An order is received for Principen (ampicillin) 25 mg/kg IV for a toddler who weighs 22 lb. The dose is to be infused over 30 minutes. The ampicillin dose arrives from the pharmacy prepared in 50 mL of solution.
How many milliliters per hour should be administered?
25 mL/hr
50 mL/hr
100 mL/hr
10 mL/hr
The Correct Answer is C
To find the milliliters per hour, you need to calculate the following:
- The patient's weight in kilograms
- The dose of Principen in milligrams
- The infusion rate in milliliters per hour using the formula: Infusion rate (mL/h) = (Total volume (mL) x Flow factor (gt/mL)) / Time (min) x 60 min/h
First, convert the patient's weight from pounds to kilograms by dividing by 2.2:
22 lb / 2.2 = 10 kg
Next, multiply the patient's weight by the dose of Principen per kilogram to get the total dose in milligrams:
10 kg x 25 mg/kg = 250 mg
Then, use the formula for infusion rate to find how many milliliters per hour the IV pump should deliver:
Infusion rate (mL/h) = (Total volume (mL) x Flow factor (gt/mL)) / Time (min) x 60 min/h
Since the medication is prepared in 50 mL of solution and the infusion time is 30 minutes, plug in these values into the formula:
Infusion rate (mL/h) = (50 mL x 1 gt/mL) / 30 min x 60 min/h
Simplify and solve for the infusion rate:
Infusion rate (mL/h) = 100 mL/h
Therefore, the nurse should administer **100 mL/h** to infuse Principen 250 mg over 30 minutes.
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Related Questions
Correct Answer is C
Explanation
To find the hours to finish the infusion, you need to calculate the following:
- The volume of saline solution in milliliters
- The time in hours using the formula: Time (h) = Total volume (mL) / Infusion rate (mL/h)
First, convert the volume of saline solution from liters to milliliters by multiplying by 1000:
1.5 L x 1000 = 1500 mL
Next, use the formula for time to find how many hours it will take to infuse the saline solution at the current rate:
Time (h) = Total volume (mL) / Infusion rate (mL/h)
Since the total volume is 1500 mL and the infusion rate is 75 mL/h, plug in these values into the formula:
Time (h) = 1500 mL / 75 mL/h
Simplify and solve for the time:
Time (h) = 20 h
Therefore, it will take **20 hours** to finish the infusion at the current rate.
Correct Answer is D
Explanation
This numeric form is appropriate, according to the Joint Commission, because it does not use a trailing zero after a decimal point, which is a common cause of medication errors and should be avoided. A trailing zero may be misread or misinterpreted as a larger dose or omited altogether, resulting in a 10-fold overdose or underdose, respectively. For example, when prescriptions have been writen for "Coumadin 1.0 mg," patients have received 10 mg in error¹². Therefore, the Joint Commission requires that a trailing zero may be used only when required to demonstrate the level of precision of the value being reported, such as for laboratory results, imaging studies that report the size of lesions, or catheter/tube sizes. It may not be used in medication orders or other medication-related documentation.
The other options are not appropriate numeric forms because:
a) 3.0 uses a trailing zero after a decimal point, which poses a risk of confusion or error.
b) 0.30 uses a trailing zero after a decimal point, which poses a risk of confusion or error.
c) 0.03 is not equivalent to 0.3, as it is 10 times smaller.
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