Rx-Success

The order you have is: 1000mL D₅NS q 12 h

Steps:

The patient will receive a large or small bag of fluid?

a. large bag

Correct

b. small bag

Incorrect. 1000mL is a large bag of fluid.

The bag of fluid contains no electrolytes.

a. true

Incorrect. The NS in the order means normal saline. Saline has sodium and chloride in it.

b. false

Correct! NS means normal saline. Saline always contains sodium and chloride which are electrolytes.

The solution provides the patient with some calories.

a. true

Correct. The "D" in the order means "dextrose" which provides calories.

b. false

Incorrect. The "D" in the order means "dextrose" which provides calories.

The order you have is:
Vancomycin 500 mg in 150mL NS to run over 60 minutes via IVPB q8h

Steps:

The medication in 150 mL NS is considered the patient's main IV.

a. true

Incorrect. This medication is to be put in only 150mL of fluid and will only run for 1 hour. This is an intermittent IV, not a "main" IV.

b. false

Correct. The order clearly states this is an IV piggyback. This bag will only run for 1 hour so is not a "main" IV.

How much fluid is in the IV bag?

a. 500 mg

Incorrect. 500mg is the dry weight of the drug Vancomycin. mg is never a fluid measure. Do not confuse "mL" with "mg", which is easy to do since they look so much alike.

b. 150mL

Correct. The order asks for 150 mL of NS.

c. 60 mL

Incorrect. Re-read the problem carefully. There is not a 60 mL value in this order.

The fluid in the IVPB is a saline solution with 0.45% sodium chloride in it.

a. true

Incorrect. NS is a saline solution so will have sodium and chloride, but NS stands for normal saline; normal saline is a 0.9% solution. A 0.45% saline solution is half normal saline.

b. false

Correct. NS stands for normal saline which is 0.9% sodium and chloride. A 0.45% solution is half normal saline.

How long will it take for the 150mL of NS to flow into the patient?

a. 1 hour

Correct. The order instructs you to infuse the bag in 60 minutes, or 1 hour.

b. 8 hours

Incorrect. This is how often you will hang the bag of medication, but each bag will infuse over 60 minutes. Do not confuse infusion time with frequency of dosing.

The IV tubing has a drop factor of 10. In one minute 30 drops have fallen in the drop chamber.

Steps:

How many mL have been infused?

a. 1 mL

Incorrect. Only 10 drops are needed for 1 mL to fall. If 30 drops have fallen, more than 1 mL must have infused. If you had trouble with this problem, treat it as a simple conversion. Set up as a conversion, the information looks like this:

b. 2 mL

Incorrect. 20 drops would equal 2 mL. If you had trouble with this problem, treat it as a simple conversion. Set up as a conversion, the information looks like this:

c. 3 mL

Correct. If you had trouble with this problem, treat it as a simple conversion. Set up as a conversion, the information looks like this:

The IV tubing has a drop factor of 20gtts/mL.

Steps:

How many drops must fall in order for 10 mL to be infused?

a. 20 gtts

Incorrect

b. 100 gtts

Incorrect

c. 200 gtts

Correct. If it takes 20 drops to infuse 1 mL, it will take 10 times that number to infuse 10 mL:

d. 2000 gtts

Incorrect

You have an IV set with a drip factor of 60 gtts/mL.

Steps:

If 30 gtts fall each minute, how many mL will the patient receive in one hour?

a. 15 mL

Incorrect. Treat this as a simple conversion problem looking for an answer in mL, then account for the time factor:

Now you know how many mL fall in one minute, so how many fall in one hour? In one hour, sixty minutes will pass:

b. 30 mL

Correct. Each minute 30 gtts fall. This means only ½ a mL falls each minute. In one hour, sixty minutes will pass:

c. 60 mL

Incorrect. Treat this as a simple conversion problem looking for an answer in mL, then account for the time factor:

Now you know how many mL fall in one minute, so how many fall in one hour? In one hour, sixty minutes will pass:

d. 120 mL

Incorrect. Treat this as a simple conversion problem looking for an answer in mL, then account for the time factor:

Now you know how many mL fall in one minute, so how many fall in one hour? In one hour, sixty minutes will pass:

Now that you have completed the practice problems,please take the time to review your answers for each problem. Please click here to view/print this document to and to check your answers.

These problems should help you see how you can use the drop factor in simple calculations. In the modules that follow, you will need to use the drop factor in any question that asks you to calculate gtts/minute.

Be sure never to confuse gtts/mL, which is the drop factor, with gtts/minute, which tells you how fast the fluid is infusing.