MATH 102 Chapter 8 Calculation of Basic IV Drip Rates.doc

8/17/2019 MATH 102 Chapter 8 Calculation of Basic IV Drip Rates.doc

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Chapter 8 Calculation of Basic IV Drip Rates

Microdrips

Macrodrips

Types of Intravenous FluidsSterile plastic bagsSterile glass bottles

Careful to prepare our solutionsvoid any errors ! "ay result in patient

electrolyte i"balance

#ritten order ! co"e fro" the physician$abel "ay be di%erent

D &' De(trose# &' #ater

)S &' )or"al Saline *+,-. saline&' +,- g per /++ "$0ater1

#ritten Supply/+++ "$ D2# /+++ "$ D2.#2++ "$ D2S 2++ "$ D2.+,-)S32+ "$ D2/43)S 32+ "$ D2.+,52)S

2++ "$ D2/46)S 2++ "$ D2.+,66)S2++ "$ )S 2++ "$ +,-. )S/+++ "$ /43 )S /+++ "$ +,52.)S

7inds of IV Drip Factors


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Chec Infusion Set9 See needle in the cha"ber9"icrodrip Deliver to the patient /"$ :uid

;+ drops < ;+ gtt < /"$

Infusion sets 0ith no needle in the cha"ber !"acrodrip

Ba(ter&Travenol "acrodrip set to deliver /+gtt4"$

bbott "acrodrip set to deliver /2 gtt4"$

Tubing for the above sets can be cla"ped *opened orclosed to set the drip rate1

Infusion pu"ps ! need only t0o pieces of info/1 total nu"ber of "illiliters31 nu"ber of "illiliters per hour *infusion rate1

Can also do IV=B

>rder9 2++ "$ D2# IVRun9 2+ "$4hour

=ri"ary versus SecondaryIV=B"picillin 3 g IV=B in /++"$ )S over / hour


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$abeling IVs$abel such that 0hat drip rate is and 0hat is beinginfused into the patient

=atient 7atherine =apade"asDate? Ti"e /+4+3? /6++>rder /+++ "$ D2#/43)S Ti"e /6++ to +/++Roo" 56;BRate 2+gtt4"inRun 2+ "$4hrInitials DD

)ote9 /+++ "$Run ti"e9 Finish ti"e ! start ti"e < total hours IVruns

Calculating Basic IV Drip Rates

"$4hour

Step /9 Total nu"ber of "$s ordered < no, "$4hr)u"ber of hours to run


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Step 39)u"ber of "$s4hr ( Tubing Drip Factor *TF1 < drops per "inute*gtt4"in1

)u"ber of "inutes

>rder9 /+++ "$ Ringer@s $actate IV 8a"&8p"vailable9 an infusion pu"p

$ogic9Run ti"e9 /3 hours

Step /9/+++ "$4/3 hours < 86,66*round to nearest 0hole nu"ber1

Anter9 total volu"e9 /+++ "$ "$4hr9 86

>rder9 2++ "$ D2)S IV /3noon&5p"vailable9 "icrodrip at ;+ gtt4"$

Macrodrip at 3+ gtt4"$

$ogicRun ti"e9 5 hr

Step /9 "$4hr < 2++ "$45hr < /32 "$4hr


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Step 39 Macrodrip calculation

"$4hr ( TF < /32"$4hr ( 3+ gtt4"$ < 5/,;

gtt4"in "in ;+ "in< 53 gtt4"in

/ hr < ;+ "in

Step 39 Microdrip calculation

"$4hr ( TF < /32"$4hr ( ;+ gtt4"$ < /32gtt4"in

"in ;+ "in

#hich one should you choose

Ese Microdrip 0hen

IV ad"inistered over a long period of ti"eS"all a"ount of :uid to be infusedMacrodrops per "inute are too fe0

Ese Macrodrip 0hen

$arge a"ount of :uid is ordered in a short ti"eMicrodrips per "inute are too "any and countingthe drip rate "ight be diGcult for the nurse


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)eed for continuous observationChec IV freHuently

ravity

=atient@s "ove"ents 9 in the tube#atch the :o0 of the :uid 0ith respect to0here the needle has been inserted ! chec forinJltration

S0elling=ainCoolness=allor at the insertion site

Ag, >rder9 2++ "$ D2/46)S IV 7V> for 35◦vailable9 "icrodrip at ;+ gtt4"$ "acrodrip/+gtt4"$#ill have to choose the IV set *as no infusion pu"p1

Step /9

"$4hr < 2++ "$435 hr < 3+,86 "$4hr < 3/ "$4hr

Step 39 Macrodrip

"$4hr ( TF < 3/ "$4hr ( /+ gtt4"$ < 6,2 gtt4"in;+ "in ;+ "in

< 5 gtt4"in

Step 39 Microdrip


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"$4hr ( TF < 3/ "$4hr ( ;+gtt4"$ < 3/gtt4"in

;+ "in ;+ "in

#hich do 0e chooseMacrodrip 5gtt4"in too slo0

Select "icrodrip infusion setSet drip rate at 3/ gtt4"in

)o, 5 on p, 3+6

>rder9 /8+ "$ D2 /46)S /3 noon ! ;p"vailable9 "acrodrip */+gtt4"$1 "icrodrip *;+gtt4"$1

Step //8+ "$4; hr < 6+ "$4hr

Step 3 Macrodrip6+"$4hr ( /+gtt4"l < 2 gtt4"in

;+ "in

Step 3 Microdrip6+ "$4hr ( ;+ gtt4"$ < 6+ gtt4"in

;+ "in

Choose "icrodrip

Determining hours an IV runs


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)u"ber of "$s ordered < run ti"e *hrs to run1)u"ber of "$s4hr

>rder9 2++ "$ )S IV run K2 "$4hr

2++ "$ < ;,;;hr &' ;,K hrK2 "$4hr

>rder9 a"inophylline 2++ "g in 32+ "$ D2# IV at2+"$4hr

32+"$ < 2 hr2+ "$4hr

Adding Medications to IV#hen continuous IV order includes "edication add

"edication to IV and deter"ine rate of :o0Aither phar"acist or nurse 0ill add "edication

Buretrol9 IV delivery syste" 0ith tubing and cha"ber*can hold /2+ "$ delivered as "icrodrip1

Medications ordered over several Lours

>rder9 /+++ "$ D2# 0ith 3+ "AH 7Cl IV /+a"&/+p"vailable9 vial of 7Cl 5+ "AH43+ "$? "icrodrip*;+gtt4"in1? "acrodrip *3+ gtt4"in1


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D ( S < L

Desire9 3+"AHLave9 5+"AH Supply9 3+ "$a1 3+"AH ( 3+"$ < /+ "$ *dosage a"ount1

5+"AH

b1 Calculate drip factor

Step /9 "$4hr < /+++ "$4/3 hr < 86 "$4hr

Step39 Macrodrip86 "$4hr ( 3+ gtt4"$ < 38 gtt4"in ;+ "in

Step 39 "icrodrip86 "$4hr ( ;+ gtt4"$ < 86 gtt4"in

;+ "in

Class chose "acrodripdd /+ "$ 7Cl to the IV bag

>rder9 2 "illiunits penicillin in /+++ "$ D2# IV

H8hrvailable9 "acrodrip */+ gtt4"$1? "icrodrip*;+gtt4"$1

$ogic9


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Milliunit &' "illion units 2 "illiunits &' 2++++++ units of =enicillin potassiu"

Supply9 2&"illiunits vial of po0derDirections9 reconstitute 0ith /++ "$>rder is safeEse a /+&"$ syringe to re"ove :uid aseptically fro"/+++&"$ bag D2#Inect /+"$ into vial containing po0der ! "ae sureall liHuidNNNNNNNInect the ne0 supply into the bag *--+ "$ O /+ "$1

)o0 that "edication has been added ! calc the dripfactors and chooseNNNN

Step /9 /+++"$48hr < /32 "$4hr

Step 39Macro

/32"$4hr ( /+ gtt4"$ < 3+,86 gtt4"in


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p, 3+K&3+8buretrol < "icrodrip>rder9 a"inophylline 32+ "g in 32+ "$ D2# run at2+ "$4hrvailable9 a"pule of a"inophylline /g in /+"$Buretrol that delivers ;+ gtt4"$

$ogic9 "pule ! /g 4/+++ "$ < /+++ "g4/+++ "$*/1 Ese For"ula Rule

32+ "g ( /+ "$


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Ag, Self Test 6 ! )o, 6

>rder9 32+ "g hydrocortisone sodiu" succinate in/+++ "$ 8M ! /3 "idnightvailable9 vial of hydrocortisone sodiu" succinatelabeled 32+ "g 0ith a 3"$ diluent "icrodrip tubing

/1 deter"ined total ti"e8a" ! /3 "idnight < /; hours

31 deter"ine "$4hr < run ti"e/+++ "$4/; hours < ;3,2 "$4hr &' round to ;6 "$4hr

61 "$4hr ( TF < ;6 "$4hr ( ;+ gtt4"in < ;6gtt4"in

;+ "in ;+ "in

51 $abel IV9

Medications for Intermittent IntravenousAdministration

IV=BH5h? H;h? or H8h < ti"e intervals

"ost in po0der for"chec dr@s order *drug? route? ti"e interval1


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nurse "ust research "anufacturer@s directionsfor a"ount and type of diluent and ti"e for infusionto run

Rule to solve IV=B sa"e as rule to solve IV

"$ ( TF < gtt4"in"in

"$ < type and a"ount of diluent stated onlabel4insert

TF9 tubing for IV=B&' called secondary ad"inistrationset and has a "acrodrip factor, Shorter than "ainline IV tubing ! chec label for Tubing drip factor

"in &' if nu"ber of "in not given for IV=B? thengeneral rule9 6+ "inutes for every 2+ "$ solution for

adults

Ag, >rder9 cefaPolin / g IV=B H;hSupply9 pacage insert for IV=B dilution of cefaPolinsodiu"9Reconstitute 0ith 2+ to /++ "$ sodiu" chlorideinection or other solution listed *D2#? D/+#? D2$R?

D2)S1

Ese 2+ "$ D2#s no ti"e given9 use 6+ "in for 2+"$


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"$ ( TF < gtt4"in "in

2+"$ ( /+ gtt4"in < /;,; < /K gtt4"in 6+ "in

Ese reconstitution device *sterile i"ple"entcontaining 3 needles that connects vial and 2+ "$bag1

Admixture IVsIf health care phar"acy reconstitutes and preparesIV=B in a sterile environ"ent using la"inar :o0 hood! you as nurse still need to chec for proper labelingetc,Chec dose? chec e(piration date? etc,

Changing the Intravenous drip RateIf ining of tube? "ove"ent of patient? place"ent ofneedle4catheter? gravity a%ect :o0 ! then "ighthave to recalculate IV drip

Ag,$abel on IV9 /+++ "$ D2# IV to run 8a" ! 5p" Tubing is "acrodrip */+gtt4"$1 rate set at 3+gtt4"in Ti"e no09 /p"


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"ount of :uid you observe left in IV bag9 ;++ "$Change drip

$ogicStep /9 calculate "l4hr/+++"l48hr


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/+++"$4/32 "$4hr < 8 hr

5

>rder9 2++ "$ a"inophylline +,2g to infuse at 2+"$4hr,Lo0 "g patient receive per hour

+,2 g < 2++ "g2++ "g in 2++ "$ &' /"g4"$ *concentration ofdrug1

/"g4"$ ( 2+ "$4hr & 2+ "g per hour

MATH 102 Chapter 8 Calculation of Basic IV Drip Rates.doc

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