CHAPTER 18 IV Medication and Titration Calculations

Transcription

1 CHAPTER 8 IV MEDICATION AND TITRATION CALCULATIONS 69 CHAPTER 8 IV Medication and Titration Calculations Objectives The learner will calculate:. flow rates to infuse ordered dosages.. dosages and flow rates based on kg body weight. 3. dosage and flow rate ranges for titrated medications. Suggested Review Questions. How is the dimensional analysis (DA) equation written when calculating IV flow rates if strength of medication is given and dose per hour or per minute is ordered?. What is the two-step process for using DA to calculate IV flow rates when medication dosages are ordered by body weight? 3. What is the one-step process for using DA to calculate IV flow rates when medication dosages are ordered by body weight?. What does it mean to titrate a medication dose? How are titrated medication doses to be calculated? Answers to Review Questions. The DA equation for calculating IV flow rates when strength of medication and dose per hour are given is /hr strength of medication present (/) rate in /hr hr When the dose is specified in amount of drug per minute, the conversion of 60 min hr needs to be added to the equation. When the dose per minute or hr is given as a measure different than the strength of medication provided, the conversion for the measure needs to also be included in the equation. Therefore, when /hr infusion rate is desired for a 00 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

2 70 SECTION 6 INTRAVENOUS CALCULATIONS medication dosage of mcg/min and the medication dosage provided is /volume of fluid, the equation is (volume on hand) (dose conversion) mcg desired 60 min /hr (of drug in vol) 000 mcg min (time to deliver dose) hr. The two-step process for using DA to calculate /hr IV flow rates for medications ordered by body weight is to first calculate the dosage for the patient s weight and then proceed with the DA equation. So the patient s weight in kg is determined, then the ordered dose per kg. The dosage for the patient s weight is entered third in the equation as noted above. Remind students to compute body weight in kg to the nearest tenth and to calculate IV flow rates of medications to the nearest tenth. 3. The one-step process for using DA to calculate /hr IV flow rates for medications ordered by body weight is to include the dose per patient s weight conversion in the DA equation. This does result in a long equation and careful attention must be paid to the entry of ratios. The patient s weight is converted to kg (if given in lb) before the patient s weight is entered into the equation. The desired dose per kg weight is entered as the third ratio of the equation with the desired dose as numerator and kg/min as denominator. The patient s weight in kg is entered as the numerator in the last ratio of the equation. The equation is: hr mcg desired 60 min wt in kg 000 mcg min hr. To titrate a medication dose is to adjust the medication dose within a specified range to achieve the physiologic response desired. When a titrated dose of medication is ordered, a minimum dose and maximum dose are identified. Both of these doses are calculated. Treatment is initiated using the minimum dose; the dose is then increased as needed, but it never exceeds the maximum dose unless new medication orders are written. Minimum and maximum doses are calculated using DA following the equations previously learned. 00 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

3 CHAPTER 8 IV MEDICATION AND TITRATION CALCULATIONS 7 Name Date Chapter 8: IV Medication and Titration Calculations Additional Practice Problems Calculate the dosages and IV flow rates as requested for the medications below. Round answers to nearest tenth.. Lidocaine hydrochloride 0 mcg/kg/min has been ordered for a patient with a cardiac dysrhythmia. The patient weighs 79.5 kg. The solution available is g in 50 D5W. mcg/min dosage. Dopamine hydrochloride has been ordered for a patient who weighs 73.6 kg to maintain blood pressure. The dosage range is to 5 mcg/kg/min. The solution available is 00 in 500 D5W. What is the dosage range for this patient? What is /hr flow rate to deliver mcg/kg/min? 3. Dobutamine has been ordered for a child who weighs 3.6 kg. The ordered dose is 5 mcg/kg/min. Solution available is 50 /50 of 0.9% NaCl. mcg/min dosage. Nitroglycerin is ordered for a patient with chest pain. The ordered dose is 5 mcg/kg/min to keep the patient pain free. The patient weighs 6. kg. The IV solution available is nitroglycerin in normal saline at a concentration of 500 mcg/. mcg/min dosage 5. A dosage of medication is ordered to infuse at 7 /hr. The IV solution is prepared at the concentration of 50 of medication in 500 of D5W. /hr flow rate 6. An IV infusion containing g of medication in L of normal saline is to infuse at to 3 /min. What is the /hr flow range? 00 Cengage Learning. All Rights Reserved. Permission to reproduce granted for classroom use only.

4 7 SECTION 6 INTRAVENOUS CALCULATIONS 7. A dosage of medication at a concentration of g in 500 D5W is ordered to infuse at 96 /hr. 8. The initial dose of a cardiac drug is ordered at 5 /hr. The solution was prepared at a concentration of 5 /00 of D5W. 9. A medication at the dose of mcg/min has been ordered. The solution was prepared at a concentration of in 50 of D5W. 0. A medication is to be titrated to 0 mcg/kg/min. The IV solution was prepared by adding 50 of the medication to 50 D5W. The patient weighs 60 kg.. Epinephrine in D5W is to be run at mcg/min to maintain BP and heart rate. The IV solution was prepared by adding of epinephrine to 50 D5W.. A medication is to be titrated to 50 mcg/kg/min. The IV solution was prepared by adding.5 g of medication to 50 of D5W. The patient weighs 9.8 kg. 3. An initial dose of a cardiac drug is ordered at 5 /hr. The solution was prepared by adding 5 of the medication to 00 of D5W.. A medication is ordered to infuse at 0 mcg/kg/min. The patient weights 60 kg. The IV solution was prepared at a concentration of g of medication in 500 D5W. 00 Cengage Learning. All Rights Reserved. Permission to reproduce granted for classroom use only.

5 CHAPTER 8 IV MEDICATION AND TITRATION CALCULATIONS The physician ordered aminocarproic acid 30 /kg/hr for a child who is bleeding. The child weighs 7.3 kg. The IV solution has been prepared at a concentration of 5 g of aminocarproic acid in 50 of NS. /hr dose 6. A medication dosage of 3 mcg/kg/min has been ordered for a patient who weighs 87.3 kg. The IV solution was prepared at a concentration of 50 in 50 D5W. /hr flow rate 7. Procainamide at the dose of 6 /min has been ordered for a patient experiencing a dysrhythmia. The medication was prepared at a concentration of g procainamide in 50 of NS. /hr flow rate 8. A medication dosage of mcg/min has been ordered. The medication has been prepared at a concentration of /50 D5W. /hr flow rate 9. The physician has ordered amiodarone at a dose of 0.5 /min. The medication has been prepared at a concentration of g aminodarone to 500 of NS. /hr flow rate 0. Propofol at the dose of 5 mcg/kg/min has been ordered to maintain sedation for a patient receiving mechanical ventilation. The patient weighs 8 kg. The medication was prepared at a concentration of 500 in 50 of D5W. 00 Cengage Learning. All Rights Reserved. Permission to reproduce granted for classroom use only.

6 7 SECTION 6 INTRAVENOUS CALCULATIONS Solutions to Additional Practice Problems Calculate the dosages and IV flow rates as requested for the medications below. Round answers to the nearest tenth.. mcg/min 0 mcg/kg/min 79.5 kg 590 mcg/min Convert g to : g 000 before setting up the DA equation 50 0 mcg 60 min hr mcg kg /min hr /hr (rounded to the nearest tenth) 3.9 /hr 79.5 kg Lower dosage range mcg/kg/min 73.6 kg 7. mcg/min Upper dosage range 5 mcg/kg/min 73.6 kg 368 mcg/min. Dosage range is 7. to 368 mcg/min mcg 60 min 883. hr mcg min hr /hr (rounded to the nearest tenth) /hr 6 3. mcg/min 5 mcg/kg/min 3.6 kg 8 mcg/min 50 8 mcg 60 min 780 hr mcg min hr /hr (rounded to the nearest tenth). /hr 6. mcg/min 5 mcg/kg/min 6. kg 307 mcg/min 307 mcg 60 min 8 hr 500 mcg min hr /hr (rounded to the nearest tenth) 36.8 /hr hr /hr hr 00 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

7 CHAPTER 8 IV MEDICATION AND TITRATION CALCULATIONS hr hr min 0 60 /hr to min hr 3 60 min /hr min hr 7. Convert g to : g 000 before setting up the DA equation 500 hr /hr hr hr /hr hr hr 000 mcg mcg 60 min 0 30 /hr min hr hr mcg 00 0 mcg kg /min 60 min hr 60 kg /hr hr 000 mcg mcg min 60 min 60 5 /hr hr. Convert.5 g to :.5 g 500 before setting up the DA equation mcg 60 min hr mcg kg /min hr /hr (rounded to the nearest tenth) 8.6 /hr kg 6, Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

8 76 SECTION 6 INTRAVENOUS CALCULATIONS hr /hr hr 5. Convert g to : g 000 before setting up the DA equation 500 hr mcg 5 0 mcg kg /min 60 min hr 60 kg /hr /hr 30 /kg/hr x 7.3 kg 89 /hr Convert 5 g to : 5 g 5000 before setting up the DA equation kg 89 hr 5000 hr /hr (rounded to the nearest tenth) /hr mcg 60 min hr mcg kg /min hr /hr (rounded to the nearest tenth) 78.6 /hr kg hr min /hr min hr hr 000 mcg mcg 60 min 0 30 /hr min hr 9. Convert g to : g 000 before setting up the DA equation 500 hr min 30 5 /hr min hr 00 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

9 CHAPTER 8 IV MEDICATION AND TITRATION CALCULATIONS hr mcg 00 5 mcg kg /min 60 min hr 8 kg /hr Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.