Math chapter 14,17

Ordered: Heparin 1,000 units subcutOn hand: Heparin 10,000 USP units/mL

0.1 mL

The patient is a 5-year-old child who weighs 42.6 lb. Ordered: Levsin 5 mcg/kg 30 min prior to anesthesia On hand: Levsin 0.5 mg/mL single-use vials Calculate the amount to administer:

0.19 mL

The patient is a 55 lb child receiving myelosuppressive chemotherapy. Ordered: Neupogen 100 mcg subcut daily. Refer to the information from the package insert for the dose on hand. If this is a safe dose for this patient, determine amount to administer: _______________. If it is not a safe dose, write: not safe.

0.33 mL

Calculate the amount of subcutaneous heparin to administer using the following information. Ordered: Heparin 7,500 units subcutOn hand: Heparin 20,000 USP units/mL

0.38 mL

Calculate the amount to administer: _______________. Ordered: Akineton 2 mg IM now On hand: Akineton 5 mg/mL

0.4 mL

The patient is a 5-day-old newborn who weighs 7 lb 3 oz. Ordered: Nebcin 4 mg IM q12h. Refer to information from package insert. If this is a safe dose, calculate the amount to administer: _______________ If it is not a safe dose, write: not safe.

0.4 mL

The BSA for a patient who is 76 cm and weighs 9.5 kg is _______________. (Round to the nearest hundredth)

0.42 m2

Calculate the amount of subcutaneous heparin to administer using the following information. Ordered: Heparin 10,000 units subcutOn hand: Heparin 20,000 USP units/mL

0.5 mL

The child weighs 1 lb 4 oz. Convert this weight to kg: _______________. (Round to the nearest hundredth)

0.57 kg

Find the number of milliliters per dose. Ordered: Heparin 3,000 units subcut On hand: Heparin 5,000 USP units/mL

0.6 mL/dose

Using the child nomogram, a child who is 3 ft tall and 36 lb has a BSA of

0.64 m2.

The patient weighs 88 lb and is receiving myelosuppressive chemotherapy. Ordered: Neupogen 200 mcg IVPB over 30 minutes. Refer to information from the package insert for the dose on hand. If this is a safe dose for this patient, determine the amount to administer: _______________. If it is not a safe dose, write: not safe.

0.67 mL

Ordered: Heparin sodium 7,000 units subcutOn hand: Heparin 1:10,000 for injection

0.7 mL

Calculate the amount of subcutaneous heparin to administer using the following information. Ordered: Heparin 7,500 units subcutOn hand: Heparing 10,000 USP units/mL

0.8 mL

Ordered: Valium® 4 mg IV nowOn hand: Valium® 5 mg/mL

0.8 mL

Calculate the amount of subcutaneous heparin to administer using the following information. Ordered: Heparin 5,000 units subcutOn hand: Heparin 5,000 USP units/mL

1 mL

Find the amount of drug to administer.Ordered: Epinephrine 0.5 mg IVOn hand: Vial of epinephrine 1:2,000 solution for injection

1 mL

Select the proper syringe to administer 0.9 mL of a medication IM.

1 mL tuberculin syringe

Calculate the amount of subcutaneous heparin to administer using the following information. Ordered: Heparin 7,500 units subcutOn hand: Heparin 5,000 USP units/mL

1.5 mL

Find the amount of drug to be administered. Ordered: Lorazepam 3 mg IMOn hand: Lorazepam 2 mg/mLThe patient is 18 years old.

1.5 mL

Height = 167 cm; weight = 63.6 kg. Calculate the BSA: _______________. (Round to the nearest hundredth)

1.72

If you were mixing an infusion of 7,500 units heparin IV bolus, you would select the bottle containing _______________ per milliliter.

10,000 USP units

Ordered: Dopamine 400 mg in 250 mL D5W to deliver 4 mcg/kg/min to a 165 lb patient. The infusion pump should be set at _______________. (Round to the nearest whole number)

11 mL/h

The child's BSA is 0.56 m2. The recommended dosage is 25 mcg/m2. The recommended dosage for this child is

14 mcg

Calculate the recommended dosage for 125 mg/m2 for a patient whose BSA is 1.12 m2: _______________.

140 mg

The patient is a 13-year-old with a severe throat infection. The patient weighs 45 kg.Ordered: Erythromycin 650 mg PO q8h for 7 daysOn hand: See label Determine if the dose is safe. If it is safe, calculate the amount to administer: _______________. If the dose is not safe, write: not safe.

16.3 mL

Leucovorin calciumFor IM or IV use350 mgRx onlySingle-dose vialReconstitute with 17.5 mL of sterile water for injection.Each 1 mL when mixed contains 20 mg leucovorin.Store the solution at 25°C. How much diluent should you add to the vial in the example above?

17.5 mL

Calculate the flow rate Mrs. Williamson weighs 142 lb and is a patient in your ICU. Ordered: Nesiritide 0.03 mcg/kg/min IV. On hand: Nesiritide 1.5 mg/250 mL D5W infusing via infusion pump.

19 mL/ h

Calculate the amount to administer: _______________. Ordered: Acetylcysteine 400 mg q4h inhalation On hand: Acetylcysteine 20% solution

2 mL

Leucovorin calciumFor IM or IV use350 mgRx onlySingle-dose vialReconstitute with 17.5 mL of sterile water for injection.Each 1 mL when mixed contains 20 mg leucovorin.Store the solution at 25°C. Calculate the amount of solution to inject to give the patient 40 mg of leucovorin.

2 mL

Ordered: Vasopressin 0.04 units/min IV On hand: Vasopressin 60 units50 mL60⁢ units50⁢ mL NS The hourly flow rate is:

2 mL/h

A 14-year-old child sustained head trauma when he dived into a local pond. He is currently comatose, although his EEG shows that his brain patterns are normal, and he is expected to live. While he is unconscious, his daily maintenance fluids must continue to be met. The child weighs 108 lb. His DMFN is _______________.

2,080 mL

The patient is a 3-year-old child who weighs 26 lb and has a severe infection. Ordered: Amoxicillin 120 mg po q8h On hand: See label. The package insert says the dosing regimen for children is 20 to 40 mg/kg/day q8h. Determine if the order is safe. If it is, calculate the amount to administer: _______________. If the dose is not safe, write: not safe.

2.4 mLA

Calculate the starting flow rate for this patient Ordered: dopamine: Begin infusion of 2 mcg/kg/min for bradycardia and systolic BP less than 90. Increase infusion up to 10 mcg/kg/ min as needed. You have a premixed bag of dopamine with 250 mg in 500 mL of D5W. The patients weights 185 Lb .

20 mL/h

Calculate the DMFN for a child weighing 3.25 kg: _______________.

325 mL

The patient is a 4-year-old child who weighs 33 lb 6 oz. Ordered: Erythromycin suspension 180 mg po qid for 7 days On hand: See label Determine if the dose is safe. If it is safe, calculate the amount to administer: _______________. If the dose is not safe, write: not safe.

4.5 mL

Ordered: 10,000 units of heparin in 250 mL D5W to deliver 1,600 units/h. The infusion pump should be set at _______________.

40 mL/h

Ordered: 10,000 units of Heparin in 500 mL D5W infusing at 20 mL/h. The hourly heparin dose is _______________.

400 units/h

According to the excerpt from a heparin protocol, which of the following heparin dosages represents the maximum safe initial heparin infusion rate per 24 hours?

43,200 units

Mr. Deere has an IV of morphine 2 mg/h that has been infusing since 2000 hours yesterday. It is currently 0700 hours. The concentration of morphine is 50 mg100 mL50⁢ mg100⁢ mL NS. How much solution has he received?

44 mL

The patient's blood pressure remains low and you increase the rate to 65 mL/h. Calculate the dosage per minute the patient is receiving at this time: _______________. (Round to the nearest whole number)

5 mcg/kg/min

Calculate the recommended dosage for 200 mg/m2 for a patient whose BSA is 0.26 m2: _______________.

52 mg

Ordered: Nitroglycerin 10 mcg/min IV On hand: Nitroglycerin 25 mg in 250 mL D5W The hourly flow rate for this order is:

6 mL/h

Calculate the DMFN for a child weighing 6 kg: _______________.

600 mL

Mrs. Williamson's weight in kg is _______________. (Round to the nearest tenth)

64.5 kg

Ordered: 4 mg Norepinephrine in 250 mL D5W to infuse at 18 mcg/min. The infusion pump should be set at

67.5 mL/h

Ordered: 4 mg Norepinephrine in 250 mL D5W to infuse at 18 mcg/min. The infusion pump should be set at _______________.

67.5 mL/h

Ordered: 15,000 units of heparin in 500 mL D5W infusing at 25 mL/h. The hourly heparin dose is _______________.

750 units/h

Order: Morphine 4 mg/h IV On hand: Morphine 500mg/100mL Ns What is the hourly flow rate

8 mL / h

A burn patient's BSA is 1.72 m2. The recommended dosage range is 37−52 mg/m2. The maximum safe dose for this patient is _______________. (Round to the nearest milligram)

89 mg

Cindy is an 11-year-old, 79 lb child who sliced her forearm open on a sharp piece of metal while helping her father clean out the garage. At the emergency room, the wound was cleaned up and the physician determined that she would need several sutures. Cindy is very upset, and the physician orders Midazolam for injection to sedate her and help decrease her anxiety. However, when Cindy sees the needle, she becomes very agitated, so the physician changes the order to Midazolam HCl syrup 18 mg PO. On hand, the emergency room has a 118 mL bottle of Midazolam HCl syrup 2 mgmL2⁢ mgmL . According to the package insert, the usual oral dose is 0.25 to 1 mg/kg. Determine if the ordered dose is safe. If it is safe, determine the amount to administer: _______________. If the dose is not safe, write: not safe.

9 mL

A 42-year-old patient has been diagnosed with mesothelioma. The physician has prescribed pemetrexed 850 mg IV over 10 minutes every 21 days. According to the package insert, the usual dose is 500 mg/m2. The patient is 5 ft 6 in. and weighs 154 lb. The maximum safe dose for this patient is _______________.

900 mg

With regard to insulin syringes, which of the following is true?

An insulin syringe can only be used with U-100 insulins.

Which of the following would not be included in a heparin protocol?

Dosage based on BSA

Which of the following is not a recommendation for working with geriatric patients?

Instruct them to take their medication using color of tablets.

With regard to insulin, which of the following is true?

It stimulates glucose metabolism.

After drawing up the shorter-acting dose of an insulin combination, the longer-acting insulin is drawn up until the _______________ of the syringe reaches the calibration indicating the total dose.

Leading ring

A loading dose of heparin is given to

achieve a therapeutic blood level of heparin.

If you know the total amount of medication, the total volume of solution, and the volume of solution the patient has received, you can determine the

amount of medication received.

A(n) ___________ medication is administered to regulate the heart rate or rhythm.

antidysrhythmic

Vasoactive medications, which cause the _______________ to dilate or constrict, are administered to maintain a patient's blood pressure.

blood vessels

A nomogram is a special chart that can be used to determine a patient's

body surface area

Physicians may be inclined to order larger than normal intramuscular drug doses for patients experiencing which of the following?

circulation impairment

A by-product of muscle metabolism found in the blood is _______________.

creatinine

One indicator of the rate at which kidneys filter blood is the patient's _______________.

creatinine clearance

The total fluids a patient needs over 24 hours is known as _______________.

daily maintenance fluid needs

The elderly tend to have lower muscle mass; this often causes a(n)

decreased creatinine clearance.

Another term for solvent is _______________.

diluent

Drugs can be _____ through sweat, feces, or any other body secretion.

eliminated

The process through which a drug leaves the body through urine, sweat, feces, or other body secretions is called _______________.

elimination

DMFN would not include

fluids used to flush a Foley catheter.

When performing dosage calculation for a high-alert medication, you should

have another healthcare professional calculate the dosage independently.

Another term for the process of biotransformation is _______________.

metabolism

The child weighs 33 lb. Ordered: Depakene syrup 120 mg po q12h. Refer to the information from the package insert for the dose on hand. If this is a safe dose for this patient, calculate the amount to administer: _______________ If it is not a safe dose, write: not safe.

not safe

The patient is a 3-day-old newborn who weighs 4 lb. Ordered: Nebcin 4 mg IM q12h. Refer to information from the package insert. If this is a safe dose for this newborn calculate the amount to administer: _________. If it is not a safe dose, write: not safe.

not safe

The patient is a 92-year-old male, 5 ft 10 in. tall, weighs 170 lb, and has a creatinine clearance of 6 mL/min diagnosed with a complicated urinary tract infection. Assume that the patient has impaired renal function. Ordered: Fortaz 500 mg IV q12h. Is this a safe dose to administer? Write: safe or not safe.

not safe

Polypharmacy refers to

patients taking many medications at the same time.

The study of what happens to a drug after it is administered to a patient is _______________.

pharmacokinetics

Mr. Paul takes eight different prescription medications plus several OTC medications. Taking multiple medications is called _______________.

polypharmacy

Which of the following is a factor in causing an adverse drug reaction?

polypharmacy

A heparin _______________ is a preprinted order set that is used to guide administration of IV heparin.

protocol

Mrs. Sanderson was admitted to the hospital with a severe methicillin-resistant Staphylococcus aureus (MRSA) infection. She is 84 years old, 5 ft 4 in. tall, and weighs 180 lb. She has normal renal function. The physician has ordered Garamycin® 70 mg IM q8h. On hand: Garamycin® Injectable 40 mg/mL. According to the package insert, the usual dosage for patients with serious infections and normal renal function is 1 mg/kg q8h. Doses higher than this amount are considered unsafe. The ideal weight range for this patient is 122 to 157 lb. If the ordered dose is safe, calculate the amount to

safe 1.8 mL

When calculating for safe titration, you will need to calculate the _______________ rate and the minimum and maximum allowable rates.

starting

When calculating the rate to administer a heparin solution in milliliters/hour, Q is the dosage unit, H is the dose on hand, A is the amount to administer, and D is the rate of

the desired dose

When calculating the rate to administer a heparin solution in milliliters/hour, Q is the dosage unit, H is the dose on hand, A is the amount to administer, and D is the rate of

the desired dose.

Insulins are classified by

timing of action.

The adjustment of a medication administration rate based on its effect on a patient's heart rate is called

titration

The adjustment of a medication administration rate based on its effect on a patient's heart rate is called

titration.

Insulin is administered in

units.

Insulin syringes are calibrated in

units.

Which of the following are frequently titrated in response to the patient's vital signs to maintain the blood pressure within the normal range?

vasoactive medications

Pharmacokinetic processes in children are different from those in adults partly because children have a higher percentage of _______________ per kilogram of body weight.

water