Question: The Patient Medication Order Reads Cyanocobalamin 500 Mcg IM Now

The patient medication order reads “Cyanocobalamin 500 mcg IM now.” You find a vial of cyanocobalamin that is 1,000 mcg/mL and give the patient a 1 mL injection in the deltoid muscle of her left arm. When you get ready to chart the medication, you realize you should have given only 0.5 mL of the medication. What should you do now? Terms In This Set (35) calculating IV drop factors

Volume (mL)/Time (hr) * drop factor (gtt/ml)/60 different types of syringes and uses tuberculin – tb tests, intradermal, 1 mL, tenths to hundredths calibration insulin – insulin only, U-100, lo dose and 1 mL, units, subq

  • IM – intramuscular
  • PCA patient controlled analgesia name different parts morphine (1 mg/mL) – concentration
  • Continuous/basal dose – amount that goes in even if the pump is not pushed by patient
  • PCA (demand dose) – what is given when patient pushes the pump
  • Locket (PCA) interval -amount of time that the pump is locked out for

Hourly dose limit (includes continuous dose) – the maximum amount the patient can push within an hr

Clinical loading dose – the amount that the RN administers from the beginning, the very first dose Rule of 9’s parkland burn formula that determines the percentage of the body is burned. Add together the percentages anterior and posterior. PCA calculations patient push total amount received (mL)/ PCA dose = number of pushes by pt. PCA calculations dose per hr divide 60 mins/PCA lockout = number of total doses PCA dose * number of total doses = PCA dose per hr calculating doses

(Dose ordered/ dose on hand) * Quantity = X dose

Determining infusion times and volumes

Gtt/min= amount of solution (mL) * drop factor / Time (min) reading prescription labels, know equivalents other sheet order: amoxil 0.5 g po q6h available: amoxil caps 250 mg/capsule how many capsules will pt receive (500 mg/250 mg) * 1 = 2 capsules to ensure accuracy and reduce misinterpretation place a zero before the decimal point T/F true bid twice a day pc after meals

  • 5.2 kg = ? g
  • 5200 g
  • 30 mL = ? oz
  • 1 oz
  • 10 t = ? mL
  • 50 mL
  • 1 t = ? mL
  • 4 mL
  • 80 mg is equivalent to 0.08 g a medicine ordered q6h would be given how many times a day
  • 4
  • 1 oz is equivalent to
  • 30 mL
  • order: furosemide 15 mg IM qd
  • available: furosemide 20 mg/2 mL

How many milliliters will be administered?

  • 15 mg/ 20 mg * 2 = 1.5 mL order: compazine 8 mg po stat available: compazine syrup labeled 5 mg per 5 mL

How many milliliters will you administer?

  • 5 mg/5mL = 1 to 1
  • 8mg =8 mL

A client’s intake was the following:

  • 1 1/4 cup (10 oz) of coffee, 4 oz of cranberry juice, 1 1/2 bowl of chicken broth (9 oz), 3
  • 1/2 glasses of water (21 oz)

The client voided urine as follows: 240 mL, 160 mL, 500 mL and 425 mL

Calculate the client’s intake and output in mL

A. Intake: ___mL B. Output: ___mL intake: 23+21 = 44 oz = 44*30 = 1320 mL output:1365 mL

The physician prescribes 1000 mL of normal saline to be infused over a period of 10 hrs. The drop factor is 15 drops/mL. The nurse adjusts the flow rate at how many drops per minute?

  • Volume (mL)/Time (hr) * drop factor (gtt/mL)/60
  • 1000 mL/ 10 hr* 15 gtt/mL/60 = 25 gtt/min

The client is to receive 1000 mL of D5W at 100 mL/hr. The drop factor is 10 drops/mL.

The nurse adjusts the flow rate to deliver how many drops per minute?

  • Volume (mL)/Time (hr) * drop factor (gtt/mL)/60
  • 1000 mL/10 hrs * 10 gtt/mL/60 = 16.6=17

The physician orders 500 mL of 0.9% normal saline to rub over 6 hrs. The drop factor is

  • 10 drops/mL. The nurse adjusts the flow rate to run at how many drops per minute?
  • Volume (mL)/Time (hr) * drop factor (gtt/mL)/60
  • 500 mL/6 hrs * 10 gtt/mL/60 = 14

The physician’s order reads cyanocobalamin (Vit B12), 150 mcg IM. The medication label reads cyanocobalamin, 100 mcg/mL. The nurse prepares to administer how many mL to the client?

  • 100 mcg per 1 mL 150 mcg = 1.5 mL
  • 150/X = 100/1 mL =
  • 100X=150=
  • 150/100=1.5 mL
  • 850 mL ringer lactate at 40 mL/hr

Determine the infusion time and completion time in military and traditional time

The IV started at 7am. When will the infusion be complete?

What type of syringe is used for heparin?

  • tuberculin

What type of syringe is used for Humulin regular U-100 units

  • insulin

A child weighs 45 lbs. What is their weight in kg? Always round weights to the tenth place

  • 45 / 2.2 = 20.5 kg

A child is ordered gentamicin 45 mg IV q8h, the recommended dosage is 6-7.5 mg/kg/day in 3 divided doses, what is the safe 24 hr dosage range for this child? Is his dosage safe? round to nearest tenth place

  • 6*20.5 = 123 7.5 * 20.5 = 153.75 range: 123 mg – 153.8 mg

Yes 45 mg is safe because 45 * 3 = 135 mg how to calculate Body surface area 

Formula

  • BSA= Sq root (Wt (kg) * Ht (cm))0/3600 calculate the body surface area using formula for a child weighing 13 kg and 65 cm.
  • BSA= Sq root (Wt (kg) * Ht (cm))/3600
  • Sq root ((13 kg * 65 cm)/3600) = 0.48 = 0.5

THIS SET IS OFTEN SAVED IN THE SAME FOLDER AS…

Terms In This Set (30)

A male client receives a prescription for ondansetron hydrochloride (Zofran) 4 mg IV to prevent postoperative nausea after an inguinal hernia repair. The medication is available in 2 mg/ml. How many ml should the nurse administer? (Enter numeric value only.)

  • Use ratio and proportion, 4 mg : X ml = 2 mg : 1 ml 2X = 4 X = 2

The nurse is preparing to administer Hepatitis B Vaccine, Recombinant (Engerix-B) 5 mcg IM to a school-aged child. The vaccine is labeled, 10 mcg/ml. How many ml should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth).

  • Use ratio and proportion, 5 mcg : X ml :: 10 mcg : 1ml 10X = 5 X = 0.5 ml

At the end of the shift, the nurse is recording the fluid balance for a client receiving a continuous gastrostomy tube (GT) feeding. Based on the client’s records, how many ml should the nurse record for the total fluid balance (intake – output) for the shift that started at 0700 and ended at 1900? (Enter numeric value only.) (Click on each image asset for additional information.)

695

The tube feeding is administered at 75 ml/hour for 11 hours (0700 – 1800) and then turned off for one hour because the residual is greater than 200 ml. 11 hours x 75 ml/hr = 825 ml. Three doses of 20 ml of medication are administered, with 10 ml of water used to flush the GT before and after each dose. 20 ml x 3 doses = 60 ml; 10 ml (flush) x 2 x 3 doses = 60 ml; so 825 ml + 60 ml + 60 ml = 945 ml. 250 ml of residual is removed and not replaced. 945 ml – 250 ml = 695 ml total fluid balance (Intake – output).

A 180-pound adult male is admitted to the Emergency Center after receiving thermal burns to 60 percent of his body. Using the Parkland formula of 4 ml/kg/24 hours, the client should receive how many ml of fluid during the first 24 hours? (Enter the numeric value only. If rounding is required, round to the nearest whole number.)

19632

Using the Parkland formula, the client’s fluid requirements for the first 24 hours after injury: 4 ml lactated Ringer’s solution x Body weight (in kilograms) x Percent burn.

Convert 180 pounds to kg = 180 / 2.2 = 81.8 kg 4 ml x 81.8 kg x 60 = 19632 ml over the first 24 hours.

The healthcare provider prescribes acetazolamide (Diamox) 600 mg/m2/day divided into 3 doses. The nurse calculates the child’s body surface area (BSA) as 0.7 m2. How many mg should the child receive per dose? (Enter the numeric value only.) Using the child’s BSA, 0.7 m2, calculate the mg/dose, 600 mg x 0.7 m2 = 420 mg/day/3 doses = 140 mg/dose

A loading dose of acetylcysteine (Mucomyst) 8 grams, which is available as a 20% solution (200 mg acetylcysteine per ml) is prescribed by nasogastric tube for a client with acetaminophen toxicity. How many ml of diluent should be added to the medication to obtain a 1:4 concentration? (Enter the numerical value only. If rounding is required, round to the whole number.)

8 grams = 8,000 mg prescribed dose. Using the formula, D/H x Q, 8,000 mg / 200 mg x 1 ml = 40 ml of the 20% solution. Dilute the 40 ml to a 1:4 concentration for administration using ratio and proportion, 1 : 4 solution :: 40 ml : X X= 160 ml total volume to administer. Subtract total volume of 160 ml – 40 ml of 20% concentration = 120 ml diluent is added to obtain a 1:4 concentration.

A child who weighs 55 pounds receives a prescription for atovaquone with proguanil (Malarone Pediatric) 125 mg/50 mg PO daily. A drug reference states that children 11 to 20 kg should receive 1 pediatric tablet daily; 21 to 30 kg should receive 2 pediatric tablets daily; 31 to 40 kg should receive 3 pediatric tablets daily; and those greater than 40 kg should receive 1 adult tablet daily with food. The drug is available as atovaquone 62.5 mg/proguanil 25 mg pediatric tablets. How many tablets should the nurse administer?

Calculate each drug component dose, using the formula, D/H 125 mg / 62.5 mg (atovaquone) = 2 combined with 50 mg / 25 mg (proguanil) = 2. The child should receive 2 tablets.

A child who is scheduled for a kidney transplant receives a prescription for basiliximab (Simulect) 20 mg IV 2 hours prior to surgery. The medication is available in a 20 mg vial that is reconstituted by adding 5 ml sterile water for injection, and administered in a 50 ml bag of normal saline over 30 minutes. The nurse should program the infusion pump to deliver how many ml/hour? (Enter the numeric value only.)

After reconstituting the medication vial, the nurse adds the 5 ml of medication to the 50 ml of sterile water to result in a 55 ml volume to infuse in 30 minutes. Using the formula,

  • Volume/Time = 55 ml / 0.5 hours = 110 ml/hour

A client with a gastrostomy tube (GT) receives a prescription for Osmolite® 1/2 strength enteral formula at 80 ml/hour. To prepare a 4 hour solution, the nurse should dilute the full-strength formula with how many ml of water? (Enter numeric value only.) Determine the total volume needed at 80 ml/hour x 4 hours = 320 ml. Use the formula, Desired strength/strength on Hand x Volume = 50/100 x 320 = 160 ml of Osmolite® enteral formula, which must be diluted to half strength. Or use ratio and proportion,

Desired strength (1/2 = 1 part : 2 parts) :: Volume of full strength : Total Desire volume 1

  • : 2 :: X : 320 ml 2X = 320, and X = 160 ml of Osmolite® enteral formula, full strength 320 ml total volume – 160 ml of full-strength formula = 160 ml of water to create 1/2 strength or 50% concentration.