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Math Problem Set 5

1. An IV of 250 ml D5W with 500 mg Aminophylline is to infuse over 24 hours.


How many mg/hr of Aminophylline will the patient receive? The pump should be
set at how many ml/hr for infusion?

2. An IV solution is to infuse over 10 hours. The total amount of fluid is 1000 ml


and the drop factor is 10. How many drops per minute would the nurse give?

3. The order reads 5000 units Heparin subcut every six hours. The vial reads 20,000
units/ml. How many milliliters would the nurse give?

4. The physician has prescribed Demerol 50 mg IM prn for pain in a post-


hysterectomy patient. The medication is available as 25 mg/ml. The nurse
calculates that the patient will receive 2 ml of medication. The patient states, “ I
am not having any pain now. I feel much better after walking. I might need a
pain shot at bedtime if I have pain then, but I will let you know.” After double-
checking the dosage calculation, the nurse decides to:
a. Not administer the medication as prescribed and calculated
b. Administer 1 ml of the medication instead of the dosage calculated
c. Administer the medication as prescribed and calculated, and monitor for
bronchospasm and photosensitivity
d. Administer medication as prescribed and calculated, and proceed with
further patient teaching.

5. The doctor has ordered 500 ml D5W with 2 gm Bretylium per IV pump to titrate
at 1-2 mg/min for ventricular arrhythmias. The pump should be set at how many
ml/hr for the lowest dosage? How many ml/hr for the highest dosage?

6. A patient weighing 161 pounds has a Dobutrex solution of 500 mg in 250 ml


D5W ordered per pump to titrate between 3-10 mcg/kg/min. What is the dosage
range?
The pump should be set at how many ml/hr for the lowest dosage, how many
ml/hr for the highest dosage?

7. A continuous infusion of Isuprel is ordered for a patient in cardiogenic shock.


The solution is 2 mg Isuprel in 500 ml D5W, and the rate of infusion is 40 ml/hr.
How many mcg/min are infusing?

8. Nipride 3 mcg/kg/min is ordered for a patient weighing 192 pounds. The solution
strength is 50 mg Nipride in 250 ml D5W. How many mcg will the patient
receive per minute? At what rate will the pump be set?

9. A patient is receiving 1000 ml of D5W with 12,500 units Heparin at 30 gtt/min


using a set with a drop factor of 20. How many units of Heparin will the patient
receive per hour?
10. The doctor has ordered Lasix 40 mg IV for a patient with pulmonary edema. The
medication is available as 10 mg/ml. The nurse calculates that the patient will
receive 0.4 ml of medication. The patient states, “This medicine will take fluid
off my lungs so I can breathe better. I will urinate a lot.” After double-checking
the dosage calculation, the nurse decides to:
a. Not administer the medication as prescribed and calculated
b. Administer 4.0 ml of medication instead of the dosage calculated
c. Administer the medication as prescribed and calculated, and monitor for
postural hypotension, leg cramps, tachycardia, drowsiness, and
restlessness.
d. Administer medication as prescribed and calculated, and proceed with
further patient teaching.

11. The patient is to receive Novantrone IV. The recommended dose is 12 mg/m2
daily. The patient’s BSA is 1.97 m2. What will his daily dose be?

12. A patient with metastatic testicular carcinoma is to receive Platinol. The


recommended dosage is 20 mg/m2 IV daily for 5 days. The patient weighs 173 lb
and is 65 inches tall. What is his BSA? What will his daily dosage be? What will
his total dosage be for the 5-day period?

13. The physician has ordered Amoxicillin potassium (Augmentin) 500 mg every 6
hours for a patient with cellulitis. The medication is available in 250 mg tablets.
The nurse calculates that the client will receive two tablets every eight hours for a
total of six tablets in a 24-hour period. The client states, “I will take this medicine
with my meals. If my infection goes away before I finish my prescription, I can
save the rest of the pills for the next time I get sick.” After double-checking the
dosage calculation, the nurse decides to:
a. Not administer the medication as prescribed and calculated
b. Administer one tablet three times a day instead of the dosage calculated
c. Administer the medication as prescribed and calculated, and monitor for
cardiac studies.
d. Administer the medication as prescribed and calculated, and proceed with
further client teaching.

14. You have an order for Lanoxin 0.6 mg IV stat for your patient in atrial fibrillation.
Your Pyxis has an ampule labeled 500 mcg per 2 ml. How much will you give
slow IV push?

15. The doctor ordered 50,000 units subcut Heparin for a patient with pulmonary
emboli. The vial contains 20,000 units/ml. The nurse calculates that the client
will receive 2.5 ml of Heparin. The patient states, “ This medication will help my
blood not to clot.” After double-checking the dosage calculation, the nurse
decides to:
a. Not administer the medication as prescribed and calculated
b. Administer 0.2 ml of the medication instead of the dosage calculated
c. Administer medication as prescribed and calculated and monitor for
bruising, bleeding gums, and blood in urine and stool
d. Administer medication as prescribed and calculated and proceed with
further patient teaching.
16. Pronestyl 2 grams in 500 ml D5W is ordered for a patient with frequent
ventricular aberrant beats, to run at 30 ml/hr. Calculate the number of mg/min the
patient is receiving. The normal dosage range for this drug is between 1-6
mg/min. Is the dosage range within these limits?

17. Esmolol is to titrate between 50-100 mcg/kg/min. The patient weighs 175
pounds. The solution is mixed with 2500 mg medication in 250 ml D5W. What is
the dosage range in mcg/min? What is the flow rate range using an infusion
pump?

18. For a patient with multiple fracture, the doctor has ordered 2 liters D51/2NS each
with 20,000 units of Heparin to infuse at 50 ml/hr. Calculate the hourly Heparin
dosage. The set calibration is a microdrip. You do not have a pump available.
What will the flow rate be?

19. A 500 ml bag of D5W with 20,000 units Heparin are to infuse at 1000 units/hour
using a microdrip tubing. Calculate the flow rate in gtts/min.

20. The doctor has ordered Heparin 1000 units/hr by IV infusion for a patient with
thrombophlebitis. The IV drip contains 25,000 units of Heparin in 500 ml D5W.
The nurse calculates that the patient will receive 50 ml of the IV solution per
hour. The patient states, “I will use a soft-bristle toothbrush when I brush my
teeth.” After double-checking the dosage calculation, the nurse decides to:
a. Not administer the medication as prescribed and calculated
b. Administer 20 ml/hr of the medication instead of the dosage calculated
c. Administer the medication as prescribed and calculated and monitor PTT
lab values
d. Administer medication as prescribed and calculated and proceed with
further client teaching.

21. Codeine is available as a 1-grain tablet. Codeine 30 mg is to be administered.


How many tablets will you give?

22. The nurse is to administer 100 ml of fluid in 2 hours. At what rate will the pump
be set?

23. Your patient is a 125 lb adult with duodenal ulcer and abdominal pain. She has
an order for Tagamet 5mg/kg in 50 ml D5W IVPB to be infused in 20 minutes.
Available is Tagamet for injection, 300mg/2ml. Your piggyback tubing is labeled
10 gtts/ml. How many ml of Tagamet will you add to the IV fluid? What will be
your flow rate in gtts/min? In ml/hr?

24. Ordered is Gentamycin 60 mg IM three times a day. The recommended dose


range is 3 mg/kg/day. Your patient weighs 132 pounds. Is this an appropriate dose
for your patient? The Gentamycin on hand is 40 mg/ml in a 2 ml vial. How
much will you draw up per dose?

25. The order is for Atropine grains 1/100 IM on call to OR. On hand you have
Atropine 0.4 mg/ml. How much will you draw up?
Answers:
1. 10 ml/hr
b. 20 mg/hr
2. 17 gtt/min
3. 0.25 ml
4. a
5. 15ml/hr-30 ml/hr
6. 220 mcg/min-732 mcg/min
7 ml/hr-22 ml/hr
7. 2.6 mcg/min
8. 262 mcg/min
b. 79 ml/hr
9. 1125 u/hr
10. b.
11. 24 mg
12. a. 2 m2
b. 40 mg
c.200 mg
13. a.
14. 2.4 ml
15. a.
16. 2 mg/min
17. 3977 mcg/min-7954 mcg/min
24 ml/hr-48 ml/hr
18. 1000 units/hr, 50 gtt/min
19. 25 gtt/min
20. 20 ml/hr
b.
21. ½ tab
22. 50 ml/hr
23. 1.9 ml
b. 25 gtts/min
c. 150 ml/hr
24. a. 60 mg, yes
b. 1.5 ml
25. 1.5 ml