Medmath week 5

• A drug in powder form is necessary when a medication is unstable as a liquid
• Reconstituted: dissolved with a sterile diluent
• Diluents can be ingested orally, parenterally or Inhaled
• If there are no directions on the vial or package consult the physicians Desk Reference
• Strength of medication is dependent on the amount of diluent added
• An IV medication or infusion may be administered by a licensed prescriber, nurse or technician
• medications and electrolyte milliequivalents are additives to IV fluids
• IV fluids are administered via an IV infusion set
• To calculate drops/min the nurse must know the tubing drop factor
• The larger the tubing the bigger the drop will be
• Drop factor: number of drops contained in 1mL
• Sets that deliver 10,15, or 20 drops/mL are called macrodrip sets
• A set that delivers 60 drops/mL is called a microdrip set
• Macrodrip > microdrip
• Count drops per minute by watching the drip chamber for 1 minute and adjusting the roller clamp as needed
• 50mL/hour or less uses a microdrip
• 125mL/hour or more requires a macrodrip set
• The order for type and amount of IV and the number of hours the IV fluid will run/rate is written by the licensed prescriber
• Time frame for IVPB is usually 60 minutes or less
• Nurse must follow manufacturers guideline if prescriber does NOT include infusion time or rate
• Irregular flow rate can lead to:

  • fluid overload
  • dehydration
  • medication overdose
• Drops per minute will always be rounded to the nearest whole number
• When administering an IV fluid or medication by gravity the nurse solves for gtt/min
• When administering medication or IV fluid by an IV pump the nurse solves for mL/hour
• An advantage of IV pumps is safety for the patient
• Solute: solid material
• Diluent: specified fluid to dissolve the solute
• All information is found on the label
• IV infusion: slow introduction of fluid into a vein
• Additional licensure is usually required for an LVN to start IV’s
• LVN’s are allowed to:

  • hang piggyback medications
  • add medications to IV solutions
  • calculate IV infusion rates
  • insert peripheral catheters
  • teach patients about IV therapy
• Hypotonic solutions are considered unsafe for children
• IV solution should be clear
• Types of IV sets:

  • primary IV sets
  • Secondary/piggyback sets
  • parallel/ Y sets
  • controlled-volume sets
• Change IV tubing every 96 hours or every 7 days
• Primary tubing uses gravity delivery
• A “Y” set is used to infuse blood products
• Blood products are NEVER infused into the same line as medications or other fluids
• Transfusion: introduction of blood components into the blood stream
• Potassium Is never given as a bolus because it can cause cardiac arrest