Calculate with Confidence

5th edition
Gray Morris

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Intravenous Calculations
Unit 5: Chapter 22

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IV Calculations: Objectives
After reviewing this chapter, you should
be able to:
1.
2.
3.
4.
5.

Calculate milliliters per hour (mL/hr).

Identify two types of administration tubing.
Identify drop factor on tubing package.
Calculate IV flow rate in drops per mL (gtt/mL).
Calculate IV flow rate in gtt/min using the
shortcut method.
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IV Calculations: Objectives
(contd)
6.
7.
8.
9.

Calculate flow rate for medications ordered IV

over a specific time.
Calculate infusion times and completion times.
Recalculate IV flow rates and determine the
percentage (%) of increase or decrease.
Calculate the rate for medication administered
by IV push.

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IV Flow Rate Calculation

Nurse is responsible for ensuring that the IV

fluid infuses at the correct rate.
Rate is usually expressed in mL per hr.
If calculation yields a decimal expression,
round to nearest whole number of mL/hr.
If the infusion is managed without an
electronic pump, the rate is calculated in
drops per min (gtt/min)

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Calculating Flow Rates for

Volumetric Pumps

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Formula method
Problem: Infuse 3,000 mL over 24 hr

Amount of solution
x mL/hr (whole number) =
Time in hours
3,000 mL
x mL/hr =
24 hr
x = 125 mL/hr
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Calculating IV Flow Rates in

Drops (gtt) per Minute

If pumps are not available, the rate is

manually regulated with flow regulator in
tubing
Drops per minute is determined by the drip
factor of the drop chamber below IV bag
Calibration is printed on package

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IV Tubing

Macrodrop

Standard type for general infusions

Delivers 10, 15, or 20 gtt/mL for each mL
Used to deliver large volumes

Microdrop

Delivers tiny drops60 gtt/mL

Used to deliver small amounts with exactness
Because drop factor is 60 gtt/mL, drops per minute
equals mL per hour (e.g., 25 mL per hr = 25 gtt/min)

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Figure 22-2 Observing the drop chamber to count drops per minute. (From
Potter PA, Perry AG: Fundamentals of nursing, ed. 7, St. Louis, 2009, Mosby.)

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Calculating Flow Rates in

Drops per Minute
Can be used for primary solutions and
intermittent solutions of large and small
volumes (e.g., IVPB and boluses)

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Formula Method
Problem: Infuse NS at 100 mL per hr. The drop factor
on tubing is 10 gtt/mL. How many gtt/min?

Amount of solution (mL) Drop factor

x = gtt/min =
Time in min
100 mL 10 gtt/mL
x = gtt/min =
60 min
100
x=
= 16.6
6
x = 17 gtt/min
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Dimensional Analysis
Problem: Infuse D5W at 100 mL per hr
What is rate in gtt/min? DF = 10 gtt/mL

gtt
10 gtt
100 mL
1 hr
x

min
1 mL
1 hr
60 min
10 100
100
x

60
6
x = 16.6 = 17 gtt/min
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Calculating Drops per Minute

with Large Volumes of Fluid

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Review

IV fluid can be ordered in large volumes over

several hours (e.g. 1,000 mL over 6 hours)
Preliminary step to determine the volume per
hour:

Amount of solution (mL)

x mL/hr =
Time in hours

Dimensional analysis incorporates this

preliminary step in one equation
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Dimensional Analysis
Problem: IV of 1,000 mL NS to infuse in 8 hr
IV tubing has drop factor of 20 gtt/mL
gtt
20 gtt
1,000 mL
1 hr
x

min
1 mL
8 hr
60 min
20 1,000
x
60 (8)
20,000
1,000
x =
=
480
42
x = 41.6 = 42 gtt/min
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Calculation of IV Flow Rates

Using a Shortcut Method

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Shortcut Method

All tubings in facility must have same gtt/mL

throughout to prevent errors in macrodrops.
Can also be used for microdrop (60 gtt/mL)
IV flow rate must be expressed in mL per hr
or mL per 60 min.
Must obtain drop factor constant.
For 15 gtt/mL:

60
4 (drop factor cons tan t 4)
15
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Problem: Administer 0.9% NS at 100 mL/hr

Drop factor = 20 gtt/mL Constant = 3

Remember: Drop factor constant is obtained by dividing

60 by drop factor of tubing (20)

100 mL/hr
x gtt/min =
= 33.3 = 33 gtt/min
3

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Calculating IV Flow Rates When

Several Solutions are Ordered

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Background for Several Solutions

May have different amounts and types

ordered over an extended period
Usually for 24-hr period
Usually divided by 3 shifts

Steps to calculate:
1. Add up the total amount of fluid
2. Proceed as with other IV calculations
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Order: Administer the following IVs for 24 hours:

a. 1,000 mL D5W with 10 mEq KCl (potassium chloride)
b. 500 mL D5NS with 1 amp MVI (multivitamin)
c. 500 mL D5W
Steps:
Calculate mL per hr of
2,000 mL
total volume
x mL per hr =
= 83.33... = 83 mL per hour

24 hr

Calculate gtt per min

Reduce

83 mL 15 gtt per mL
x gtt per min =
60 min
83 15 83 1
x=
=
= 20.7 = 21 gtt per min
60
4
x = 21 gtt per min

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Determining Amount of Medication in

Specific Amount of Solution

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Order: Mix solution of 20 mEq KCl in

1,000 mL of NS. Administer at 2 mEq per
hour.

Step 1 Calculate number of mL needed to

deliver 2 mEq of KCl from this solution
20 mEq : 1,000 mL = 2 mEq : x mL
20 x = 2,000
2,000
x=
therefore x = 100 mL
20
Step 2 Calculate rate of flow to deliver 100 mL
per hr via pump or by drop factor

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Calculating a Problem with an

Unknown Using the Formula Method

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Steps
1.
2.

Take information in problem and place in

formula
Place an x in position of unknown

3.
4.
5.

For time in hours place x in position for min.

When answer obtained, divide by 60 to get
hours.
For volume place x in position for volume

Set up algebraic equation to solve for x.

Solve the equation.
Label the answer in hours or milliliters.
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Problem: An IV is regulated at 20 microgtt/min.

How many hours will it take to infuse 100 mL?
1. Set up formula

100 mL 60 gtt/mL
20 microgtt/min =
x time in min
20x 100 603 100 3

1
20
20
1
x = 300 min

2. Reduce

3. Change minutes to hours

60 min = 1 hr
300 min
therefore
= 5 hr
60

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Recalculating IV Flow Rate

Change in rate for gravity flow infusions

Rate can change with changes in position of client

in the bed or positional IVs

If change is greater than 25% variance,

physician should be notified.
ALWAYS check status of client before
compensating, and follow facility policy.

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Checking Amount of Change

Amount of or
= % variance from original rate*
Original rate
*Round to nearest whole percent

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Calculating Adjusted Flow Rate

Example 1:
1,000 mL of D5LR was to infuse in 8 hr at 31
gtt/min (macrogtt/min). The drop factor of the
tubing is 15 gtt/mL. After 4 hours, you notice
that 700 mL of fluid is left in the IV. What will
be the new rate needed to infuse the solution
in the time prescribed?

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Shortcut Method
Time remaining: 8 hr - 4 hr = 4 hr
Volume remaining: 1,000 mL - 300 mL = 700 mL
700 mL
= 175 mL/hr
4 hr
60
Drop factor: 15 gtt/mL, therefore constant is 4
15
175 mL/hr
x = gtt/min
x = 44 gtt/min = 43.7 = 44 gtt/min
4

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Shortcut Method

Calculate the % of variance

44 (new rate) - 31 (old rate)/31(old rate) =
13/31; 13/31= 0.419 = 42% Notify prescriber,
42% is greater than 25%. The order may
need to be revised.

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Calculating Total Infusion Times

IV rates often ordered in mL per hr.

Need to calculate volume infused over time:

Total number of mL to infuse

= Total infusion time
mL/hr infusing at

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Calculating Infusion Time When

Rate in mL per hr Is Not Indicated
Prescriber orders a specific large volume of fluid
and a rate in gtt/mL, but not mL/hr
Steps:
1. Convert gtt/min to mL/min
2. Convert mL/min to mL/hr
Problem: Client is receiving 1,000 mL of RL. The
IV is infusing at 21 gtt/min. Drop factor is 10
gtt/mL. Calculate the infusion time.
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1. Use R&P to change gtt per min to mL per min

10 gtt : 1 mL = 21 gtt : x mL
10x 21
=
= 2.1 mL per min
10
10
2. Convert mL per min to mL per hr
2.1 mL per min (60 min) = 126 mL per hr
3. Determine infusion time
1,000 mL
a.
7.93 hr
126 mL per hr
b. 0.93 hr 60 min = 55.8 = 56 minutes
c. Infusion time = 7 hrs and 56 min
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Charting IV Therapy and

Labeling Bags

IV administration may be charted on special

flow sheets and may include IV site
assessment.
IV bags must be labeled with contents, rate,
and client identifiers.
Rate tapes may be applied to visually cue
hour and volume correlations.

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Figure 22-5 IV solution with time taping. (From Potter PA,

Perry AG: Fundamentals of nursing, ed. 7, St. Louis, 2009, Mosby.)

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Administration of Medications
by IV Push

IV push medications are given via injection

ports.
Results are rapid; drugs are potent.
Administer or over 1 to 5 minutes, depending
on drug guidelines.
Medications are diluted in various volumes.
Solution compatibility is verified.
Tubing is flushed.
Calculate rate of push using R & P.
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Order: Tagamet 200 mg IV push now.

Available: Tagamet 300 mg per 2 mL
Note: Literature says dilute Tagamet to 20 mL

300 mg : 2 mL = 200 mg : x mL
300x 400
=
300
300
x = 1.33... = 1.3 mL
(Continue for solution of dilution and rate)
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To dilute 1.3 mL of Tagamet to total 20 mL volume

20 mL desired
-1.3 mL dosage
18.7 mL to add
To calculate rate of IV push infusion over 5 minutes
20 mL : 5 min = x mL : 1 minute
5(x ) = 20(1)
5x 20

5
5
x = 4 mL per min
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