A 58 year-Old male is admitted to the medical/surgical unit following surgery for transurethral resection of prostrate. The physician's post-operative orders include:
• Admit to the medical/surgical unit
• Monitor intakes and output
• Monitor urinary output hourly
• Vitals every 2 hr
• Monitor for symptoms of TURP syndrome
• Adjust rate of continuous bladder irrigation (CBI) 3 liter bags of sterile normal saline to maintain patent catheter, adjust rate to maintain pink to clear urine, and maintain urinary catheter traction
• IV D5W/0.45% normal saline 1000ml/8 br
• Ciprofloxacin (Cipro) 400 mg IV every 12 hr
• Docusate sodium (colace) 100 mg PO bid
• Dimenhydrinate 25 mg IV every 4 hr prn
• Acetaminophen (Tylenol) 300 mg with 30 mg of codeine PO 1 to 2 tablets every 4 to 6 hrs prn
• Discontinue IV when drinking well
• Complete blood count, electrolytes, creatinine in am
• Identify. the orders that require calculations
• Set up and solve each problem using dimensional analysis. Show all work
1. Calculate how many ml/hr to set the IV pump.
Supply: D5% NS W/0.45% NS 1000ml bag
2. Calculate how many gtt/min using 20 gtt/mL IV tubing
3. Calculate how many ml/hr to set the IV pump to deliver the Cipro.
Supply: Ciprofloxacin 400mg/ 200ml D5W to infuse over 60 minutes.
4. Calculate how many capsules to give of Colace.
Supply docusate sodium 100mg/capsule.
5. Calculate how many ml be given of dimenhydrinate
1. To calculate the ml/hr to set the IV pump, we need to determine the flow rate. The total volume (1000ml) is to be infused over 8 hours (8 br = 8 hours) or 480 minutes.
Flow rate (ml/hr) = Total volume / Time (minutes)
Flow rate (ml/hr) = 1000ml / 480 minutes
Flow rate (ml/hr) ≈ 2.08 ml/hr
2. To calculate the gtt/min using 20 gtt/mL IV tubing, we need to know the flow rate in ml/hr. Using the result from question 1, we can calculate the gtt/min.
Flow rate (ml/hr) = 2.08 ml/hr
Gtt/min = Flow rate (ml/hr) * Drop factor (gtt/mL)
Gtt/min = 2.08 ml/hr * 20 gtt/mL
Gtt/min ≈ 41.6 gtt/min (Round to the nearest whole number: 42 gtt/min)
3. To calculate the ml/hr to set the IV pump to deliver the Cipro, we need to determine the flow rate. The total volume (200ml) is to be infused over 60 minutes.
Flow rate (ml/hr) = Total volume / Time (minutes)
Flow rate (ml/hr) = 200ml / 60 minutes
Flow rate (ml/hr) ≈ 3.33 ml/hr
4. To calculate how many capsules of Colace to give, we need to know the desired dose. The order states 100mg PO bid (twice a day). We will assume the patient will be taking it twice a day.
Dose (mg/day) = Desired dose (mg/dose) * Frequency (doses/day)
Dose (mg/day) = 100mg/dose * 2 doses/day
Dose (mg/day) = 200mg/day
To find the number of capsules to give, we need to divide the total dose by the strength of each capsule.
Number of capsules = Dose (mg/day) / Strength of each capsule (mg/capsule)
Number of capsules = 200mg/day / 100mg/capsule
Number of capsules = 2 capsules
5. The question is incomplete. Please provide the complete information for the calculation.
To calculate the answers to each question, we will use dimensional analysis, which involves canceling out units to find the desired answer. Let's solve these step by step:
1. Calculate how many ml/hr to set the IV pump.
To set up this calculation, we will use the following information:
- Supply: D5% NS W/0.45% NS 1000ml bag
We need to set the rate in ml/hr. Since there was no specific rate mentioned in the question, we will assume a standard rate for this calculation.
Let's set up the calculation:
x ml/hr = 1000ml / 8 Hr
To cancel out the units, we will multiply both sides of the equation by the reciprocal of the units in the denominator:
x ml/hr = (1000 ml / 8 Hr) * (1 Hr / 60 min)
Simplifying the equation, we have:
x ml/hr = 1000 ml / (480 min)
Calculating the value, we get:
x ml/hr ≈ 2.08 ml/hr
Therefore, the IV pump should be set at approximately 2.08 ml/hr.
2. Calculate how many gtt/min using 20 gtt/mL IV tubing.
To calculate the gtt/min, we need to know the drip factor of the IV tubing, which is given as 20 gtt/mL.
Let's set up the calculation:
x gtt/min = (2.08 ml/hr) * (20 gtt/ml) * (1 hr / 60 min)
Simplifying the equation, we have:
x gtt/min = (2.08 * 20) / 60
Calculating the value, we get:
x gtt/min ≈ 0.693 gtt/min
Therefore, the IV pump should be set at approximately 0.693 gtt/min.
3. Calculate how many ml/hr to set the IV pump to deliver the Cipro.
To set up this calculation, we will use the following information:
- Supply: Ciprofloxacin 400mg/ 200ml D5W to infuse over 60 minutes.
We need to set the rate in ml/hr.
Let's set up the calculation:
x ml/hr = (200 ml / 60 min) * (1 hr / 1)
Simplifying the equation, we have:
x ml/hr = 200 / 60
Calculating the value, we get:
x ml/hr ≈ 3.33 ml/hr
Therefore, the IV pump should be set at approximately 3.33 ml/hr to deliver the Cipro.
4. Calculate how many capsules to give of Colace.
To set up this calculation, we will use the following information:
- Supply: docusate sodium 100mg/capsule.
We need to determine the number of capsules to give.
Let's set up the calculation:
x capsules = (100 mg / 1 capsule) * (1 mg / 1000 μg) * (5000 μg / 1 capsule)
Simplifying the equation, we have:
x capsules = (100 * 5000) / 1
Calculating the value, we get:
x capsules = 500,000 capsules
Therefore, approximately 500,000 capsules of Colace should be given.
5. Calculate how many ml to give of dimenhydrinate.
The question is not complete and does not provide the necessary information to calculate the ml to be given for dimenhydrinate. Please provide the additional information so we can continue solving this calculation.