Interactive Practice Drip Calculations

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Outline

Overview

Dimensional analysis is one of the most commonly used techniques, it is easy to comprehend making it easier to work out mathematical problems for drug calculations.

Nursing Points

General

  1. 1. Heparin
    1. 12/units/kg/hr
  2. 2. Vasopressors
    1. Levophed 1mcg/kg/min
    2. Dopamine 10mcg/kg/min
  3. 3. Amiodarone
    1. 1mg/min then 0.5mg/min
  4. 4. Antibiotics
    1. Zosyn 3.375 g IV in 50 mL of NS over 30 minutes Q 8 Hours
    2. Ancef 500mg IV in 100 mL of NS over 30 minutes
  5. 5. Normal Saline
    1. 1 Liter of NS over 8 hours
    2. 1/2 NS in 500mL over 4 hours

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Transcript

Hey guys, in this lesson we’re going to do some interactive drip calculations and work out some math problems and we’re going to be using the dimensional analysis method. So let’s go ahead and get started. So the first one I want to talk about is Heparin.

So our order for heparin is 12 units per kg per hour. So let’s go ahead and work that one out now because we know that this is an infusion I need to set up my problem up as milliliters per hour because that’s the only way to fix the pump. So when a problem starts out with milliliters per hour, I always need to put milliliters first in my next little section. So in order to do that, I need to know what’s available. Usually heparin comes in a 500 ml bag and it contains 25,000 units of heparin in it. So I’m going to put 500 milliliters over 25,000 units.

In dimensional analysis rules in order to cancel something out, whatever is down here is going to be up here. So I have 12 units per kg and let’s say my patient weighs 70 kilos so I put that over an hour. So if I cancel things out, I cancel units, I cancel kilograms and I’m left with milliliters per hour. So if I multiply 500 times 12 times 70 it’s going to give me a really big number, but I’m going to have 420,000 divided by 25,000 and it’s going to give me 16.8 mls per hour. All right, simple.

Let’s do another one. So this next one I want to work out is going to be Levephed. Our order for Levophed on this particular one is going to be one microgram per kilogram per minute. So again, because this is an infusion, we’re going to start our problem with milliliters per hour. I need to know what to put here. It’s milliliters. So in order to do that, I need to know the concentration of the medication that I’m going to use. So usually levophed, comes in a 250 ml bag and it contains four milligrams. So I’m going to put 250 mls over 4 milligrams.

Well, I know that I need to start with milligrams, but I need to convert it over to mcgs because my order is in mcgs. So I’m going to have to do some conversions. So one milligram over one that was in mcg, and now I can put my mcg up here over kilograms. Uh, let’s say this patient weighs 80 kilos so that is over a minute, but I’m solving this problem an hour, so I need to convert that over.

Okay,

so now let me make sure I can cancel everything out. Milligrams and milligrams cancel out mcg and mcg cancel out kilos and kilos cancel out. And that’s supposed to be a minute, minute and minute cancels out. So I am left with hour and milliliters, which is perfect. It’s what I wanted. So I multiply 250 times, one times one times 80 times 16, I end up with a big number. And then I need to multiply four times a thousand and I end up with a smaller number of 4,000. And when I divide this out, I get 300 milliliters per hour. If you need to rewind this little section to do this problem over and over again, please do that. My best advice is if it’s milliliters per hour, your first segment is going to start with mls and whatever’s here you have to put up here so it cancels out. Let’s do another one. This one is going to be Amiodarone and it’s going to be at one milligram a minute.

So again, it’s an infusion. So we’re going to start with milliliters per hour. I need to know what is available because I’m going to start with mls. Since mls is here, I have to start with mls there. So I need to know what’s available. So in this particular case with Amiodarone, I have 1.8 milligrams per every ml. And depending on the bag, some bags may contain 250 milliliters. Others may contain a hundred mls. It just depends. Um, but the concentration is usually that. So we’re going to do one ml and it has 1.8 milligrams. My order is one milligram a minute.


Well I need to change that to hours. So 60 minutes over one hour and let’s go back and cancel things. Milligrams and milligrams, minutes and minutes. And I am left with mls and hours, which is what I’m trying to solve for. So one times one times 60 equals 60 over 1.8. When you divide that out, it gives me 33.3 mls. All right, let’s do a couple more. A lot of students always get antibiotics confused. Keep this simple. If I have an order for Zysyn 3.375 grams in 50 mls of normal saline over 30 minutes. So again, this is an infusion. What am I solving for? Ml per hour. Well, what do I know? I know I have a 50 ml bag and I need to run that over 30 minutes.

So this one is very, very simple. So 30 minutes. So here, I need to convert it over to hours because if I cancel this out, I have mls and hours left. So 50 times 60 equals 3000 and I divide that by 30 because 30 times one is 30 and I get 100 mils per hour. This is where a lot of people get confused. They want to add this in here and there’s absolutely no need to, if I were to have my problem set up with 50 milliliters over 3.375 grams, well from what I’ve told you about dimensional analysis, whatever is down here, I have to start up here. I have no other grams, so I would not be able to cancel this out. So with antibiotics, there’s no need to add the dosage in there. Just how long to run it for.

Okay, so keep these very simple and let’s go ahead and do another one. These are a little bit more simpler. So let’s say we have normal saline, one liter over eight hours. So it’s an infusion, so milliliters per hour. And I know that one leader is at a thousand mls over eight hours. That’s it. And then I’m going to divide and it’s going to be 125 milliliters per hour. That’s all. There’s nothing else to add in the problem. So keep these simple.

Okay, so a little recap. Most math problems that nursing schools teach nowadays are with dimensional analysis. It’s an easier method of instruction to do, math problems with medications because it’s a step by step process, whatever is here, if that’s your problem and this is milliliters here you start with milligrams will usually milligrams will go up there. If you have kilograms here will kilograms will go up here so that it cancels each other.

That’s what makes it a step by step process that it’s easier to eliminate what you don’t need. And it’s very important when you do this type of medication, problems that you know the concentration of the medication because then you know exactly what to plug in, especially right here, right here. So always know the concentration of the medication so that you set your pumps up correctly. And never just rely on the pumps. Pumps are machines. They can fail. Always double check your math.
So I hope that this lesson has helped you guys with some simple and quick and easy dimensional analysis problems and how to set them up. If you need any additional resources, make sure you check out our pharmacology section and in our med administration for any additional help. So as always, make sure you guys go out and be your best selves today and happy nursing.

 

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Pharmacology for Nursing (MedMaster)

The Pharmacology Course is a one-stop-shop for all things medication related! We’ll talk you through how to be successful in pharmacology and how to be safe when administering meds. We break down the most common and most important medication classes into easy-to-understand sections. We even walk you through how to conquer the often intimidating med math and drug calculations! When you finish this course you’ll be able to confidently and safely administer medications to your patients!

Course Lessons

0 - Pharmacology Course Introduction
Pharmacology Course Introduction
1 - NCLEX Must Knows
12 Points to Answering Pharmacology Questions
54 Common Medication Prefixes and Suffixes
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Essential NCLEX Meds by Class
6 Rights of Medication Administration
Pharmacodynamics
Pharmacokinetics
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
2 - Math for Meds
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Oral Medications
Injectable Medications
IV Infusions (Solutions)
Complex Calculations (Dosage Calculations/Med Math)
Interactive Pharmacology Practice
Interactive Practice Drip Calculations
Pediatric Dosage Calculations
3 - Disease Specific Medications
Disease Specific Medications
4 - Antianxiety Agents
Antianxiety Meds
Benzodiazepines
Alprazolam (Xanax) Nursing Considerations
Lorazepam (Ativan) Nursing Considerations
Midazolam (Versed) Nursing Considerations
Diazepam (Valium) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Antianxiety Meds
5 - Antiarrhythmics
ACLS (Advanced cardiac life support) Drugs
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
6 - Anticoagulants & Thrombolytics
Anti-Platelet Aggregate
Clopidogrel (Plavix) Nursing Considerations
Coumarins
Warfarin (Coumadin) Nursing Considerations
Thrombin Inhibitors
Enoxaparin (Lovenox) Nursing Considerations
Heparin (Hep-Lock) Nursing Considerations
Thrombolytics
Alteplase (tPA, Activase) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
7 - Anticonvulsants
Anticonvulsants
Carbamazepine (Tegretol) Nursing Considerations
Divalproex (Depakote) Nursing Considerations
Gabapentin (Neurontin) Nursing Considerations
Lamotrigine (Lamictal) Nursing Considerations
Levetiracetam (Keppra) Nursing Considerations
Phenytoin (Dilantin) Nursing Considerations
8 - Antidepressants
Antidepressants
Bupropion (Wellbutrin) Nursing Considerations
MAOIs
Selegiline (Eldepyrl) Nursing Considerations
SSRIs
Escitalopram (Lexapro) Nursing Considerations
Fluoxetine (Prozac) Nursing Considerations
Paroxetine (Paxil) Nursing Considerations
Sertraline (Zoloft) Nursing Considerations
TCAs
Amitriptyline (Elavil) Nursing Considerations
9 - Antidiabetic Agents
Antidiabetic Agents
Glipizide (Glucotrol) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Insulin
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
10 - Antihistamines
Histamine 1 Receptor Blockers
Diphenhydramine (Benadryl) Nursing Considerations
Promethazine (Phenergan) Nursing Considerations
Histamine 2 Receptor Blockers
Cimetidine (Tagamet) Nursing Considerations
Famotidine (Pepcid) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
11 - Antihypertensives
Renin Angiotensin Aldosterone System
Sympatholytics (Alpha & Beta Blockers)
Atenolol (Tenormin) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
ACE (angiotensin-converting enzyme) Inhibitors
Captopril (Capoten) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Angiotensin Receptor Blockers
Losartan (Cozaar) Nursing Considerations
Calcium Channel Blockers
Amlodipine (Norvasc) Nursing Considerations
Diltiazem (Cardizem) Nursing Considerations
Nifedipine (Procardia) Nursing Considerations
Verapamil (Calan) Nursing Considerations
Cardiac Glycosides
Digoxin (Lanoxin) Nursing Considerations
12 - Anti-Infectives
Anti-Infective – Aminoglycosides
Gentamicin (Garamycin) Nursing Considerations
Anti-Infective – Antifungals
Metronidazole (Flagyl) Nursing Considerations
Nystatin (Mycostatin) Nursing Considerations
Anti-Infective – Antitubercular
Isoniazid (Niazid) Nursing Considerations
Rifampin (Rifadin) Nursing Considerations
Anti-Infective – Antivirals
Acyclovir (Zovirax) Nursing Considerations
Anti-Infective – Carbapenems
Meropenem (Merrem) Nursing Considerations
Anti-Infective – Fluoroquinolones
Ciprofloxacin (Cipro) Nursing Considerations
Levofloxacin (Levaquin) Nursing Considerations
Anti-Infective – Glycopeptide
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Lincosamide
Clindamycin (Cleocin) Nursing Considerations
Anti-Infective – Macrolides
Erythromycin (Erythrocin) Nursing Considerations
Azithromycin (Zithromax) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Amoxicillin (Amoxil) Nursing Considerations
Ampicillin (Omnipen) Nursing Considerations
Cefaclor (Ceclor) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Cephalexin (Keflex) Nursing Considerations
Anti-Infective – Sulfonamides
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Anti-Infective – Tetracyclines
Tetracycline (Panmycin) Nursing Considerations
13 - Antipsychotics
Atypical Antipsychotics
Chlorpromazine (Thorazine) Nursing Considerations
Antipsychotics
Haloperidol (Haldol) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Olanzapine (Zyprexa) Nursing Considerations
14 - Autonomic Nervous System Meds
Autonomic Nervous System (ANS)
Methylphenidate (Concerta) Nursing Considerations
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Dobutamine (Dobutrex) Nursing Considerations
Dopamine (Inotropin) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Parasympathomimetics (Cholinergics) Nursing Considerations
Neostigmine (Prostigmin) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Benztropine (Cogentin) Nursing Considerations
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
15 - Bronchodilators & Respiratory Drugs
Guaifenesin (Mucinex) Nursing Considerations
Bronchodilators
Albuterol (Ventolin) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Salmeterol (Serevent) Nursing Considerations
16 - Diuretics
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Furosemide (Lasix) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Spironolactone (Aldactone) Nursing Considerations
Mannitol (Osmitrol) Nursing Considerations
17 - GI Meds
Bisacodyl (Dulcolax) Nursing Considerations
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations
Lactulose (Generlac) Nursing Considerations
Loperamide (Imodium) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Ondansetron (Zofran) Nursing Considerations
Pancrelipase (Pancreaze) Nursing Considerations
Sucralfate (Carafate) Nursing Considerations
Proton Pump Inhibitors
Omeprazole (Prilosec) Nursing Considerations
Pantoprazole (Protonix) Nursing Considerations
18 - Hormone & Immune Related Drugs
Epoetin Alfa
Epoetin (Epogen) Nursing Considerations
Glucagon (GlucaGen) Nursing Considerations
Iodine Nursing Considerations
Levothyroxine (Synthroid)
Propylthiouracil (PTU) Nursing Considerations
Cyclosporine (Sandimmune) Nursing Considerations
19 - Lipid Lowering Drugs
HMG-CoA Reductase Inhibitors (Statins)
Atorvastatin (Lipitor) Nursing Considerations
20 - Mineral and Electrolyte Drugs
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Magnesium Sulfate (MgSO4) Nursing Considerations
Calcium Acetate (PhosLo) Nursing Considerations
Calcium Carbonate (Tums) Nursing Considerations
Ferrous Sulfate (Iron) Nursing Considerations
Alendronate (Fosamax) Nursing Considerations
21 - Mood Stabilizers
Mood Stabilizers
Lithium (Lithonate) Nursing Considerations
22 - Non-Opioid Analgesics
Acetaminophen (Tylenol) Nursing Considerations
Phenazopyridine (Pyridium) Nursing Considerations
NSAIDs
ASA (Aspirin) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Ibuprofen (Motrin) Nursing Considerations
Indomethacin (Indocin) Nursing Considerations
Ketorolac (Toradol) Nursing Considerations
Naproxen (Aleve) Nursing Considerations
23 - OB Meds
Tocolytics
Terbutaline (Brethine) Nursing Considerations
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
Meds for Postpartum Hemorrhage (PPH)
Methylergonovine (Methergine) Nursing Considerations
Oxytocin (Pitocin) Nursing Considerations
Prostaglandins in Pregnancy
Rh Immune Globulin in Pregnancy
Lung Surfactant for Newborns
Eye Prophylaxis for Newborn
Phytonadione (Vitamin K) for Newborn
Hepatitis B Vaccine for Newborns
24 - Opioid Analgesics
Opioids
Opioid Analgesics in Pregnancy
Butorphanol (Stadol) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Fentanyl (Duragesic) Nursing Considerations
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Morphine (MS Contin) Nursing Considerations
Nalbuphine (Nubain) Nursing Considerations
Oxycodone (OxyContin) Nursing Considerations
25 - Sedatives / Hyponotics
Sedatives-Hypnotics
Barbiturates
Phenobarbital (Luminal) Nursing Considerations
Pentobarbital (Nembutal) Nursing Considerations
Anesthetic Agents
Propofol (Diprivan) Nursing Considerations
Lidocaine (Xylocaine) Nursing Considerations
26 - Steroids
Corticosteroids
Betamethasone and Dexamethasone in Pregnancy
Cortisone (Cortone) Nursing Considerations
Dexamethasone (Decadron) Nursing Considerations
Fluticasone (Flonase) Nursing Considerations
Methylprednisolone (Solu-Medrol) Nursing Considerations
27 - Vasodilators
Hydralazine
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
28 - Vasopressors
Vasopressin
Epinephrine (EpiPen) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
29 - Medications By Class
ACLS (Advanced cardiac life support) Drugs
Anti-Infective – Aminoglycosides
Anti-Infective – Carbapenems
Anti-Infective – Macrolides
Anti-Infective – Fluoroquinolones
Anti-Infective – Sulfonamides
Anti-Infective – Tetracyclines
Anti-Infective – Antifungals
Anti-Infective – Antivirals
Anti-Infective – Lincosamide
Thrombolytics
Anticonvulsants
Antidiabetic Agents
Sympatholytics (Alpha & Beta Blockers)
Anti-Infective – Antitubercular
Anti-Infective – Glycopeptide
Bronchodilators
Opioids
Barbiturates
Anesthetic Agents
30- Antineoplastics
Antineoplastics
Alkylating Agents
Antimetabolites
Anti Tumor Antibiotics
Plant Alkaloids Topoisomerase and Mitotic Inhibitors
31 – Medication Infusion
Patient Controlled Analgesia (PCA)
Epidural
Insulin Drips