Math Basics for the Health Care Professional Copyright © 2014, 2009 by Pearson Education, Inc. All Rights Reserved FOURTH EDITION UNIT The Basics of Intravenous Fluid Administration 13

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Student Learning Outcomes 1.Calculate intravenous flow rate, time, and volume 2.Calculate amount infused versus amount remaining to be infused 3.Use the language that is used for intravenous infusion

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Intravenous: Overview Intravenous (IV) infusions  Placed directly into bloodstream  Have very quick effect  Used when meds needed immediately  Used to deliver large doses 13-3

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Intravenous: Overview Uses of IV solutions  Provide therapy  Maintain/replace fluids  Keep vein open 13-3

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Abbreviations Common abbreviations used  Intravenous (IV)  Piggy-back (PB)  Drop/drops (gtt/gtts)  Hour (hr)  Minutes (min)  Drops per minute (gtts/min)  Drops per milliliter (gtts/mL)  Milliliters per hour (mL/hr) 13-3

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Abbreviations Common abbreviations used  Water (H 2 0, W)  5% dextrose water (D 5 W)  10% dextrose water (D 10 W)  Normal Saline (0.9%)(NS)  ½ normal saline, 0.45% (½ NS)  Ringer’s lactate solution (RL)  Lactated Ringer’s solution (LR) 13-3

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister IV Infusion Sets Infusion set parts  Sealed plastic bag or bottle  Drip chamber  Tubing Macrodrip (10, 15, or 20 gtts/mL) Microdrip (60 gtts/mL)  Needle or catheter  Clamp 13-3

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Infusion Rate Drug order contains  Type of fluid, amount of fluid, # of hours to infuse DRIP RATES Microdrip administration60 drops per milliliter Standard administration (macrodrip administration) 10, 15, 20 drops per milliliter Blood administration 10 drops per milliliter Drop factor: # of drops in 1 mL Macrodrip: ≥ 125 mL/hour Microdrip : ≤ 50 mL/hour 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Infusion Flow Rates Flow rates  Rate (the flow rate) = volume / time OR Example: Infuse 3000 mL of D 5 W IV over next 24 hrs. V/t = R (formula) 3000 mL ÷ 24 hr = R 125 ml/hr = R 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Calculating IV Infusion Rates Three pieces of information  Amount to be infused  Time in minutes  Administration set drop factor Formula: SHORTCUT: To convert hours to minutes quickly, replace the [hours] with [hours × 60 minutes] in the formula. 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Calculate: by Formula Problem  To administer 500 mL of IV fluid over 12 hours using a microdrip administration set, how many drops/min would the nurse administer? 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Calculate: by Formula Problem Hint: Microdrip has a drop factor = 60 drops/min. FORMULA 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Calculate: Dimensional Analysis Problem  To administer 500 mL of IV fluid over 12 hours using a microdrip administration set, how many drops/min would the nurse administer? 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Calculate: Dimensional Analysis Problem Hint: Microdrip has a drop factor = 60 drops/min. 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Solving a (Complex) Problem Problem: The doctor has prescribed 750 mg of Ampicillin in 125 mL NS to infuse over 45 min. What is the mL per hour infusion rate? First, change minutes to hours. 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Solving our Problem (continued) Problem: The doctor has prescribed 750 mg of Ampicillin in 125 mL NS to infuse over 45 min (0.75 hr). What is the mL per hour infusion rate? 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Solving: Dimensional Analysis Problem: The doctor has prescribed 750 mg of Ampicillin in 125 mL NS to infuse over 45 min. What is the mL per hour infusion rate? 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Handy Helpers for Missing Info Solve for either of the three missing items: V, R, t 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Example: Missing “ t ” in Rx Problem: The doctor orders D 5 ½ NS 1000 mL at 175 mL/hr. ( Note: We’re missing “t”.) 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Converting Decimal to hrs/mins Problem: The doctor orders D 5 ½ NS 1000 mL at 175 mL/hr (t = 5.71 hours Convert the decimal 5.71 hrs to hours and minutes. Separate the whole number from the decimal number. 5 hours and 0.71 hrs 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Converting Decimal to hrs/mins Convert the decimal 5.71 hrs to hours and minutes Multiply the decimal number 0.71 × 60 min = 42.6 minutes Round to the nearest minute: 43 minutes Place the hours and minutes back together. 5 hours 43 minutes The final answer is 5 hours 43 minutes 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Solving: Dimensional Analysis Problem: The doctor orders D 5 ½ NS 1000 mL at 175 mL/hr. ( Note: We’re missing “t”.) 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Converting Decimal to hrs/mins Problem: The doctor orders D 5 ½ NS 1000 mL at 175 mL/hr (t = 5.71 hours Convert the decimal 5.71 hrs to hours and minutes. Separate the whole number from the decimal number. 5 hours and 0.71 hrs 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Converting Decimal to hrs/mins Convert the decimal 5.71 hrs to hours and minutes Multiply the decimal number 0.71 × 60 min = 42.6 minutes Round to the nearest minute: 43 minutes Place the hours and minutes back together. 5 hours 43 minutes The final answer is 5 hours 43 minutes 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Example: Missing “V” in Rx Problem: What is the total volume infused in 5 hours if the infusion rate is 65 mL/hr? Solve using the formula. 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Example: Missing “V” in Rx Problem: What is the total volume infused in 5 hours if the infusion rate is 65 mL/hr? Solve using dimensional analysis. 13-1

Math Basics for the Health Care Professional, Fourth Edition Michele Benjamin Lesmeister Calculate infused versus remaining to be infused Infuse 2000 milliliters at 125 milliliters per hour. Infuse for _____________. Ordered: 1800 milliliters 0.45% NS at 75 milliliters per hour. What is the total time of infusion? _______________ Ordered: 750 milliliters RL at 83 milliliters per hour. What is the total time of infusion? _______________ 13-2