?
Answer: 80 ml To obtain the answer the following math should have been performed: 4 kg x (20 ml/kg) = 80 ml Notice the kilograms were canceled out.
You are asked to start a dog on maintenance fluids. The dog weighs 80 pounds. What fluid rate do you start on this dog?
Answer: 90 mL/hr There are several ways to calculate maintenance fluids. Some are more accurate than others, with the more accurate ones requiring more complex math. Fortunately, in most patients, being off by a few milliliters does not adversely affect the patient. The most basic calculation to approxiamte maintenance rate fluids in a dog is: 60mL/kg/day 80 pounds/2.2= 36 kg 60mL X 36 kg = 2160 mL per day 2160 mL/24 hours in a day = 90 mL per hour
A 3-year old male neutered Labrador Retriever presents for lethargy and inappetence of a few days in duration. The dog is approximately 7% dehydrated with pale and dry mucous membranes, a capillary refill time > 2 sec, heart rate > 170 bpm and weak femoral pulses. The veterinarian diagnoses the dog with hypovolemic shock and orders isotonic crystalloid fluid therapy. What is the isotonic crystalloid total "shock dose" in dogs?
Answer: 90 ml/kg The isotonic crystalloids shock dose in dogs is 90 ml/kg. 1/4 to 1/3 of this volume should be administered initially and the patient reassessed. In cats, the isotonic crystalloids shock dose is 40-60 ml/kg. Synthetic colloids can be administered at a dose of 10-20 ml/kg in dogs and 5-10 ml/kg in cats; hypertonic saline can be administered at a dose of 5 ml/kg.
