Question

# The order is for promethazine 25 mg IM stat and 15 mg IM every 4 hours...

1. The order is for promethazine 25 mg IM stat and 15 mg IM every 4 hours as needed (prn). How many mL of promethazine will the nurse administer
1. Calculate the gtt/min for 2 L of IV fluids to be given over 5 hours. The available IV tubing has a drop factor of 10 gtts/mL.

1. A client is ordered 75 mcg of Fentanyl citrate intravenously. How many mL will the nurse administer?

1. The doctor has ordered 100 mL of IV fluids to infuse over an hour. The IV tubing available has a drop factor of 15 gtts/mL. The IV should run at ________ gtts/min?
1. The physician has ordered phenobarbital 200 mg po twice daily. The recommended dosage for this anticonvulsant is 1-3 mg/kg/day. The patient weighs 203 pounds. Is the ordered dose safe for this patient?
1. The physician has ordered penicillin G potassium 350, 000 units IM. The nurse is to choose.

Using the above label, choose the reconstitution that will deliver this dose in the smallest volume. The nurse will use __________mL diluent for a concentration of ____________ units/mL

The nurse will administer __________ mL IM to the patient.

Weight Based Medication Orders

The recommended doses/ranges are given by the manufacturer, you will not have to memorize them, but they are all based on ONE kg, so as the nurse you must individualize this to the patient’s weight by multiplying the recommendation by the weight of the actual patient. This will give you the recommended maximum dose or the recommended range (lowest/highest doses). This is NOT the ordered dose, so do not use it to determine how much to give.

Instead, compare the ordered dose with the recommended dose and determine if it is safe. When you are doing this, make sure to compare the correct doses.

Is the ordered dose per day or per dose?

Is the recommended dose per day or per dose?

[1].

1 ml =1000mg

Therefore, 1mg=0.001ml

So, 25mg=25×0.001ml

=0.025ml stat

And 15mg=15×0.001ml

=0.015ml every 4 hours

[2]

Given 10 drops per ml

1 L=1000ml=10 ×1000 drops=10000 drops

10, 000 drops in 5 hrs

=10, 000 drops in 5 × 60 minutes

Therefore gtt per minute

Otherwise drops per minute

i.e. for 1 min=10, 000/5×60

=10, 000/30, 000

=33. 33

=33 gtts / min approx.

[3].

1 ml = 1000mcg

75 mcg=1/1000 ×75

=0.075 ml pf Fentanyl citrate IV

[4].

100ml IVF in 1 hr

Available, 15 gtts per ml

1 ml= 15 drops

100ml=15×100 drops

15, 00 drops in 60 minutes

1 minute= 1500/60 drops

=25gtts/ min

[5].

200 PO BD

implies 400 mg per day

Patient wt.=203 pounds

1 pound =1/2 Kg

Therefore 203 pound= 203× 1/2 Kg

=203×.5 Kg

=101.5 Kg

Patient can take dose upto,

101.5×3=304.5 mg( recommended dose 1 to 3 mg per Kg per day)

Therefore this dose is safe.

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