1.Enoxaparin 1.5 mg per kg once a day is prescribed for a patient weighing 50 kg.A prefilled syringe with enoxaparin 80 mg per 0.8 mL is
Question Answered step-by-step 1. Enoxaparin 1.5 mg per kg once a day is prescribed for a patientweighing 50 kg. A prefilled syringe with enoxaparin 80 mg per 0.8 mL is available. How many milliliters (mL) should be administered? 2. The physician prescribes lorazepam 250 mg in 250 mL to run at 2 mg/hr. At what rate should you set the pump? 3. The patient is admitted in atrial fibrillation. The physician orders Cardizem to run at 5 mg/hr. The pharmacy supplies Cardizem 10 mg in 125 mL of 0.9%NSS. At what rate do you set the pump? 4. Order: 250 mL of a medication to be administered over 4 hours. Available: tubing with drip factor of 60 gtts/mLHow many gtts/min will the medication be administered? 5. Order: 500 mL of a medication to be administered over 12 hours.Available: tubing with drip factor of 30 gtts/mLHow many gtts/min will the medication be administered? 6. Physician orders Heparin to be infused at 8 units/kg/hr. The patient weighs 120 lbs. The pharmacy stocks the medication as 25,000 units of heparin in 250 mL of 0.9%NSS. How many mL/hr will you program the pump? 7. Physician orders regular insulin to be infused at 10 units/hr. The patient weighs 220 lbs. The pharmacy stocks 100 units of regular insulin in 100 mL of 0.9%NSS. How many mL/hr will you program the pump? GWYNEDD VALLEY HOSPITALGWYNEDD VALLEY, PADate/ Time Cardiac Heparin Order Set Pharmacy Mnemonic: HEP PROT Patient weight: ________ kg Heparin Infusion 25,000 units per 250 mL NSS 0.9% = 100 units per mL 1. Heparin bolus dose: (Max. 4,000 units) ___________ units IV PUSH 2. Initiate Infusion: ____________ units per kg per hour (Max. 1,000 units per hour or 10 mL per hour) IV = mL per hour. (Round to nearest mL) DO NOT GIVE ENOXAPARIN (Lovenox) or FONDAPARINUX (Arixtra) WHILE PATIENT IS ON HEPARIN 3. TITRATE AS FOLLOWS TO MAINTAIN PTT = 50 – 70 seconds Write order and send to Pharmacy for any rate changePTT (seconds)Dosing AdjustmentCheck PTTLess than 40Increase rate by 2 mL per hour6 hours41 to 49Increase rate by 1 mL per hour6 hours50 to 70Maintain rate, at goalNext a.m.*71 to 85Decrease rate by 1 mL per hour6 hours86 to 100Stop heparin infusion for 30 min and decrease by 2 mL per hour6 hours101 to 150Stop heparin infusion for 1 hour, and decrease by 2 mL per hour6 hoursGreater than 150Stop heparin infusion for 1 hour, and decrease by 2 mL per hour2 hours Recheck PTT. Call Physician and Anticoagulation Service (ext. 6000) Then follow Protocol. Do not increase rate if repeat PTT is < 50. * If within first 24 hours, repeat PTT in 6 hours, otherwise monitor daily 4. LAB: PTT, PT/INR, CBC w/diff now, if not already ordered today. PTT in 4 hours after heparin infusion begun, and as per titrating dosing orders. PTT daily, until heparin discontinued. Platelet count q 2 days until heparin discontinued. For the following questions, please refer to the heparin protocol on the previous page. 8. A patient was admitted to your unit with a new onset of uncontrolled atrial fibrillation. The physician initiates a heparin protocol. The patient weighs 160 lbs. The bolus ordered is 40 units/kg and the pharmacy stocks vials of heparin 5000 units/mL. How many milliliters (mL) will you administer? 9. After the bolus is administered, you prepare the patient to receive a heparin infusion to run at 8 units/kg/hr per the physician’s order. How many mL/hr will you program the pump? 10. After 6 hours, the lab calls with your patients first PTT result of 92 seconds. What is your action at this time? 11. What is the new infusion rate (if indicated)? 12. When do you check your patient’s next PTT? 13. The physician orders IVF D5W 1 liter to run at 80 mL/hr You hang your first bag at 0815. What time will the bag finish? Record your answer in military time. 14. Your patient consumes 1 scoop of eggs, 2 pieces of toast with 1 tsp of butter and 1 tsp of jelly on each piece, 6 oz of coffee and 120 mL of orange juice for breakfast. For her 1000 medications, you hang a piggyback 100 mL of Ceftriaxone, 2g, to run over 1 hour. She also asked for a can of ginger ale – you give her a 4oz can from the kitchen area. Shortly after, she complains of nausea and vomits a total of 120 mL; she also uses the bathroom for 200 mL of clear urine. For lunch, your patient is feeling a little better and orders broth. She consumes 6 oz of broth and another 4 oz of ginger ale. During the afternoon, your patient voids another 300 mL of clear urine. For dinner, she consumed 4oz of orange gelatin and 6oz of chicken broth. With her 1800 medications, she consumes 120 mL of water. Prior to your shift ending, she voids again for 300 mL of urine. Your patient also was receiving IVF of NSS 0.45% at 100 mL/hr over the course of your 0700-1900 shift. Calculate your patient’s intake and output for your shift. Intake: ____________ Output: ____________ 15. A physician orders 1 liter of Ringers Lactate to run at 125 mL/hr; how many hours will it take for the bag to infuse? 16. A child weighs 90 lbs and has an order to receive gabapentin 300 mg three times a day. The recommended dose for a child is 5 to 10 mg/kg/dose. What is the safe dose range for this child? _________________ to __________________ 17. A child weighs 85 lbs and has an order to receive phenytoin IV. The order is for 6 mg/kg/day in two divided doses. How many milligrams (mg) of medication should be administered per dose? 18. Order: 250 mg of a medication to be administered 4 times a daySupply: 500 mg tablets, scored.How many tablets would you administer per dose? 19. Order: 1000 mg of a medication to be administered every 8 hours x 1 day.Supply: 500 mg tablets, scored.How many tablets would you administer in total? 20. Order: Augmentin 250 mg to be administered twice a day.Supply: Augmentin 400mg/5mLHow many mL would you administer per dose? 21. The physician orders dobutamine at 7mcg/kg/min. The concentration is dobutamine 1g in 200mL of 0.9% NSS. The patient weighs 55kg. How will you program the pump? 22. The provider orders epinephrine 2 mcgs/min. The concentration of epinephrine available is 1 mg/150 ml NSS. How many ml/hr will you program the pump? 23. A type 1 diabetic presents with increasing lethargy; his mom stated that his symptoms began this afternoon. A fingerstick reveals a glucose level of 630mg/dL. The ab confirms a critical value of 660mg/dL on the chemistry profile. An insulin drip is ordered to run at 25 units/hr. The pharmacy stocks 100 units of regular insulin in 100mL of 0.9% NSS. How will you program your pump? The power went out and you quickly convert the medication off pump. Your tubing drip factor is 10gtts/mL. How many drops per minute will you run the insulin? 24. Convert: 60 mg _______________ kg 25. Convert: 5mg _______________g 26. Convert: 60 kg _____________ lbs 27. Convert: 3 Tblsp ______________mL 28. Convert: 30mL ________________tsp 29. Convert: 10 tsp _____________ L 30. Patient is ordered 120mg of Tobramycin; how many mL will you draw from the vial? What is the route(s) that this medication can be administered? 31. A five year old patient weighs 13kg, and is ordered Prednisilone PO. The safe dosing in pediatrics is 1-2mg/kg/dose. What should the patient’s dose of Prednisilone be in milligrams? ________________ to ________________ 32. A two year old patient is ordered 150mg of Tylenol PO. The patient weighs 10kg. The infant droppers of Tylenol are dosed 80mg/0.8mL. The health care professional ordered this medication based on the safe dosage range of 10-15mg/kg/dose. How many milliliters should the nurse draw up? Is this dose safe? 33. A fifteen-year old patient is having nausea, and is ordered 3mg Zofran IV PRN every 8 hours. The patient has not had this medication yet, so you are going to give her a dose. Zofran is dosed 4mg/2mL. How many milliliters should you draw up? 34. A six-year old patient weighs 59.4lbs and is getting 270mg clindamycin IV every 6 hours. The health care professional ordered this medication based on the dosing: 25 mg-40mg/kg/day. Is this dose safe? CAN YOU SHOW WORK TOO? Health Science Science Nursing NUR 419 Share QuestionEmailCopy link Comments (0)
