Med-Surg Math

A client is to receive 4 mg morphine sulfate IV push. The pharmacy delivers 5 mg in a 2-mL vial. How much should the nurse administer for one dose? (Record your answer using a decimal rounded to the nearest tenth.) ____ mL

1.6 XmL= 2 mL ÷ 5 mg x 4 mg = 1.6 mL

A nurse assesses a client with a brain tumor. The client opens his eyes when the nurse calls his name, mumbles in response to questions, and follows simple commands. How should the nurse document this client's assessment using the Glasgow Coma Scale shown below? a. 8 b. 10 c. 12 d. 14

12 The client opens his eyes to speech (Eye opening: To sound = 3), mumbles in response to questions (Verbal response: Inappropriate words = 3), and follows simple commands (Motor response: Obeys commands = 6). Therefore, the client's Glasgow Coma Scale score is: 3 + 3 + 6 = 12.

A nurse cares for a client with acute pancreatitis who is prescribed gentamicin (Garamycin) 3 mg/kg/day in 3 divided doses. The client weighs 264 lb. How many milligrams should the nurse administer for each dose? (Record your answer using a whole number.) ____ mg/dose

120 X mg/dose= 3 mg ÷ 1 kg/day x 1 kg ÷ 2.2 lb x 264 lb3 mg/day x 264 lb= 792 ÷ 2.2 lb= 360360 mg/day ÷ 3 divided doses= 120 mg/dose

A client has developed malignant hyperthermia. The client weighs 136 pounds. What is the safe dose range for one dose of dantrolene sodium (Dantrium)? (Enter your answer using whole numbers, separated by a hyphen with no spaces.) _____ mg

124-186 Xmg= 136/2.2= 62 kg2-3 mg x 62 kg= 124-186 mg Dose is 2-3 mg/kg/safe dose range 124-186 mg

A client is prescribed 250 mL of normal saline to infuse over 4 hours via gravity. The facility supplies gravity tubing with a drip factor of 15 drops/mL. At what rate (drops/min) should the nurse set the infusion to deliver? (Record your answer using a whole number.) _____ drops/min

16 Xdrops/min= 4 hours x 60 mins = 240 mins 250 mL ÷ 240 mins = 1.04166666667 x 15 drops=15.625 rounded to 16 drops/min

A postoperative client has the following orders:IV lactated Ringer's 125 mL/hr. NG tube to low continuous suctionReplace NG output every 4 hours with normal saline over 4 hoursMorphine sulfate 2 mg IV push every hour as needed for painNPOUp in chair tonightAt 1600 (4:00 PM), the nurse measures the nasogastric (NG) output from noon to be 200 mL. What is the client's total IV rate for the next 4 hours? (Record your answer using a whole number.) _____ mL/hr

175 200 mL of NG output ÷ 4 hours = 50 mL/hr125 mL/hr + 50 mL/hr = 175 mL/hr

A nurse is preparing to give an infusion of acetaminophen (Ofirmev). The pharmacy delivers a bag containing 50 mL of normal saline and the Ofirmev. At what rate does the nurse set the IV pump to deliver this dose? (Record your answer using a whole number.) ____ mL/hr

200 Intravenous acetaminophen (Ofirmev) is approved for treatment of pain and fever in adults and children ages 2 years and older and is given by a 15-minute infusion. To deliver 50 mL in 15 minutes, set the IV pump for 200 mL/hr. To run 50 mL in 60 minutes, the pump would be set for 50 mL/hr. To run this volume in one quarter of the time, divide by 4: 200 4 = 50.

A nurse cares for a client who is prescribed 5 mg/kg of infliximab (Remicade) intravenously. The client weighs 110 lbs and the pharmacy supplies infliximab 100 mg/10 mL solution. How many milliliters should the nurse administer to this client? (Record your answer using a whole number.) ____ mL

25 X mL= 10 mL ÷ 100 mg x 1 kg ÷ 2.2 lb x 110 lb10 mL x 5 mg x 110= 5500 mL100 mg x 2.2 lb= 2205500 mL ÷ 220= 25 mL

A nurse prepares a client with acute renal insufficiency for a cardiac catheterization. The provider prescribes 0.9% normal saline to infuse at 125 mL/hr for renal protection. The nurse obtains gravity tubing with a drip rate of 15 drops/mL. At what rate (drops/min) should the nurse infuse the fluids? (Record your answer using a whole number, and rounding to the nearest drop.) _____ drops/min

31 Xdrops/min= 125 mL ÷ 60 mins = 2.08333333333 x 15 = 31.25 rounded to 31

A nurse cares for a client who is prescribed 4 mg of calcium gluconate to infuse over 5 hours. The pharmacy provides 2 premixed infusion bags with 2 mg of calcium gluconate in 100 mL of D5W. At what rate should the nurse administer this medication? (Record your answer using a whole number.) ____ mL/hr

40 X mL/hr= 100 mL ÷ 2 mg x 4 mg ÷ 5 hr100 mL x 4 mg= 400 mL2 mg x 5 hr= 10400 mL ÷ 10 hr= 40 mL/hr

A client's white blood cell count is 7500/mm3. Calculate the expected range for this client's neutrophils. (Record your answer using whole numbers separated with a hyphen; do not use commas.) ______/mm3

4125-5625 The normal range for neutrophils is 55% to 75% of the white blood cell count. 7500 × 0.55 = 4125 7500 × 0.75 = 5625 So the range would be expected to be 4125/mm3 to 5625/mm3.

A client is prescribed 1000 mL of normal saline to infuse over 24 hours. At what rate should the nurse set the pump (mL/hr) to deliver this infusion? (Record your answer using a whole number.) ____ mL/hr

42 XmL/hr= 1000 mL ÷ 24 hours = 41.6 rounded to 42 mL/hr

A nurse assesses a 66-year-old client who is attempting to quit smoking. The client states, "I started smoking at age 16, and smoked one pack each day until 10 years ago. Then I decreased to a half of a pack per day." How many pack-years should the nurse document for this client? (Record your answer using a whole number.) ___ pack-years

45 66 (current age) - 16 (year started smoking) = 50 years of smoking.(40 years ´ 1 pack per day) + (10 years ´ 0.5 pack per day) = 45 pack-years

A client in the intensive care unit with acute kidney injury (AKI) must maintain a mean arterial pressure (MAP) of 65 mm Hg to promote kidney perfusion. What is the client's MAP if the blood pressure is 98/50 mm Hg? (Record your answer using a whole number.) _____ mm Hg

66 98+(2 x 50)/3 = MAP 66 mm Hg

A nurse prepares to administer 12 mg/kg of 5-fluorouracil chemotherapy intravenously to a client who has colon cancer. The client weights 132 lb. How many milligrams should the nurse administer? (Record your answer using a whole number.) _____ mg

720 Xmg= 132 lb ÷ 2.2 lb = 60 kg 12 mg/kg x 60 kg = 720 mg

A nurse is caring for a client who weighs 220 pounds and is started on enoxaparin (Lovenox). How much enoxaparin does the nurse anticipate administering? (Record your answer using a whole number.) _____ mg

90 The dose of enoxaparin is 1 mg/kg body weight, not to exceed 90 mg. This client weighs 220 pounds (110 kg), and so will get the maximal dose