Question 1

Which three variables must be considered when calculating the rate of infusion of a critical care medication?

Accepted Answer

1. volume to be administered
2. concentration of medication
Units of time over which the volume is to be infused

Question 2

What is calculated first when calculating the infusion rate of a critical care medication in solution on the basis of total dosage per hour?

Accepted Answer

Calculate the medication dose per milliliter of solution

Question 3

What is calculated second when calculating the infusion rate of a critical care medication in solution on the basis of total dosage per hour?

Accepted Answer

Calculate the number of milliliters per hour that delivers the ordered dose

Question 4

The healthcare provider prescribes 400 mcg of Precedex in 100 mL of normal saline (NS) to infuse at 18 mcg/hr. Based on this, the nurse should set the infusion pump for ________ mL/hr.

Accepted Answer

First, 400mcg / 100mL
Second, 18mcg/hr / 4 mcg/mL
Answer, 4.5 mL/hr

Question 5

The medication order is for Lidocaine 8 mg in 250 mL, to infuse at 10 mcg/min. Based on this, the nurse has to infuse at the rate of 
18.8
 mL/hr (rounded to the nearest tenth).

Accepted Answer

1. 8mg / 250 mL = 0.032mg/mL = 32 mcg
2. 10mcg/min / 32mcg/min = 0.312mL/min
3. To calculate per hour, multiply by 60minutes/hour
= 0.312mL/min x 60min/hr = 18.72
round to nearest tenth = 18.8 mL/hr

Question 6

Dose per kilogram of patients weight steps:

Accepted Answer

a. Calculate the concentration of critical care meds in 1mL of solution
b. Convert the pt's weight to kilograms
c. Calculate the concentration per minute by multiplying pt's weight by the dosage per kg per minute

Question 7

...continued

Accepted Answer

d. Divide the concentration per minute by the concentration of the solution
e. Convert milliliters per minute to milliliters per hour

Question 8

To see how these calculations work, consider this example. The prescriber orders 50 mg of nitroprusside in 500 mL D5W to be infused at 3 mcg/kg/min. The patient weighs 135 lb. Solution contains 50 mg/500 mL. How many milliliters per hour should you infuse

Accepted Answer

Step 1: 
Calculate the concentration of critical care medication in 1mL of solution. This requires the conversion factor 1 milligram = 1,000 micrograms
50mg/500mL = 50,000mcg/500mL = 100mcg/mL

Question 9

....continued

Accepted Answer

Step 2: 
Convert the pt's weight to kilograms, remember 2.2lbs = 1kg
135lb/2.2lb = 61.36kg or 61.4kg (rounded to nearest tenth)

Question 10

.....continued

Accepted Answer

Step 3: 
Calculate the concentration per minute
61.4kg x 3mcg/kg/min = 184.2mcg/min

Question 11

....continued

Accepted Answer

Step 4:
Divide the concentration per minute by the concentration of the solution
184.2mcg/min */. 100mcg/mL = 1.84mL/min

Question 12

.....continued

Accepted Answer

Step 5:
Convert milliliters per minute to milliliters per hour. This requires the converstion factor of 60 minutes = 1 hour
1.84mL/min x 60 min = 110.45mL/hr or 110.4 mL/hr

Question 13

Calculating mL per hour: A prescriber orders an IV infusion of 10,000 units of heparin in 500 mL of D5W to be administered at 20 mL/hr. How much heparin should the patient receive per hour?

Accepted Answer

10,000units/500mL x 20mL/1hr
10,000 units / 500 x 20 / 1
20,000 / 500
= 400 units/hr

Question 14

Calculating mL per hour: A prescriber orders an IV infusion of 25,000 units of heparin in 1,000 mL of D5W to be administered at 25 mL/hr. How much heparin should the patient receive per hour?

Accepted Answer

25,000 units / 1,000 mL x 25 mL / 1 hr
25,000 units / 1,000 x 25 / 1 hr
625,000 units / 1 hr
= 625 units/hr

Question 15

Calculating drops per minute from units per minute: The prescriber orders heparin 600 units/hr in a solution of 15,000 units in 250 mL of D5W. The administration set has a drop factor of 60 gtt/mL. How many drops per minute should you administer?

Accepted Answer

60gtt/1mL x 250mL/15,000units x 600units/60min
60gtt/1 x 250/15,000 x 600/60
250gtt/25min
=10gtt/min

Question 16

What is a bolus dose?

Accepted Answer

a dose of a medication or a contrast material, radioactive isotope, or other pharmaceutic preparation injected all at once intravenously.

Question 17

To determine heparin bolus and continuous infusion rates, follow these steps:

Accepted Answer

1. Calculate the patient’s weight in kilograms, if needed.
2. Calculate the heparin bolus dosage.
3. Calculate the rate for the continuous infusion.
4. Determine the flow rate (in milliliters per hour) to use with the infusion device.

Question 18

Define 'basis of titration'

Accepted Answer

refers to the infusion rate adjustments made on an electronic infusion pump, within set parameters, to achieve a desired patient response

Question 19

What are examples of titrated medications?

Accepted Answer

1. An insulin infusion that's altered in response to a pt's hourly BGL
2. A lidocaine infusion that's changed due to an increase or decrease in irregular hearbeats
3. A morphine infusion that's adjusted in response to reported pain levels

BSN 215 Week 8

Sherpath - calculating/determining infusion rates

Question	Answer
Which three variables must be considered when calculating the rate of infusion of a critical care medication?	1. volume to be administered 2. concentration of medication Units of time over which the volume is to be infused
What is calculated first when calculating the infusion rate of a critical care medication in solution on the basis of total dosage per hour?	Calculate the medication dose per milliliter of solution
What is calculated second when calculating the infusion rate of a critical care medication in solution on the basis of total dosage per hour?	Calculate the number of milliliters per hour that delivers the ordered dose
The healthcare provider prescribes 400 mcg of Precedex in 100 mL of normal saline (NS) to infuse at 18 mcg/hr. Based on this, the nurse should set the infusion pump for ________ mL/hr.	First, 400mcg / 100mL Second, 18mcg/hr / 4 mcg/mL Answer, 4.5 mL/hr
The medication order is for Lidocaine 8 mg in 250 mL, to infuse at 10 mcg/min. Based on this, the nurse has to infuse at the rate of 18.8 mL/hr (rounded to the nearest tenth).	1. 8mg / 250 mL = 0.032mg/mL = 32 mcg 2. 10mcg/min / 32mcg/min = 0.312mL/min 3. To calculate per hour, multiply by 60minutes/hour = 0.312mL/min x 60min/hr = 18.72 round to nearest tenth = 18.8 mL/hr
Dose per kilogram of patients weight steps:	a. Calculate the concentration of critical care meds in 1mL of solution b. Convert the pt's weight to kilograms c. Calculate the concentration per minute by multiplying pt's weight by the dosage per kg per minute
...continued	d. Divide the concentration per minute by the concentration of the solution e. Convert milliliters per minute to milliliters per hour
To see how these calculations work, consider this example. The prescriber orders 50 mg of nitroprusside in 500 mL D5W to be infused at 3 mcg/kg/min. The patient weighs 135 lb. Solution contains 50 mg/500 mL. How many milliliters per hour should you infuse	Step 1: Calculate the concentration of critical care medication in 1mL of solution. This requires the conversion factor 1 milligram = 1,000 micrograms 50mg/500mL = 50,000mcg/500mL = 100mcg/mL
....continued	Step 2: Convert the pt's weight to kilograms, remember 2.2lbs = 1kg 135lb/2.2lb = 61.36kg or 61.4kg (rounded to nearest tenth)
.....continued	Step 3: Calculate the concentration per minute 61.4kg x 3mcg/kg/min = 184.2mcg/min
....continued	Step 4: Divide the concentration per minute by the concentration of the solution 184.2mcg/min */. 100mcg/mL = 1.84mL/min
.....continued	Step 5: Convert milliliters per minute to milliliters per hour. This requires the converstion factor of 60 minutes = 1 hour 1.84mL/min x 60 min = 110.45mL/hr or 110.4 mL/hr
Calculating mL per hour: A prescriber orders an IV infusion of 10,000 units of heparin in 500 mL of D5W to be administered at 20 mL/hr. How much heparin should the patient receive per hour?	10,000units/500mL x 20mL/1hr 10,000 units / 500 x 20 / 1 20,000 / 500 = 400 units/hr
Calculating mL per hour: A prescriber orders an IV infusion of 25,000 units of heparin in 1,000 mL of D5W to be administered at 25 mL/hr. How much heparin should the patient receive per hour?	25,000 units / 1,000 mL x 25 mL / 1 hr 25,000 units / 1,000 x 25 / 1 hr 625,000 units / 1 hr = 625 units/hr
Calculating drops per minute from units per minute: The prescriber orders heparin 600 units/hr in a solution of 15,000 units in 250 mL of D5W. The administration set has a drop factor of 60 gtt/mL. How many drops per minute should you administer?	60gtt/1mL x 250mL/15,000units x 600units/60min 60gtt/1 x 250/15,000 x 600/60 250gtt/25min =10gtt/min
What is a bolus dose?	a dose of a medication or a contrast material, radioactive isotope, or other pharmaceutic preparation injected all at once intravenously.
To determine heparin bolus and continuous infusion rates, follow these steps:	1. Calculate the patient’s weight in kilograms, if needed. 2. Calculate the heparin bolus dosage. 3. Calculate the rate for the continuous infusion. 4. Determine the flow rate (in milliliters per hour) to use with the infusion device.
Define 'basis of titration'	refers to the infusion rate adjustments made on an electronic infusion pump, within set parameters, to achieve a desired patient response
What are examples of titrated medications?	1. An insulin infusion that's altered in response to a pt's hourly BGL 2. A lidocaine infusion that's changed due to an increase or decrease in irregular hearbeats 3. A morphine infusion that's adjusted in response to reported pain levels

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