I really don't know how to begin to approach this problem.
A 6-year-old patient underwent an outpatient tonsillectomy and adenoidectomy The surgeon ordered 1,000 cc D5W, dispensed at a rate of 600 cc every 8 hours, to maintain hydration levels. A pharmacist calculated the infusion rate for the IV drip to be administered. He used a calculator and checked his calculations twice. He then listed the infusion rate on the electronic medical chart as 200 mL/hr.
The nurse who started the infusion obtained a bag of D5W, which contains 1,000 cc of fluid, and administered the IV solution to the child. Like other nurses in her unit, she relied on the accuracy of the pharmacist since he had a reputation for correctness. Therefore, she did not check his calculations even though her job duties include verifying dosages. Once the first 1,000 cc bag of D5W was empty, she hung a second bag to infuse.
The child began vomiting frequently, which is not unusual in the recovery for this surgery. The child was given medicine to ease the vomiting. Forty minutes later the child exhibited seizure-like activity, which is unusual in the recovery from this type of surgery. This behavior increased over the course of the day, during which a third 1,000 cc bag of D5W was hung to dispense.
The pediatrician on call noticed the patient was experiencing hyponatremia and water intoxication due to the high IV infusion rate and lack of sodium chloride in the infused medicine. In fact, the child's sodium level was 107 mEq/L, whereas the normal range is 136-145 mEq/L. Despite treatment, the child did not survive.
Assuming all three bags were completely administered, how much D5W did the child actually receive compared to the amount ordered? Assuming the surgeon's orders were correct, what should the IV rate have been in cc/hour? How long should the IV have continued to administer the 1,000 cc ordered by the surgeon? By what percent was the child's sodium level beneath the normal range?
This is actually for a math class and not a medical class. I know nothing about medicine and am struggling with how to begin. Obviously this patient was not given the correct dose, but how can I prove this?
1cc=1ml. Therefore 600cc= 600ml.
so 600cc per 8 hours transforms to 600ml/8=75ml per hour. So the child should have been administered 75ml (=75cc) per hour ( and not 200ml per hour).
a. 3 bags of 1000cc equals 3000cc=3000ml. At he rate of 200ml/hr it took 3000/200=15 hours to administer. Actullay in 15 hours, the boy should have been given 15x75=1125ml. So he received 3000cc instead of 1125cc.
b. As shown above, the correct rate is 75cc/hr
c. At the rate of 75cc/hr, the 1000cc IV shoud have taken 1000/75= 13.33 hours.
d. (136-107)x100/136=21.32% to (145-107)x100/145 =26.2%
for futher help contact me on profkn7 at gmail
How would I explain that in the form of a paragraph.
How
Would i explain that in a form of a paragraph??
To approach this problem, we need to analyze the given information and use basic math skills to find the answers. Let's break down the questions one by one and explain the steps to find the answers:
1. How much D5W did the child actually receive compared to the amount ordered?
- The surgeon ordered 1,000 cc of D5W. We know that three bags of D5W were administered.
- Each bag contains 1,000 cc of D5W, so the total amount administered is 1,000 cc x 3 = 3,000 cc.
- Therefore, the child actually received 3,000 cc of D5W.
2. Assuming the surgeon's orders were correct, what should the IV rate have been in cc/hour?
- The pharmacist listed the infusion rate as 200 mL/hr.
- To convert mL to cc, since 1 mL is equal to 1 cc, the infusion rate is 200 cc/hr.
3. How long should the IV have continued to administer the 1,000 cc ordered by the surgeon?
- The infusion rate was 200 cc/hr.
- To find the infusion time, we can divide the total amount ordered (1,000 cc) by the infusion rate (200 cc/hr).
- 1,000 cc ÷ 200 cc/hr = 5 hours
- Therefore, the IV should have continued to administer for 5 hours to deliver the entire order of 1,000 cc.
4. By what percent was the child's sodium level beneath the normal range?
- The child's sodium level was 107 mEq/L, while the normal range is 136-145 mEq/L.
- To find the percentage, we can use the formula: (actual value - normal range low value) / normal range low value x 100.
- (107 - 136) / 136 x 100 = -29 / 136 x 100 = -21.3%
- Therefore, the child's sodium level was 21.3% beneath the normal range.
To prove that the patient was not given the correct dose, you can compare the amount actually received (3,000 cc) to the amount ordered by the surgeon (1,000 cc). The discrepancy between these two amounts clearly shows that the patient received a higher dose than what was ordered.
Remember, while this explanation provides step-by-step guidance to solve the problem, it is important to consult medical professionals for accurate and comprehensive information regarding patient care.