intravenous fluids
TRANSCRIPT
1
1
Intravenous Fluids
22
TUBING CALIBRATIONS
MACROTUBING10 gtt / cc
15 gtt / cc
20 gtt / cc
printedon
Package Called
Set calibration
•You MUST know that a microdrip or microdrop set or minidrip or minidrop set always= 60gtts/cc.
MICRO TUBING = 60 gtts / cc
3
3
IV Flow Rates
Expressed: cc/hr and gtt/min
1. Find the cc/hr flow rate
2. Find the gtts/min flow rate
4
MEMORIZE FORMULA
VOLUME TIME = CC/HR. (in cc) (in hrs)
5
IV Flow Rates
Examples cc/hr.
#1 Order: LR 1000cc over 8 hrs (Vol) 1000 ÷ 8 (time) =
125 cc/hr. Use whole # for drip rates
#2 Order: NS 500cc over 12 hrs 500 ÷ 12 = 41.6
= 42 cc/hr Use whole # for flow rates
• Example: gtts./min.
• Memorize formula:
• cc/hr. x gtt factor
60 min.
#1.
• 125cc/hr , set calibration or drop factor is 15 gtt/cc
• 125 x 15 = 31.25 or
60 31 gtts./min.6
IV FLOW RATES
7
COMMON IV PROBLEM # 1
Order
1L D5LR Over 8 hrs. set calibration is
20 gtts./cc
Find
1. cc/hr.
2. gtts/min.
Common IV problem # 2
• Order: 500cc of D5W over 24hrs. Use a mini/micro dripper .
• 1. Find cc/hr
• 2. Find gtts/min.
8
9
IV FLOW RATES
• ANYTIME YOU HAVE A SET CALIBRATION OF
60 gtts / cc
Also called drip factor/drop factor, as you do with a mini/micro dripper
cc/hr.= gtts/min.
10
Example: Time < 1 hour
OrderAmpicillin 250 mg/30 cc
over 30 minsIgnore extraneous infolike medication /dose
VOLUME ONLY
Set calibration: 15gtt/cc
30cc x 15gtt/cc = 30 min
15 gtt/min
Example 2, Piggy back medications
• 1 g of Methicillin in 50cc to run over 30 minutes
• Using a micro dripper, how many drops per minute should IV run?
11
12
33
Infusion Time
Total time for given volume of IVF to infuse
Infusion Time = Total Vol.cc/hr.
Example 1 = 1L NSS @ 100cc/hr.1000 = 10 hrs.100
Example 2 1L D5W @ 125/hr.1000 = 8 hrs.125
1333
MEDICALQUESTION OF THE
DAY
• QUESTION
• WHAT IS A
• TABLET
14
PEDIATRIC IVMEDICATIONS
• I
IV MED INFUSION PUMP
15
Heparin
• anticoagulant
• measured in units
• various concentration
•Concentration for sc. = 10,000 units/cc
1000 units/cc = IV heparin 100 units/cc = CL heparin flush 1o units/cc = PHL flush
16
Parenteral Medications
s.c. subcutaneous
**Should be 1cc
Heparin s.c is a common one.
17
SC HEPARIN
Order: 4000 units Heparin s.c. now.On Hand: Heparin 1,000 units/cc
Heparin 10,000 units/cc
Which would you chooseAnd why How much would you give
18
SC Heparin
If you choose 1,000 units/ml
1000units 4000units
1 cc xcc
1000 x = 4000
x = 4 cc
TOO MUCH s.c.
So cannot go by closest concentration rule with s.c. injections, SO
19
SC Heparin cont..
Choose 10,000 units / ml
10,000 units 4000 units
1cc x cc
10,000 x = 4000
x = 0.4 cc
OK for a subcutaneous
injection
20
Heparin Infusion
Order1000cc D5W +
50,000 unitsheparin TRA 25 cc/hr
*How many Units/hr is your patient getting
1000 cc : 50,000 units : 25 cc = X 1000x = 1,250,000 units
X = 1,250 Units
21
Order1 L D5W c 50,000units heparin
Run @ 2,000 units per hour
What is flow rate in cc/hr.
50,000 units :1,000 cc:: 2,000 units: Xcc
50,000x = 2,000,000 X = 40 cc/hr.
22
HEPARIN INFUSION
• ORDER:
• 1LNS with 50,000 units Heparin @ 30cc/hr.
• How many units/hr is your patient receiving?
23
INSULIN INJECTIONSnot on exam
I liked this slide
2459
Critical Care Drugs
1. Ordered by dosagesi.e., mcg/kg/min
mg/minYou will need to find cc/hr.
2. Should use IV pump! If not,use mini-dripper only!REMEMBER A MINI DRIPPER = 60 gtts / cc
3. Be sure you have like units.
4. Very potent drugs!!
25
CRITICAL CARE CALCULATIONS
Order: Lidocaine 4mg/min
On Hand: Lidocaine 1g/250cc
What is IV flow rate?? cc/hr?
1. Convert to like units: 1g=1000mg
2. 1000 mg: 250 :: 4mg: x cc
1000x = 1000 x = 1cc/min.
26
60
1 cc / minute, the question asked for cc/hr.!!
WE NEED HOURLY RATE SO STEP 3.
3. Multiply by 60 min. to getcc/hr
1 cc/min (60 min) = 60 cc/hr is our answer.
27
61
OrderPronestyl 3mg/min
Have on Hand500mg Pronestyl in
250 cc D5W
Rate in cc/hr??1. No conversion necessary
2. 500 mg : 250 cc = 3 mg : Xcc
500 x = 750 X = 1.5 cc/min.
1.5 cc/ minute , we need cc/hr.
28
Pronestyl
3. calculate the flow rate in cc/hr
1.5 cc/min x 60 min ( per hr) = 90 cc/hr.
29
MEDICAL QUESTION
•WHAT DOES
•DILATE MEAN
30
ORDER2.5 mcg/kg/minHave on Hand
Nipride 50mg/250cc
Wt: 136 lbsRate cc/hr ?
1. 136 · 2.2 = 61.8 kg ( 62kg.)2.5 mcg. X 62 kg. = 155
mcg/min.
2. Convert to like units155 mcg/min = ? mg/min
= 0.155 mg/min
46
31
Nipride
3. Calculate flow rate cc/min
0.155mg. : x cc :: 50mg : 250cc50 x = 250 x ( 0.155)50 x = 38.75x = 0.775 cc/min.
4. Calculate flow rate cc/hr. 0.775/min x 60min/hr. = 46.5 cc/hr. or 47 cc/hr.
32
64
OrderLidocaine 2 mcg/kg/min
Have on Hand: Lidocaine 1 g/250 cc
Pt Wt: 62kgRate? cc/hr.
1. 2 mcg x 62 kg = 124 mcg/min
2. 1g Lidocaine = 1000mg
124 mcg. = 0.124 mg.
33
Lidocaine Problem cont..
3. 1000mg : 250cc :: 0.124 mg : x cc1000 x = 250 ( 0.124)1000 x = 31
x =0. 031
4. 0.031 cc/ minute
Not finished , need cc/hr. SO,
0.031 x 60 = 1.86 cc/hr.
34
Unacceptable Abbreviations
• OFFICIAL DO NOT USE LIST, ( and soon to be not used)
IN DOSAGE CALC FOLDER
• They are changing as we speak