Chapter 12: Calc IV: Clinical Flashcards
(33 cards)
1
Q
BMI formula
A
2
Q
CALCULATIONS
1. A male patient comes to the pharmacy and tells the pharmacist he is 6’7” tall and 250 pounds. His waist circumference is 43 inches. Calculate his BMI. Round to the nearest whole number. Is the patient underweight, normal weight, overweight or obese?
A
28 Kg/m2
3
Q
- Calculate the BMil for a male who is 6 tall and weighs 198 lbs. Round to the nearest whole number. Is the patient underweight, normal weight, overweight or obese?
A
27 Kg/m2
4
Q
IBW formula
A
5
Q
Adjusted body weight formula
A
6
Q
A female patient is to receive 5 mg/kg/day of theophylline. The patient is 5’7” and weighs 243 pounds. Calculate the daily theophylline dose the patient should receive.
A
308 mg
7
Q
- A 34-year-old male (height 6’7”, weight 287 pounds) is hospitalized after a motor vehicle accident. He develops a Pseudomonas aeruginosa infection. The physician orders tobramycin 2 mg/kg IV Q8H. Calculate the tobramycin dose. Round to the nearest 10 milligrams.
A
216.8 mg
Round to 220 mg IV q8h
8
Q
- A patient will receive 400 mg of a drug in a 250 mL IV bag. The rate of drug administration is 375 mcg per minute. Calculate the flow rate in milliliters per hour. Round to the nearest whole number.
A
14 mL/hr
9
Q
- The pharmacist has an order for heparin 25,000 units in 250 mL DSW to infuse at 1,000 units/hour. The pharmacy has the following premixed heparin bags in stock: 25,000 units in 500 mL ½ NS, 10,000 units in 250 mL D5W, and 25,000 units in 250 mL D5W. What should the infusion rate be set at in mL/hour?
A
10 mL/hr
10
Q
- If 200 mg of drug are added to a 500 mL bag, what rate of flow, in milliliters per hour, will deliver 500 mcg of drug per hour? Round to the nearest hundredth.
A
1.25 mL/hr
11
Q
- A nurse is hanging a 4% lidocaine drip for a patient. If the dose ordered is 6 mg/min, how many hours will a 250 mL bag last? Round to the nearest whole number.
A
28 hrs
12
Q
- A 68 kg patient is receiving a drug in a standard concentration of 400 mg/250 mL of ½ NS running at 15 mL/hr.
Calculate the dose in mcg/kg/min. Round to the nearest hundredth.
A
5.88 mcg/kg/min
13
Q
- The pharmacist has an order for heparin 25,000 units in 250 mL D5W to infuse at 1,000 units/hour. How many hours will it take to infuse the entire bag?
A
25 hrs
14
Q
- If 50 mg of drug are added to a 500 mL bag, what rate of flow, in milliliters per hour, will deliver 5 mg of drug per hour?
A
50 mL/hr
15
Q
- A patient is to receive Keppra at a rate of 5 mg/min. The pharmacy has a 5 mL Keppra vial (100 mg/mL) which will be diluted in 100 mL of NS. What is the Keppra infusion rate, in mL/min? Do not include the volume of the 5 mL additive.
A
1 mL/min
16
Q
- A patient is to receive 600,000 units of penicillin G potassium in 100 mL D5W. A vial of penicillin G potassium 1,000,000 units is available. The manufacturer states that when 4.6 mL of diluent is added, a 200,000 units/mL solution will result. How many milliliters of reconstituted solution should be withdrawn and added to the bag of D5W?
A
3mL
17
Q
- A patient is to receive Flagyl at a rate of 12.5 mg/min. The pharmacy has a 5 mL (100 mg/mL) Flagyl injection vial to be diluted in 100 mL of NS. How much drug in milligrams will the patient receive over 20 minutes?
A
250 mg
18
Q
- A physician has ordered 2 grams of cefotetan to be added to 100 mL NS for a 56-year-old female with an anaerobic infection. Using a reconstituted injection containing 154 mg/mL, how many milliliters should be added to prepare the order? Round to the nearest whole number.
A
13 mL
19
Q
- JY is a 58-year-old male hospitalized for a total knee replacement. He was given unfractionated heparin and developed heparin-induced thrombocytopenia (HIT). Argatroban was ordered at a dose of 2 mcg/kg/min.
The pharmacy mixes a concentration of 100 mg argatroban in 250 mL of DSW. JY weighs 187 lbs. At what rate (mL/hour) should the nurse infuse argatroban to provide the desired dose? Round to the nearest whole number.
A
26 mL/hr
20
Q
- A 165-pound patient is to receive 250 mL of a dopamine drip at a rate of 17 mcg/kg/min. The pharmacy has dopamine premixed in a concentration of 3.2 mg/mL in DSW. Calculate the infusion rate in mL/minute. Round to the nearest tenth.
A
0.4 mL/min
21
Q
- An order is written for phenytoin IV. A loading dose of 15 mg/kg is to be infused at 0.5 mg/kg/min for a 33-pound child. The pharmacy has phenytoin injection solution 50 mg/mL in a 5 mL vial in stock. The pharmacist will put the dose into 50 mL NS. Over how many minutes should the dose be administered? Round to the nearest whole number.
A
30 min
22
Q
- A physician orders an IV infusion of D5W 1 liter to be delivered over 8 hours. The IV infusion set delivers 15 drops/mL.
A
31 drops/min
23
Q
- A physician orders 15 units of regular insulin in liter of D5W to be given over 10 hours. What is the infusion rate, in drops/minute, if the IV set delivers 15 drops/mL? Do not include the insulin volume in the calculation.
A
25 drop/min
24
Q
- The pharmacy has insulin vials containing 100 units of insulin/mL. A physician orders 15 units of regular insulin in 1 liter of D5W to be given over 10 hours. How many units of insulin will the patient receive each hour if the IV set delivers 15 drops/mL? Do not round the answer.
A
1.5 unit/hr
25
22. An order is written for 10 mL of a 10% calcium chloride injection and 10 mL of multivitamin injection (MVI) to be added to 500 mL of D5W. The infusion is to be administered over 6 hours. The IV set delivers 15 drops/mL. What should be the rate of flow in drops/minute to deliver this infusion? Round to the nearest whole number.
22 drops/min
26
23. RS is a 45-year-old male, 5'5", 168 pounds, hospitalized with a diabetic foot infection. The pharmacist prepared a 500 mL bag of DSW containing 1 gram of vancomycin to be infused over 4 hours using a 20 gtts/mL IV tubing set.
How many milligrams of vancomycin will the patient receive each minute? Round to the nearest tenth.
4.2 mg/min
27
24. A patient is to receive 1.5 liters of NS running at 45 gtts/min using a 15 gtts/mL IV tubing set. Calculate the total infusion time in hours. Round to the nearest tenth.
8.3 hrs
28
25. The 8 AM medications scheduled for a patient include Tygacil dosed at 6 mg/kg. The patient weighs 142 pounds.
The nurse has Tygacil labeled 500 mg/50 mL NS. The dose will be administered over thirty minutes. The IV tubing in the unit delivers 15 drops per milliliter. What is the correct rate of flow in drops per minute? Round to the nearest drop.
19 drop/min for 30 min
29
26. Looking at the laboratory values below, make an assessment of the patient's hydration status.
A. The patient appears to be well hydrated.
B. The patient appears to be too hydrated.
C. The patient is not experiencing dehydration.
D. The patient is experiencing dehydration.
E. The patient is experiencing fluid accumulation.
Answer D
30
27. NK is receiving a furosemide infusion at 5 mg/hr. The nurse notices her urine output has decreased in the last hour. Laboratory values are drawn and the patient has a SCr of 1.5 mg/dL and a BUN of 26 mg/dL. The nurse wants to know if she should stop the furosemide infusion due to the patient becoming dehydrated. What is the correct assessment of the patient's hydration status?
A. The patient appears to be too hydrated given the laboratory results.
B. The patient is not experiencing dehydration given the laboratory results.
C. The patient is experiencing dehydration and may need to be started on fluids.
D. The patient has objective information indicating dehydration but the patient needs to be assessed subjectively as well.
E. None of the above are correct.
B
31
28. A 64-year-old female patient (height 5'5", weight 205 pounds) is hospitalized with a nosocomial pneumonia which is responding to treatment. Her current antibiotic medications include ciprotoxacin, Primaxin and van comycin.
Her morning laboratory values include: K 4 mEg/L, BUN 60 mg/dL, SCr 2.7 mg/dL and glucose 222 mg/dL. Based on the renal dosage recommendations from the package labeling below, what is the correct dose of Primaxin for this patient?
500 mg IV q12h
32
29. Levofloxacin, dosing per pharmacy, is ordered for an 87-year-old female patient (height 5'4", weight 103 pounds).
Her labs include BUN 22 mg/dL and SCr 1 mg/dI. Choose the correct dosing regimen based on the renal dosage adjustments from the package labeling below.
250 mg q24h
33
30. A 50-year-old male (height 6'1", weight 177 pounds) has HIV and is being started on tenofovir disoproxil fumarate, emtricitabine and efavirenz therapy. His laboratory values include K 4.4 mEg/L, BUN 40 mg/dL, SCr 1.8 mg/dL, nd CD4 count of 455 cells/mm'. Using the renal dosage recommendations from the package labeling below. what is the correct dose of tenofovir for this patient?
55 min/min
