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** D_{5}W q**12hr**. 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**.

- Calculate how many milliliters you will add to the IVBP for the correct dose.
- Calculate the flow rate for the main IV in gtt/min.
- 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 over**15 minutes**.

- Calculate how many mg of Tagamet the patient will receive in one day.
- Calculate how many mg of drug the patient will receive in one dose.
- 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.

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

The MD orders **1000mL** of D_{5}W. 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**.

- What is the flow rate in mL/hr of the first 250 mL of the D
_{5}W? - What is the flow rate in mL/hr for the remainder of the D
_{5}W? - How many mL's will you add to the IVPB for the correct dose?

The doctor orders Keflin **500 mg** in **50 mL** D_{5}W 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 D_{5}W, **1500mL** q **12 hr**.

- How many mL/hr should you set on the infusion pump for the IVPB?
- How many mL's of D
_{5}W from the main IV will the patient receive in one day? - 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 D_{5}W to infuse at **6 mcg/min**. The drop factor is **60 gtt/mL**. The patient weighs **70 kg**.

- 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.
- What is the flow rate in gtt/smin?
- 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**.

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

The nurse practitioner orders a main IV of **1000mL D _{5}W **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**

**.**

- Calculate the rate of the main IV in gtt/min.
- Solve for the flow rate of the second (smaller) IV in mL/hr.
- 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** D_{5}W to the vial which contains **25 mg** of the drug.

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

The doctors orders **1000mL**of D_{5}W 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**.

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

Answers and step-by-step explanations.

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