Putting It All Together

Practice Problems

• Situation 1
• Situation 2
• Situation 3
• Situation 4
• Situation 5
• Situation 6
• Situation 7
• Situation 8
• Situation 9
• Situation 10
• Review

You are working with a patient who has a number of orders you must complete. The nurse practitioner has ordered an IV of 1000 mL D5W q12hr. The drip factor for this IV tubing is 15 gtt/mL. Additionally, the patient is to be administered 500 mg of erythromycin to be added to an IVPB of 50mL NS to infuse in 30 minutes q 6 hr. The pharmacy has sent you a 2 gram vial of erythromycin. The instructions tell you to reconstitute the drug with 4.8 mL of NS for a final volume of 5 mL. The drip factor for the IVPB tubing is 20gtt/mL.

1. Calculate how many milliliters you will add to the IVBP for the correct dose.
2. Calculate the flow rate for the main IV in gtt/min.
3. Calculate the rate in mL/hr for the IVPB.

The doctor orders Tagamet 25mg/kg/24 hours IV to be administered in four divided doses. The patient weighs 50 lbs. The stock supply of Tagamet is a 3 gram vial with instructions to reconstitute with 9.6 mL NS for a final concentration of 0.3grams/1 mL. The doctor orders the Tagamet to be administered IVPB in 10 mL of NS to infuse over15 minutes.

1. Calculate how many mg of Tagamet the patient will receive in one day.
2. Calculate how many mg of drug the patient will receive in one dose.
3. How many mL's of Tagamet will you administer for each dose?

Note: read the problem carefully. You are solving for mL's, not mg's.

The doctor order PCN G 1,000,000 units to be added to 100mL D5W to infuse over 45 minutes q 4 hours. The drip factor for the IV tubing is 15. The stock supply is PCN G 5,500,000 units in a vial. The instructions say to reconstitute with 10.5 mL of sterile water for a final concentration of 500,000 units/mL. The patient weighs 150 lbs.

Note: do not be confused because the drug here is measured in units and the order looks different than you are used to seeing. Treat the drug order just as you would if it were written in mg's or grams.

1. What is the IV flow rate in mL/hr?
2. How many mL's will you add to the IV for the correct dose?
3. What is the IV flow rate in gtt/min?

The MD orders 1000mL of D5W. The first 250 mL is to run over 30 minutes. The remainder should run over 8 hours. The MD also orders Tagamet 300mg in 75 mL NS via IVPB to run over 45 min q 6 hr. The Tagamet comes in a vial of 1.5 grams with the instructions to reconstitute with 4.8 mL NS for a final volume of 5 mL. The drop factor for each IV line is 15 gtt/mL.

1. What is the flow rate in mL/hr of the first 250 mL of the D5W?
2. What is the flow rate in mL/hr for the remainder of the D5W?
3. How many mL's will you add to the IVPB for the correct dose?

The doctor orders Keflin 500 mg in 50 mL D5W IVPB to run over 1 hour q 6 hr. The patient weighs 150 lbs. The stock supply is Keflin 1 gram vial. Instructions say to reconstitute with 3.8 mL NS for a concentration of 0.25 grams/mL. There is also an order for D5W, 1500mL q 12 hr.

1. How many mL/hr should you set on the infusion pump for the IVPB?
2. How many mL's of D5W from the main IV will the patient receive in one day?
3. How many mL's will you add to the IVPB for the correct dose of Keflin?

The doctor orders 4 mg of Levophed in 500 mL of D5W to infuse at 6 mcg/min. The drop factor is 60 gtt/mL. The patient weighs 70 kg.

1. What is the flow rate in mL/hr for this IV? Notice there is not a lot of information for you to sift through in this problem. Think carefully about what each value represents.
2. What is the flow rate in gtt/smin?
3. a. How much mcg's of Levophed will the patient receive in 30 minutes?
b. How many mg's of Levophed will the patient receive in 30 minutes?

The doctor orders Ancef 25mg/kg/day in equally divided doses. The doctor orders the drug to be added to an IVPB of 50 mL and to infuse over 30 minutes, q 8 hr. The drip factor is 15gtt/mL. The stock supply is Ancef 5 gram vial. The directions say to reconstitute with 9.5 mL sterile water to yield 1 gram/2mL. The patient weighs 40 lbs.

1. How many mL's per dose will the patient receive?
2. How many grams of Ancef will the child receive in one day?
3. What is the flow rate of the IVPB in mL/hr?

The nurse practitioner orders a main IV of 1000mL D5W to run over 8 hours. The patient is also to receive 1 gram of Pronestyl in 500mL NS to run at 5mcg /kg /min. The patient weighs 120 lbs. The drop factor for each IV is 15 gtt/mL.

1. Calculate the rate of the main IV in gtt/min.
2. Solve for the flow rate of the second (smaller) IV in mL/hr.
3. Calculate the rate in gtt/min for the second IV.

The doctor orders the following for a 10kg patient. Administer prednisone 0.2mg/kg/day in separate doses administered every 6 hours. Administer the prednisone via IVPB in 50 mL of NS; infuse over 30 minutes. The drop factor for the IV tubing is 60 gtt/mL. The prednisone comes from the pharmacy in a vial with a label reading 5mg/1mL. Your instructions for reconstitution of the prednisone tell you to add 4.8 mL D5W to the vial which contains 25 mg of the drug.

1. Calculate the flow rate for the IV in mL/hr?
2. How many mL's will you draw up for the correct dose?
3. How many mg of prednisone will the patient receive in one dose?

The doctors orders 1000mLof D5W q 10 hr for a 150 lb patient. The IV has a drop factor of 20 gtt/mL. Additionally, the patient is to receive Ceftriaxone 1 gram q 12 hours. This drug is to be delivered by IVPB in 50 mL of NS to infuse over 40 minutes.

The pharmacy sends you a vial which contains 10 grams of drug with the instructions to reconstitute with 4.8 mL of sterile water for a final fluid volume of 5 mL. The drop factor for the IVPB is 10gtt/mL.

1. Calculate the flow rate of the main IV in mL/hr.
2. What is the flow rate of the IVPB in gtt/smin?
3. How many mL's of Ceftriaxone will you add to the IVPB for the correct dose?