Chapter 6: Calculation of Basic IV Drip Rates; Henke’s Med Math – Flashcards
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Dextose
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D
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Water
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W
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Normal Saline
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NS
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5% Dextrose in Water
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D5W
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0.9% Normal Saline in water (normal saline)
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0.9% NS
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0.33% Normal Saline in water (1 /3 normal saline)
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0.33% NS
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0.45% Normal Saline in water (1 / 2 normal saline)
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0.45% NS
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When the set is small, and the drops are small as well all sets deliver 60 drops per mL (60 gttt/mL)
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Microdrip
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Infusion sets without a small needle the package label will always state the drops per mL for this infusion set.
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Macrodrip
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The tubing factor for this is 60 gttt/mL. to solve with an Infusion pump use this formula: number of ML ordered --------------------------- = ml/Hour number of hours to run
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Infusion pumps
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Every Iv must be labeled so that any professional can check both the fluid that is being infused and the drip rate. A typical order includes the following information: *patient name *room *bed number *date *time
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Labeling Ivs
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PATIENT NAME: BRIYANA JACKSON ROOM: 1234B BED NUMBER: 2 DATE: 8/26/15 TIME: 1306 (1:06PM)
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Example: Label the IV Order: 500 mL D5W 1 / 2 NS Rate: 50 mL/hr.
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Calculation Number of mL to infuse x TF ----------------------------------- = Drops per min (gtt/min) Number of minutes to infuse
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Calculating Basic IV Drip Rates
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there are 20 gtt/min 120 mL x 10 gtts ------------------- = 20 gtt/min 60 mintues
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Example: Order: Infuse 120 mL of IV Fluid over 60 minutes with a tubing factor of 10 drops per mL. solve this calculation.
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total number of mL ordered -------------------------------- = mL/hr. number of hours to run
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Solving IV calculations Using an Infusion Pump
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run 120mL/hr. 120 mL --------- = 120 mL 1 hour (60 min= 1 hour)
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Example: Order: Infuse 120 mL of Iv Fluid over 60 mins. Infusion pump Included
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Drip rates are always rounded to the nearest whole number unless using an infusion pump that can infuse in tenths or hundredths.
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REMEMBER:
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* IV is administered for a long time *a small amount is being infused *the macrodrops are to few
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Use microdrip when:
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*the order specifies a large amount over a shorter period of time *the microdrips per min are too many, and counting the drip rates becomes to difficult.
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Use Macrodrop when:
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83 mL/hr 1000 mL ----------- = 83.333 rounds to just 83 (round to whole#) 12 hours
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Example: Order: 1000 mL D5W IV 8AM-8PM Available: an infusion pump How long is it running?: 12 hours
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Micro: 500 mL x 60 gttt ------------------- = 125 gttt/min 240 min (60 x 4) Macro: 500 mL x 20 gttt ------------------ = 41. 6 or 42 gttt/ min 240 min Choose either one label the IV set the drip rate
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Order: 500 mL NS iv 12 Noon- 4pm Available: microdrip at 60 gttt/mL; macrodrip at 20 gttt/mL How long will the IV run? 4 hours Because there us no pump available, the nurse must choose the drip factor. Solve for both drip factors and choose one. Round to the nearest whole number
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Micro: 500 ml x 60 gttt ------------------ = 21 gttt/ min 1440 min Macro: 500 mL x 10 gttt --------------------- = 3 gtt/min 1440 min Choose the Micro why? it;s being administered for a long period of time a small amount is being infused the macrodrips are to few
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Order: 500 mL D5W IV KVO for 24 hours Available: microdrip at 60 gttt/min; macro at 10 gttt/min How long will it run? 24 hours or 1440 minutes Work out the problem and figure out which tubing is best to use for this patient.
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Knowing how long an IV will last will prepare you for whether the IV is moving to fast or slow, or whether you need to prepare the next IV Number of mL ordered -------------------------- Number of mL per/Hr.
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Determining Hours an IV will Run
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Run for 6.7 hours or 6 hours and 42 minutes (take .7 x 60 = 42 minutes) 500 mL ---------- = 6.7 Hours 75 mL
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Example: Order: 500 mL NS IV ; infuse at 75 mL/hour
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No math is needed. the Iv will last for 12 hours
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Order: 1000 mL 1/2 NS iv 8am-8pm
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it will run for 10 hours 500 mL ---------- = 10 Hours 50 mL in this example the amount of drug is not needed for the calculation of IV Rate
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Order: 500 mg in 500 mL D5W IV at 50 mL/hour
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When a continuous IV order includes a medication, generally this medication arrives already premixed in the infusion bag or the pharmacist can add it on site. Sometimes as the nurse, we have to add the medication ourselves and determine the rate of flow. if this happens: first calculate how much of the medication to add to the IV fluids then calculate the drip rate.
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Adding Medications to IVs
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Add 10mL to the Iv bag 20 mEq ------------ x 20 mL = 10 mL 40mEq Micro: 1000 mL x 60 ------------------ = 83 gtt/min 720 min Macro: 1000 mL x 20 ------------------ = 28 gtt/min 720 min
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Example: Order: 1000 mL D5W with 20 mEq KCl IV 10 am- 10 pm Available: a vial of KCl 40 mEq/20 mL; Micro 60gtt/min, macro 20 gttt/min How long it's running?: 12 hours or 600 mintues Calculate how many mL to add to the IV Fluids first, then solve both tubing's and pick which one you want to use.
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add 2.5 mL to the Iv 250 mg / 1000 mg x 10 mL = 2.5 Micro: 50 x 60 ----------- = 50 60 min
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Order: 250 mg in 250 mL ; run at 50 mL/hour for 1 hour Available: ampule labeled 1 g in 10 mL; Microdrip 60 gttt/min
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Some Iv medications are given not continuously but intermittently such as every 4,6,8 hours. this is known as IVPB. To solve IVPB problems, you can use the calculation much like the one needed for the IV: mL x TF ------------ = gtt/min minutes mL= given TF= normally macro, but given min= this may or may not be given, when it is not given however follow this general rule for adults; allow 30 mintues for ever 50 mL of solution.
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Medications for for Intermittent IV administrations
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give 17 gtt per min 50 mL x 10 ------------ = 17 gtt/min 30 mintues
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Example: Order: 1 g IVPB Supply: Package insert IVPB dilution. Reconstitute with 50 to 100 mL of sodium Cl injection. Use a 50 mL bag of D5W. No time was given so use 30 min for 50 mL.
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21 gtt/ min 250 ml x 10 --------------- = 21 gtt 120 min
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Order: 1 g in 250 mL IVPB 7am Supply: 500 mg powder reconstitute with 10 mL sterile water to yield 50 mg/ mL Tubing factor: 10 gtt/ mL Package insert directions: 250 mL D5W Run over 2 hours
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When your using an infusion pump for IVPB, solve the problem by setting the TF to 60 gtt
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FACT!!
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Diluting tube feeding involves mixing the nutritional supplement with a specific amount of water. the most common dilutions are: 1/2 strength 1 / 4 strength (one quarter) 1/3 strength (three quarter)
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Dilution Calculations
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Take the strength of the volume and multiply them together example: 1/4 x 250 mL= 62.5 mL Subtract your volume from this number 250 mL - 62.5 mL = 187.5 mL The number you get tells you how much water to add to the feeding bag, then infuse at the hour given.
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To solve Dilution Problems:
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Add 125 mL of water 1 /2 x 250 = 125 250 - 125= 125 mL
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Example: Prepare 1 / 2 of Isocal at 60 mL/hour. Total volume will equal 250 mL
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Add 62.5 3 /4 x 250= 187.5 250 - 187.5 = 62.5 mL
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Prepare 3 /4 Isocal at 6o mL/ Hour. Total volume will equal 250 mL
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Usually when a IVPB is infusing, the PRIMARY stops infusing. After the IVPB is completed, the primary IV flow begins again.
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Recording Intake
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11 hours x 50 of primary IV = 550 1 HOUR of IVPB x 100 = 100 --------------------------------------- 12 hours= 650 mL intake.
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Example: The primary IV is infusing at 50 mL/hour. For 12 hours, the IV intake would be 600 mL (12 x 50 = 600). If you administer an IVPB of 100 mL once during the 12 hours and infuse the IVPB at 100 ml /hour, then your intake would be as follows:
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900mL ----------- = 9 HOURS 100 ml 9 AM + 9 HOURS = 6 PM
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A total of 900 mL of an IV solution is to infuse at 100 mL/ hour. If it is 9 am when the infusion starts, at what time will it be completed?
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75 x 4 = 300 mL (24 hours/ 6 hours is 4 times 75 mL is being infused over 24 hours) 125 x 20 = 2500 mL answer is 2800mL
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A patient/ client is receiving an antibiotic IVPB in 75 mL q6h to run over 1 hour plus a maintenance IV of 125 mL/hour. What is the 24 hour intake parenterally?
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10000 x 10 -------------- = 21 gtt/min 480
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An IV of 1,000 mL is infusing at 10 microdrips per min. what is the intake for 8 hours?
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80 mL 10 microdrips x 8 = 80 mL
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An Iv of 1000 mL is infusing at 10 microdrips per min. what is the parenterally intake for 8 hours?
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The IV is 0.5 g or 500 mg in 500 mL. this is equal to 1 mg= 1 mL the patient receives 50 mL per hour so he or she receives 50 mg each hour
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A doctor orders 500 mL with aminophyllline 0.5 g to infuse at 50 ml /hour. How many milligrams will the client receive each hour?
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50 x 3 = 150 (24 hours divided by 8 = 3, that's 3 times 50 mL was infused in 24 hours) 100 x 21 = 2100 (24-3 times it was given) answer is 2250
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A patient is receiving an antibiotic IVPB in 50 mL q8H to run over 1 hour plus a maintenance IV of 100 mL/ hour. What is the 24 hour parenterally intake?
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250 x 4 = 1000 (24 / 6=4, 4 times 250 mL was infused in 24 hours) Answer is 1000 mL
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A patient is receiving an antibiotic IVPB in 250 mL q6h. What is the 24 hour parenterally intake?
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The IV is 100 units in 100 mL or 1 Unit/mL. They receive 10 mL per hour so he or she receives 10 units each hour 100 ------ = 1 unit/ mL x 10 = 10 units 100
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A physician orders 100 units of regular insulin in 100 mL to infuse at 10 mL per hour. How many units will the patient receive each hour?
