Pediatric Medication Calculations, Calculation Quiz I, IV dosage calculation practice test, HESI Dosage Calculations Practice Exam, Intravenous (IV) calculations, Intravenous Calculations,

Pediatric Medication Calculations, Calculation Quiz I, IV dosage calculation practice test, HESI Dosage Calculations Practice Exam, Intravenous (IV) calculations, Intravenous Calculations, convert :20 pounds 5 ounces to kilogram - ANSWER 1st: need to convert 5 ounces to a fraction of a pound 5 divided by 16=0.31 2nd: 20.31 pounds divided by 2.2=9.23 kg Note: medication would be calculated based on 9.23 kilograms DO NOT ROUND TO 9.2 Pediatric specific Calculations - ANSWER Mg / Kg dosing based on Weight (Kg) Safe dosing ranges IV pediatric infusion rates IV administration of meds via IV pump or Syringe pump. 24 hour fluid calculation child: 5 years: weight 44 lbs order: famotidine (pepcid) 5 mg IV bid Drug guide: 0.25 mg/Kg q 12 hr IV up to 40mg/day. - ANSWER Convert lb t kg: 44 kg= 20 kg Determine safe dose: 20 kg* 0.25 mg= 5 mg 5 mg is safe meets mg/kg rule and does not Exceed 40 mg/day 5 mg bid= total of 10 mg/day calculate dose pepcid is provided as 10 mg/ml - ANSWER 10 mg/1mL= 5 mg/ X mL 5/10x = 0.5 mL of Pepcid The Physician order will never say to flush The line - ANSWER YOU MUST DO THIS WITH EACH IV MEDICATION A medication order: 1 L D-5-W IV q 8 h. If the infusion pump (or administration set) delivers 10 drops/ml, calculate the infusion rate in drops/min. - ANSWER 20.8 drops/min How many fluid ounces (,) Robitussin Cough Syrup are there in 2.5 L? - ANSWER 84.5 fl. oz. An ophthalmic solution contains 1 mg dexamethasone phosphate/mL. How many mg dexamethasone phosphate are provided by 2 drops of the solution if the eye dropper delivers 20 drops/mL? - ANSWER 0.1 mg Given Info: Glycerin = 10 mL ZnO = 25 g Ointment base qs 100 g S. of glycerin is 1.25 How many g ointment base need to be weighed? - ANSWER 62.5 g Cocoa Butter (Theobroma Oil) suppository base has a sp. Gr. = 0.86. If 48 mL of melted Cocoa Butter is needed to make a batch of suppositories, how many grams of unmelted cocoa butter need to be weighed? - ANSWER 41.28 g a nurse is reviewing a client's prescriptions. the nurse should contact the provider to clarify what prescription? - ANSWER acetaminophen (Tylenol) 325 mg by mouth PRN for headache (prescription contains name of med, dosage, route, circumstance of administration, but no frequency) a nurse is preparing to administer medication to a client who has a prescription for doxycycline (Vibramycin) 100 mg PO daily at 0800. what times are appropriate for the nurse to administer the medication? - ANSWER anywhere within 30 min of the scheduled time (ex: 0745 or 0830) when teaching the parents of a toddler about feeding & eating, the nurse should include what safety measures? - ANSWER do not offer the child raw vegetables (other foods such as: raw vegetables, hot dogs, grapes, nuts, popcorn, candy have all been implicated in choking deaths & should be avoided at least until the child is 3 yrs) a nurse is preparing to administer ethosuximide (Zarontin) 500 mg PO every 12 hr. available is ethosuximide syrup 250 mg/tsp. how many ML should the nurse administer? round to nearest whole number. - ANSWER 10 mL * convert tsp to mL a nurse is preparing to administer methylprednisolone (Medrol) 4 mg PO daily. available is methylprednisolone 8 mg tablets. how many tablets should the nurse administer daily? - ANSWER 0.5 tablets a nurse is preparing to administer hydromorphone (Dilaudid) 4 mg PO every 6 hr PRN for pain. available is hydromorphone oral liquid 5 mg/5 mL. how many mL should the nurse administer per dose? round to nearest whole number. - ANSWER 4 mL a nurse is preparing to administer doxycycline (Vibramycin) 100 mg PO every 12 hr. available is doxycycline 50 mg tablets. how many tablets should the nurse administer per dose? round to nearest whole number. - ANSWER 2 tablets a nurse is preparing to administer triazolam (Halcion) 0.25 mg PO every 12 hr PRN for agitation. available is triazolam 0.125 mg tablets. how many tablets should the nurse administer per dose? round to nearest whole number. - ANSWER 2 tablets a nurse is preparing to administer furosemide (Lasix) 60 mg PO daily. available is furosemide 40 mg tablets. how many tablets should the nurse administer daily? - ANSWER 1.5 tablets a nurse is preparing to administer amoxicillin (Amoxil) 500 mg PO every 8 hr. available is amoxicillin oral suspension 250 mg/5 mL. how many tsp should the nurse administer per dose? round to nearest whole number. - ANSWER 2 tsp * convert 5 mL to tsp a nurse is preparing to administer imipramine hydrochloride (Tofranil) 75 mg PO daily. available is imipramine hydrochloride 50 mg tablets. how many tablets should the nurse administer? - ANSWER 1.5 tablets a nurse is preparing to administer trazodone (Oleptro) 50 mg PO at bedtime. available is trazodone 100 mg tablets. how many tablets should the nurse administer per dose? - ANSWER 0.5 a nurse is preparing to administer lamivudine (Epivir) 150 mg PO every 12 hr. available is lamivudine oral solution 10 mg/mL. how many mL should the nurse administer per dose? a nurse is preparing to administer - ANSWER 15 mL a nurse is preparing to administer fluoxetine (Prozac) 35 mg PO daily. available is fluoxetine solution 20 mg/5 mL. how many mL should the nurse administer daily? round to nearest whole number. - ANSWER 9 mL a nurse is preparing to administer methadone (Dolophine) 10 mg PO every 3 hr. available is methadone 5 mg tablets. how many tablets should the nurse administer per dose? round to nearest whole number. - ANSWER 2 tablets a nurse is preparing to administer rifampin (ifdain) 0.6 g PO daily. available is rifampin 150 mg tablets. how many tablets should the nurse administer? round to nearest whole number. - ANSWER 4 tablets * convert mg into g a nurse is preparing to administer albuterol (Proventil) 4 mg PO every 6 hr. available is albuterol syrup 2 mg/5 mL. how many mL should the nurse administer per dose? round to nearest whole number. - ANSWER 10 mL a nurse is preparing to administer zolpidem (Ambien) 10 mg PO at bedtime. available is zolpidem 5 mg tablets. how many tablets should the nurse administer per dose? - ANSWER 2 tablets a nurse is preparing to administer lithium carbonate (Eskalith) 600 mg PO. available is lithium carbonate 300 mg capsules. how many capsules should the nurse administer? round to nearest whole number. - ANSWER 2 capsules a nurse is preparing to administer methylprednisoline acetate (Depo-Medrol) 15 mg IM every other week. available is methylprednisolone acetate injection 20 mg/mL. - ANSWER 0.8 mL a nurse is preparing to administer furosemide (Lasix) 40 mg IV bolus state. available is furosemide injection 10 mg/mL. how many mL should the nurse administer? - ANSWER 4 mL a nurse is preparing to administer digoxin (Lanoxin) 0.2 mg IV bolus daily. available is digoxin injection 0.1 mg/mL. how many mL should the nurse administer per dose? - ANSWER 2 mL a nurse is preparing to administer lorazepam (Ativan) 2 mg IV bolus 20 min prior to surgery. available is lorazepam injection 4 mg/mL. how many mL should the nurse administer? round to nearest tenth. - ANSWER 0.5 mL a nurse is preparing to administer diazepam (Valium) 3 mg IV bolus every 3 hr PRN for anxiety. available is diazepam injection 5 mg/mL. how many mL should the nurse administer per dose? round to nearest tenth. - ANSWER 0.6 mL a nurse is preparing to administer penicillin G benzathine (Bicillin L-A) 1,200,000 units IM every week for 3 weeks. available is penicillin G benzathine injection 2,400,000 units/4 mL. how many mL should the nurse administer per dose? - ANSWER 2 mL a nurse is preparing to administer levothyroxine (Synthroid) 0.25 mg IV bolus stat. available is levothyroxine injection 500 mcg/mL. how many mL should the nurse administer? round to nearest tenth. - ANSWER 0.5 mL a nurse is preparing to administer diazepam (Valium) 7 mg IV bolus every 4 hr PRN for muscle spasm. available is diazepam injection 5 mg/mL. how many mL should the nurse administer per dose? round to nearest tenth. - ANSWER 1.4 mL a nurse is preparing to administer ceftriaxone (Rocephin) 400 mg IM every 12 hr. available is ceftriaxone injection 350 mg/mL. how many mL should the nurse administer per dose? round to nearest tenth. - ANSWER 1.1 a pt drinks 8 oz of water. what is the equivalent in mL? - ANSWER 240 mL what's an example of correct administration of the prescribed medication? - ANSWER amoxicillin 1 g PO prescribed; 2 500-mg tablets given what is the most appropriate documentation of a pt's response to a pain med? - ANSWER pt reports pain decreased to 3/10, 30 mins after med administration a drug's generic name is the - ANSWER same as its nonproprietary name you're reading the physician's orders and note date and time of the prescriptions as well as the physician's signature. what prescription is complete? - ANSWER digoxin (lanoxin) 1.25 mg PO daily what is your highest priority action for ensuring overall safety during med aministration? - ANSWER id the pt by 2 acceptable methods a pt is receiving 12.5 mg of prednisone (Deltasone) by mouth daily. med available in 5 mg tablets. how many tablets should the nurse administer for each dose? - ANSWER 2.5 tablets a nurse is preparing to administer an intradermal injection. what should the nurse do to ensure proper technique? - ANSWER use a tuberculin syringe w/ a 3/8-5/8inch, 25-27 gauge needle a nurse is administering a subcutaneous injection to a pt. what data should the nurse recognize as the highest priority to prevent potential complications? - ANSWER ID if pt has allergies to the medication proper needle length when giving an IM injection in the ventrogluteal area to an average-sized adult is what? - ANSWER 1 1/2 inches a nurse is preparing to given aintramuscular injection into the left ventrogluteal muscle. what should the nurse do to locate the appropriate site? - ANSWER w/ the heel of the hand on the greater trochanter, point the index finger up toward the anterior superior iliac spine, extending the other fingers back along the iliac crest a pt is to receiving 30 mg of ketorolac (toradol) IM every 6 hr for 48 hr. the med is available in a 60 mg/2 mL vial. how many mL should the nurse administer for each dose? - ANSWER 1 mL a nurse is preparing to administer an insulin injection to a pt. what is appropriate? - ANSWER rotate injection sites to avoid tissue injury. a nurse administers the first dose of a pt's prescribed antibiotic via IV piggyback. during the first 10-15 min of administration of the medication, the nurse gives priority to what assessment? - ANSWER check pt for systemic allergic reaction a nurse is about to administer an IV med directly into the vein. the nurse should understand that a disadvantage of parenterally administered medications is that they ___ - ANSWER are irreversible a nurse is caring for a pt w/ a peripherally inserted central catheters (PICC line). what is true about this type of IV route? - ANSWER a PICC line is a long catheter inserted through the veins of the antecubital fossa a pt was admitted to the hospital for same day surgery and has orders for continuous IV therapy. before performing a venipuncture, the nurse should - ANSWER inspect the iv solution for fluid color, clarity, and expiration date a pt is to receive 1 g of ceftriaxone (Rocephin) in 100 mL over 30 min. the tubing drip rate is 10 gtt/mL. the nurse should adjust the flow rate to what infusion rate? - ANSWER 33 gtt/min a nurse is assessing a pt receiving IV normal saline at 125 mL/hr. what should the nurse recognize as a possible complication related to the IV therapy? - ANSWER pt reports cough and shortness of breath a nurse is caring for a pt who's receiving D5W w/ 20 mEq of KCL at 75 mL/hr. the provider has prescribed 1 g ceftriaxone (Rocephin) IV. when preparing to administer this med by IV piggyback, what data is the highest priority for the nurse to collect? - ANSWER the medication's compatibility w/ the primary IV solution a nurse is caring for a pt receiving 0.9% sodium chloride (normal saline) at 75 mL/hr through a triple lumen central venous catheter. the pump is alarming that there is an occlusion. what is the first thing the nurse should do? - ANSWER check the line at or above the hub for kinked tubing that is creating a resistance to flow IM - ANSWER intramuscular 1 cup = __ fl oz - ANSWER 8 fl oz 1 lb. = __ ounces - ANSWER 16 ounces 1 t= ? mL - ANSWER 5 mL 1 T = ___ t = ___ mL = ____ fl oz - ANSWER 3t, 15mL, 1/2 fl oz 1 fl oz = ? mL - ANSWER 30 mL 1 in = ? cm - ANSWER 2.54 cm 1 cup = ___ oz - ANSWER 8 oz 1 cup = ___ mL - ANSWER 240 mL A male patient comes to the pharmacy and tells the pharmacist he is 6'7" tall and 250 pounds. His waist circumference is 43 inches. Calculate his BMI. Round to nearest whole number. Is the patient underweight, normal weight, overweight, or obese? - ANSWER 28 kg/m^2, overweight Calculate the BMI for a male who is 6' tall and weighs 198 lbs. Round to nearest tenth. Is the patient underweight, normal weight, overweight, or obese? - ANSWER 26.9 kg/m^2, overweight A female patient is to receive 5 mg/kg/day of theophylline. The patient is 5'7" and weighs 243 pounds. Calculate the daily theophylline dose the patient should receive. - ANSWER Dose on IBW 308 mg A 34-year-old male (height 6'7", weight 287 pounds) is hospitalized after a motor vehicle accident. He develops a Pseudomonas aeruginosa infection. The physician orders tobramycin 2 mg/kg IV Q8H. Calculate the tobramycin dose. Round to nearest 10 milligrams. - ANSWER Dose on AdjBW 220 mg A patient will receive 400 mg of a drug that has been put in a 250 ml IV bag. The rate of drug administration is 375 mcg per minute. Calculate the flow rate in milliliters per hour. Round to the nearest whole number. - ANSWER 14 ml/hr The pharmacist has an order for heparin 25,000 units in 250 ml D5W to infuse at 1,000 units/hr. The pharmacy has the following premixed heparin bags in stock: 25,000 units in 500 ml 1/2 NS, 10,000 units in 250 ml D5W, and 25,000 units in 250 ml D5W. What should the infusion rate be set in ml/hour? - ANSWER 10 ml/hr If 50 mg of drug are added to a 500 ml bag, what rate of flow, in milliliters per hour, will deliver 5 mg of drug per hour? - ANSWER 50 ml/hr If 200 mg of drug are added to a 500 ml bag, what rate of flow, in milliliters per hour, will deliver 500 mcg of drug per hour? Round to nearest hundredth - ANSWER 1.25 ml/hr A 68 kg patient is receiving a drug in a standard concentration of 400 mg/250 ml of 1/2 NS running at 15 ml/hr. Calculate the dose in mcg/kg/min. Round to nearest hundredth - ANSWER 5.88 mcg/kg/min Calculate using Volume/Time: 500 ml/6 hours = 83.3 ml/hour 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? - ANSWER 100 First convert hours to minutes: 10 hrs x 60 = 600 minutes. Using the formula Volume/Time x drop factor: 1000 ml /600 minutes = 1.66666 x 60 = 100 gtts minute. An IV infusion of dextrose 5% in normal saline with oxytocin (Pitocin) 20 units in 1,000 ml is prescribed for a client to control postpartum bleeding. The solution is to be administered at a rate of 2 mu/minute. The nurse should program the infusion pump to administer how many ml/hour? (Enter numeric value only. If rounding is required, round to the nearest whole number.) - ANSWER 6 First calculate the number of units/hour. 0.002 units/minute x 60 minutes = 0.12 units/hour. Next calculate the number of ml/hour needed to administer 0.12 units/hour. 20 units : 1,000 ml :: 0.12 units : X 20/0.12 :: 1,000/X 20X : 120 X = 6 The healthcare provider prescribes an IV solution of 5% dextrose in water with magnesium sulfate 4 gram/50 ml 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.) - ANSWER 100 To calculate the rate of infusion for ml/hour: 50 ml: 30 minutes :: X ml : 60 minutes 50 ml / X ml :: 30 min / 60 min 3000 = 30X X = 100 ml/hour 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.) - ANSWER 180 240 ml Ensure : 1 :: X ml Ensure : 0.75 240/X : 1 / 0.75 X = 240 x 0.75 = 180 ml Ensure + 60 ml water = 240 ml 0.9% normal saline with inamrinone (Inocor) 0.1 grams/100 ml is prescribed for a client with heart failure. The medication is to be delivered at a rate of 400 mcg/minute. 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.) - ANSWER 24 First calculate the number of mcg/hour: 400 mcg x 60 minutes = 24000 mcg/hour. Next calculate the number of ml/hour needed to administer 24,000 mcg/hour: 100,000 mcg: 100ml :: 24,000 mcg : X 100,000/24,000 :: 100/X 100,000X = 2,400,000 X = 24 ml/hour. A client experiencing cardiogenic shock receives a prescription for an IV infusion of 0.9% normal saline with milrinone (Primacor) 10 mg in 100 ml at a rate of 46 mcg/minute. 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.) - ANSWER 28 First calculate the number of mcg/hour: 46 mcg x 60 minutes = 2760 mcg/hour. Next calculate the number of ml/hour needed to administer 2760 mcg/hour: 10,000 mcg : 100 ml :: 2760 mcg : X 10,000 / 2760 :: 100 / X 10,000X = 276000 X = 27.6 (rounded to) 28 ml/hour. A client with septic shock receives a prescription for dextrose 5% in water with dopamine (Intropin) 0.6 grams/250 ml at a rate of 5 mcg/kg/minute. The client's weight is 148 lbs. 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 whole number.) - ANSWER 8 First convert the weight into kilograms: 148 pounds/2.2 kg = 67 kg. Next calculate the number of mcg/kg/minute: 5 x 67 x 1 minute = 335 mcg/min. Calculate the number of mcg/hour: 335 x 60 minutes = 20,100 mcg/hour. Now calculate the number of ml/hour needed to administer 20,100 mcg/hour: 600,000 mcg : 250 ml :: 20,100 mcg : X ml 600,000/20100 :: 250/X 600,000X = 5,02500 X = 8.375 (rounded to) 8 ml/hour. A client with type 2 diabetes is receiving metformin (Glucophage) 1 gram PO twice daily. The medication is available in 500 mg tablets. How many tablets should the nurse administer? (Enter numeric value only.) - ANSWER 2 Using the known equivalent, 1 gram = 1000 mg, the nurse should first convert the dose to the same unit of measurement, which is 1 gram = 1000 mg. Using the formula, Desired / Available x 1 tablets: 1000 mg / 500 mg x 1 = 2 tablets A client with Mycobacterium avium complex (MAC) is receiving an infusion of 5 % dextrose in water 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.) - ANSWER 2.3 First convert gram to milligram: 1 gm = 1000mg .572 gram x 1000 = 572 mg. Next use the formula D/H x Q: 572/250 x 1 = 2.288 (rounded to) 2.3 ml. A client with pericardial effusion has phrenic nerve compression resulting in recurrent hiccups. The healthcare provider prescribes metoclopramide (Reglan) liquid 10 mg PO q 6 hours. Reglan is available as 5 mg/5 ml. A measuring device marked in teaspoons is being used. How many teaspoons should the nurse administer? - ANSWER 2 First, using the formula, Desired dose/dose on Hand x Quantity of volume on hand (D/H x Q), 10 mg / 5 mg x 5ml = 10 ml. Next using the known conversion of 5 ml = 1 tsp: 5 ml : 1 tsp :: 10 ml : X 5 / 10 : 1 / X 5X = 10 X = 2 A client is receiving alprazolam (Xanax) 0.75 mg PO BID for anxiety. Alprazolam is available in 0.5 mg scored tablets. How many tablets should the nurse administer? (Enter numeric value only.) - ANSWER 1.5 Using the conversion of 1 gram = 1000 mg: 0.1 gram = 100 mg 100 mg = 1 capsule A client with multiple sclerosis is prescribed Dantrolene (Dantrium) 0.1 grams PO BID for spasticity. Dantrolene is available in 100 mg capsules. How many capsules should the nurse administer? (Enter numeric value only.) - ANSWER 1 Using the conversion of 1 gram = 1000 mg: 0.1 gram = 100 mg 100 mg = 1 capsule A client has a prescription for inamrinone (Inocor) 0.75 mg/kg IV bolus to be delivered over 3 minutes. The client weighs 80 kg. Inamrinone is available for injection 100 mg/20 ml. How many ml of inamrinone should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.) - ANSWER 12 First calculate the mg/kg dosage needed: 0.75 mg x 80 kg = 60 mg needed. Then calculate Desired / Have x ml 60 mg / 100 mg x 20 ml = 12 ml. A client who had mitral valve replacement surgery receives a prescription for dextrose 5% in water with 0.5 grams of dobutamine in 250 ml 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.) - ANSWER 11.3 First calculate the number of mcg/kg/minute: 5 x 75 = 375 mcg/minute. Calculate the number of mcg/hour: 375 x 60 minutes = 22,500 mcg/hour. Next calculate the number of ml/hour needed to administer 22,500 mcg/hour: 500,000 mcg : 250 ml :: 22,500 mcg/ X ml 500,000X = 5,625,000 X = 11.25 (rounded to 11.3 ml/hour). A healthcare provider prescribes a continuous infusion of 0.9% sodium chloride with pancuronium (Pavulon) 25 mg/250 ml at a rate of 0.1 mg/kg/hr for a client with coronary artery bypass grafting. The client weighs 78 kg. 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 tenth. - ANSWER 78 First calculate the number of mg the client will receive in 1 hour: 0.1 mg x 78 kg = 7.8 mg/hour. Next calculate the number of ml containing 7.8 mg of medication: 25 mg : 250 ml :: 7.8 mg : X 25 mg/ 7.8 mg :: 250 ml/X 25X = 1950 X = 78 ml/hour. 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.) - ANSWER 100 Calculate: 50 ml : 30 minutes :: X ml : 60 minutes 50/X :: 30/60 3000 = 15X X = 100 ml The healthcare provider prescribes an IV infusion of 0.9% sodium chloride with 40 mEq KCl/500 ml to infuse over 3 hours for a client with hypokalemia. 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.) - ANSWER 167 To determine ml/hour: 500 ml : 3 hours :: as X ml : 1 hour 500/X :: 3/1 500 = 3X X = 166.66 (rounds to)= 167 ml/hour. The healthcare provider prescribes a continuous infusion of 5% dextrose in 0.45% sodium chloride at 85 ml/hour. The IV administration set delivers 10 gtt/ml. The nurse should regulate the drop rate to deliver how many gtts/minute? (Enter numeric value only. If rounding is required, round to the nearest whole number.) - ANSWER 14 Volume/Time (minutes) x drop factor (gtt/ml) = 85 ml/ 60 minutes x 10 gtt/ml = 14.16 = 14 gtt/minute The patient has an order for 100ml of NS to infuse in 30 minutes. The gtt factor is 15. How many gtt/min will the patient receive? - ANSWER 50gtt/min The patient is to receive 3000ml of D5W at 125 ml/hr. The gtt factor is 60. At how many gtts/min will you regulate the IV? - ANSWER 125gtt/min The physician has ordered 1500 ml of LR to infuse in 12 hours. The gtt factor is 15. Calculate the flow rate to deliver the volume in the prescribed time frame? - ANSWER 31gtt/min The physician has ordered Timentin 3.1gm to be administered. Timentin is diluted in 100 ml of NS and is to be administered over 45 minutes. Available is buretrol. At what rate will you regulate the IV? - ANSWER 133gtt/min The doctor has ordered ml to infuse over 4 hours. The gtt factor is 20. At what rate will you regulate the IV. - ANSWER 42gtt/min The patient is to receive 2000 ml over 12 ours. Using a microdrip, at what rate will you regulate the IV - ANSWER 167gtt/min The patient is to receive Ancef 1 gram in 50ml over 30 minutes. The IV tubing states 10 gtts/ml. At how many gtts/min will you administer the Ancef? - ANSWER 17gtt/min You are to administer 1000 ml of RL over 4 hours. An infusion pump is available. At what rate would you set the pump? - ANSWER 250 ml/hr The patient is to receive 3.375 gm of Zosyn IV. Zosyn is diluted in 100 ml of NS and is to be administered over 45 minutes. Using an infusion pump, at what rate would you regulate the IV? - ANSWER 133.3 ml/hr The physician has ordered 250 ml of D5W with 20 MEq KCL to infuse over 4 hours. The drop factor is 10. Using an infusion pump, at what rate will you regulate the IV? - ANSWER 62.5ml/hr The physician has ordered Zantac 50 mg. Zantac 50 mg is available in 50 ml bags of IVF's and is to infuse in 30 minutes. The drop factor on your tubing is 15 gtts/ml. At what rate will you set the Baxter pump? - ANSWER 100ml/hr An IV of 500 ml's is infusing at 100ml/hr... How long will it take the IV to infuse? - ANSWER 5 hrs The IV has 875 ml left. If the rate is 75ml/hr, how long will the infusion last? - ANSWER 11 hrs 40 minutes The IV has 575 ml left. The rate of infusion is 80ml/hr. How long will the IV last? - ANSWER 7hrs 11 minutes The patient has an order for 1500 ml of D5LR to infuse at 75ml/hr. How long will the the IVF's take to infuse? - ANSWER 20 hr At 0730 there is 675 ml left in your patient's IV bag. If the IV is infusing at 95 ml/hr. At what time will you need to hang a new bag of IVF's? - ANSWER 7 hrs 7 minutes It is 0900 and the physician ordered an IV of 2L NS to infuse at 125ml/hr. The gtt factor is 15. At what times will you need to hang the second bag of IVF's? - ANSWER 1700 An IV has 825 ml left in the bag at 1000. The IV is infusing at 120ml/hr. At what time will you need to hang a new bag of fluids? - ANSWER 6 hrs 53 minutes The patient has an IV 250 ml of D5W to infuse at 100 ml/hr. How many hours and minutes will it take to infuse the bag of fluid? - ANSWER 2hrs 30 minutes Your patient has an IV of D5W 250 ml with 20 MEq KCL to infuse at 5mEq/hour. How long will the IV last? - ANSWER 4hrs Zantac 50 mg is in 50 ml of NS and is to infuse over 30 minutes. The drop factor is 12 gtt/ml. Calculate the gtts/min. Using the information calculate4 the rate using a volumemetric pump. - ANSWER 20gtt/min 100ml/hr Zosyn 3.375gm is ordred IV qoh. The IVPB contains 50 ml of NS and is to infuse over 45 minutes. Using a microdrop calculate the rate of flow. Using the information calculate the rate of flow using an infusion pump. - ANSWER 67 gtt/min 66.7ml/hr Gentamycin 60 mg is to be diluted in 20 l using a buretrol. If the medication is to infuse over 45 minutes. What is the correct infusion rate? - ANSWER 27gtt/min You have an order for 250 ml of 0.9% NS IV. Calculate the flow rate in drops per minute. The drop factor is 10 drops per milliliter, and the infusion time is 2 hours. - ANSWER 21gtt/min The physician has ordered 500 ml of D5W to infuse over 2 hours. The drop factor is 15 drops per milliliter. Calculate the flow rate. - ANSWER 63gtt/min The physician ordered 250 ml to infuse over 4 hours. At what rate will you set an infusion pump? - ANSWER 62.5ml/hr You have a 250 ml bag of IVF infusion at 120 ml /hr. How many hours and minutes will this bag last? - ANSWER 2hrs 5 minutes The patient has an IV of 1000 ml of D5 1/2NS infusing at a rate of 115ml/hr. If the start time was 0700 when will the infusion be completed? - ANSWER 1542 Your patient has 1000 ml to be infused in 8 hours. The gtt factor is 15. At what rate will your set the IV? - ANSWER 31gtt/min Your patient has an order for 200 ml of NS to be infused in 1 hour. The gtt factor is 10. At what rate will you set regulate the IV? - ANSWER 33gtt/min The patient is to receive 50 mg of Zantac in 50 ml of Ns to infuse in 30 minutes. The administration set Delivers 15 gtts/ml. At what rate will you set the IV? - ANSWER 25gtt/min The patient is to receive 250 ml to be infused in 1 1/2 hour. Using a microdrip, at what rate will you set the IV? - ANSWER 167gtt/min An IV of 500 ml of D5W is infusing at 95 ml/hr. How many hours and minutes will it take the IV to infuse? - ANSWER 5hrs 16 minutes The IV has 250 ml left when you go into the patient's room at 0435. The rate is 65 ml/hr. At what time will you need to hang the new bag of IV fluid? - ANSWER 0826 You are to administer an IVPB- Zosyn 3.375 gm in 100 ml of IVF over 45 minutes. The drop factor is 10. At what rate will you set the infusion pump? - ANSWER 133.3 ml/hr The physician ordered 250 ml of NS with 20 MEq of KCI to infuse over 4 hours (.A). At what rate would you set the infusion pump? (B) How many mEq is the patient receiving per hour? - ANSWER A) 62.5 ml/hr B) 5mEq/hr The IV container has 575 ml left. The rate is 75 ml/hr. How many hours and minutes will it take the IV to infuse? - ANSWER 7 hrs 40 minutes You enter the patient's room at 0930 and find that there is 775 ml of fluid left in the IV container. If the IV is infusing at 125 ml/hr. When time will the next container need to be administered - ANSWER 1542 Client with an infusion pump has an order for 3,000 mL D5W over 24 hours 1) Think: pump is regulated in mL/hr 2) Set up in formula using Formula Method - ANSWER 3,000 mL/24 hr x= 125 mL/hr A client on an infusion pump is to receive an antibiotic in 50 mL of 0.9% NS over 30 minutes 1) Think: The pump infuses in mL/hr. Use dimensional analysis to determine mL/hr 2) Set up porblem - ANSWER 50 mL/30 min x= 1.667 = 1.667*60 min x= 100 min Calculate Flow Rate 1,800 mL of D5W in 24 hours by infusion pump - ANSWER 1,8000/24 x= 75 mL/hr. Calculate Flow Rate 2,000 mL in D5W in 24 hours by infusion pump - ANSWER 2,000/24 x= 83.3 mL/hr Calculate Flow Rate 100 mL 0.45% NS in 45 min by infusuin Remember: mL/time * 60 - ANSWER 100mL/45 min * 60 min 100 mL/45 x= 2.222 x= 2.222/60 x= 133 mL/hr Calculate Flow Rate 30 mL of antibiotic in 0.9% NS in 20 min by infusion pump Remember: mL/time * 60 - ANSWER 30 mL/20 min * 60 30 mL/20 min x= 1.5 * 60 x= 90 min Calculate flow rate Administer D5RL at 75 mL/hr. The drop factor is 10 gtt/mL Remember: mL/time * 60 - ANSWER 75 mL * 10 gtt/10 gtt/mL /60 min 75 mL* 10 gtt/mL x= 750 x=750/60 x= 12.5 Round up to 13 Calculate flow rate Administer 1,000 mL D5 0.33% NS in 6 hr. The drop factor is 15 gtt/mL Remember: mL/time * gtt/60 - ANSWER 1,000 mL/6 hr x= 166.67 166.67 * 15 gtt/mL x= 2,500.05 2,500.05/60 min x=41.6675 Round up to 42 gtt/mL Calculate flow rate An IV mediation in 60 mL of 0.09% NS is to be administered in 45 minutes. The drop factor is a microgram Remember: mL * gtt/time - ANSWER 60 mL * 60 gtts/45 min x= 3,600 3,600/45 minutes x= 80 Calculate flow rate 1,000 mL of Ringer lactate solution (RL) to infuse in 16 hr. The drop rate factor is 15 gtt/mL Remember: mL/time * gtt/60 - ANSWER 1,000 mL/16 hr x= 62.5 round to 63 mL/hr 63 mL * 15 gtt/mL x= 945 945/60 x= 15.75 round up to 16 gtt/mL Calculate flow rate Infuse 150 mL of D5W in 2 hr. The drop rate is 20 gtt/mL Remember: mL/time * gtt/60 - ANSWER 150 mL/2 hr x= 75 75 * 20 x= 1,500 1,500/60 x= 25 gtt/hr Calculate flow rate for gtt/min An IV medication in 60 mL D5W is to be administered in 30 minutes. The drop factor is a microdrop Remember: mL * gtt/time - ANSWER 60 mL * 60 x= 3,600 3,600/30 x= 120 Calculate the Drop Factor constant 20 gtt/ml Remember: 60/gtt - ANSWER 60/20 gtt/ml x= 3 Calculate the Drop Factor constant 10 gtt/ml Remember: 60/gtt - ANSWER 60 min/10 gtt/ml x= 6 Calculate the rate in gtt/min using the shortcut method Order: D5W 200 mL/hr Drop factor: 10 gtt Remember: 60/gtt * mL/constant - ANSWER 60 min/10 gtt/mL x= 6 200/6 x=33.333 round to 34 Calculate the rate in gtt/min using the shortcut method Order: RL 50 mL/hr Drop factor: 15 gtt Remember: 60/gtt * mL/constant - ANSWER 60 min/ 15 gtt x= 4 50/4 x= 12.5 round up to 13 gtt Calculate The rate flow in gtt/min Order: Dextrose 5% with ringer lactate solution (D5RL) with 20 units pictcoin for 2 L at 125 mL/hr. Drop factor: 15 gtt/mL Remember: x gtt/min = mL * mL/60 - ANSWER x gtt/min= 125 mL/hr * 15 gtt/mL x= 1,875 1,875/60 x= 31.25 round down 31 gtt/hr Calculate order to infuse Order: Ti infuse in 16 hr. Drop factor: 10 gtt/mL D5w 500 mL with 10 mEq KCL D5W 1,000 mL D5W 1,000 mL with 1 ampule MVI (multivitamin) Remember: total mL * gtt; time * 60; divide - ANSWER 2,500 mL * 10 gtt/ 16 * 60 x= 25,000 x= 960 25,000/960 x= 26.04 round down 26 gtts Calculate The rate flow in gtt/min Order: 1,000 mL D5 0.9% NS for 3L at 100 mL/hr. Drop factor: microdrop Remember: Look for the mL attached to time mL * gtt/60 - ANSWER 100 mL * 60 x= 6,000 6,000/60 x= 100 gtt/min Calculate The rate flow in gtt/min Order: D5W 1,000 mL + 20 mEq KCL for 2L to infuse in 10 hr. Drop factor: 15 gtt/mL Remember: x gtt/min= ml * gtt/60 - ANSWER Convert 2L 2,000 mL/10 x= 200 200 * 15 x= 3,000 3,000/60 x= 50 Calculate the rate in gtt/min for meds being administered IVPB Order: Ampicillin 1 g is added to 50 mL D5W to infuse over 45 minutes. Drop factor: 10 gtt/mL. For IV reconstitute 10 mL of diluent to get 1 g per 10 mL Remember: TOTAL mL * gtt/time given - ANSWER 60 mL * 10 x= 600 600/45 x= 13 gtt/min Solve for the unknown You find that there is 150 mL of D5W left in an IV. The IV is infusing at 60 macrograms/min. How many hours will the fluid last? Remember: x gtt/min= mL * DF/time - ANSWER 60= 150 * 60 x= 9,000 9,000/60 x= 150 = 2 hours 30 min A client who weighs 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.) - ANSWER 100 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. 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.) - ANSWER 95 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 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.) - ANSWER 2 Use ratio and proportion, 4 mg : X ml = 2 mg : 1 ml 2X = 4 X = 2 The nurse is preparing to administer Hepatitis B Vaccine, Recombinant (Energix-B) 5 mcg IM to a school-aged child. The vaccine is labeled, 10 mcg/ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth). - ANSWER 1 or 0.5 Use ratio and proportion, 5 mcg : X ml :: 10 mcg : 1ml 10X = 5 X = 0.5 ml A client's daily PO prescription for aripiprazole (Abilify) is increased from 15 mg to 30 mg. The medication is available in 15 mg tablets, and the client already received one tablet today. How many additional tablets should the nurse administer so the client receives the total newly prescribed dose for the day? (Enter numeric value only.) - ANSWER 1 30 mg (total dose) - 15 mg (dose already administered) = 15 mg that still needs to be administered. Using the Desired/Have formula: 15 mg/15 mg = 1 tablet At the end of the shift, the nurse is recording the fluid balance for a client receiving a continuous gastrostomy tube (GT) feeding. Based on the client's records, how many ml should the nurse record for the total fluid balance (intake - output) for the shift that started at 0700 and ended at 1900? (Enter numeric value only.) (Click on each image asset for additional information.) - ANSWER 695 The tube feeding is administered at 75 ml/hour for 11 hours () and then turned off for one hour because the residual is greater than 200 ml. 11 hours x 75 ml/hr = 825 ml. Three doses of 20 ml of medication are administered, with 10 ml of water used to flush the GT before and after each dose. 20 ml x 3 doses = 60 ml; 10 ml (flush) x 2 x 3 doses = 60 ml; so 825 ml + 60 ml + 60 ml = 945 ml. 250 ml of residual is removed and not replaced. 945 ml - 250 ml = 695 ml total fluid balance (Intake - output). The nurse is administering a 250 milliliter (ml) intravenous solution to be infused over 2 hours. How many ml/hour should the nurse program the infusion pump? (Enter numeric value only.) - ANSWER 125 250 ml : 2 hours = X ml : 1 hour 250 = 2X X = 250 divided by 2 = 125 ml/hr The nurse is preparing to administer 0.25 mg of bumetanide (Bumex) 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.) - ANSWER 1 Using the Desired/Have x Volume formula: Desired = 0.25 mg Have = 1 mg Volume = 4 ml 0.25 mg/1 mg x 4 ml = 1 ml 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 numeric value only.) - ANSWER 3 Using the formula D/H x Q, 120/200 x 5 = 3 ml A 180-pound adult male 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 numeric value only. If rounding is required, round to the nearest whole number.) - ANSWER 19632 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 burn. Convert 180 pounds to kg = 180 / 2.2 = 81.8 kg 4 ml x 81.8 kg x 60 = 19632 ml over the first 24 hours. 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 numeric value only.) - ANSWER 140 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 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 numeric value only. If rounding is required, round to the nearest whole number.) - ANSWER 120 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 : X X= 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. 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? - ANSWER 2 Calculate each drug component dose, using the formula, D/H 125 mg / 62.5 mg (atovaquone) = 2 combined with 50 mg / 25 mg (proguanil) = 2. The child should receive 2 tablets. 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 in a 50 ml bag of normal saline over 30 minutes. The nurse should program the infusion pump to deliver how many ml/hour? (Enter numeric value only. - ANSWER 110 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 client with a gastrostomy tube (GT) receives a prescription for Osmolite® 1/2 strength enteral formula at 80 ml/hour. To prepare a 4 hour solution, the nurse should dilute the full-strength formula with how many ml of water? (Enter numeric value only.) - ANSWER 160 Determine the total volume needed at 80 ml/hour x 4 hours = 320 ml. Use the formula, Desired strength/strength on Hand x Volume = 50/100 x 320 = 160 ml of Osmolite® enteral formula, which must be diluted to half strength. Or use ratio and proportion, Desired strength (1/2 = 1 part : 2 parts) :: Volume of full strength : Total Desire volume 1 : 2 :: X : 320 ml 2X = 320, and X = 160 ml of Osmolite® enteral formula, full strength 320 ml total volume - 160 ml of full-strength formula = 160 ml of water to create 1/2 strength or 50% concentration. The nurse notes that a client is receiving an oxytocin (Pitocin) infusion via a pump that is programmed to deliver 30 ml/hour. The available solution is Ringer's Lactated 1,000 ml with Pitocin 20 units. How many milliunits/minute is the client receiving? (Enter numeric value only.) - ANSWER 10 Convert units to milliunits, 20 x 1,000 = 20,000 units. Using D/H x Q = 30 ml/hour X/20,000 units x 1,000 ml = 30 ml/hour (60 minutes) X/20 =30/60, reduce X/2 = 1/2, and 2X = 20, so X = 10 milliunits/minute OR 20/1,000 = 0.02 1000 : 0.02 :: 30 : X = 0.6 :: 1,000X X = 600 and 600/60 = 10 milliunits/minute. A client is receiving Heparin Sodium 25,000 Units in 5% Dextrose Injection 500 ml IV 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 pump to deliver how many ml/hour? (Enter numeric value only.) - ANSWER 18 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 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.) - ANSWER 3 Using 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. Docusate sodium (Colace) 0.3 grams is prescribed for a client who has frequent constipation. Each capsule contains 100 mg. How many capsules should the nurse administer? - ANSWER 3 Using the known equivalent, 1 gram = 1000 mg, the nurse should first convert the dose to the same unit of measurement, which is 0.3 gram = 300 milligram. Using the formula, Desired / Available x 1 capsule = 300/100 x 1 = 3 capsules. A client who has a sinus infection is receiving a prescription for amoxicillin/clavulanate potassium (Augmentin) 500 mg PO q8 hours. The available form is 250 mg amoxicillin/125mg clavulanate tablets. How many tablets should the nurse administer for each dose? (Enter numeric value only.) - ANSWER 2 Using Desired/Available formula: 500 mg/250 mg x 1 tablet = 2 The healthcare provider prescribes acetaminophen elixir (Tylenol elixir) 600 mg PO q6 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.) - ANSWER 18 Using the formula D/H x Q: 600 mg/500mg x 15 ml = 18 ml A client who has AIDS is receiving octreotide (Sandostatin) 1,200 mcg by subcutaneous injection every day for symptoms of diarrhea. Octreotide is available for injection in 1 mg/ml vials. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.) - ANSWER 1 or 1.2 First, to convert micrograms to milligrams, divide the number of micrograms by 1000: 1,200/1000 = 1.2 mg. Using the Desired/Have available formula: 1.2 mg/1 mg x 1 ml = 1.2 ml. 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 48.5 kg. What is the maximum safe dose the nurse should administer? (Enter numeric value only. If rounding is required, round to the nearest whole number.) - ANSWER 97 Determine the maximum number of mg this client should receive in a day: 48.5 kg x 8 mg/kg/day = 388 mg/day. Next determine how many mg the nurse should deliver each dose: 388 mg/4 doses = 97 mg. A child with a urinary tract infection is receiving Cephalexin (Keflex) 100 mg suspension PO QID. Keflex oral suspension is labeled 125 mg in 5 ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.) - ANSWER 4 Using the formula Desired/Have available x Quantity: 100/125 x 5 = 500/125 = 4 ml The healthcare provider prescribes a continuous intravenous infusion of dextrose 5% and 0.45% sodium chloride with KCl 20 mEq/1000 ml to be delivered over 8 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.) - ANSWER 125 Using the formula volume/time: 1000 ml/8 hours = 125 ml/hour A client receives a prescription for an intravenous infusion 0.45% sodium chloride 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.) - ANSWER 83 Solve for the unknown There is 90 mL of D5 0.33% NS left in an IV that is infusing at 60 macrograms/min. The drop factor is 60 gtt/mL. How many hours will the fluid last? Remember: x gtt/min= mL * DF/time - ANSWER 60= 90 mL * 60 x= 5,400 5,400/60 x= 90 = 1 hour 30 minutes Solve for the unknown 0.9% NS is infusing at 35 macrograms/min. The drop factor is 15 gtt/mL. How many millitiers of fluid will the client receive? Remember: x gtt/min= mL * DF/time - ANSWER 35= 15 * x/60 * 5 35/1 = 15x/ 300 35 * 300 x= 10,500 10,500/15x x= 700 mL Solve for the unknown 180 mL of D5 RL is left in the Iv that is infusing at 45 macrogtt/min. The drop factor is 15 gtt/mL. How many hours will the fluid last? Remember: x gtt/min= mL * DF/time - ANSWER 45 = 180 mL * 15 gtt/x 45 = 27,00/x 27,00/45x x= 60 = 1 hour Recalculate the IV flow rates in gtt/min rates 500 mL of 0.9% NS was ordered to infuse in 8 hrs at the rate of 16 gtt/min. The drop factor is 15 gtt/mL. After 5 hrs you find 250 mL of fluid left. Remember: New mL * New 15 gtt/gtt difference * 60 old gtt - new gtt = answer/ old gtt = answer * 100 - ANSWER 250 mL * 15 gtt/3 * 60 3,750/18 x= 20.8 or 21 gtt 16 gtt - 21 gtt = -5/16 0.312 * 100 x= 31% Recalculate the IV flow rates in gtt/min rates 250 mL of D5W was to infuse in 3 hrs at a rate of 21 gtt/min. Drop factor: 15 gtt/mL. With 1 1/2 hr remaining, you find 200 mL left. Remember: New mL * New 15 gtt/gtt difference * 60 old gtt - new gtt = answer/ old gtt = answer * 100 - ANSWER 200 mL * 15/ 1.5 * 60 3,000/ 90 x= 33.33 or 33 gtt/min 33 gtt - 21 gtt 12/21 0.5714 * 100 x= 5714 or 57 % Determine infusion time An IV of 500 mL NS is to infuse at 60 mL/hr Remember: ordered mL/remaining mL - ANSWER 500 mL/60 mL x= 8.33 .33 * 60 x= 19.8 round up to 20 infusion time = 8 hr 20 min a nurse is caring for a client who has a prescription for meperidine (Demerol) 50 mg PO every 3 hr PRN for moderate pain, & meperidine 75 mg PO every 3 hr PRN for severe pain. at 1200, the client reports back pain rated as 8 on a pain scale of 0-10. the client received 75 mg PO at 0700 & 50 mg PO at 1000. what action should the nurse take? - ANSWER administer meperidine 75 mg PO now (it's been 5 hrs since the previous dose so this is the appropriate action) a nurse is reviewing a client's prescriptions. the nurse should contact the provider to clarify what prescription? - ANSWER Morphine 2.5 mg IV bolus PRN for incisional pain (prescription contains name of med, dosage, route, circumstance of administration, but no frequency ... therefore needs clarification) a nurse is preparing to administer a medication subcutaneously. what should the nurse use? - ANSWER 5/8-inch, 25 gauge needle a nurse is transcribing medication prescriptions for a group of clients. what is an example of the appropriate way for the nurse to record medications that require the use of a decimal point? - ANSWER 0.6 mL a nurse is transcribing a provider's prescription for a client. the prescription reads morphine 2mg IV bolus at 1400. the nurse recognizes this as which of the following types of medication orders? - ANSWER single order The pharmacist has an order for heparin 25,000 units in 250 ml D5W to infuse at 1,000 units/hour. How many hours will take to infuse the entire bag? - ANSWER 25 hours A nurse is hanging a 4% lidocaine drip for a patient. If the dose ordered is 6 mg/min, how many hours will a 250 ml bag last? Round to nearest tenth - ANSWER 27.8 hours A patient is to receive Keppra at a rate of 5 mg/min. The pharmacy has a 5 ml Keppra vial (100 mg/ml) which will be diluted in 100 ml of NS. What is the Keppra infusion rate, in ml/min? Do not include the volume of the 5 ml additive. - ANSWER 1 ml/min A patient is to receive 600,000 units of penicillin G potassium in 100 ml D5W. A vial of penicillin G potassium 1,000,000 units is available. The manufacturer states that when 4.6 ml of diluent is added, a 200,000 units/ml solution will result. How many milliliters of reconstituted solution should be withdrawn and added to the bag of D5W? - ANSWER 3 ml A patient is to receive Flagyl at a rate of 12.5 mg/min. The pharmacy has a 5 ml (100 mg/ml) Flagyl injection vial to be diluted in 100 ml of NS. How much drug in milligrams will the patient receive over 20 minutes? - ANSWER 250 mg A physician has ordered 2 grams of cefotetan to be added to 100 ml NS for a 56 year old female with an anaerobic infection. Using a reconstituted injection containing 154 mg/ml, how many milliliters should be added to prepare the order? Round to nearest whole number - ANSWER 13 ml JY is a 58 year old male hospitalized for a total knee replacement. He was given unfractionated heparin and developed heparin-induced thrombocytopenia (HIT). Argatroban was ordered at a dose of 2 mcg/kg/min. The pharmacy mixes a concentration of 100 mg argatroban in 250 ml of D5W. JY weighs 187 lbs. At what rate (ml/hour) should the nurse infuse argatroban to provide the desired dose? Round to nearest whole number - ANSWER 26 ml/hr A 165 pound patient is to receive 250 ml of a dopamine drip at a rate of 17 mcg/kg/min. The pharmacy has dopamine premixed in a concentration of 3.2 mg/ml in D5W. Calculate the infusion rate in ml/minute. Round to the nearest tenth. - ANSWER 0.4 ml/min An order is written for phenytoin IV. A loading dose of 15 mg/kg is to be infused at 0.5 mg/kg is to be infused at 0.5 mg/kg/min for a 33 pound child. The pharmacy has phenytoin injection solution 50 mg/ml in a 5 ml vial in stock. The pharmacist will put the dose into 50 ml NS. Over how many minutes should the dose be administered? Round to nearest whole number. - ANSWER 30 minutes A physician orders an IV infusion of D5W 1 liter to be delivered over 8 hours. The IV infusion set delivers 15 drops/ml. How many drops/min will the patient receive? Round to nearest whole number. - ANSWER 31 drops/min A physician orders 15 units of regular insulin to be added to a liter of D5W to be given over 10 hours. What is the infusion rate, in drops/minute, if the IV set delivers 15 drops/ml? Do not include the insulin volume in calculation. - ANSWER 25 drops/min The pharmacy has insulin vials containing 100 units of insulin/ml. A physician orders 15 units of regular insulin to be added to a liter of D5W to be given over 10 hours. How many units of insulin will the patient receive each hour if the IV set delivers 15 drops/ml? Do not round the answer. - ANSWER 1.5 units/hr An order is written for 10 ml of a 10% calcium chloride injection and 10 ml of multivitamin injection (MVI) to be added to 500 ml of D5W. The infusion is to be administered over 6 hours. The IV set delivers 15 drops/ml. What should the rate of flow in drops/minute to deliver this infusion? Round to nearest whole number. - ANSWER 22 drops/min RS is a 45 year old male, 5'5", 168 pounds, hospitalized with diabetic foot infection. The pharmacist prepared a 500 ml bag of D5W containing 1 gram of vancomycin to be infused over 4 hours using a 20 gets/ml IV tubing set. How many mg of vancomycin will the patient receive each minute? Round to nearest tenth. - ANSWER 4.2 mcg/min A patient is to receive 1.5 liters of NS running at 45 gets/min using a 15 gtts/ml IV tubing set. Calculate the total infusion time in hours. Round to nearest tenth. - ANSWER 8.3 hours The 8 a.m. medications scheduled for a patient include Tygacil dosed at 6 mg/kg. The patient weighs 142 pounds. The nurse has Tygacil labeled 500 mg/50 ml NS. The dose will be administered over thirty minutes. The IV tubing in the unit delivers 15 drops per milliliter. What is the correct rate of flow in drops per minute? Round to nearest drop. - ANSWER 19 drops/min A patient is taking 3 calcium citrate tablets daily (one table, TID). Each weighs 1,500 mg total (non-elemental) weight. She wishes to trade her calcium tablets for the carbonate form. If she is going to use 1,250 mg carbonate tablets (by weight), how many tablets will she need to take to provide the same total daily dose? - ANSWER 2 tablets A physician writes an order for aminophylline 500 mg IV, dosed at 0.5 mg per kg per hour for a female patient (185 pounds, 5'1"). There is only theophylline in stock. How many milligrams (mg) of theophylline will the patient receive per hour? Round to nearest whole number. - ANSWER 19 mg/hr A pharmacist adds 250 mg of drug A to 500 ml of 0.9% Sodium Chloride. If the solution is administered at 1.6 ml/min, how many milligrams of drug A will the patient receive in 1 hour? (Round to nearest WHOLE number) - ANSWER 48 mg A 51-year-old male (height 5'9" and weight 175 lbs) is hospitalized after a motor vehicle accident. He develops a Pseudomonas aeruginosa infection. The physician orders tobramycin 1.5 mg/kg IV Q8H. Calculate the tobramycin dose that will be given every 8 hours. Use the patient's IBW. (Round to nearest TEN milligrams) - ANSWER 110 mg How many 0.000065 g doses can be prepared from 0.130 g of drug? - ANSWER 2000 doses A RPh fills 3 compounded Rxs using the following quantities of hydromorphone HCl: 1/8 oz., ¼ oz, 1-1/2 oz. How many ounces of drug remain in the original container of 3 oz of drug from which she withdrew the 3 amounts of drug? - ANSWER 9/8 oz. or 1.125 oz. A RPh had 5 g codeine phosphate which she used in filling 3 Rxs for capsules as follows: viii caps each containing 0.0325 g; xii caps each containing 0.015 g; xviii caps each containing 0.008 g. How much codeine phosphate remained in the RPh's inventory? - ANSWER 4.416 g 26 patients out of 2105 patients enrolled in a clinical research protocol reported a headache after 1 dose of the investigational drug. What % of patients reported this adverse event? - ANSWER 1.24% An insulin product contains 100 u/mL. How many mL should be injected to provide 40 u? - ANSWER 0.4 mL Lanoxin brand of digoxin pediatric elixir contains 0.05 mg dig/mL. If the Rx calls for 0.6 mL po, how many mg of digoxin is the patient receiving per dose? - ANSWER 0.03 mg A cough syrup contains 10 mg dextromethorphan HBr per tsp. How many mg of the drug are contained in a 4 . container? - ANSWER If use 5 mL, then 236.8 mg If use 4.92 mL, then 240.65 mg An IV solution is adjusted to deliver 15 mg drug per hr. How many mg of the drug is the patient receiving per minute? - ANSWER 0.25 mg/min Filgrastim (Neupogen®), a biotech drug, is available in vials labeled 480 μg/0.8 mL. If a patient receives an injection of 0.5mL, what dose (in μg) did the patient receive? - ANSWER 300 mcg A compounding operation calls for 50 tabs of 0.025 mg potency. The pharmacist only has 0.1 mg strength tablets in stock. How many 0.1 mg tabs must be used to provide the amount of active ingredient needed to compound this Rx? - ANSWER 12.5 tablets An MDI contains 225 mg metaproterenol sulfate which is sufficient for 300 inhalations. What dose does the patient receive with each inhalation? - ANSWER 0.75 mg/inhalation A pediatric vitamin contains 1500 units Vitamin A/mL. An Rx for a child specifies 2 gtts. daily. If the dropper delivers 20 drops per mL, what dose of Vitamin A is the child receiving? - ANSWER 150 units What does the abbreviation "gtts" mean? - ANSWER drops A 5 g packet of KCl granules provides 20 mEq of K ion. How many g would provide 6 mEq potassium ion? - ANSWER 1.5 g A PK study reveals that Cp values for ciprofloxacin exhibit dose proportionality. If a 250 mg single dose of ciprofloxacin results in a Cp of 1.2 μg/mL, what Cp would result from a 500 mg dose of the antibiotic? - ANSWER 2.4 mcg/mL 0.5 mL mumps virus vaccine contains 5000u. How many units are present in each mL once 0.5 mL of the vaccine is diluted 2 mL with SWFI? - ANSWER 2500 u/mL If Acetaminophen in doses greater than 4 g/day is assumed to cause liver toxicity, what is the maximum number of 500 mg tablets a patient may "safely" take per day? - ANSWER 8 tablets/day An Albuterol inhaler contains 20 mg. How many inhalation-doses can be delivered if each contains 90 mcg. - ANSWER 222 doses Adalimumab (a biotech drug) is available as a "prefilled syringe," containing 40 mg/0.8 mL. Calculate the concentration on a mg/mL basis. - ANSWER 50 mg/mL Digoxin is available for parenteral pediatric use in a concentration of 0.1 mg/mL. How would you obtain a dose of 40 μg? - ANSWER 0.4 mL An IV solution containing 123 mg drug in each 250 mL bag is to be infused at a rate of 200 mcg/min. How many mL should be administered per hr? - ANSWER 24.4 mL/hr An estradiol transdermal system is a round patch with a diameter of 4.3 cm. Express this in mm. - ANSWER 43 mm 1 pound (lb) is equal to how many grams? - ANSWER 454 g 1 kg is equal to how many pounds? - ANSWER 2.2 lbs The starting dose of chlorambucil is 150 mcg/kg. How many mg should be administered to a frail 85 yo female who weighs 154 lb? - ANSWER 10.5 mg If a cough syrup contains 0.09 g dextromethorphan HBr per ., how many mg of this synthetic cough suppressant would the patient receive in a 1 tsp. dose? In a 1 tbsp. dose? - ANSWER 15.2 mg 2 mg An IV bolus injection contains 125 mg/25 mL. Express this as μg/μL. - ANSWER 5 mcg/mcL Prochlorperazine (Compazine®) injection comes as 10 mL MDVs., 5 mg/mL. How many 2 mg doses can be withdrawn from a single vial? What is the volume of each dose? - ANSWER 25 doses Each dose is 0.4 mL. An IV solution contains 123 mg of drug in each 250 ml bag. It is infused at a rate of 200 mcg/min. How many mL would be administered in 1 hr? - ANSWER 24.39 mL The order is for 200 mg. The label reads 250mg /5ml. You would give ____ml(s). - ANSWER 4ml The order is for 60 ml. You would give ____tablespoon(s). - ANSWER 4 TB The order is for 60mg. The label reads 60 mg/2 ml. You would give ___ml. - ANSWER 2ml The order is for 1000 ml. of I.V. solution to be infused at 125 ml/hr. You would infuse the solution for ___hours. - ANSWER 8hr The order is for 6000 ml of IV solution to run over a 24 hour period. The drop factor of the I.V tubing is 10 gtts/ml. You would infuse _____gtts/min. - ANSWER 42gtt/min Your patient weighs 75 kg and you are ordered to infuse 250 mg dobutamine in 500 ml NS at 10 mcg/kg/min. How many MILLIGRAMS of dobutamine will infuse per hour? - ANSWER 45mg/hr The order is 500 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. How much will the patient receive per day? Is this within the normal range? - ANSWER minimum = 525mg maximum = 1050mg The doctor prescribed 500 x3= 1500mg per day; this is not within the safe range The order is Solumedrol 3mg/kg for a child weighing 20kg. Solumedrol is available as 125 mg / 2 ml. How many ml must the nurse administer? - ANSWER 0.96ml The order : KayCiel 30 mEq PO Bid pc. Available: Kay Ciel 45 mEq/15 ml. How many ml of KayCiel should you administer? - ANSWER 10ml The order is for 25 mg. The label reads 75mg/ml. How many ml(s) would you give? - ANSWER 0.33ml The order is for 400mcg of thyroxin. The label reads 0.2 mg tablets. How many tablets would you give? - ANSWER 2 tablets The order is Penicillin G 1.2 million units IM daily. Available: Penicillin G 9 million units/1 ml. How many ml will you give? - ANSWER 0.13ml A client with cardiogenic shock weighs 220 lb and is receiving dopamine at the rate of 3 mcg/kg/minute. The solution strength available is dopamine 400 mg in 250 ml of D5W. 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.) - ANSWER 11.3 First, convert pounds to kg, 220 lb : X = 2.2 lb : 1 kg = 100 kg. Next, calculate the dosage per minute, 3 mcg/kg/min x 100 kg = 300 mcg/min. Convert mcg/min to mcg/hour, 300 mcg/min x 60 min=18,000 mcg/hour. Convert mcg/hr to mg/hour, 18,000 mcg/hr = 18.0 mg/hour. Calculate the rate, 400 mg : 250 ml = 18 mg : X ml 400X = 4500 X = 11.25 = 11.3 ml. So, 18 mg/11.3 ml should be infused at 11.3 ml/hour. A client with hypertension who weighs 72.4 kg is receiving an infusion of nitroprusside (Nipride) 50 mg in D5W 250 ml 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.) - ANSWER 3.5 Calculate the mg/hour infusing, 50 mg : 250 ml = X : 75 ml 250X = 3750 and X = 15 mg/hour. Next, convert mg/hr to mcg/hour, 15 mg/hour = 1 mg / 1000 mcg = 15,000 mcg/hour, then divide by 60 min = 250 mcg/minute. Lastly, 250 mcg/72.4 kg/min = 3.45 = 3.5 mcg/kg/minute. A client who weig