Medical Dosage Calculation A Dimensional Analysis Approach Tenth

Directory • Classroom Response System Questions • Lecture Note Presentation Medical Dosage Calculations: A

Classroom Response System Questions Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June

Question #1 The medication order states that 12, 000 units of heparin are to

Question #1 Choices 1. 2. 3. 4. 25 m. L/hr 22 m. L/hr 2.

Question #1 Response 1. 2. 3. 4. 25 m. L/hr 22 m. L/hr 2.

Question #2 The prescriber has ordered 1000 milliliters of NS with an addition of

Question #2 Choices 1. 2. 3. 4. 5 hr 30 min 2 hr 20

Question #2 Response 1. 2. 3. 4. 5 hr 30 min 2 hr 20

Question #3 The prescriber ordered: morphine sulfate 100 mg in 100 m. L 5%

Question #3 Choices 1. 2. 3. 4. 2 m. L/1 hr 5 m. L/1

Question #3 Response 1. 2. 3. 4. 2 m. L/1 hr 5 m. L/1

Question #4 The prescriber ordered: 250 m. L 5% D/W with 25, 000 units

Question #4 Choices 1. 2. 3. 4. 10 m. L/hr 15 m. L/hr 20

Question #4 Response 1. 2. 3. 4. 10 m. L/hr 15 m. L/hr 20

Question #5 The prescriber ordered 3 g Timentin (Ticarcillin disodium) IVPB in 100 m.

Question #5 Choices 1. 2. 3. 4. 10 gtt/min 0. 25 gtt/min 0. 10

Question #5 Response 1. 2. 3. 4. 10 gtt/min 0. 25 gtt/min 0. 10

Lecture Note Presentation Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L.

Learning Outcomes 1. Convert from dosage rates (drug/time) to IV rates (volume/time). 2. Convert

Learning Outcomes 5. Calculate flow rates for IV push medications. 6. Calculate the duration

Intravenous Piggyback Infusions Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L.

Figure 11. 1 Primary and secondary (IVPB) infusion setup. Medical Dosage Calculations: A Dimensional

Figure 11. 2 Packages of secondary IV tubing: (a) 60 drops per m. L,

Figure 11. 2 (continued) Packages of secondary IV tubing: (a) 60 drops per m.

Converting Flow Rate to Dosage Rate Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth

Example 11. 1 • An IV is infusing at 100 m. L/h. The strength

Example 11. 2 • The patient is receiving 10 mg/min through an IVPB. The

Calculating Dosage Rates Based on the Size of the Patient • A medication order

Example 11. 3 • The prescriber ordered: 250 m. L 5% D/W with 9

Example 11. 3 (continued) • Size of the Patient X Compound Order = Dosage

IV Push Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen

Example 11. 4 • 500 mg of a drug is ordered IVP over 2

Example 11. 4 a) Convert 500 mg to m. L using the strength as

Adding Drug to an IVPB Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition

Example 11. 5 • A patient must receive 300 mg of a drug IVPB

Example 11. 5 (continued) a) Using the vial strength convert 300 mg to m.

Chapter Summary • A secondary line is referred to as an IV piggyback. •

Chapter Summary • An order containing mg/kg/min directs that each minute, the patient must

Chapter Summary • When the size of the patient is multiplied by a compound

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Medical Dosage Calculation A Dimensional Analysis Approach Tenth Edition 11 CHAPTER Calculating Flow Rates for Intravenous Medications Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Directory • Classroom Response System Questions • Lecture Note Presentation Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Classroom Response System Questions Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #1 The medication order states that 12, 000 units of heparin are to be added to 250 milliliters of 5% D/W. The patient is to receive 1200 units per hour IV. How many milliliters per hour will your patient receive? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #1 Choices 1. 2. 3. 4. 25 m. L/hr 22 m. L/hr 2. 5 m. L/hr Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #1 Response 1. 2. 3. 4. 25 m. L/hr 22 m. L/hr 2. 5 m. L/hr Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #2 The prescriber has ordered 1000 milliliters of NS with an addition of 200 units of regular insulin IV. Infuse at a rate of 2. 5 milliliters per minute. How many hours will it take to complete this infusion? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #2 Choices 1. 2. 3. 4. 5 hr 30 min 2 hr 20 min 5 hr 40 min 6 hr 40 min Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #2 Response 1. 2. 3. 4. 5 hr 30 min 2 hr 20 min 5 hr 40 min 6 hr 40 min Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #3 The prescriber ordered: morphine sulfate 100 mg in 100 m. L 5% D/W, IVPB. Infuse at a rate of 0. 005 g/hr. How many milliliters will the patient receive per hour? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #3 Choices 1. 2. 3. 4. 2 m. L/1 hr 5 m. L/1 hr 4 m. L/5 hr 2 m. L/5 hr Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #3 Response 1. 2. 3. 4. 2 m. L/1 hr 5 m. L/1 hr 4 m. L/5 hr 2 m. L/5 hr Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #4 The prescriber ordered: 250 m. L 5% D/W with 25, 000 units of heparin, infuse at 1500 units/hour IVPB. Calculate the flow rate in minutes per hour. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #4 Choices 1. 2. 3. 4. 10 m. L/hr 15 m. L/hr 20 m. L/hr 25 m. L/hr Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #4 Response 1. 2. 3. 4. 10 m. L/hr 15 m. L/hr 20 m. L/hr 25 m. L/hr Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #5 The prescriber ordered 3 g Timentin (Ticarcillin disodium) IVPB in 100 m. L D 5 W infuse in 60 minutes. Calculate the flow rate in drops per minute if the drop factor is 15 gtt/m. L. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #5 Choices 1. 2. 3. 4. 10 gtt/min 0. 25 gtt/min 0. 10 gtt/min 25 gtt/min Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #5 Response 1. 2. 3. 4. 10 gtt/min 0. 25 gtt/min 0. 10 gtt/min 25 gtt/min Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Lecture Note Presentation Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Learning Outcomes 1. Convert from dosage rates (drug/time) to IV rates (volume/time). 2. Convert from IV rates (volume/time) to dosage rates (drug/time). 3. Calculate infusion rates when medication must be added to an IVPB bag. 4. Calculate infusion rates based on the size (weight or BSA) of the patient. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Learning Outcomes 5. Calculate flow rates for IV push medications. 6. Calculate the duration of an IVPB infusion. 7. Calculate flow rates for medication requiring titration. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Intravenous Piggyback Infusions Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Figure 11. 1 Primary and secondary (IVPB) infusion setup. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Figure 11. 2 Packages of secondary IV tubing: (a) 60 drops per m. L, (b) 10 drops per m. L. (Courtesy of Baxter Healthcare Corporation. All rights reserved. Photos by Al Dodge. ) Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Figure 11. 2 (continued) Packages of secondary IV tubing: (a) 60 drops per m. L, (b) 10 drops per m. L. (Courtesy of Baxter Healthcare Corporation. All rights reserved. Photos by Al Dodge. ) Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Converting Flow Rate to Dosage Rate Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 11. 1 • An IV is infusing at 100 m. L/h. The strength of the solution is 200 mg in 500 m. L. Find the dosage rate in mg/h. • Convert 100 m. L/h to mg/h using the strength of the solution as the unit fraction. 20 1 Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 11. 2 • The patient is receiving 10 mg/min through an IVPB. The solution has a strength of 400 mg per 100 m. L. Find the flow rate in m. L/h. • Convert mg/min to m. L/h using the strength of the solution as the unit fraction. 15 1 Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Calculating Dosage Rates Based on the Size of the Patient • A medication order might include the compound rate: “ 2 mg/kg/min. ” • This means that each minute the patient is to receive 2 milligrams of the drug for every kilogram of body weight. For computational purposes this is written as Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 11. 3 • The prescriber ordered: 250 m. L 5% D/W with 9 mg Aredia, 0. 001 mg/kg/min IV stat. • The patient weighs 80 kilograms, and the drop factor is 20 drops per milliliter. Calculate the flow rate in gtt/min. • • Patient’s weight: 80 kg. Order: 0. 001 mg/kg/min. Solution strength: 9 mg = 250 m. L. Drop factor: 20 gtt = 1 m. L. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 11. 3 (continued) • Size of the Patient X Compound Order = Dosage Rate Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

IV Push Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 11. 4 • 500 mg of a drug is ordered IVP over 2 min. The concentration of the drug is 100 mg/m. L. How many m. L will you administer? Determine the number of m. L you will push during each 30 -second interval. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 11. 4 a) Convert 500 mg to m. L using the strength as the unit fraction. = 5 m. L b) Convert 30 sec to m. L using the rate of 500 mg/2 min. 30 sec = ? m. L 1 2 Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Adding Drug to an IVPB Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 11. 5 • A patient must receive 300 mg of a drug IVPB in 100 m. L NS over 60 minutes. • How many m. L must be added to the IV bag if the vial of the drug has strength of 75 mg/m. L? At what rate should the pump be set? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 11. 5 (continued) a) Using the vial strength convert 300 mg to m. L. 4 4 m. L 1 b) Add 4 m. L of the drug to the 100 m. L bag of NS to yield a total volume of 104 m. L. Because the infusion is over 60 min (1 hour), set the pump at 104 m. L/h. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Chapter Summary • A secondary line is referred to as an IV piggyback. • IV push, or bolus medications can be injected into a heplock/saline lock or directly into the vein. • In a gravity system, the IV bag that is hung highest will infuse first. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Chapter Summary • An order containing mg/kg/min directs that each minute, the patient must receive the stated number of milligrams of medication for each kilogram of the patient’s body weight. • For calculation purposes write mg/kg/min as: Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Chapter Summary • When the size of the patient is multiplied by a compound rate, the dosage rate is obtained. • When titrating medications, the dose is adjusted until the desired therapeutic effect is achieved. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.