1. Insulin Administration A patent is admitted to ICU with a diagnosis of DKA. The MD orders a Regular Insulin drip to be infused at 5 units/hour. Review the container and calculate the rate or cc’/hour_____. The nurse reviews the blood sugars and follows the protocol to decrease the rate to 3 units/hr. The nurse then sets the pump at cc’s/hour.____The nurse has an order to discontinue the insulin drip and begins the following sliding scale. Blood Sugar minus target of 100 divided by 40 the sensitivity equals the dose the nurse needs to administer. The nurse performs the finger stick blood sugars and obtains: 6am 249, 12noon 198 6pm 310, 12mn 395. What is the amount of insulin needed for each injection at the given times. Review of past content. What type of syringe will the nurse need? How much Insulin in units can a ½ cc syringe hold?

2. Pt with CHF has Atrial Flutter and will be started on a Diltiazem drip Prepare a Diltiazem drip. The vial reads 50mg in 10cc. The nurse prepares the drip so that the final concentration is 250mg in 250ml of Normal Saline. The MD writes to start the drip at 10mg/hr. The nurse should set the pump to infuse at _____cc’s/hr.

3. Nitroglycerin Drip The nurse is preparing a Nitroglycerin Drip the container is labeled 100mcg/cc. The client is having severe chest pain and is to have the drip started at 5mcg/min. The rate on the pump should be set at ____cc’s/hr. The nurse then titrates the Nitroglycerin drip up until the patient is not having chest pain. The drip is now at 20mcg/min. The nurse should find the pump set at _____cc’s/hr.

4. Aminophylline Drip A patient enters the ICU unit with a Aminophylline Drip infusing. The order is 1mg/kg/hr. The patient weighs 160 lbs. Calculate the correct cc’s/hour the pump should be set at when the nurse assesses the patient. Based on the fact that the bag is labeled 500mg of medication in 500ml of D5W how long can nurse anticipate the infusion will last based on the current rate.

5. Lidocaine Drip The patient enters the ED and is suspected of having a Myocardial Infarction. The patient is currently receiving 3mg/min and the IV drip is on a pump with the number 30cc/hr set as the flow rate. Is this correct? ____The bag is labeled 2grams of Lidocaine in 500ml of D5W. The MD comes in and ask that the drip be increased to 4mg/min. How will the nurse adjust the rate. ______cc’s/hr

6. Mary Heart Attack is on a Dopamine Drip Mary Heart Attack enters the ICU with a Diagnosis of Cardiogenic shock. Her BP is 60/30. The MD orders Dopamine at 5mcg/kg/min. The label reads 400mg of medication in 250ml of D5W. The patient weighs 90 kg. Calculate the correct cc’s per hour the pump should be set at. Because of continued low BP the rate is increased to 9mcg/kg/min. The nurse should now set the pump at ____cc’s/hr

7. Pitocin Drip to induce labor MD orders 16mu/min The bag is labeled 10 units in 1000cc of D5LR Calculate the rate for the pump the dose would be for cc’s/hr Note!!!! 1unit = 1000 milliunits

8. Dobutamine Administration A patient enters the emergency department and is started on a Dobutamine drip. The IV dose is 2.5- 10mcg/kg/min up to 40mcg/kg/min. The bag is labeled 500mg in 250ml of D5W. The patient weighs 180 lbs. Calculate the drug rate for cc’s per hour for 10mcg/kg/min______ 40mcg/kg/min______

9. Magnesium Sulfate Administration Michelle comes in the OB unit with a diagnosis of Pre- eclampsia. She is to be started on a drip of Magnesium Sulfate. Loading dose is 4grams in 100ml and is to be infused over 20minutes. Calculate the correct rate for the pump._____cc’s/hr The drip is begun at 2grams/hour. The container is labeled 20grams in 500ml of D5W. Calculate the correct IV rate for the pump.______cc’s/hr

10. Heparin Administration A patient is admitted with a DVT. The MD orders the bolus of Heparin to be given IV push at 80units per kg. The patient weighs 132lbs. Calculate the dose.___ The nurse prepares a drip and is to begin the infusion at 18 units of Heparin per kg per hour. Calculate the rate to set the pump at. If a nomogram is being used and in 6hours the PTT is 38 seconds. What are the dose adjustments needed.