Exam 17: Advanced Adult Intravenous Calculations

An ICU patient weighing 70 kg has an order for dobutamine 5 mcg/kg/min to be administered IV and regulated by infusion pump. The supply of dobutamine is 500 mg in 500 mL D5W. -Based on an order for 350 mcg/min or 0.35 mg/min, compute the volume of mL infused per minute.

Answer the following questions about his continuous IV. How many milliliters per day will he receive with his regular IV? $\quad$ $\underline{\quad\quad}$$\mathrm{mL} /$ day How many hours will his continuous IV flow per 24 hours? $\quad$ $\underline{\quad\quad}$ hours/day What will his regilar IV flow rate be in $\mathrm{mL}$ /hour? $\quad$ $\underline{\quad\quad}$$\mathrm{mL} / \mathrm{h}$

The following questions refer to your patient who is on IV heparin therapy according to the "Standard Weight Based Heparin Protocol" noted below. The patient weighs 144 pounds. On admission, the patient's APTT is 30 seconds. You initiate IV heparin therapy at 1130 on 06/06/XX. Record your answers in the spaces below unless provided with the "Standard Weight Based Heparin Protocol Worksheet" by your instructor. Standard Weipht Based Heparin Pratocal For all patients an heparin drips: 1. Weight in kalograms. Reqquired far arder to be proces5ed: $\underline{\quad\quad}$ kg 2. Heparin 25,000 units in 250 mL of $1 / 2$ NS. Boluses to be piven as 1000 unitshmL. 3. APTT q. fh or 6 hours after rate change; q. d. after two consecutive therapeutic APTT's. 4. CBC initally and repeat every $\underline{\quad\quad}$ day(5). 5. Obtain APTT' and PT/NR on day one prior to initiation of therapy. 6. Guaiac stadi initially, then every $\underline{\quad\quad}$ day(s) until heparin diecontinued. Natify if positive. 7. Neura checks every hours while an heparin. Natify physician of any changes. 8. D/C APTT and CBC ance heparin drip is diecontinued unless atherwrise ardered. 9. Natify physician of any bleeding prablems. 10. Bolus with 80 U/kg Start dip at 18 units/ $/ \mathrm { Kg } / \mathrm { h }$ . 11. If APTT' is $< 35$ secs: $\quad$ Rebolus writh 80 units/s and increase rate by 4 units/kg/h 12. If APTT' is 36-44 secs: $\quad$ Rebolus writh 4D units/se and increase rate by 2 units/kg/h 13. If APTT' is 45-75 secs: $\quad$ Continue curtent rate 14. If APTT is 76–90 secs: $\quad$ Decrease rate by 2 unitsh /kg/h 15. If APTT' is > 90 secs: $\quad$ Hold heparin far I hour and decrease rate by 3 units/kg/h -According to the protocol/sample order, how often should the patient's APPT be checked? q.__________h At 1730, the patient's APPT is 38 seconds. Rebolus with heparin $\quad$ $\underline{\quad\quad}$$\text { units }$$\quad$ $\quad$ ( $\underline{\quad\quad}$$\mathrm{mL}$ ) How much should you change the infusion rate? __________ increase or __________ decrease heparin __________ units/h and __________ ml/h. The new infusion rate will be heparin __________ mL/h.

An ICU patient weighing 70 kg has an order for dobutamine 5 mcg/kg/min to be administered IV and regulated by infusion pump. The supply of dobutamine is 500 mg in 500 mL D5W. -Compute the flow rate in ml/h. Flow rate __________ mL/h

Order: 500 mL D5W with heparin 5000 units IV to infuse at 1000 units/h. The drop factor is 10 gtt/mL. Calculate the flow rate. Flow rate: __________ gtt/min

Compute the answers to the following questions based on this information. -Order: $\quad$ Pepcid $20 \mathrm{mg}$ added to $100 \mathrm{~mL} \mathrm{D}_{5} \mathrm{~W}$ IV in $30 \mathrm{~min} \mathrm{q} .12 \mathrm{~h}$ $\quad$$\quad$$\quad$$\quad$ An infusion pump will be used. Supply: $\quad$ Pepcid $10 \mathrm{mg} / \mathrm{mL}$ Compute the volume of Pepcid to be added to the 100 mL D₅W. Compute the flow rate. Pepcid: __________ mL Flow rate: __________ mL/h

At 0600 0n 06/07/XX, the patient's APPT is 50 seconds. What should you do now? When should the APPT be checked again? $\quad$ $\underline{\quad\quad}$ (hours) on $\quad$ $\underline{\quad\quad}$ (date)

Order: 1,000 mL D5W with heparin 20,000 units IV is to infuse at a rate of 750 units/h. The drop factor is 12 gtt/mL Calculate the flow rate. Flow rate: __________ gtt/min

Given:Complete the following advanced IV calculations. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient's age, condition, reaction, additional medications, and other factors. -One of your patients has an IV that is flowing at a rate of 10 gtt/min. The IV bag contains a solution of 500 mL NS with 20,000 units of heparin. The drop factor is 15 gtt/mL. How many units is the pataent receving per 24 hours? $\quad$ $\underline{\quad\quad}$ units/24h

Order: Lidocaine 2 g IV in 1,000 mL D5W to infuse at a rate of 3 mg/min by infusion pump. Calculate the flow rate. Flow rate: ___________ gtt/min

How many hours per day does his IV PB flow?

Given:Complete the following advanced IV calculations. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient's age, condition, reaction, additional medications, and other factors. -1,000 mL $\frac { 1 } { 2 }$ NS with 10,000 units heparin to infuse at 750 units/h $\text { The drop factor is } 12 \mathrm{gtt} / \mathrm{mL} \text {. }$ $\quad$$\quad$$\quad$ Flow rate:: $\quad$ $\underline{\quad\quad}$$\mathrm{gtt} / \mathrm{min}$

Compute the answers to the following questions based on this information. A critical care patient who weighs 80 kg has an order for 10 mcg/kg/min of dobutamine to be administered IV and regulated by an electronic pump. The supply of dobutamine is 500 mg in 250 mL of D₅W. -Compute the flow rate in mL/h. __________ mL/h

The following questions refer to your patient who is on IV heparin therapy according to the "Standard Weight Based Heparin Protocol" noted below. The patient weighs 144 pounds. On admission, the patient's APTT is 30 seconds. You initiate IV heparin therapy at 1130 on 06/06/XX. Record your answers in the spaces below unless provided with the "Standard Weight Based Heparin Protocol Worksheet" by your instructor. Standard Weipht Based Heparin Pratocal For all patients an heparin drips: 1. Weight in kalograms. Reqquired far arder to be proces5ed: $\underline{\quad\quad}$ kg 2. Heparin 25,000 units in 250 mL of $1 / 2$ NS. Boluses to be piven as 1000 unitshmL. 3. APTT q. fh or 6 hours after rate change; q. d. after two consecutive therapeutic APTT's. 4. CBC initally and repeat every $\underline{\quad\quad}$ day(5). 5. Obtain APTT' and PT/NR on day one prior to initiation of therapy. 6. Guaiac stadi initially, then every $\underline{\quad\quad}$ day(s) until heparin diecontinued. Natify if positive. 7. Neura checks every hours while an heparin. Natify physician of any changes. 8. D/C APTT and CBC ance heparin drip is diecontinued unless atherwrise ardered. 9. Natify physician of any bleeding prablems. 10. Bolus with 80 U/kg Start dip at 18 units/ $/ \mathrm { Kg } / \mathrm { h }$ . 11. If APTT' is $< 35$ secs: $\quad$ Rebolus writh 80 units/s and increase rate by 4 units/kg/h 12. If APTT' is 36-44 secs: $\quad$ Rebolus writh 4D units/se and increase rate by 2 units/kg/h 13. If APTT' is 45-75 secs: $\quad$ Continue curtent rate 14. If APTT is 76–90 secs: $\quad$ Decrease rate by 2 unitsh /kg/h 15. If APTT' is > 90 secs: $\quad$ Hold heparin far I hour and decrease rate by 3 units/kg/h -What is the patient's weight as measured in kilograms? (Round to the nearest 10 kg.) __________ kg What does the protocol/sample order indicate for the standard bolus dosage of heparin for this patient? __________ units/kg

The following questions refer to your patient who is on IV heparin therapy according to the "Standard Weight Based Heparin Protocol" noted below. The patient weighs 144 pounds. On admission, the patient's APTT is 30 seconds. You initiate IV heparin therapy at 1130 on 06/06/XX. Record your answers in the spaces below unless provided with the "Standard Weight Based Heparin Protocol Worksheet" by your instructor. Standard Weipht Based Heparin Pratocal For all patients an heparin drips: 1. Weight in kalograms. Reqquired far arder to be proces5ed: $\underline{\quad\quad}$ kg 2. Heparin 25,000 units in 250 mL of $1 / 2$ NS. Boluses to be piven as 1000 unitshmL. 3. APTT q. fh or 6 hours after rate change; q. d. after two consecutive therapeutic APTT's. 4. CBC initally and repeat every $\underline{\quad\quad}$ day(5). 5. Obtain APTT' and PT/NR on day one prior to initiation of therapy. 6. Guaiac stadi initially, then every $\underline{\quad\quad}$ day(s) until heparin diecontinued. Natify if positive. 7. Neura checks every hours while an heparin. Natify physician of any changes. 8. D/C APTT and CBC ance heparin drip is diecontinued unless atherwrise ardered. 9. Natify physician of any bleeding prablems. 10. Bolus with 80 U/kg Start dip at 18 units/ $/ \mathrm { Kg } / \mathrm { h }$ . 11. If APTT' is $< 35$ secs: $\quad$ Rebolus writh 80 units/s and increase rate by 4 units/kg/h 12. If APTT' is 36-44 secs: $\quad$ Rebolus writh 4D units/se and increase rate by 2 units/kg/h 13. If APTT' is 45-75 secs: $\quad$ Continue curtent rate 14. If APTT is 76–90 secs: $\quad$ Decrease rate by 2 unitsh /kg/h 15. If APTT' is > 90 secs: $\quad$ Hold heparin far I hour and decrease rate by 3 units/kg/h -Calculate the dosage of heparin that should be administered for the bolus for this patient. __________ units What does the protocol indicate as the required solution concentration (supply dosage) of heparin to use for the bolus? __________ units/mL Calculate the dose volume of heparin that should be administered for the bolus for this patient. __________ mL

An ICU patient weighing 70 kg has an order for dobutamine 5 mcg/kg/min to be administered IV and regulated by infusion pump. The supply of dobutamine is 500 mg in 500 mL D5W. -Compute the number of micrograms and the number of milligrams that the patient will receive. mcg/min __________ mg/min __________

Given:Complete the following advanced IV calculations. The problems and drug orders are presented for practice only, and actual prescribed dosages will vary according to a patient's age, condition, reaction, additional medications, and other factors. -1 L D₅W with 10,000 units heparin to infuse at 1000 units/h The drop factar is $20 \mathrm { gtt/mL }$ . $\quad$$\quad$$\quad$$\quad$ Flow rate:: $\quad$ $\underline{\quad\quad}$ gtt/min

Compute the answers to the following questions based on this information. A critical care patient who weighs 80 kg has an order for 10 mcg/kg/min of dobutamine to be administered IV and regulated by an electronic pump. The supply of dobutamine is 500 mg in 250 mL of D₅W. -Compute the number of micrograms and the number of milligrams per minute that the patient will receive. Hicroprans per minute: $\quad$ $\underline{\quad\quad}$$\quad$$\quad$$\quad$ milliprans per minute: $\quad$ $\underline{\quad\quad}$

Compute the answers to the following questions based on this information. A critical care patient who weighs 80 kg has an order for 10 mcg/kg/min of dobutamine to be administered IV and regulated by an electronic pump. The supply of dobutamine is 500 mg in 250 mL of D₅W. -Compute the volume of milliliters infused per minute. __________ mL/min

At 2345, the patient's APPT is 46 seconds. What should you do now?