Role Transition med calc
The nurse is preparing to administer bumetanide (Bumex) 0.25 mg IV. The medication is available in a vial labeled "1 mg/4 ml." How many ml of medication should the nurse administer? (Enter numeric value only.)
1 Rationale Using the Desired/Have x Volume formula: 0.25 mg Desired / 1 mg Have x 4 ml Volume =0.25 mg/1 mg x 4 ml = 1 ml
The healthcare provider prescribes furosemide (Lasix) 15 mg IV STAT for a client. On hand is an ampoule labeled, furosemide (Lasix) 20 mg/2ml. How many milliliters should the nurse administer? 1 ml. 1.5 ml. 1.75 ml. 2 ml.
1.5 ml Rationale The correct calculation: Dosage on hand/amount on hand = Dosage desired/X amount. 20mg : 2ml = 15mg : X20X = 30X = 30/20 = 1 1/2 or 1.5 ml
A client who weighs 70 kg is receiving a solution of 0.9% Sodium Chloride (Normal Saline) 500 ml with dopamine 800 mg at 5 ml/hour. How many mcg/kg/minute is the client receiving? (Enter the numeric value only. If rounding is required, round to the nearest tenth.)
1.9 Rationale To change ml/hour to mcg/kg/minute, use the formula: desired rate (5 ml/hour) / volume available (500ml) x dose available (800mg) = 8 mg/hour.Next, convert milligrams/hour to mcg/kg/minute: mg (8) x 1000 / kg (70) / 60 minutes = 1.904 = 1.9 mcg/kg/minute.
A client scheduled for surgery is to receive an IV infusion of 0.9% sodium chloride with prochlorperazine edisylate (Compazine) 10 mg/50 ml over 30 minutes. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only, as a whole number.) Submit
100 Rationale Calculate: 50 ml : 30 minutes :: X ml : 60 minutes50/X :: 30/603000 = 15XX = 100 ml
A client who weights 176 pounds is receiving an IV infusion with esmolol hydrochloride (Brevibloc) at 48 ml/hour. The IV solution is labeled with the concentration of Brevibloc 10 mg/ml. How many mcg/kg/minute is the client receiving? (Enter numeric value only. Round to nearest whole number.) Submit
100 Rationale Convert pounds to kg by dividing 176 pounds by 2.2 pounds = 80 kg.Convert the IV concentration from mg to mcg. 1 mg : 1000 mcg :: 10 mg : 10,000 mcg.Infusion rate (48 ml/hour) x concentration (10,000 mcg/ml) divided by 60 minutes/hour x 80 kg =48 x 10,000 divided by 60 x 80 = 480,000 / 4800 = 100 mcg/kg/minute.
A client returns to the nursing unit from surgery with a prescription for Lactated Ringer's solution 1,000 ml to be infused over 10 hours. The IV administration set delivers 60 gtts/ml. The nurse should regulate the infusion to deliver how many gtts/minute? (If rounding is required, enter a whole number.)
100 Rationale First convert hours to minutes:10 hrs x 60 = 600 minutesUsing the formula Volume/Time x drop factor:1000 ml /600 minutes = 1.66666 x 60 = 100 gtts/minute
The healthcare provider prescribes a secondary infusion of Dextrose 5% in Water (D5W) 50 mg IV with magnesium sulfate 4 gram/50 mI to be infused over 30 minutes for a client with preeclampsia. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)
100 Rationale Using ratio and proportion to calculate the rate of infusion for ml/hour: 50 ml: 30 minutes :: X ml : 60 minutes50 ml / X ml :: 30 min / 60 minutes3000 = 30XX = 100 ml/hour
Heparin 20,000 units in 500 ml D5W at 50 ml/hour has been infusing for 5.5 hours. How many units of heparin has the client received? 11,000 units. 13,000 units. 15,000 units. 17,000 units.
11,000 units. Rationale The correct calculation: 20,000 units/500 ml = 40 units (the amount of units in one ml of fluid). 40 units/ml x 50 ml/hr = 2,000 units/hour (1,000 units in 1/2 hour). 5.5 x 2,000 = 11,000 units.OR, multiply 5 x 2,000 and add the 1/2 hour amount of 1,000 to reach the same conclusion = 11,000 units.
A client who had mitral valve replacement surgery receives a prescription for Dextrose 5% in Water (D5W) 250 ml with dobutamine 0.5 grams for IV infusion at a rate of 5 mcg/kg/minute. The client weighs 75 kg. The nurse should program the infusion pump to deliver how many ml/hr? (Enter numeric value only. If rounding is required, round to the nearest tenth.)
11.3 Rationale First calculate the number of mcg/kg/minute: 5 x 75 = 375 mcg/minuteCalculate the number of mcg/hour: 375 x 60 minutes = 22,500 mcg/hourNext calculate the number of ml/hour needed to administer 22,500 mcg/hour: 500,000 mcg : 250 ml :: 22,500 mcg/ X ml500,000X = 5,625,000X = 11.25 (rounded to 11.3 ml/hour
A client with cardiogenic shock who weighs 220 pounds is receiving a solution of Dextrose 5% in Water (D5W) 250 ml with dopamine 400 mg at the rate of 3 mcg/kg/minute. The nurse should set the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest tenth.)
11.3 Rationale First, convert pounds to kg, 220 lb : X = 2.2 lb : 1 kg = 100 kgNext, calculate the dosage per minute, 3 mcg/kg/min x 100 kg = 300 mcg/minuteConvert mcg/min to mcg/hour, 300 mcg/min x 60 min=18,000 mcg/hour and Convert mcg/hour to mg/hour, 18,000 mcg/hr = 18.0 mg/hourCalculate the rate, 400 mg : 250 ml = 18 mg : X ml400X = 4500 X = 1.25 = 11.3 ml. So, 18 mg/11.3 ml should be infused at 11.3 ml/hour.
A child who is scheduled for a kidney transplant receives a prescription for basiliximab (Simulect) 20 mg IV 2 hours prior to surgery. The medication is available in a 20 mg vial that is reconstituted by adding 5 ml sterile water for injection, and administered as a secondary infusion of normal saline 50 ml to be infused over 30 minutes. The nurse should program the infusion pump to deliver how many ml/hour? (Enter the numeric value only as a whole number.)
110 Rationale After reconstituting the medication vial, the nurse adds the 5 ml of medication to the 50 ml of sterile water to result in a 55 ml volume to infuse in 30 minutes.Using the formula, Volume/Time = 55 ml / 0.5 hours = 110 ml/hour
A loading dose of acetylcysteine (Mucomyst) 8 grams, which is available as a 20% solution (200 mg acetylcysteine per ml) is prescribed by nasogastric tube for a client with acetaminophen toxicity. How many ml of diluent should be added to the medication to obtain a 1:4 concentration? (Enter the numerical value only. If rounding is required, round to the whole number.)
120 Rationale 8 grams = 8,000 mg prescribed dose.Using the formula, D/H x Q, 8,000 mg / 200 mg x 1 ml = 40 ml of the 20% solution.Dilute the 40 ml to a 1:4 concentration for administration using ratio and proportion, 1 : 4 solution :: 40 ml : XX= 160 ml total volume to administer.Subtract total volume of 160 ml - 40 ml of 20% concentration = 120 ml diluent is added to obtain a 1:4 concentration.
The nurse is administering an intravenous solution 250 ml to be infused over 2 hours. How many ml/hour should the nurse program the infusion pump? (Enter numeric value only, whole number.)
125 Rationale 250 ml : 2 hours = X ml : 1 hour2X = 250X = 125 ml/hour
The healthcare provider prescribes acetazolamide (Diamox) 600 mg/m2/day divided into 3 doses. The nurse calculates the child's body surface area (BSA) as 0.7 m2 . How many mg should the child receive per dose? (Enter the numeric value, whole number, only.)
140 Rationale Using the child's BSA, 0.7 m2, calculate the mg/dose, 600 mg x 0.7 m2 =420 mg/day/3 doses = 140 mg/dose
A client is receiving 5% Dextrose Injection 500 ml IV with Heparin Sodium 25,000 Units at 1,000 unit/hour per protocol for acute coronary syndrome (ACS). The client's partial thromboplastin time (PTT) is 76 seconds. Based on the ACS protocol, the infusion should be decreased by 100 units/hour for a PTT between 71 to 80 seconds. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only, whole number.)
18 Rationale Adjust the infusion to 900 units/hour (1,000 units/hour minus 100 units/hour per protocol). Using the formula, D/H x Q, 900 units/1 hour divided by 25,000 units x 500 ml = 90/5= 18 ml/hour
The healthcare provider prescribes acetaminophen elixir (Tylenol elixir) 600 mg PO every 6 hours for an adult client experiencing pain associated with maxillofacial surgery. The bottle is labeled 500 mg/15 ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)
18 Rationale Using the formula D/H x Q:600 mg/500mg x 15 ml = 18 ml
An IV infusion of terbutaline sulfate 5 mg in 500 ml of D5W, infusing at a rate of 30 mcg/min, is prescribed for a client in premature labor. How many ml/hr should the nurse set the infusion pump? 30. 60. 120. 180.
180 Rationale 180 ml/hr = 500 ml/5 mg X 1mg/1000 mcg X 30 mcg/min X 60 min/hr.
A client who has a gastrostomy feeding tube is receiving 3/4 strength Ensure 240 ml every 6 hours. Full strength Ensure is available in a 240 ml can. The nurse should use how many ml of Ensure to prepare the feeding? (Enter numeric value only. If needed, round to the nearest whole number.) Submit
180 Rationale 240 ml Ensure : 1 :: X ml Ensure : 0.75240/X : 1 / 0.75X = 240 x 0.75 = 180 ml Ensure + 60 ml water = 240 ml
An adult male who weighs 180-pound is admitted to the Emergency Center after receiving thermal burns to 60 percent of his body. Using the Parkland formula of 4 ml/kg/24 hours, the client should receive how many ml of fluid during the first 24 hours? (Enter the numeric value only. If rounding is required, round to the nearest whole number.)
19632 Rationale Using the Parkland formula, the client's fluid requirements for the first 24 hours after injury:4 ml lactated Ringer's solution x Body weight (in kilograms) x Percent burnConvert 180 pounds to kg = 180 / 2.2 = 81.8 kg4 ml x 81.8 kg x 60 = 19632 ml over the first 24 hours
A child who weighs 55 pounds receives a prescription for atovaquone with proguanil (Malarone Pediatric) 125 mg/50 mg PO daily. A drug reference states that children 11 to 20 kg should receive 1 pediatric tablet daily; 21 to 30 kg should receive 2 pediatric tablets daily; 31 to 40 kg should receive 3 pediatric tablets daily; and greater than 40 kg should receive 1 adult tablet daily with food. The drug is available as atovaquone 62.5 mg/proguanil 25 mg pediatric tablets. How many tablets should the nurse administer?
2 Rationale Calculate each drug component dose, using the formula, D/H125 mg / 62.5 mg (atovaquone) = 2combined with 50 mg / 25 mg (proguanil) = 2The child should receive 2 tablets of the combination drug, Malarone Pediatric.
A male client receives a prescription for ondansetron hydrochloride (Zofran) 4 mg IV to prevent postoperative nausea after an inguinal hernia repair. The medication is available in 2 mg/ml. How many ml should the nurse administer? (Enter numeric value only, whole number).
2 Rationale Use ratio and proportion, 4 mg : X ml = 2 mg : 1 ml 2X = 4 X = 2
A client with Mycobacterium avium complex (MAC) is receiving an infusion of 5 % dextrose in water (D5W)with amikacin (Amikin) 0.572 grams/100 ml every 12 hours. The nurse prepares the dose of amikacin using a vial labeled, " 250 mg/ml." How many ml should the nurse add to the infusion? (Enter numeric value only. If rounding is required, round to the nearest tenth.)
2.3 Rationale First convert gram to milligram:1 gm = 1000 mg so 0.572 gram x 1000 = 572 mgNext use the formula D/H x Q:572/250 x 1 = 2.288 (rounded to) 2.3 ml
The nurse prepares 5% Dextrose Injection, USP, 1,000 ml IV to be infused over 8 hours. The infusion set delivers 10 drops per milliliter. The nurse should regulate the IV to administer how many drops per minute? (Round to nearest whole number.) 80. 8. 21. 25.
21.
The healthcare provider prescribes oxytocin (Pitocin) 0.5 milliunits/minute for a client in labor. One liter Ringer's Lactate with 10 units of oxytocin (Pitocin) is infusing. The nurse should program the infusion pump at how many ml/hour? (Enter numeric value only.) Submit
3 Rationale Convert units to milliunits = 10 units x 1,000 = 10,000 milliunits per literUsing the formula, D/H x Q = 0.5 milliunits / 10,000 milliunits x 1000 ml = 0.05 ml/minute Multiply by 60 minutes = 3 ml/hour
A client with hypertension receives a prescription for carteolol (Cartel) 7.5mg PO daily. The drug is available in 2.5 mg tablets. How many tablets should the nurse administer? (Enter numeric value only, whole number.) Submit
3 Rationale Using D/H: 7.5mg / 2.5mg = 3 tablets
The healthcare provider prescribes trimethoprim-sulfamethoxazole (Bactrim-DS Oral Suspension) 120 mg BID for a child with bronchitis. The Bactrim bottle is labeled "200 mg/5ml." How many ml should the nurse administer at each dose? (Enter the numeric value, whole number, only. )
3 Rationale Using the formula D/H x Q, 120/200 x 5 = 3 ml
A client with hypertension who weighs 72.4 kg is receiving an IV infusion of Dextrose 5% in Water (D5W) 250 ml with nitroprusside (Nipride) 50 mg at 75 ml/hour. How many mcg/kg/minute is the client receiving? (Enter numeric value only. If rounding is required, round to the nearest tenth.) Submit
3.5 Rationale Calculate the mg/hour infusing, 50 mg : 250 ml = X : 75 ml250X = 3750 and X = 15 mg/hourNext, convert mg/hr to mcg/hour, 15 mg/hour = 1 mg / 1000 mcg = 15,000 mcg/hour, then divide by 60 min = 250 mcg/minuteLastly, 250 mcg/72.4 kg/min = 3.45 = 3.5 mcg/kg/minute
A client receives a prescription for an intravenous infusion of Dextrose 5% in 0.45% Sodium chloride (D51/2 NS) 500 ml to be infused over 6 hours. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.)
83 Rationale Calculate using Volume/Time: 500 ml/6 hours = 83.3 ml/hour = 83 ml/hour
The healthcare provider prescribes an IV infusion of Ringer's Lactate 1,000 ml with 30 Units of Pitocin to run in over 4 hours for a client who has just delivered a 10 pound infant by cesarean section. The tubing has been changed to a 20 gtt/ml administration set. The nurse plans to set the flow rate at how many gtt/minute? 42 gtt/min. 83 gtt/min. 125 gtt/min. 250 gtt/min.
83 Rationale Ratio proportion using Dimentional analysis.Drops/ Minutes (gtt/min) = 20gtt/ml X 1000 ml/4hrs X 1 hr/60 min = 83 gtts/minute
The nurse is preparing the change-of-shift report for a client who has a 265 ml secondary infusion that was started 2 hours ago at a rate of 85 ml/hour via an infusion pump. The nurse should report that how many ml remain to be infused by the on-coming nurse? (Enter numeric value only.)
95 Rationale 85 ml x 2 hours = 170 ml has infused. 265 ml (total amount to be infused) - 170 ml (amount infused) = 95 ml remain to be infused.
A client is receiving dantrolene sodium (Dantrium) PO for malignant hyperthermia. The maximum safe dose is 8 mg/kg/day in 4 divided doses. The client currently weighs 48.5kg. What is the maximum safe dose the nurse should administer? (Enter numeric value only. If rounding is required, round to the nearest whole number.)
97 Rationale Determine the maximum number of mg this client should receive in a day:48.5 kg x 8 mg/kg/day = 388 mg/dayNext determine how many mg the nurse should deliver each dose:388 mg/4 doses = 97 mg
A client who has been NPO for 3 days is receiving an infusion of Dextrose 5% in 0.45% Sodium chloride (D51/2 NS) with potassium chloride (KCl) 20 mEq at 83 ml/hour. The client's 8-hour urine output is 400 ml, blood urea nitrogen (BUN) is 15 mg/dl (5.355 mmol/L), lungs are clear bilaterally, serum glucose is 110 mg/dl ( 6.1 mmol/L), and serum potassium is 3.7 mEq/L (3.7 mmol/L). Which action should the nurse implement? A) Notify healthcare provider and request to change the IV infusion to hypertonic D10W. B) Decrease in the infusion rate of the current IV and report to the healthcare provider. C) Document in the medical record that these normal findings are expected outcomes. D) Obtain potassium chloride 20 mEq in anticipation of a prescription to add to present IV.
C) Document in the medical record that these normal findings are expected outcomes. Rationale The results are all within normal range (BUN 10 to 20 mg/dl or 3.6-7.1 mmol/L (SI units), serum glucose 70 to 110 mg/dl or less than 6.1 mmol/L (SI), and serum potassium 3.5 to 5.0 mEq/L or 3.5-5.0 mmol/L (SI units). The other actions are not indicated.
The nurse is caring for a client who is receiving 24-hour total parenteral nutrition (TPN) via a central line at 54 ml/hr. When initially assessing the client, the nurse notes that the TPN solution has run out and the next TPN solution is not available. What immediate action should the nurse take? A. Infuse normal saline at a keep vein open rate. B. Discontinue the IV and flush the port with heparin. C. Infuse 10% dextrose and water at 54 ml/hour. D. Obtain a stat blood glucose level and notify the healthcare provider.
C. Infuse 10% dextrose and water at 54 ml/hour. Rationale TPN should be discontinued gradually to allow the client to adjust to decreased levels of glucose. Administering 10% dextrose in water at the prescribed rate should reduce the client's risk of hypoglycemia until the next TPN solution is available. The other actions are not indicated.
What action should the nurse implement when accessing an implanted infusion port for a client who receives long term IV medications? A. Cleanse the site with iodine solution. B. Insert a Huber-point needle into the port. C. Flush tubing with 5 ml of normal saline. D. Place a sterile dressing over the port. Submit
Insert a Huber-point needle into the port. Rationale An implanted infusion port needs to be accessed using a Huber-point needle (non-coring) to be prevent damage to the self-sealing septum of the port. The other actions are not necessary when accessing an implanted infusion port.
