Chapter 8, Intravenous calculations, presents information and calculations unique to administering intravenous (IV) medications. After introducing IV solutions, attention is turned to calculating fl ow rates. Students also learn calculations for intermittent IV infusions, infusion times, and infusion volumes.
MathforthePharmacyTechnician: ConceptsandCalculations EglerBooth Chapter8:Intravenous Calculations Calculations McGrawưHill â2010bytheMcGrawưHillCompanies,IncAllRightsReserved 8ư2 IntravenousCalculations McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 83 Learning Objectives When you have successfully completed Chapter 8, you will have mastered skills to be able to: Identify the components and concentrations of IV solutions Calculate IV flow rates. Calculate infusion time based on volume and flow rate McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 84 Learning Objectives (con’t) Calculate infusion completion time based on flow rate Calculate volume based on infusion time and flow rate. Calculate medications for intermittent IV infusions. McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 85 Introduction Intravenous (IV) fluids are solutions including medication that are delivered directly into the bloodstream via a vein Blood is also delivered by IV IV fluids have a rapid effect Are necessary during emergencies or other critical care situations McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 86 IV SolutionsFunctions Replacement fluids Maintenance fluids KVO (Keep Vein Open) fluids Therapeutic fluids McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 87 IV Replacement Fluids Replace electrolytes and fluids lost due to hemorrhage, vomiting, or diarrhea Examples: Whole blood Nutrient solutions Fluids to treat dehydration McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 88 IV Maintenance Fluids Maintain normal electrolyte and fluid balance Example: – Normal saline given during and after surgery McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 89 IV KVO Fluids To keep the vein open (KVO or TKO) Example: 5% dextrose in water McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 810 Therapeutic Fluids • Deliver medication to the patient McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 830 Calculating Infusion Completion Time To calculate the time when an infusion will be completed, you must first know the time the infusion started in military time and the total time in hours and minutes to infuse the solution ordered McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 831 Calculating Infusion Completion Time (con’t) Since each day is only 24 hours long, when the sum is greater than 2400 (midnight), you must start a new day by subtracting 2400. This will determine the time of completion, which will be the next calendar day McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 832 Review and Practice Determine when the infusion will be completed Ordered: 750 mL LR to infuse at a rate of 125 mL/hr, started at 11 p.m on 08/04/05 The infusion will be complete at 0500 or 5:00 a.m. on 08/05/05 McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 833 Calculating Infusion Volume Use the formula V = T X F or dimensional analysis to find V the infusion volume in mL, where the T (time) must be expressed in hours F (flow rate) must be expressed in milliliters per hour McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 834 Review and Practice Find the total volume infused in hours if the infusion rate is 35 mL/h V=175 mL or the volume that will infuse over 5 hours McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 835 Review and Practice Find the total volume infused in 12 hours if the infusion rate is 200 mL/h V = 2400 mL = the volume that will infuse over 12 hours McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 836 Intermittent IV Infusion IV medications are sometimes delivered on an intermittent basis Delivered through IV secondary line Saline Heparin lock Can be delivered with continuous IV therapy or when no continuous IV solutions are infusing McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 837 Secondary Lines (Piggybacks or IVPB) IV setup that attaches to a primary line Used to infuse medications or other compatible fluids on an intermittent basis (such as q6h) Uses shorter tubing IVPB bags are smaller: 50,100, or 150 mL McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 838 Intermittent Peripheral Infusion Devices Saline or heparin locks An infusion port attached to an already inserted IV needle or catheter Allow direct injection of medication or infusion of IV medications Medications ordered as IV push or bolus McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 839 Intermittent Peripheral Infusion Devices (con’t) Since there is no continuous flow of fluids through the IV line you must flush the device 2 to 3 times per day to prevent blockage Saline lock is an infusion port attached to an already inserted catheter for IV access, flushed with saline. Heparin lock is an infusion port attached to an already inserted catheter for IV access, flushed with heparin. McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 840 Preparing and Calculating Intermittent Infusions Flow rate is calculated for prepared medications the same as regular IV infusions Amount of fluid may be less and time to infuse may be less than an hour Calculate the flow rate you will need to change the number of minutes into hours McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved Preparing and Calculating Intermittent Infusions (con’t) 841 When preparing medications for an intermittent IV infusion: Reconstitute the medication using the label and package insert Calculate amount to administer and the flow rate McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 842 Review and Practice Identify four functions of IV fluids Answers: Replacement Maintenance KVO Therapeutic McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 843 Review and Practice How many mg of sodium chloride is in 100 mL of normal saline? Answer: 900 mg NaCl How many mg of sodium chloride is in 100 mL of 0.45% NS? Answer: 450 mg NaCl McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 844 Intravenous Calculations As a pharmacy technician you will need to know how to perform accurate IV calculations. Results can be fatal if the wrong medication or dosage is given THE END McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved ... ©2010 by the McGrawHill Companies, Inc All Rights Reserved 8 10 TherapeuticFluids Delivermedicationto thepatient McGrawưHill â2010bytheMcGrawưHillCompanies,IncAllRightsReserved 8 11 IVLabels Solutionsarelabeledwith The name of the components The exact amount of the ... Use this formula or dimensional analysis to find T, the infusion time in hours McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved 8 28 Review and Practice Find the total... will be completed, you must first know the time the infusion started in military time and the total time in hours and minutes to infuse the solution ordered McGrawHill ©2010 by the McGrawHill Companies, Inc All Rights Reserved