Nursing Concepts Module 5 Test
750/60 = 12.5 .5 x 60 = 30 12 hours and 30 minutes
750 ml D5W IV. Infuse at 60 ml/hr. How many hours will the fluid infuse?
0700
7:00 am
1900
7:00 pm
q8h
8 hours at a time (infuse over 8 hours)
1 mg
1000 mcg
1 g
1000 mg
1000 ml ordered/12 hours = 83.33 = 83 mL/hr
1000 ml D5W IV from 6am-6pm 1000 ml is amt to be infused over 12 hours What will the pump be set at?
1000/12 = 83.33 to 83 ml/hr
1000 ml NS 0600-1800. How many ml/hr do we set the pump to?
1 oz
30 mL
1800
6:00 pm
gtt
Drop
Manufacturer For example, Baxter-Travenol macrodrip sets deliver 10 gtt/mL, so 10 drops drip in the drip chamber (10 gtt = 1 mL); Abbott sets deliver 15 gtt/mL, so 15 drops drip in the drip chamber (15 gtt = 1 mL).
Drops per milliliter differ according to what?
1. Total number of milliliters to be infused 2. The number of milliliters per hour
Electric infusion pumps also deliver IV fluid. Some are easy to operate; others are more complicated. With basic IV infusion, you must enter two pieces of information:
1. Intermittent 2. Cyclic 3. Continous
Enteral Nutrition can be administered with a pump by?
LR
Lactated Ringer's solution (or Lactated Ringers)
Macrodrip
Need to check the package tubing 10 gtt/ml 15 gtt/ml 20 gtt/ml
NS
Normal (or isotonic) saline
Full strength 1/4 strength 1/2 strength 3/4 strength
Order will be to administer the feeding either?
1. Fluid from the body 2. Urine (foley, urinal) 3. Diarrhea 4. Vomiting 5. Suctioning device contents 6. Bleeding and drainage devices that are collecting
Output is considered these things:
Step 1 ¾ x 250 =750/4 = 187.5 mL Step 2 250mL- 187.5mL = 62.5 Answer: 187.5 mL Osmolite Answer: 62.5mL water
Prepare ¾ strength Osmolite. Total volume is 250mL. How much Osmolite is to be mixed with how much water? Step 1- Step 2- Answer: ______ mL Osmolite Answer: ______ mL water
Output
Record the type and amount of all fluids the patient has lost and the route. Describe them as urine, liquid stool, vomitus, tube drainage (including from chest, closed wound drainage, and nasogastric tubes), and any fluid aspirated from a body cavity
Small needle
Sets with a ____ needle in the chamber are called microdrip because their drops are small
mL
The healthcare provider will indicate the number of milliliters to be infused in the order
hours
The number of hour to run depends on the way the order is written
Milliliters
The total amount for IV pumps that will be infused should always be in?
60 gtt = 1 ml
To deliver 1 ml of fluid to a client, 60 drops drip in the drip chamber
Enteral Nutrition
Used when a patient/client cannot eat or cannot eat enough
1. Foley drainage bags 2. Urinals 3. Urinal hats 4. Graduated cylinder 5. Medicine cups 6. Syringes
Utensils that we use to measure
W
Water
Approximately half their volume
What about ice chips?
1. Record the type and amount of all fluids the patient has lost and the route 2. Describe them as urine, liquid stool, vomitus, tube drainage (including from chest, closed wound drainage, and nasogastric tubes), and any fluid aspirated from the body cavity
What things do we calculate as output?
1. Any fluid that has went into the body is counted as intake 2. So not only was oral intake part of intake and there is a sheet to place the oral intake, but there will be an area for parenteral intake 3. Any IVF's or IV antibiotics received will be calculated 4. Any enteral nutrition received will be counted
What things would be considered intake?
Tubing
Where will the drop factor be found?
1000
10:00 am
2200
10:00 pm
1100
11:00 am
2300
11:00 pm
0.33% NS
0.33% saline in water (1/3 normal saline)
0.45% NS
0.45% saline in water (1/2 normal saline)
0.9% NS
0.9% saline in water (normal saline)
1000 ml
1 L
8 oz = 1 cup 240 ml = 1 cup 240 ml in 1 cup of coffee
1 cup coffee is _____ mL
60 minutes
1 hour (infuse over 1 hour)
90 minutes
1.5 hours (infuse over 1.5 hours) (to get the number of hours, divide minutes by 60)
120 ml/1 hour = 120 ml/hour
120 ml of IV fluid over 60 minutes -The 60 minutes will be converted to hours, so (60 min = 1 hour)
2400
12:00 am, midnight
1200
12:00 pm
1 tbsp
15 mL
1500/75 = 20 hours
1500 ml LR IV. Infuse at 75 ml/hr. How many hours will this fluid infuse?
0100
1:00 AM
1300
1:00 pm
1 kg
2.2 lbs
1 c (8 oz)
240 mL
275/100 = 2.75 hour 0.75 x 60 = 45 minutes 2 hours and 45 minutes Start at 1400 hours and ends at 1645 hours
275 ml NS IV/ Infuse at 100 ml/hr How long? When will it finish?
0200
2:00 am
1400
2:00 pm
0300
3:00 am
1500
3:00 pm
30 mL = 1 oz 30 ml = x ml --------------- 1 oz = 4 oz = 30 x 4 = 120 = 1x x = 120 mL
4 oz orange juice is _____ mL
0400
4:00 am
1600
4:00 pm
1 tsp
5 mL
D5W
5% dextrose in water
500/2 = 250 ml/hr
500 ml 0.45% to infuse over 2 hours. How many ml/hr would we set the pump to?
500 ml/75 ml/hr = 6.67 hours = 6.7 .7 x 60 minutes = 42 minutes Will end at 2:42 pm if started at 8 am (0800-1442)
500 ml D5W; infuse at 75 ml/hour
0500
5:00 am
1700
5:00 pm
10am-4pm
6 hours (infuse over 6 hours)
Microdrip
60 gtt/mL
0600
6:00 am
0800
8:00 am
2000
8:00 pm
0900
9:00 am
2100
9:00 pm
IVPB is 50 ml q8h or three times in 24 hours 50 x 3 = 150 ml in 24 hours The client is receiving 100 ml for 21 hours (24 hours - 3 hours that the IVPB is running) 100 x 21 = 2100 2100 mL + 150 mL = 2250 mL in 24 hours
A client is receiving an antibiotic IVPB in 50 ml q8h to run over 1 hour plus a maintenance IV of 100 ml/hour. What is the 24-hour intake parentally?
IVPB is 75 ml q6h or four times in 24 hours. 75 x 4 = 300 ml in 24 hours The client is receiving 125 ml for 20 hours (24 hours - 4 hours that the IVPB is running) 125 x 20 = 2500 ml in 20 hours 300 ml + 2500 ml = 2800 ml in 24 hours
A client is receiving an antibiotic IVPB in 75 ml q6h, to run over 1 hour plus a maintenance IV of 125 ml/hour. What is the 24-hour intake parentally?
900 ml at 100 ml/hour = 9 hours to run If the IV starts at 0900, -1800 hours or 6 pm
A total of 900 ml of an IV solution is to infuse at 100 ml/hour. If it is 0900 hours when the infusion starts, at what time will be completed?
Step 1 ¼ x 80ml = 80/4=20 mL (this is the amt Ensure) Step 2 80mL - 20 mL = 60mL (this is the amt of water) Step 3 Start infusion pump at 40mL/hr
Administer ¼ strength Ensure at 40 mL/hr. Total volume is 80mL. How much Ensure is mixed with how much water?
1.Begin by taking ¼ of the volume to be infused ¼ X 250mL= 62.5 mL (this is the amount of Jevity to put in the bag) 2.Subtract that number from total volume 250mL - 62.5mL = 187.5 mL ( this is the amount of water to put in the bag) 3. Now the pump can be started to infuse at 60mL/hour
Administer ¼ strength Jevity at 60mL/hour. The total volume will equal 250ml
...
An infusion pump's basic setting is set in milliliters per hour, so your dosage calculations are in milliliters per hour as well
Total mL ordered/# hours to run = mL/hr
Calculate IV drip for pumps
Number of mL to infuse x Drip Factor/Number minutes to infuse = gtt/min
Calculate IV gtt rates
Number of mL ordered/Number ml/hour = hours to run
Determine hours TV will run
How long to run a IVF
Determining how to calculate how long an IV will last helps you to know when to prepare the next IV or be aware if it is infusing too fast or slow
D
Dextrose
Whole number
For IV pumps (ml/hr) always round to?
Tube passed through nasal or oral cavity to the stomach. (NG tube or nasogastric), oral gastric, or more permanent - G tube or gastrostomy tube into the stomach
How to use enteral nutrition?
120 mL orange juice + 240 mL coffee -------------------- 360 mL intake (oral)
I & O for Breakfast will be?
Different types of IV drip factors
IV fluids are administered through infusion sets. These consist of plastic tubing attached at one end to the IV bag and at the other end to a needle or catheter inserted into a blood vessel. The top of the infusion set contains a chamber
120 ml x 10 gtt/ml / 60 min = 1200/60 = 20 gtt/min
Infuse 120 ml of D5 1/2 NS over 60 minutes with a DF of 10 gtts/ml
150 x 10 / 30 = 1500/30 = 50 gtts/min
Infuse 150 ml of 1/2 NS over 30 minutes with a drop factor of 10 gtt/ml. Calculate gtt per minutes
1500 x 15 / 180 = 22,500/180 = 125 gtts/min
Infuse 1500 ml of D5W over 3 hours with a drop factor of 15 gtt/ml. Calculate the gtt per minute
1500 x 60 / 120 = 90,000 /120 = 750 gtts/min
Infuse 1500 ml of LR over 2 hours using a microdrip factor. Calculate the gtt per minute
250/1.5 = 166.66 round to 167 ml/hr
Infuse 250 ml D5W for 90 minutes. How many ml/hr would this be?
750/8 = 93.75 round to 94 ml/hr
Infuse 750 ml LR q8h. How many ml/hr would this be?
Without
Infusion sets _____ a small needle in the chamber are called macrodrip
4 oz orange juice 1 cup of coffee
Intake: 1 scrambled egg 4 oz orange juice 1 sausage patty 1 biscuit 1 cup of coffee
I & O
intake and output