1. Calculation of Basic IV Drip Rates
Marion Technical College
NUR 1021
Spring 2016

2. IV Therapy Fluids
IV therapy fluids will come in sterile plastic bags or glass bottles
Physicians & Health Care Providers order IV fluids & flow rates

3. IV Orders The prescriber is responsible for writing the order
Administering and monitoring an IV = nursing responsibility
IV order must specify the following:
Name of the IV solution
Name of medication to be added if any
Amount (volume) to be administered
Time period during which the IV is to infuse

4. Practice IV ORDERS: 1. Infuse 1000 mL D5W every 8 hours- Is it OK?
2. Infuse 0.9% 125ml- Is it OK?
3. Give 500 mL of 0.45% NS over 2 hours- Is it OK?
4. Give 0.9% NS with 20 mEq KCL every 8 hours- Is it OK?

5. Review - Types of IV Fluids
D5W = D5%W
D5S = D5 %0.9NS
D5½NS = D5 %0.45NS
NS = 0.9%NS
½NS = 0.45% NS
LR = Lactated Ringers

6. IV fluids & medications -administered by continuous & intermittent infusion
Continuous IV infusions replace or maintain fluids, and electrolytes
Continuous infusion -flows continuously until it is changed
IV Delivery Methods

7. IVPB Set-Up
Intermittent IV infusions (e.g., IV piggy back [IVPB], IV push)
Used to administer medications and supplemental fluids
Intermittent peripheral infusion devices- saline or heparin locks
Used to maintain venous access without the need of continuous infusion

8. IV BAG SIZES 1000 mL Routine IV’s 500 mL Medications or slow IV’s
250 mL Medications or NS for blood infusions.
100 mL Medications
50 mL Medications

9. Kinds of IV Drip Factors
IV fluids are administered through infusion sets
Plastic tubing attached at one end to the IV bag
The other end to a catheter inserted into a blood vessel
Drop factor is # of gtts = 1 mL
This is found on the IV tubing package

10. IV Drip Factors Microdrip = 60 gtt/mL Macrodrip need to check package
To calculate IV drip rates, this information must be known.

11. Drip Chambers IV Sets with a small needle in the chamber Microdrip
1 mL = 60 gtts (60 gtts in drip chamber = 1 mL)
IV Sets without a small needle
Macrodrip
Baxter tubing macrodrip / 1 mL = 10 gtts(10 gtts in drip chamber = 1 mL)
Other companies tubing may be 15 gtt/mL or 20 gtts/mL

12. Regulation of IV drip rate manually
Tubing for these sets contain a roller camp
Can open or close & regulate rate manually
Use a watch with a second hand to count number of drops per minute in the chamber

13. Electric Infusion Pumps
IV Infusion pumps utilized to deliver IV fluids accurately- set at mL/hour
Need to enter the total number of milliliters to be infused
Need to enter the number of milliliters per hour
Electric Infusion Pumps

14. Labeling IV’s Every IV must be labeled so any professional can check :
The fluid infusing is correct
The rate of infusion is correct
Label:
Patient name
Room/bed #
Date & time
IV order

15. Practice Label Order: 1000 mL 0.9% NS at 125 mL per hour
Patient: Jane Doe
Room#: 2140
Date/Time: 10/10/2014
IV Order: 1000 mL 0.9% NS
Rate: 125 mL per hour
Signature: M. Baxter, RN

16. Calculating Basic IV Drip Rates
No Pump = rate will be gtt/min- also known as Gravity Drip
Formula for gtt/min: mL/hr X drop factor = gtt/min
60 (minutes)

17. Example of calculating gtts/min:
Order: 1000 mLof D5/W to infuse 130 mL /hr.
Drop factor of tubing is 20 gtts = 1 mL
Formula:
mL/hr X drop factor = gtt/min
60 minutes
130mL/hr x 20 gtt/min = = 43 gtt/min
60 minutes = 1 hr
Manually would have to count drops as you watch the clock for one minute
HINT: Count for 15 seconds and multiply by 4 = 60 seconds

18. Practice: A 20 gtt/mL set is to be used to infuse an IV at a rate of 90 mL/hr. Calculate the gtt/min flow rate.
Set it up: 90 mL/hr x 20 gtt/mL = ____ gtt/min
60 min
Answer: 30 gtt/min

19. Practice: Calculate the gtt/min flow rate to administer an IV at 100 mL/hr using a set calibrated at 15 gtt/mL.
Set it up:
100 ml/hr x 15 gtt/mL = ___________gtt/min.
60 minutes
Answer: 25 gtt/min

20. Practice: Dr. Order: Adm 125 mL/hr; gtt factor is 10 gtt/mL
Practice: Dr. Order: Adm 125 mL/hr; gtt factor is 10 gtt/mL. How many gtt’s per minute will this infuse at?
Set it up:
125ml/hr x 10gt/ml = ______gtt/min
60 min
Answer: gtt/min = 21 gtts/min
*Always round off since the pump cannot be set at decimals

21. NCLEX Practice Question
Order: 1000 mL D5W at 120 mL/hour . Available macrodrip tubing of 15 gtt/mL
What is the drip factor in drops per minute?
A. 30 gtt/minute
B. 31 gtt/minute
C. 32 gtt/minute
D. 33 gtt/minute

22. Answer A. 30 gtt/minute Formula:ml/hr x gtt factor = gtt/minute
120 mL x 15 gtt/mL = 30 gtt/minute
60 minutes

23. PRACTICE: Doctor’s order: Infuse 500 mL D5 W over next 12 hours
PRACTICE: Doctor’s order: Infuse 500 mL D5 W over next 12 hours. Use a microdrip tubing. What is the drop per minute rate?
Set it up: Requires 2 steps mL ÷ 12 hrs = = 42 mL/hr mL/hr x 60 gtts/mL = _______gtts/min 60 minutes Answer: 42 gtts/min HINT: Note the 60’s cancel out and the remaining number is always the answer with microdrip tubing

24. Electronic Volumetric Pumps
Infuse fluids into the vein under pressure & against resistance
Do not depend on gravity
Pumps are programmed to deliver a set amount of fluid per hour
Milliliters per hour (mL/hr)
Milliliter calculation that results in a decimal fraction -round to a whole milliliter
Pumps in ICU may have decimal capability and may use fractions

25. Smart Pumps Smart pumps have customized software
Has a reference library of medications- indicates the minimum and maximum rates at which medications should safely infuse
Select medication dosage and rate automatically is programmed

26. IV Pump using Controller
IV Pump = rate will be mL/hr
Formula:
Total # of mL ordered = mL/hr
Total # of hours ordered

27. Example of calculating mL/hr to set the pump at:
FORMULA:
Total number of milliliters ordered = mL/hour
Number of hours to run
Order: mL LR to infuse in 10 hours
Using formula for setting up calculation:
Determine the amount of IV fluid ordered and divide this by the number of hours
2000 mL = mL/hr
10 hr
Answer: Set the IV Pump controller at 200 mL/hr

28. Practice
Order: 400 mL LR to infuse for 4 hours, then 600 mL LR to infuse for 8 hours.
Use the formula to set the problem up:
Total number of milliliters ordered = mL/hour
Number of hours to run
a. 400 mL 4 hrs = 100 mL/Hr (set pump at 100/hr for 4 hours) Then calculate second amount b. 600 mL 8 hrs = 75 mL/hr (set pump now at 75 mL/hr for 8 hours)

29. Calculating the Rate/Hr for an IVPB

30. Practice Doctor’s order: Keflin 2 g IVPB over 30 min
Practice Doctor’s order: Keflin 2 g IVPB over 30 min. Keflin is in 100mL bag and drop factor is 15 gtt/mL. At what rate should the IV be regulated? HINT: Need to find out what to set the pump at per hour
Set it up:
Total number of mL = X mL
Infusion time (minutes) minutes
100 mL = X mL
30 min min
Answer: 200 mL/hr
HINT: DO NOT NEED TO USE THE DROP FACTOR FOR CALCULATION OF IV RATE WITH INFUSION PUMP

31. IVPB : Calculate the rate to set the pump at
Order: Keflex 250 mg IV every 12 hrs.
Keflex 250 mg comes from pharmacy in a bag of 100 cc 5D/W; directions are infuse over 1 hr. per IV pump
Set it up:
100 mL = x mL
60 min min
x = mL
Answer: Set pump at 100 mL/hr

32. IVPB : Calculate the rate to set the pump at
Order: Floxin 600 mg IVPB every 8 hrs.
Available: Floxin 600 mg in a 50 cc bag of 5D/W. Infuse over 30 minutes
Set it up:
50 mL = x mL
30 min min (Use 60 minutes since the IV pump can only be set by the hour)
x = mL
Answer: Set pump at 100 mL/hr

33. Determining the Number of Hours an IV Will Run
Formula:
Number of milliliters ordered = Number of hours to run
Number of milliliters per hour

34. Example of how to calculate how long IV will run
How many hours will 500 mL of D5½NS run at 125 mL/hour?
Number of milliliters ordered = Number of hours to run
Number of milliliters per hour
500 mL = 4 hours
125 mL/hour

35. Calculate the number of hours the IV will run
PRACTICE:
Order= LR 1000 mL IV at 125 mL/hour
Calculation:
1000mL = 8 hours
125 mL

36. Safety Alert !
Several electronic devices are on the market for infusing IV solutions
Always familiarize yourself with the equipment before use
Follow the institution's protocol for IV administration
Nurses have the primary responsibility for monitoring the client during IV therapy
Nurses are responsible for any errors that occur in administration of IV fluids (e.g., inadequate dilution, too rapid infusion)
Pay close attention to IV abbreviations

37. What have you learned?
What are the 2 types of IV tubing? Microdrip & Macro drip
What are drop factors ? IV tubing package- # of gtts = 1 mL
How do you calculate the IV rate for gtts/min?
Formula:
mL/hr X drop factor = gtt/min
60 minutes

38. What else have you learned?
What is the formula for mL/hr?
Total number of milliliters ordered = mL/hour
Number of hours to run
How do you calculate how long an IV will run?
Number of milliliters ordered = Number of hours to run
Number of milliliters per hour
How do you calculate the ml/hr to set the IV pump?

39. The “BENEFITS” of IV Therapy