chapter 015
TRANSCRIPT
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Chapter 15
Reconstitution and Dosages Measured in Units
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Objectives
Calculating drug dosage problems that first require reconstitution of a powdered drug into a liquid form
Using a proportion to solve problems involving drugs measured in unit dosages
Drawing a line through an insulin syringe to indicate the number of units desired
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Units
Common drugs measured in units: Penicillin Heparin Insulin
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Penicillin
Ask patients whether they have had previous allergic reactions to penicillin.• Find out what reaction they may have. Just
because family members are allergic does not mean they are
Observe patients for signs of allergic reactions.
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Heparin
Doses that are too large might cause hemorrhage. Doses that are too small might not produce the
desired result.
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Insulin
Doses that are too large might cause insulin shock.
Doses that are too small might result in a diabetic coma.
Available in prefilled insulin pens.
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Powder Reconstitution
Required when medication is unstable over long periods of time in its liquid form• Common sterile diluents include water, normal
saline solution, and 5% dextrose solution. Must be performed before administration using a
sterile diluent
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Powder Reconstitution (cont’d)
Method: Read information and directions on drug label
carefully. Identify the type of diluent, amount of diluent,
and route of administration. Note the drug strength or concentration after
reconstitution.
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Powder Reconstitution (cont’d)
Method (cont’d): Note the length of time that medication is usable
after reconstitution. Note the directions for storage of reconstituted
medication. the total reconstituted amount can be greater than
the amount of diluent added.
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Powder Reconstitution (cont’d)
Place on drug label after reconstituting: Your initials Date and time of preparation Date and time of expiration
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Oral-Dosage Problems (Dosages Measured in Units)
Example:
The physician orders penicillin V 300,000 units po four times a day. Penicillin V 500,000 units/2 mL is available. How many milliliters of penicillin V will be administered?
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Parenteral-Dosage Problems (Dosages Measured in Units)
Example:
The order states heparin 8000 units subcutaneous q8 h. Heparin 6500 units/mL is available. How many milliliters of heparin will be administered?
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Insulin Given with a Lo-Dose Insulin Syringe
Example:
The order states Lantus U-100 insulin 36 units subcutaneous in AM. You have 10 mL of Lantus U-100 insulin and a U-100 Lo-Dose syringe. Draw a vertical line through the syringe to indicate the correct dose.
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Insulin Given with a Lo-Dose Insulin Syringe (cont’d)
Lo-Dose
5 15 25 35 45 0.5 mL
10 20 30 40 50 units
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Mixed Insulin Administration
Guidelines: Inject air into each vial. Draw insulin from regular insulin bottle first. The practice of mixing insulins is decreasing
with the rise in use of Lantus insulin.
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Mixed Insulin AdministrationPhysicians sometimes prescribe two types of insulin to be administered at the same time. The two types of insulin are drawn into the same syringe to reduce the number of times that the patient needs to be injected.
The air that is injected into each vial should be equal to the amount of insulin that will be withdrawn. Do NOT touch the insulin solution with the tip of the needle when injecting air into the vials.
When drawing insulin from the regular insulin bottle, use the same syringe that was used for injecting air into the vials.
Always draw up clear insulin (Regular) before any other insulin
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Mixed Insulin Administration (cont’d)
Guidelines (cont’d): Remove any air bubbles found in syringe. Draw insulin from cloudy insulin bottle. Have another nurse check your insulin.
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Mixed Insulin Administration (cont’d)
Example:
Physician orders Humulin L Lente U-100 insulin 46 units plus regular Humulin R U-100 20 units subcutaneous every morning. You have 10 mL of Humulin L Lente insulin and 10 mL of regular Humulin R insulin. A U-100 insulin syringe is available. Draw vertical lines through the syringe to indicate the correct doses.
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Mixed Insulin Administration (cont’d)
Insulin
20 40 60 80 100 units
10 30 50 70 90
RegularLente
46 units 20 units