Question

Advanced Medication Dosage Calculation Test #2

The physician orders a dopamine drip to be started for your patient. Your order reads 6 mcg/kg/min of dopamine. Your patient’s daily weight is 68kg.

What is the mcg/min that your patient is to receive?

The dopamine is prepared as 500mg/500mL in an IV bag. What rate would you set your IV pump to administer the correct dosage.

The physician orders an Humulin R drip for your patient. The order reads: Humulin R 4 units per hour to start, titrate insulin per protocol. The solution that you are provided by pharmacy is 50 units Humulin R in 500mL NS.

What would you set your pump to administer to administer the starting dose?

Using a 10 gtt/mL set, what would your drip rate be to administer the prescribed insulin?

The insulin protocol for your facility reads:

If blood glucose is >150 give IV regular insulin—bolus or loading dose of 0.1 units/kg

Initiate infusion rate at the calculated dose:

Blood Glucose (BG) – 60 x 0.02 = units insulin/hour

Your patient weighs 92kg and blood glucose reads 260. Calculate the bolus or loading dose.

What would be the infusion rate for this patient?

See the following Heparin Protocol to answer question 4:

PTT (in seconds)

STARTING Rate

<45 seconds

45-58 seconds

49-66 seconds

67-109 seconds (therapeutic)

110-130 seconds

>130 seconds

Bolus or Loading Dose

Loading dose of 40 units/kg

Bolus with 40 units/kg

Bolus with 20 units/kg

No bolus

No bolus

No bolus

No bolus

Rate Adjustment

Start infusion at 2 units/kg/hr

Increase/ start rate by 3 units/kg/hr

Increase rate by 2 units/kg/hr

Increase rate by 1 unit/kg/hr

No Change

Decrease rate by 1 unit/kg/hr

Stop infusion for 1 hour THEN decrease rate by 2 units/kg/hr

Next Lab

PTT in 6 hours

PTT in 6 hours

PTT in 6 hours

PTT in 6 hours

PTT next AM

PTT in 6 hours

PTT in 6 hours

Your patient weighs 70kg. Based on heparin protocol above, what would your loading dose be for a patient starting the heparin protocol? What rate would you start the infusion at (units/hr)?

The first PTT result comes back after Heparin Protocol was initiated. The PTT is 56. Is a bolus dose appropriate? If so, how much will you bolus the patient? What will the new rate be? When will we plan on re-checking the PTT?

The PTT is repeated 6 hours later and the PTT is 95. What are your actions?

Answer 1

1 mcg=0.001mg,

for 68 kg body weight , patient should receive 408 mcg/min. (0.408mg)

formula:

desired dose ordered: 6 mcg/kg/min X (pt weight)68kg

have:500mg dopamine it must convert to mcg by multiplying by1000.

volume: 500ml (volume in IV bag)

also include time conversion of 60 min/hr

24.48ml/ hr.