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Practice Time
Solve the problems below
1. The provider orders 1 liter of D5W to infuse at a rate of 75 mL/hr at 12 drops/mL.
The nurse started the infusion at 10:00 am.
a. What is drip rate?
b. How long will the D5W take to infuse?
c. What time will the infusion be completed?
2. Order: 1000 mL of D5 ½NS to infuse over 12 hours.
Available: Microdrip set
Calculate the IV flow rate in drops per minute. ______
3. Order: 3 L of IV solution to infuse over 24 hours: with 1 L of D5W and 2 L of D5 ½NS
a. One liter is equal to how many milliliters? ______
b. Each liter should infuse for how many hours? ______
c. The institution uses a set with a drop factor of 15 gtt/mL. How many drops per
minute should the patient receive per liter of fluid? ______
4. Order: 250 mL of D5W over 3 hours. Determine the flow rate. _____
Practice Time
Ordered: Heparin sodium 800 units/h.
Available: Heparin sodium 40 units/mL.
Calculate the flow rate. _________
Order: 25000 units heparin sodium in 250 mL 0.9% sodium
chloride (NS) to infuse at 35 mL/h.
Calculate units per hour. _________
E. Infusion Time and Completion Time
Infusion Time – How long will administration of this drug take to infuse?
Completion Time – At what time will the infusion end?
F. Reading Labels
Practice Time
Order: Heparin 6000 units subcutaneous NOW and 2500 units subcutaneous daily.
a. How many milliliters should the nurse administer for the NOW dose? ______________
b. How many milliliters should the nurse administer for the daily dose? _____________
c. How many vial(s) of heparin are needed? ________________
More Practice – Reading Labels
Order: Cefaclor oral suspension 20 mg per kg per day in three divided doses for a
pediatric patient who weighs 66 lb.
How many milliliters will the nurse administer per dose? _____________
a. What is the generic name? __________________________
b. What is the trade name? ______________________________
c. Is this drug a controlled substance? ____________
d. What is the amount of the drug and the form? _________________
e. How many tablets are in the package? ____________
f. How should this drug be stored? ____________________
a. What is the generic name? __________________________
b. What is the trade name? ______________________________
c. Is this drug a controlled substance? ____________
d. What is the amount of the drug and the form? _________________
e. How many tablets are in the package? ____________
f. How should this drug be stored? ____________________
Reconstitution – Practice Time
6. Order: Nebcin (tobramycin) 88 mg IM STAT
A. How much diluent is added to reconstitute the vial?
__________________
B. What is the concentration of the medication after the reconstitution? ____________
C. How many mLs should the nurse administer for one dose?
__________________
D. Mark the syringe below with the appropriate dose.
7. Read the medication label below and answer the following questions
A.
How much diluent is added to reconstitute the vial?
____________________
B.
What is the concentration of the medication after the reconstitution? ________________
8. Order: Ceftriaxone 25g IV every 12 hours
a. How much diluent is added to reconstitute the vial for IM administration? _____________
b. How much diluent is added to reconstitute the vial for IV administration? _____________
c. What is the concentration of the medication for IM administration? ________________
d. What is the concentration of the medication for IV administration? ________________
e. How many mLs should the nurse administer to deliver the IM dose? ________________
f. How many mLs should the nurse administer to deliver the IV dose? ________________
g. How should this drug be stored? ____________________
1.
The physician orders 500 mg of a medication. The reconstitution directions say to
add 6.2 mL of sterile water to yield a concentration of 450 mg/mL. What should the
nurse administer to the patient?
____________________mL
2.
The physician orders 400 mg of a medication. The reconstitution directions say to
add 7.2 mL of sterile water to yield a concentration of vial read 650 mg/mL.
How many mL should the nurse administer to the patient?
_____________mL
Practice Time
Solve the problems (1 – 10) on the following pages
1. The prescriber orders Trexall (methotrexate) 150 mg IV once every 14 days to treat a
cancer. The patient weighs 164 lbs.
The safe dose for this drug is 2.5 mg/kg IV every 14 days.
What would be the safe dose for this patient?
_________________mg
Is the dose ordered for this patient safe? (yes/no)
_______________
2. The prescriber orders gentamycin sulfate 3 mg/kg/day IVPB in 3 divided doses q8h for a
client weighing 161 pounds.
How many kg does the patient weigh?
________________kg
How much medication should the patient receive per day?
______________mg
How much medication should the patient receive per dose?
_____________mg
ERROR ALERT! Wording is a source of confusion. Questions that ask for mg/kg/day are
calculating the total dose in a day. If it says to administer the medication in divided doses, the
nurse needs to divide the total for the day by the number of doses requested. If the order is given
in individual doses, like Question #2, the nurse must multiply the amount per dose by the number
of doses to determine the total per day.
3. The prescriber orders gentamycin sulfate 240 mg IVPB q12h for a patient who weighs 172 lb.
The safe dose range for gentamycin is 1 mg/ kg up to 5 mg/kg per day.
How many kg dose the patient weigh?
___________kg
What is the lowest effective dose per day for this patient?
____________mg
What is the highest effective dose per day for this patient?
____________mg
What is the total dose per day ordered for
390.9 mg/day
q dose space mg/day = 78.1-
____________mg
Based on the calculations above, is the dose ordered for this patient within the safe
dose range?
___________________
Would the dose be considered subtherapeutic, therapeutic, or toxic?
_____________________
4.
The prescriber orders morphine sulfate 0.3 mg IM stat for a child who weighs 68
pounds. The recommended dose is 0.01 mg per kg.
How many kg does the child weigh?
_____________kg
What would be the recommended dose for a child of this weight?
____________mg
Is this a safe dose for this child?
______________
The morphine sulfate on hand comes in a concentration of 0.5 mg per mL.
How many mL should the nurse administer to the child if the dose is determined
to be safe?
____________mL
I. Desired Over Have
Practice Time
The prescriber orders Amoxil oral suspension 0.25 g by mouth every 12 hours for a pediatric
patient at home. The label on the bottle reads:
125 mg/5 mL
NDC 0029-6008-23
AMOXIL
AMOXICILLIN
FOR ORAL SUSPENSION
a. Mark an “X” next to the measure on the medication cup to indicate how much liquid
medication to administer to the child with each dose: Show your working.
150 mL
(when reconstituted)
25 mL_____
20 mL _____
15 mL_____
10 mL_____
5 mL_____
3 mL_____
b. The patient’s mother does not have a medicine cup. She only has teaspoons. How
many teaspoons of medicine should she administer to the child for each dose?
The prescriber orders morphine sulfate 0.175 mg IVP now for a patient. The label below show
how the medication is available
a. How much morphine sulphate should the nurse administer to the patient to deliver this dose?
b. Circle the best syringe below and draw an arrow on the syringe to indicate where the nurse
should pull back on the plunger to administer this dose. Choose only ONE syringe.
J. Insulin Problems
The prescriber orders 18 units of NPH insulin and 5 units of Regular insulin in one injection
subcutaneously every morning. Fill in the blank spaces below to describe how the nurse should
accurately mix the two types of insulin in the same syringe. In your answer, use a capital R for
the regular Insulin.
a.
_______ of ___________ insulin should be added to the syringe first.
b.
_______ of _______ insulin should be added to the syringe second.
c.
The total amount of insulin in the syringe after the two types of insulin have been
mixed equals _________.
J. B. has a diagnosis of Diabetes Mellitus Type 2 and is on daily Insulin injections. The
prescriber orders NPH insulin 35 units and Regular insulin 9 units subcutaneously daily before
breakfast in one injection.
The required amount of air is already in the syringe.
Fill in the spaces below with the appropriate information and draw a line from the information to
the syringe on the right to indicate how far back the nurse should position the plunger to draw up
the amount required to add each type of insulin. In your answer, use a capital R for the
regular Insulin.
a. _______ units of ______ insulin should be added to the
syringe FIRST by drawing the plunger back to _______.
Draw an arrow to indicate how far back the
nurse needs to position the plunger to add the first
amount of insulin.
b. ______ units of ________ insulin should be added to
the syringe SECOND by drawing the plunger back to
______. Draw an arrow to indicate how far back the
nurse needs to position the plunger to add the second
amount of insulin.
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