hello everyone good afternoon this is miss Henderson and today I'm coming to you with a
simple video on medication calculations so as always if you like this video please give it
a thumbs up and please subscribe to my channel thank you so the student learning outcomes are
the student learning objectives are the goals that are set for this chapter upon completion
of today's lesson the students will be able to demonstrate the following competencies discuss
indication for intravenous medications demonstrate effective use of dimensional analysis to solve
IV flow rates demonstrate the ability to calculate milliliters per hour calculate
IV flow rate of medication units per kilogram weight base heparin use the formula method to
calculate medication dosage integrate critical thinking skills to solve problems calculate IV
flow rates in milliliters per hour using the formula method ability to integrate nursing
considerations when administering medications and clinical judgment to enhance patient safety
so our second slide talks about the indication for heparin injections so we know heparin it's
an anticoagulant and it's giving some of the reasons why patient gets heparin some patients
like with pulmonary embolism patients with acute arterial occlusion will be candidates for heparin
orthopedic surgery surgeries such as patients had a hip replacement there are patients that
are armed had a knee replacement might be candidates for heparin injections profile
actively patients with acute myocardial infarctions might be candidates for heparin
so I have contraindications for heparin injections our patient with history of thrombocytopenia or
patients with an acute bleeding you cannot give heparin to those patients so we have a
simple NCLEX style question here and I'm going to read it for you what signs and symptoms
should the nurse monitor for patients who is receiving heparin 5,000 units subcutaneously
daily prophylactic for right knee replacements select all that applies so as we know patients
that are receiving anticoagulants are at risk for bleeding also easy bruising also can be a cold in
in stool could be they could be bleeding to the stool so you have to monitor that hemoptysis is
coughing up blood also might be an signs and symptoms that they're bleeding so the
correct answer is all of the above so calculating intravenous flow rates intravenous flow fluid is
administered directly into the bloodstream for hydration purposes or hypovolemic shock so if
patients are dehydrated and they come in for dehydration or they're bleeding from a wound
they might be candidates for intravenous fluids so I have a simple infusion calculation here and
in this particular problem we are looking for drops per minute so the physician has ordered
his span 500 milliliters to be infused in three hours the drop factor is 15 drops per l ml how
many drops per minute should be administered to infused the total amount of his spanning three
hours so using dimensional analysis as you can see we're looking for extra per minute
so the IV tubing that was giving to us 15 drops per ml the volume of his span that was given to
us is V is equal to 500 milliliters and the time that was given to us just three hours so we have
to set up the equation in such a way that we can solve so we have here milliliters and milliliters
cancelling out now we know since we're looking for minutes we were giving hours so we have to
convert hours into minutes so we know that one hour is equal to 60 minutes so now we can use
dimensional analysis cross out hours and hours and we leave with minutes so if you multiplied
15 multiplied by 500 will give you 7,500 and then you have 60 times 3 that will give you
180 so if you divide that in you divide 7,500 to 180 your drops per minute will be 41 point six
six so because six is greater than anything that is greater than five you round it up to the next
whole number so you can program your IV pumps so we'll run this up to 42 drops per minutes
it's look so sample math problem so we know that you always set up what you're looking the formula
method its total volume to be infused time to drop factor total amount of time in minutes so that's
the basic formula for calculating flow rates let's look at the arm the different on intramuscular
sights that medications can be given the deltoid is our upper arm we know that's a common sight
that medication can be given intramuscularly we have the ventral gluteal sight the vastus
lateralis is also another site and the dorsal lateral that derive lateralis is another site
that medication skin on being injected so the most common sight in children is the vastus lateralis
we have another problem here using dimensional analysis a patient has an order for regular
insulin IV at five units per hour the concentration is insulin 100 units per
100 ml 0.9 in point nine normal saline at what rate in ml per hour should the IV pump
be programmed for so again we're looking here for flow rates we're looking for MLS
per hour so we set up our equation using that mention and that analysis looking for XML so
100 MLS was given to us and that is infusing in 100 units and we also have five units per
hour so we have five units in one hours so units and units cancelled out 100 and
100 cancel out and we'll leave with five MLS per hour and that's the answer simple as that
so we have an n click star question here what lab test should be monitored for patient on
heparin subcutaneously daily secondary to status for hip fracture as I previously said
that patients that had knee replacements or hip fractures they commonly get down it
could be either coumadin heparin love an axe they get these medications prophylactically
in order to prevent or to reduce the incident of developing and devein thrombosis so the lab test
that needs to be monitored is PT and partial thromboplastin time Bea's the answer so I have
a few questions here medication calculations as a worksheet so you can try to solve these
problems they're not difficult you know you could set up dimensional analysis and try to
work on that worksheet parental medication this is another simple one we have here the
physician has ordered our prison 30 milligrams infamous Q larly the medication is available
in 20 milligrams per ml how much more leaders will the nurse administered so how much will
you pull up solve this problem using dimensional analysis we're looking for XML so in one ml is
equal to 20 milligrams right and the medication order is 30 milligrams so we have milligrams and
milligrams canceling out we have 30 into 20 is 1.5 MLS and that's the answer that's what
the nurse is going to pull up in the syringe to administer to her patient intramuscularly
we have another simple equation dimensional analysis problem here the physician has order
counter 400 milligram I every 12 hours for ping the medication is available as point five
grams for two ml how many milliliters will the members administer so you have to convert grams
to kilograms first right so we know in one gram is equal to thousand milligram you just have to
know that memorize the conversion table and we're looking for XML so we have two ml in
five hundred so we have 0.5 grams is equal to 500 milligrams and the doctor's order
is 400 milligrams so milligrams and milligrams canceling out four times
two is eight hundred divided by 500 divided by 500 is one point six ml
so the nurse will administer one point six ml of Consular for pain
calculating IV flow rates so we know the basic formula for calculating IV flow rate is volume
in ml divided by time which is our so let's say a physician has order 1.5 liters of lactated ringers
solution to be administered over the next 12 hours calculate IV fluid in MLS per hour so we know we
have to convert 1.5 liters into milliliters because we're looking for xml's so in 1 liter
is equal to a thousand milliliters so therefore 1.5 liters is equivalent to 1,500 MLS and that
is to be infused in 12 hours so 1500 divided by 12 is equal to 125 milliliters per hour so
that is what the nurse is going to program the IV pump to administer 125 MLS per hour
this is another sample problem we have here you can work this out using the formula method or
the IV flow rate method I provided and I mention I'll announce that the physician
has order a meek in 150 milligrams i mq 8 hours a Meekins 500 milligrams per 2 mo is
available how much more leaders will than the miss administered again we're looking
for xml so a hundred of 50 milligrams in 500 milligrams for 2 ml so milligrams and
milligrams cancelling out 15 150 times 2 is 300 divided by 500 so the answer will be 0.6
ml of an emissions the nurse will actually pull up in the syringe to administer to her patient