Intro to Professional Nursing Math 2

Important IV Terms

- gtts: drops - Drop Factor: Number of drops per volume of IV fluid. Varies depending on the tubing used. Usually measured in gtts/mL. - Flow Rate: Measure of the flow of liquid from an IV. Usually measured in gtts/minute (how many drops are released every minute) or in mL/hour (how many mL flow through each hour). gtts/minute is used for manually regulating an IV while mL/hour is used when utilizing an electronic IV regulator.

Fluid Maintenance Requirement Questions 2

Example: An infant weighs 4 kg. What is the required amount of fluid per day in mL? 0-10 kg.....100 mL per kg 4 kg x 100 mL/kg = 400 mL

Iv fluid question

Example: Calculate the amount of sodium chloride in 2000 mL NS. Recall NS is 0.9% NaCl (sodium chloride) Concentration % ÷ 100 x Volume (mL) = Y (Dosage Amount in g) 0.9% ÷ 100 x 2000 mL = 18 g

Pill to pill orders

Example: Metroprolol (Lopressor), 25 mg PO, is ordered. Metropolol is available as 50 mg tablets. How many tablets would the nurse administer? Ordered ÷ by Have = Y (Tablets Required) 25 mg ÷ 50 mg = 0.5 tablets

Fluid Maintenance Requirement Questions 4

This is now an ordinary IV Flow Rate - mL Rate Question. The required volume is 1,200 mL and the time is one day. Volume (mL) ÷Time (hr) = Y (Flow Rate in mL/hr) There are 24 hours in one day. 1 day x 24 = 24 hr 1,200 mL ÷ 24 hr = 50 mL/hr

Important IV Abbreviations

D: Dextrose W: Water S: Saline NS: Normal Saline (0.9% NaCl) RL or LR: Lactated Ringer's Example: D5W = 5% Dextrose in Water Example: D5 ¼ NS = 5% dextrose in 0.225% saline solution

Dosage By Weight Questions 3

This is now an ordinary Mass/Liquid For Liquid Question. 51 mg is ordered and the medication is available as 125 mg / 2 mL. Ordered ÷ Have x Volume Per Have = Y (Liquid Required) 51 mg ÷ 125 mg x 2 mL = 0.82 mL

Dosage By Weight Questions Given the weight of a patient and a dosage specified in terms of weight, calculate the necessary dosage. These problems are a type of pediatric dosage calculations.

Example: A doctor orders 200 mg of Rocephin to be taken by a 15.4 lb infant every 8 hours. The medication label shows that 75-150 mg/kg per day is the appropriate dosage range. Is this doctor's order within the desired range? Weight in Kg * Dosage Per Kg = Y (Required Dosage) Convert 15.4 lb to kg. lb → kg ( ÷ by 2.2 ) 15.4 lb ÷ 2.2 = 7 kg 7 kg * 75 mg/kg = 525 mg (Minimum Desired Dosage) 7 kg * 150 mg/kg = 1,050 mg (Maximum Desired Dosage) 24 hours in one day and the medication is ordered every 8 hours. 24 hrs / 8 hrs = 3 times per day doctor ordered medication 200 x 3 = 600 mg ordered per day 600 mg is within the desired range of 525-1,050 mg Yes doctor has ordered a dosage within the desired range.

Mass/Time - IV mL Rate Questions 2

Example: Aggrastat at 12.5 mg in 250 mL is prescribed to be infused at a rate of 6 mcg/kg/hr in a patient who weighs 100 kg. At what flow rate in mL/hr will you set the pump? Ordered Per Hour÷ Have x Volume (mL) = Y (Flow Rate in mL/hr) The first step is to convert the order per time to the amount required for this particular patient. This is a Dosage By Weight Question. 100 kg is the weight in kg and 6 mcg/kg/hr is a dosage in terms of kg. Weight in Kg x Dosage Per Kg = Y (Required Dosage) 100 kg x 6 mcg/kg/hr = 600 mcg/hr Convert 600 mcg/hr to mg/hr. mcg → mg → g → kg ( ÷ by 1,000 ) 600 ÷ 1,000 = 0.6 mg/hr 0.6 mg/hr ÷ 12.5 mg x 250 mL = 12 mL/hr

Fluid Maintenance Requirement Questions 3

Example: An infant weighs 30.8 lb. What is the required IV flow rate in mL/hr to maintain proper fluid levels? Convert 30.8 lb to kg. lb → kg ( ÷ by 2.2 ) 30.8 lb ÷ 2.2 = 14 kg 10-20 kg=1,000 mL + 50 mL per each kg above 10kg 14 kg - 10 kg = 4 kg (There are 4 kg over 10 kg). 1,000 mL + (50 mL/kg x 4 kg) = 1,200 mL/day

Volume/Time (IV drop rate) Given a certain amount of liquid, a time period, and a drop factor (gtts/mL), what is the necessary IV flow rate in gtts/min? Measurement used when IV is regulated manually. Because it is not possible to give a patient a fraction of a drop, it is typical to round answers for these problems up or down to the nearest whole number.

Example: Calculate the IV flow rate for 1200 mL of NS to be infused in 6 hours. The infusion set is calibrated for a drop factor of 15 gtts/mL. Volume (mL) ÷ Time (min) x Drop Factor (gtts/mL) = Y (Flow Rate in gtts/min) Convert 6 hours to minutes. min ← hr ( x by 60 ) 6 hr x 60 = 360 min 1200 mL ÷360 min x 15 gtts/mL = 50 gtts/min

Volume/Time - IV Drop Rate Questions

Example: Calculate the IV flow rate for 200 mL of 0.9% NaCl IV over 120 minutes. Infusion set has drop factor of 20 gtts/mL. Volume (mL) ÷Time (min) x Drop Factor (gtts/mL) = Y (Flow Rate in gtts/min) 200 mL ÷ 120 min x 20 gtts/mL = 33 gtts/min

Amount in IV Fluid Questions Given a volume of IV fluid and a dosage expressed in percent, what is the mass of a particular dosage?

Example: Calculate the amount of dextrose in 1000 mL D5W. Concentration % ÷ 100 x Volume (mL) = Y (Dosage Amount in g) 5% ÷ 100 x 1000 mL = 50 g

Mass/Time - IV mL Rate Questions Give an order in quantity of mass per time, determine the necessary IV flow rate in mL/hr based on the given mass per volume. These types of problems are often used in critical care nursing.

Example: Give patient 500 mg of dopamine in 250 mL of D5W to infuse at 20 mg/hr. Calculate the flow rate in mL/hr. Ordered Per Hour ÷ Have x Volume (mL) = Y (Flow Rate in mL/hr) 20 mg/hr ÷ 500 mg x 250 mL = 10 mL/hr

Volume÷ Time - IV mL Rate Questions Given a certain amount of liquid and a time period, what is the necessary IV flow rate in mL/hr? Measurement used when IV regulated electronically by infusion pump.

Example: Infuse 250 mL over the next 120 minutes by infusion pump. Volume (mL) ÷ Time (hr) = Y (Flow Rate in mL/hr) Convert 120 minutes to hours. min → hr ( ÷ by 60 ) 120 min ÷ 60 = 2 hr 250 mL ÷ 2 hr = 125 mL/hr

Volume ÷ Time - IV mL Rate Questions

Example: Ordered 1000 mL D5W IV to infuse in 10 hours by infusion pump. Volume (mL) ÷ Time (hr) = Y (Flow Rate in mL/hr) 1000 mL ÷ 10 hr = 100 mL/hr

mass to liquid order

Example: Ordered Lasix 40 mg IV push now. Available: 80 mg in 1 mL. How much will the nurse draw up? Ordered ÷ Have x Volume Per Have = Y (Liquid Required) 40 mg ÷ 80 mg x 1 mL = 0.5 mL

mass to liquid order example

Example: Phenytoin (Dilantin), 0.1 g PO, is ordered to be given through a nasogastric tube. Phenytoin is available as 30 mg ÷ 5 mL. How much would the nurse administer? Ordered ÷ Have x Volume Per Have = Y (Liquid Required) Convert 0.1 g to mg. mcg ← mg ← g ← kg ( x by 1,000 ) 0.1 g x 1,000 = 100 mg 100 mg ÷ 30 mg x 5 mL = 16.7 mL

Dosage By Weight Questions 2

Example: Solumedrol 1.5 mg/kg is ordered for a child weighing 74.8 lb. Solumedrol is available as 125 mg / 2mL. How many mL must the nurse administer? Weight in Kg x Dosage Per Kg = Y (Required Dosage) Convert 74.8 lb to kg. lb → kg ( ÷ by 2.2 ) 74.8 lb ÷ 2.2 = 34 kg 34 kg x 1.5 mg/kg = 51 mg

Fluid Maintenance Requirement Questions Given the weight of a child or infant, calculate the necessary amount of fluid per day. Different hospitals may have different policies, but for learning how to perform these pediatric dosage calculations, the following commonly used table of fluid requirements may be used.

Weight Range Required Daily Fluid 0-10 kg 100 mL per kg 10-20 kg 1,000 mL + 50 mL per................................................. each kg above 10 kg 20-70 kg 1,500 mL + 20 mL per... .......................................... each kg above 20 kg Over 70 kg 2,500 mL (adult requirement)