Chronic Care Lab/Clinical Dosage Calc Study Guide

Application Exercise #6: A nurse is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Do not use a trailing zero.)

0.8 mL

Injectable dosage example: A nurse is preparing to administer heparin 8,000 units subcutaneously every 12 hr. Available is heparin injection 10,000 units/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

0.8 mL

L to mL

1 L = 1000 mL

g to mg

1 g = 1000 mg

gr to mg

1 gr = 60 mg

kg to g

1 kg = 1000 g

kg to lbs

1 kg = 2.2 lbs

lbs to oz

1 lb = 16 oz

mL to mg

1 mL = 1000 mg

mg to mcg

1 mg = 1000 mcg

oz to mL

1 oz = 30 mL

tbsp to mL

1 tbsp = 15 mL

tbsp to tsp

1 tbsp = 3 tsp

tsp to mL

1 tsp = 5 mL

Even if allowed by the Clinical Partner's Student Medication Administration Policy, Students MAY NOT administer:

1. Blood products 2. IV push medication 3. IV narcotics medications under any circumstance 4. Drugs during a "Code" 5. Central line flushes (i.e., porta-cath or PICC line)

How do you solve dosages by weight?

1. Convert to lbs or kg 2. Desired x Quantity/have

What must the student do when administering a medication?

1. Identify key information regarding the medication to be administered 2. Identify/verify patient's allergies prior to medication administration. 3. Identify the eight rights of medication administration 4. Maintain standards of patient safety, including proper hand washing and clean or sterile techniques and disposal of sharps, as appropriate during the entire medication administration process. 5. Use two patient identifiers prior to medication administration to ensure safety. 6. If the Clinical Partner's policy allows, document with the clinical faculty or Registered Nurse expert's supervision in the patient's medication administration record providing correct medication, dose, and administration time according to the institutional procedures along with licensed personnel's signature/initial.

What are the 8 rights of medication administration?

1. Right patient 2. Right medication 3. Right dose ​4. Right route ​5. Right time/frequency ​6. Right patient education ​7. Right documentation 8. Right to refuse

Application Exercise #8: A nurse is preparing to administer dextrose 5% in water (D5W) 750mL IV to infuse over 6 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.)

125 mL/hr

Electronic IV flow rate example: A nurse is preparing to administer dextrose 5% in water (D5W) 500 mL IV to infuse over 4 hr. The nurse should set the IV infusion pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

125 mL/hr

Electronic IV flow rate example: A nurse is preparing to administer cefotaxime 1 g intermittent IV bolus over 45 min. Available is cefotaxime 1 g in 100 mL 0.9% sodium chloride (0.9% NaCl). The nurse should set the IV infusion pump to deliver how many mL/hr? (Round the answer to the nearest whole number.)

133 mL/hr

Solid dosage example: A nurse is preparing to administer phenytoin 0.2 g PO every 8 hr. The amount available is phenytoin 100 mg/capsule. How many capsules should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 capsules

Dosage by weight example: A nurse is preparing to administer cefixime 8 mg/kg/day PO to divide equally every 12 hr to a toddler who weighs 22 lb. Available is cefixime suspension 100 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 mL

Application Exercise #4: A nurse is preparing to administer haloperidol 2 mg PO every 12 hr. The amount available is haloperidol 1 mg/tablet. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.)

2 tablets

Application Exercise #2: A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100mL 0.9% sodium chloride (0.9%NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.)

200 mL/hr

Application Exercise #1: A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero.)

22 gtt/min

Manual IV flow rate example: A nurse is preparing to administer ranitidine 150 mg by intermittent IV bolus. Available is ranitidine 150 mg in 100 mL of 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

33 gtt/min

Manual IV flow rate example: A nurse is preparing to administer lactated Ringer's (LR) 1,500 mL IV to infuse over 10hr. The drop factor of the manual IV tubing is 15gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

38 gtt/min

Application Exercise #5: A nurse is preparing to administer amoxicillin 20 mg/kg/day PO to divide equally every 12 hr to a preschooler who weighs 44 lb. The amount available is amoxicillin suspension 250 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Do not use a trailing zero.)

4 mL

Liquid dosage example: A nurse is preparing to administer amoxicillin 0.25 g PO every 8 hr. The amount available is amoxicillin oral suspension 250 mg/5mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

5 mL

Application Exercise #7: A nurse is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The amount available is acetaminophen liquid 500 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

6.5 mL

Application Exercise #3: A nurse is preparing to administer furosemide 80 mg PO daily. The amount available is furosemide oral solution 10 mg/1 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.)

8 mL

How should medications be administered?

Administer medications with the direct supervision of the clinical faculty or assigned Registered Nurse expert.

What may the student do beginning in NUR 4716L?

Beginning in NUR 4716L the student may irrigate/flush peripheral IV lines with saline flushes only with direct supervision of clinical faculty and/or Registered Nurse expert.

What is the formula for solid dosages, liquid dosages, and injectable dosages?

Desired x Quantity/Have

What happens if the student is unsuccessful after the third attempt?

If the student is unsuccessful after the third attempt, the student cannot meet the course objectives and cannot progress in the clinical course; therefore, a grade of 'U' is earned.

Students must be prepared to fully participate in clinical by the _________ week in NUR 3465L and 4764L (6 week rotations).

Second

What are students NOT allowed to accept?

Students are not allowed to accept verbal or telephone orders from any healthcare provider.

What must the students adhere to?

Students must adhere to the College of Nursing Medication Administration Policy and the Clinical Partner's Student Medication Administration Policy.

Students will take the medication administration exam prior to the clinical rotation. What is the exam attempt limit?

There is a three exam attempt limit.

Students must be prepared to fully participate in clinical by the __________ week in NUR 3262L, 4525L, and 4716L (12 week rotations).

Third

What is the formula for manual IV flow rates?

Volume x Drop Factor/Time

What is the formula for electronic IV flow rates?

Volume/Time

What key information must be identified regarding the medication to be administered?

a. Mechanism of action ​b. Major side effects and incompatibilities c. Rationale for medication use d. Correct medication dosage/IV rate calculation completed e. Available assessment considerations (i.e. BP, HR, drug levels, blood sugar) f. Selection of proper needle/syringe size, site (for IM/SQ administration), and volume capacity for site chosen g. Saline flush guidelines

According to JCAHO, what are acceptable patient identifiers?

​a. The individual's name b. An assigned identification number c. Telephone number d. Date of birth e. Social Security number f. Address g. Photograph