topic 3 math/drugs calculations. iv giving sets generally there are 2 types of giving sets in use...
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Topic 3Math/Drugs Calculations
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IV Giving Sets
Generally there are 2 types of giving sets in use and they deliver drops of different sizes
Blood giving sets 15 or 20 drips/ml. these are known as macrodrips
The more commonly used metrisets deliver 60/drips/ml. These are known as microdrips.
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IV calculation
For drops per minute the rule is:
Rate (drops/minute) = Volume (in ml) x Drip factor
Time (minutes)
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Example 1
• A 1L bag of N/saline is to run over 6 hours. You are using a giving set which delivers 20 drops/ml. What should the flow rate be set at?
Rate = 1000 x 20 convert the 1L to 1000ml 6 x 60 1 = 1000 x 20 common factor 10 & 4 360 1 = 2000 36 = 500 Long division 9
= 55.55
= 56 drops/ minute Rounded up to nearest whole number
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Example 2
A 500ml bag of Hartman’s solution is to run over 4 hours. The giving set delivers 20 drops/ml. What should the flow rate be?
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Solution – Example 2
Rate = 500 x 20 4 x 60 1 = 500 x 20 240 1 = 500 12 = 125 3 = 42 drops/minute
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Example 3
A patient is to receive 500ml of 5% Dextrose over 2 hours using a giving set which delivers 20 drops/ml. Calculate the drip rate in drops/minute.
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Solution - Example 3
Rate = 500 x 20
2 x 60
= 10000
120
= 250
3
= 83 drops/minute
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Example 4
A patient has to have an IV set up to deliver 1L of fluid over 4 hours, using a metriset (60 drops/ml). What should the flow rate be?
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Solution - Example 4
Rate = 1000 x 60
4 x 60
= 60000
240
= 2000
8
= 250 drops/minute
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Example 5
A dehydrated adult is ordered 1L of normal saline over 2 hours, using a macrodrip (20 drops/ml) IV giving set. Calculate the drip rate in drops/minute.
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Solution - Example 5
Rate = 1000 x 20 2 x 60 = 20000 120 = 1000 6 = 167 drops/ minute
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IV calculations
You made need to calculate how long an IV infusion will take to run through, if you know the drip rate re-organise the previous rule
For the time for a drip to run the rule is:
Time (in minutes) = Volume (in ml) x Drip factor
Rate (drops/min)
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Example 1
There is 500ml left to run through the IV metriset. The drip rate has been set at 50 drops/minute. How long will it take to run through?
Time (in minutes) = 500 x 60 50 1 = 10 x 60 1 1 = 600 minutes = 10 hours
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Example 2
There is 700ml of N/saline left to run through the IV metriset. The drip rate is set at 40 drops/minute. How long will it take to complete?
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Solution - Example 2
Time (in minutes) = 700 x 60 40 1 = 700 x 6 4 1 = 700 x 3 2 1 = 2100 2 = 1050 =17 ½ hours = 17 hours 30 minutes
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Example 3
How long will an IV take to run through if the drip rate is set at 80 drops/minute and there are 300ml left using a drip factor of 20 drops/ml?
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Solution - Example 3
Time (in minutes) = 300 x 20 80 = 6000 80 = 600 8 = 75 minutes OR = 1 ¼ hr
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Example 4
How long will 300ml of IV packed cells take to run through at 30 drops/minute using a blood giving set (15 drops/ml)?
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Solution - Example 4
Time (in minutes) = 300 x 15 30 = 4500 30 = 450 3 = 150 minutes OR = 2 ½ hr
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Example 5
How long will 2l of Normal Saline take if it is running at 100ml/hour using a metriset?
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Solution - Example 5
Time (in minutes) = 2000 x 60
100
= 120000
100
= 1200 minutes
OR = 20 hours
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IV Calculations
Sometimes you made need to calculate the hourly volume of an IV. To do this reorganise the previous rule
For volume per hour the rule is
Volume per hour = Total Volume
Time (hours)
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Example 1
The doctor has ordered 1500 ml of fluid to be given over 5 hours. What should the hourly volume be in ml per hour?
Volume = 1500
5
= 300 ml/hr
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Example 2
The client is ordered 1.2L of Hartmann’s solution over the next 6 hours. What should be the hourly volume in ml/hour?
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Solution - Example 2
Volume = 1200
6
= 200 ml/hr
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Example 3
An IV containing 600ml has to run through in the next 4 hours. What volume needs to run through every hour?
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Solution - Example 3
Volume = 600
4
= 150 ml/hr
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Example 4
A client’s IV is commenced at 1000HR. It contains 1L and is to run through by 2000HR. What should the hourly volume be (in ml per hour)?
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Solution - Example 4
Volume = 1000
10
= 100 ml/hr
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Example 5
What volume is needed every hour if a client must have 700 ml in 10 hours?
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Solution - Example 5
Volume = 700
10
= 70 ml/hr
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Paediatric Drug Doses
Clarke’s Body Weight Rule (used for children aged 1 and over)
Child’s dose = Weight of child (kg) x Adult dose
Average adult weight (70kg)
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Example 1
A child weighing 7kg is to be given ampicillin. The adult dose is 500mg. How much should the child be given?
Child’s dose = 7 x 500 70 = 1 x 500 10 = 50 mg
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Example 2
A child weighing 10 kg is to have penicillin and the adult dose is 500mg. How much would you give?
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Solution - Example 2
Child’s dose = 10 x 500 70 = 1 x 500 7 = 500 7 = 71.4 = 71 mg
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Paediatric Drug Doses
Clark’s Body Surface Area (BSA) Rule
Child’s dose = Surface area of child (m²) x Adult dose
average surface area of
adult (1.7 m²)
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Example 1
A child whose BSA is 0.7 m², is ordered penicillin. The adult dose is 1g. Calculate how much to give.
Child’s dose = 0.7 x 1000 1.7 = 7 x 1000 17 = 7000 17 = 412 mg
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Example 2
A child whose BSA is 0.6 is ordered pethidine. The adult dose is 100 mg. How much would you give?
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Solution - Example 2
Child’s dose = 0.6 x 100
1.7
= 6 x 100
17
= 600
17
= 35 mg
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Paediatric Drug Doses
Freid’s Rule (used for infants under 1yr old)
Child’s dose = Age in months x Adult dose
150
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Example 1
A six month old child is to be given amoxycillin with clavulanic acid (Augmentin). The adult dose is 500mg. How much should the child be given?
Child’s dose = 6 x 500 150 = 6 x 10 3 = 60 3 = 20 mg
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Example 2
A 4 month old is to be given tetracycline. The adult dose is 250mg. How much would you give?
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Solution - Example 2
Child’s dose = 4 x 250 150 = 4 x 5 3 = 20 3 = 6 .6666 = 7 mg
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Paediatric Drug Doses
Young’s Rule (used for children aged 2 to 12)
Child’s dose = Age in years x Adult dose
age + 12
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Example 1
The adult dose for metronidazole (Flagyl) is 500mg. How many milligrams should you give a 10 year old?
Child’s dose = 10 x 500 10 + 12 = 10 x 500 22 = 5000 22 = 227 6/22 mg = 227 mg
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Example 2
An 8 year old is ordered ampicillin. The adult dose is 500mg. How much should you give the client?
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Solution - Example 2
Child’s dose = 8 x 500 8 + 12 = 8 x 500 20 = 8 x 50 2 = 4 x 50 = 200mg