IV Calculations, Solutions, and Equipment – Flashcards
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NS
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Sodium chloride 0.9%
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1/2 NS
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Sodium chloride 0.45%
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D5W or 5%D/W
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Dextrose 5% in water
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D5RL
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Dextrose 5% and lactated Ringer's
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RL or RLS
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Lactated Ringer's solution (electrolytes)
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D5NS
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Dextrose 5% in sodium chloride
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D5 1/2NS (0.45%)
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Dextrose 5% in 0.45% sodium chloride
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D5 1/4NS (0.225%)
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Dextrose 5% in 0.225% sodium chloride
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Important to Remember
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Solution strength expressed as a percentage means gram of drug per 100mL of fluid. (%= gram per 100mL)
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Calculate the amount of dextrose in 500mL of D5W
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5% dextrose= 5 g dextrose per 100mL Solve: 5 g : 100mL = x(g) : 500mL Answer: 500 mL of D5W contains 25 g of dextrose
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Calculate the amount of sodium chloride (NaCl) in 1000 mL NS.
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0.9% = 0.9 g NaCl per 100 mL Solve: 0.9 g : 100 mL = x(g) : 1000 mL Answer: 9 g NaCl
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Calculate the amount of dextrose and sodium chloride (NaCl) in 1000 mL of 5% dextrose and 0.45% normal saline (D5 and 1/2 NS)
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D5= dextrose 5% = 5 g dextrose per 100 mL NS 0.45% = 0.45 g NaCl per 100 mL Solve: 5 g : 100mL = x(g) : 1000mL Solve: Solve: 0.45 g : 100 mL = x(g) : 1000 mL Answer: 1000 mL D5 0.45% NS contains 50 g of dextrose and 4.5 g of NaCl.
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Points To Remember
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Knowing the drop factor is the FIRST step in accurate administration
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Points To Remember
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The drop factor always appears on the package of the IV tubing.
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Points To Remember
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Macrodrops are large and deliver 10, 15, or 20 gtt/mL
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Points To Remember
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Microdrops are small and deliver 60 gtt/mL
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Points To Remember
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Drop factor= gtt/mL
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Points To Remember
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To determine flow rates for an electronic infusion device (pump or controller), determine mL/hr by using the following equation: Total mL ordered x mL/hr (rounded to the nearest whole number) = ----------------------- Total hr ordered
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Points To Remember
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To calculate IV flow rate in gtt/min, the nurse must have the volume of solution, the time factor, and the drop factor of the tubing.
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Points To Remember
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Calculation of gtt/min can be done by using the formula method or dimensional analysis. Amount of solution(mL) X gtt factor Formula: x (gtt/min)= ------------------------------------------------ Time in min
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Basic principles for Calculating IV Flow Rate
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1- Drops per minute are always expressed in whole numbers. Principles of rounding off are applied. Example: 19.5 gtt = 20 gtt 2- Carry division of the problem one decimal place to round to a whole number of drops
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Determine rate in gtt/min IV should be regulated. Order: D5W to infuse at 100 mL/hr. Drop factor: 10 gtt/mL
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100 mL X 10 gtt/mL x (gtt/min) = -------------------------- 60 min 1000 x = ------- = 16.6 = 17gtt/min 60
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Calculating Large Volumes of Fluid (mL per hour)
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Amount of solution (mL) x (mL/hr)= ----------------------------------- Time in hours
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Determine rate in gtt/min IV should be regulated. Order 1000 mL D5W to infuse in 8 hr. Drop factor: 20 gtt/mL
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Calculate mL/hr : 1000 mL x (mL/hr)= ------------- x= 125 mL/hr 8 hr Calculate gtt/min : 125 mL X 20 gtt/mL x (gtt/min) = -------------------------- 60 min 125 x = ------- = 41.6 = 42 gtt/min 3
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Shortcut for Calculating IV Flow Rate
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Determine Drop Factor Constant of the administration IV set: 15 gtt/mL = 4 20 gtt/mL = 3 10 gtt/mL = 6 60 gtt/mL = 1 mL/ hr Calculate gtt/min = ------------------------------ Drop factor constant
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Using Shortcut Method: Administer D5W at 125 mL/hr. The drop factor is 15 gtt/mL
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Drop Factor Constant = 4 125 mL/ hr Calculate gtt/min = ---------------------- = 31.2 = 31 gtt/min 4
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Using Shortcut Method: Administer 0.9% NS at 75 mL/hr. The drop factor is 60 gtt/mL
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Drop Factor Constant = 1 75mL/ hr Calculate gtt/min = ---------------------- = 75 gtt/min 1
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Shortcut for Calculating IV Flow Rate for Large Volume
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Determine Drop Factor Constant of the administration IV set: 15 gtt/mL = 4 20 gtt/mL = 3 10 gtt/mL = 6 60 gtt/mL = 1 Amount of solution (mL) Calculate x (mL/hr)= ----------------------------------- Time in hours mL/ hr Calculate gtt/min = ------------------------------ Drop factor constant
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Order: R/L 1500 mL in 12 hr. Drop factor: 15 gtt/mL
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Drop Factor Constant = 4 1500 mL Calculate mL/hr = ------------- = 125 mL/hr 12 hr 125mL/ hr Calculate gtt/min = ---------------------- = 31.2 = 31 gtt/min 4
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Order: The following IV's for 24 hours. Drop factor: 15 gtt/mL 1000 mL D5W with 10 mEq potassium chloride (KCl) 500 mL dextrose 5% in normal saline (D5NS) with 1 ampule multivitamin 500 mL D5W
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Drop factor: 15 gtt/mL Drop Factor Constant = 4 2000 mL (1000 + 500 + 500) Calculate mL/hr = ------------- = 83.3= 83 mL/hr 24hr 83 mL X 15 gtt/mL Calculate gtt/min = -------------------------- = 20.7 = 21gtt/min 60 min
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IV Medications: IVPB
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The volume of the piggyback container is usually 50 to 100 mL and should infuse over 20, 30, or 60 minutes, depending on the type and amount of medication added.
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IV Medications (IVPB): Calculate rate (gtt/min) Order : Keflin 2 g IVPB over 30 min. The Keflin is placed in 100 mL of fluid after it is dissolved. The drop factor is 15 gtt/mL.
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Drop factor: 15 gtt/mL Time: 30 min Volume= 100 mL 100 (mL) X 15 (gtt/mL) gtt/min = -------------------------------- = 50 gtt/min 30 min
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Determining the Amount of Drug in a Specific Amount of Solution
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Sometimes medications are added to IV solutions, and the prescriber orders a certain amount of the drug to be given in a certain time period. 1- Calculate the number of mL of solution needed to deliver a certain amount of the drug per hour 2- Determine rate of flow (gtt/min)
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Order: 20 mEq of potassium chloride to be placed in 1000 mL of fluid to be administered at a rate of 2 mEq of potassium chloride per hour.
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1- Calculate the number of mL of solution needed to deliver 2 mEq of potassium chloride per hour. 20 mEq : 1000 mL = 2 mEq : x (mL) 20x = 1000 x 2 20x = 2000 x= 100 mL ** 100 mL of fluid needed to administer 2 mEq of potassium chloride per hour. 2- Determine flow rate (Drop factor: 15 gtt/mL) 100 (mL) X 15 (gtt/mL) gtt/min = -------------------------------- = 25 gtt/min 60 min **25 gtt/min would deliver 2 mEq of potassium chloride per hour from this solution
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Order: 15 mEq of potassium chloride in 1000 mL of D5 and 1/2 NS to be administered at a rate of 4 mEq per hour.
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How many mL of solution are needed to administer 4 mEq/hr? 15 mEq : 1000 mL = 4 mEq : x (mL) 15x = 1000 x 4 15x = 4000 x= 266.6 = 267 mL ** 267 mL of fluid needed to administer 4 mEq per hour. Calculate the rate in gtt/min at which to deliver 4 mEq/hr. (Drop factor: 10 gtt/mL) 267 (mL) X 10 (gtt/mL) gtt/min = -------------------------------- = 44.5= 45 gtt/min 60 min **45 gtt/min would deliver 4 mEq of potassium chloride per hour from this solution
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Determining Infusion Times and Volumes
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Amount of solution (mL) X Drop factor x (gtt/min) = ---------------------------------------------------- Time in minutes
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Steps to Calculating a Problem with an Unknown with the Formula Method
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1- Take information given in the problem and place in the formula. 2- Place an x in the formula in the position of the unknown. If you're trying to determine time in hours, place x in the position for minutes; once you find the minutes, divide the number of minutes by 60 (60 minutes= 1hr) to get the number of hours. 3- Set up an algebraic equation so that you can solve for x. 4- Solve the equation 5- Label the answer in hours or mL for volume.
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Determining hour: IV is regulated at 20 microgtt/min. How many hours will it take for 100 mL to infuse?
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Note: If an IV is regulated at 20 microdrops, then the drop factor is a microdrop (60 gtt/mL). 100 mL X 60 gtt/mL 20 microgtt/min = ------------------------------ x time in minutes 20x = 100 x 60 20x = 6000 x= 300 min Change minutes to hours: 60 minutes= 1 hr 300 / 60 = 5 hours
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Determining volume: IV is regulated at 17 macrogtt/min. Drop factor = 15 gtt/mL. How much fluid volume in mL will the client receive in 8 hr?
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Change minutes to hours: 60 minutes= 1 hr 8 hr x 60= 480 minutes x (mL) X 15 gtt/mL 17 macrogtt/min = ------------------------------ 480 min 15x = 17 x 480 15x = 8160 x= 544 mL
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Recalculating IV Rate
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The recalculated flow rate should not vary from the original rate by more than 25%. Check with the prescriber regarding an IV increase >25%. To determine the percentage of increase and decrease, divide the amount of increase or decrease by the original rate.
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Recalculating IV Rate
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IV flow rates must be monitored by the nurse. When IV solutions are behind or ahead of schedule, the flow rate must be recalculated by using the following equation: Volume (mL) remaining -------------------------------- Time remaining
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Calculating Total Infusion Time
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Total number of mL to infuse ------------------------------------------- = Total infusion time mL/hr infusing at
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Calculating Total Infusion Time When Rate in mL/hr Is Not Indicated for Large Volume of Fluid
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1. Convert gtt/min to mL/min 2. Convert mL/min to mL/hr 3. Total number of mL to infuse --------------------------------------- mL/hr infusing at
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Calculate infusion time (mL/hr not indicated) A client is receiving 1000mL of RL. The IV is infusing at 21 macrogtt/min (21 gtt/min). The administration set delivers 10 gtt/mL.
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Change gtt/min to mL/min 10 gtt : 1 mL = 21 gtt : x (mL) = 2.1 mL/min Convert mL/min to mL/hr 2.1 mL/min X 60 min = 126 mL/hr Calculate infusion time 1000 mL -------------- = 7.93 = 7 hours 56 minutes 126
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Calculating Total Infusion Time (Small Volume)
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1. Calculate the mL/min 2. Divide the total volume by the mL/min to obtain the infusion time. The infusion time will be in minutes
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Calculate infusion time for small volume
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Calculate infusion time: An IV medication of 35 mL is infusing at 30 macrogtt/min. Drop factor: 15 gtt/mL 1. Calculate the mL/min 15 gtt : 1 mL = 30 gtt : x(mL) = 2 mL/min 2. Divide the total volume by the mL/min 35 mL divided by 2 mL/min = 18 minutes
