2.

Assignment: Dosages and Flow Rates and Pediatric Drug Administration Pharmacy technicians must know that parenteral or injectable medications are available in different dosage forms. The following assignment provides an opportunity for you to practice these skills. Resources: Ch. 11-12 of Pharmaceutical Calculations for Pharmacy Technicians: A Worktext and Equation Editor Due Date: Day 7 [Individual forum] Show all your calculations in a Microsoft Word document using Equation Editor. Calculate appropriate dosages and flow rates for IV medications in the following exercises: 1. Stop and Review, p. 137: Problems 1a-1j. Hint: Refer to the drug products label on pp. 135-136 2. Test Your Knowledge, pp. 145: Problems 1, 2, and 3 3. Test Your Knowledge, p. 146: Problems 20, 21, 22, 25, and 30 4. Critical Thinking, p. 147: Problem 1 5. Test Your Knowledge, p. 161: Problems 1 and 3.

Calculating IVs as Percentages 1. Calculate the amount of dextrose and/or sodium chloride in each of the following IV solutions. a. 250 mL NS sodium chloride __________g b. 3 L of D5NS dextrose __________g sodium chloride __________g c. 500 mL of D5 0.33% NaCl dextrose __________g sodium chloride __________g d. 250 mL of D10W dextrose __________g e. 1,000 mL of D5NS dextrose __________g sodium chloride __________g f. 750 mL of NS sodium chloride __________g g. 0.75 L of 0.45% NaCl sodium chloride __________g h. 300 mL of D12 0.9% NaCl dextrose __________g sodium chloride __________g i. 500 mL of D51/2 NS dextrose __________g sodium chloride __________g j. 0.5 L of D101/4 NS dextrose __________g sodium chloride __________g

For the following questions, use the drop factor to calculate the flow rate in gtt / min. Ordered: 1,000 mL of 0.45% NaCl IV at 200 mL / hr 1. Drop factor 10 gtt / mL Flow rate: __________ gtt / min 2. Drop factor 15 gtt / mL Flow rate: __________ gtt / min 3. Drop factor 20 gtt / mL Flow rate: __________ gtt / min

Complete the flow rate in drops per minute or milliliters per hour as requested. For these situations, hospital policy permits recalculating IVs when off schedule with a maximum variation in rate of 25%.

20. Ordered: 1,500 mL D5 LR IV to run for 12 hr Drop factor: 20 gtt / mL Flow rate: __________ gtt / min The IV tubing package in the accompanying figure is the IV system available in your stock for manually regulated, straight gravity flow IV administration with macrodrop. The patient has an order for 500 mL D5W IV q4h written at 1515, and you start the IV at 1530. Questions 21 through 30 refer to this situation. 21. How much IV fluid will the patient receive in 24 hours? _______________ 22. Who is the manufacturer of the IV infusion set tubing? _______________ 25. Using the shortcut (drop factor constant) method, calculate the flow rate of the IV as ordered. Show your work. Shortcut method calculation: ____________________ Flow rate: __________ gtt / min 30. After consulting the physician, you decide to use an electronic controller to better regulate the flow rate. The physician orders that the controller be set to infuse 500 mL every 4 hours. You should set the controller for __________ mL / hr.

1. An elderly patient who had pneumonia was prescribed Rocephin 1 g IV q12h by her physician. The medication, which utilized a new dispensing system, was delivered by the pharmacy technician to the hospital unit. 1 g of Rocephin was supplied as a powder attached to a 50 mL IV bag of 5% dextrose in water. The nurse hung the IV medication and infused the solution. Three days later, another nurse discovered that the Rocephin powder was still in the vial, and that the vial stopper had never been opened. The powder had not been mixed into the IV fluid during this entire period. The nurse who made the error had never worked with this new dispensing system and did not ask for instructions either from the pharmacy technician or another nurse. The pharmacy technician did not include the dispensing instructions or explain the dispensing procedure to the nurse. As a result of this situation, what could possibly happen to the patients pneumonia? What could result in the patients condition from this change?

Ordered for a child weighing 15 kg: D5 0.45% NaCl IV at 53 mL / h with ampicillin 275 mg IV q4h infused over 40 min by volume control set Recommended dosage: ampicillin 100125 mg / kg / day in 6 divided doses On hand: ampicillin 1 g / 10 mL 1. Safe daily dosage range for this child: __________ mg / day to __________ mg / day Safe single dosage range for this child: __________ mg / dose to __________ mg / dose. Is the ordered dosage safe? __________. If safe, give __________ mL / dose. If it is not safe, describe your next step. _____ ___________________________________________

Ordered for a child who weighs 55 lbs: D5 NS at 60 mL / hr with penicillin G potassium 525,000 U q4h to be infused over 20 min by control set Recommended dosage: penicillin G potassium 100,000250,000 U / kg / day in 6 divided doses q 4 hr. On hand: penicillin G potassium 200,000 U / mL 3. Childs weight: __________ kg Safe daily dosage for this child: __________ U / day to __________ U / day Safe single dosage for this child: __________ U / dose to __________ U / dose