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Dosage calulations part 2
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- 3. 32 TUBING CALIBRATIONS MACRO TUBING 10 gtt/ cc 15 gtt / cc 20 gtt / cc printed on Package Called Set calibration •You MUST know that a microdrip or microdrop set or minidrip or minidrop set always = 60gtts/cc. MICRO TUBING = 60 gtts / cc
- 4. 4 3 IV Flow Rates Expressed: cc/hrand gtt/min 1. Find the cc/hr flow rate 2. Find the gtts/min flow rate
- 5. 5 MEMORIZE FORMULA VOLUME ÷TIME = CC/HR. (in cc) (in hrs)
- 6. 6 IV Flow Rates Examplescc/hr. #1 Order: LR 1000cc over 8 hrs (Vol) 1000 ÷ 8 (time) = 125 cc/hr. Use whole # for drip rates #2 Order: NS 500cc over 12 hrs 500 ÷ 12 = 41.6 = 42 cc/hr Use whole # for flow rates
- 7. • Example: gtts./min. •Memorize formula: • cc/hr. x gtt factor 60 min. #1. • 125cc/hr , set calibration or drop factor is 15 gtt/cc • 125 x 15 = 31.25 or 60 31 gtts./min. 7 IV FLOW RATES
- 8. 8 COMMON IV PROBLEM #1 Order 1L D5LR Over 8 hrs. set calibration is 20 gtts./cc Find 1. cc/hr. 2. gtts/min.
- 9. 9 1) 1000cc ÷8O ’s = 125cc/hr 2) 125cc x 20 gtt/cc 60 min = 41.6 gtt/min or 42 gtt/min
- 10. Common IV problem #2 • Order: 500cc of D5W over 24hrs. Use a mini/micro dripper . • 1. Find cc/hr • 2. Find gtts/min. 10
- 11. Answer 500 ÷ 24= 20.83 or 21 cc/hr 21 x 60 = 21 gtts/min. 60 cc/hr = gtts/min. 11
- 12. 12 IV FLOW RATES •ANYTIME YOU HAVE A SET CALIBRATION OF 60 gtts / cc Also called drip factor/drop factor, as you do with a mini/micro dripper cc/hr.= gtts/min.
- 13. 13 Example: Time <1 hour Order Ampicillin 250 mg/30 cc over 30 mins Ignore extraneous info like medication /dose VOLUME ONLY Set calibration: 15gtt/cc 30cc x 15gtt/cc = 30 min 15 gtt/min
- 14. Example 2, Piggyback medications • 1 g of Methicillin in 50cc to run over 30 minutes • Using a micro dripper, how many drops per minute should IV run? 14
- 15. Example 2 50 ccx 60 = 30 min. 100 gtts/min 15
- 16. 16 33 Infusion Time Total timefor given volume of IVF to infuse Infusion Time = Total Vol. cc/hr. Example 1 = 1L NSS @ 100cc/hr. 1000 = 10 hrs. 100 Example 2 1L D5W @ 125/hr. 1000 = 8 hrs. 125
- 17. 1733 MEDICAL QUESTION OF THE DAY •QUESTION • WHAT IS A • TABLET
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- 19. 19 PEDIATRIC IV MEDICATIONS • I IVMED INFUSION PUMP
- 20. 20 Heparin • anticoagulant • measuredin units • various concentration •Concentration for sc. = 10,000 units/cc 1000 units/cc = IV heparin 100 units/cc = CL heparin flush 10 units/cc = PHL flush
- 21. 21 Parenteral Medications s.c. subcutaneous **Shouldbe ≤ 1cc Heparin s.c is a common one.
- 22. 22 SC HEPARIN Order: 4000units Heparin s.c. now. On Hand: Heparin 1,000 units/cc Heparin 10,000 units/cc Which would you choose And why How much would you give
- 23. 23 SC Heparin If youchoose 1,000 units/ml 1000units 4000units 1 cc xcc 1000 x = 4000 x = 4 cc TOO MUCH s.c. So cannot go by closest concentration rule with s.c. injections, SO
- 24. 24 SC Heparin cont.. Choose10,000 units / ml 10,000 units 4000 units 1cc x cc 10,000 x = 4000 x = 0.4 cc OK for a subcutaneous injection
- 25. 25 Heparin Infusion Order 1000cc D5W+ 50,000 units heparin TRA 25 cc/hr *How many Units/hr is your patient getting 1000 cc : 50,000 units : 25 cc = X 1000x = 1,250,000 units X = 1,250 Units
- 26. 26 Order 1 L D5Wc 50,000units heparin Run @ 2,000 units per hour What is flow rate in cc/hr. 50,000 units :1,000 cc:: 2,000 units: Xcc 50,000x = 2,000,000 X = 40 cc/hr.
- 27. 27 HEPARIN INFUSION • ORDER: •1LNS with 50,000 units Heparin @ 30cc/hr. • How many units/hr is your patient receiving?
- 28. 28 HEPARIN INFUSION 1000cc :50, 000units :: 30cc: x units 1000x = 1,500,000 X= 1500 units /hr
- 29. 29 INSULIN INJECTIONS not onexam I liked this slide
- 30. 30 59 Critical Care Drugs 1.Ordered by dosages i.e., mcg/kg/min mg/min You will need to find cc/hr. 2. Should use IV pump! If not, use mini-dripper only! REMEMBER A MINI DRIPPER = 60 gtts / cc 3. Be sure you have like units. 4. Very potent drugs!!
- 31. 31 CRITICAL CARE CALCULATIONS Order: Lidocaine4mg/min On Hand: Lidocaine 1g/250cc What is IV flow rate?? cc/hr? 1. Convert to like units: 1g=1000mg 2. 1000 mg: 250 :: 4mg: x cc 1000x = 1000 x = 1cc/min.
- 32. 32 60 1 cc /minute, the question asked for cc/hr.!! WE NEED HOURLY RATE SO STEP 3. 3. Multiply by 60 min. to get cc/hr 1 cc/min (60 min) = 60 cc/hr is our answer.
- 33. 33 61 Order Pronestyl 3mg/min Have onHand 500mg Pronestyl in 250 cc D5W Rate in cc/hr?? 1. No conversion necessary 2. 500 mg : 250 cc = 3 mg : Xcc 500 x = 750 X = 1.5 cc/min. 1.5 cc/ minute , we need cc/hr.
- 34. 34 Pronestyl 3. calculate theflow rate in cc/hr 1.5 cc/min x 60 min ( per hr) = 90 cc/hr.
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- 36. 36 MEDICAL HUMOR •ANSWER •TO LIVELONG •LOL again
- 37. 37 ORDER 2.5 mcg/kg/min Have onHand Nipride 50mg/250cc Wt: 136 lbs Rate cc/hr ? 1. 136 · 2.2 = 61.8 kg ( 62kg.) 2.5 mcg. X 62 kg. = 155 mcg/min. 2. Convert to like units 155 mcg/min = ? mg/min = 0.155 mg/min 46
- 38. 38 Nipride 3. Calculate flowrate cc/min 0.155mg. : x cc :: 50mg : 250cc 50 x = 250 x ( 0.155) 50 x = 38.75 x = 0.775 cc/min. 4. Calculate flow rate cc/hr. 0.775/min x 60min/hr. = 46.5 cc/hr. or 47 cc/hr.
- 39. 39 64 Order Lidocaine 2 mcg/kg/min Haveon Hand: Lidocaine 1 g/250 cc Pt Wt: 62kg Rate? cc/hr. 1. 2 mcg x 62 kg = 124 mcg/min 2. 1g Lidocaine = 1000mg 124 mcg. = 0.124 mg.
- 40. 40 Lidocaine Problem cont.. 3.1000mg : 250cc :: 0.124 mg : x cc 1000 x = 250 ( 0.124) 1000 x = 31 x =0. 031 4. 0.031 cc/ minute Not finished , need cc/hr. SO, 0.031 x 60 = 1.86 cc/hr.
- 41. 41 Unacceptable Abbreviations • OFFICIALDO NOT USE LIST, ( and soon to be not used) IN DOSAGE CALC FOLDER • They are changing as we speak
- 42. Practice, Practice, Practicefor exam! Time yourself completing 50 questions , all types Practice all sets of practice problems again Memorize the abbreviations, etc.. Email me your questions 42