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1. Problem type: IV infusion rate + infusion pump Medication: azithromycin
PROBLEM
Suppose Mrs. Turner’s orders call for 500 mg of azithromycin to be administered intravenously for community-acquired pneumonia. The solution has been diluted to a concentration of 2 mg/mL and needs to be administered over 1 hour.
At what rate should the infusion pump be set?
HINT
Start by figuring out how many milliliters will be needed to administer the ordered dose.
SAMPLE SOLUTION
- Determine how many milliliters of the concentration will be delivered to administer the ordered dose.
500 mg x 1 mL = 250 mL 2 mg
- Divide the total number of mL needed to deliver the 500 mg by the expected duration of 1 hour.
250 mL = 250 mL/hr
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1 hr
ANSWER
Number: 250
Units / Rate: mL/hr
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D (150 mg) x 1 tablet = XH (75 mg)
X = 2 tablets
ANSWER
Number: 2 Units: tablets
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3. Problem type: Total daily dosage
Medication: Acetaminophen @ hospital - hypothetical
Suppose Mrs. Turner’s provider updated her order for 325 mg, 2 tabs, by mouth q6h PRN temp. > 100.5 F to 325 mg, 2 tabs, by mouth q4h PRN temp. > 100.5 F. The Davis’s Drug Guide reports that acetaminophen has a maximum recommended dosageof 4 g/day.
How many doses can Mrs. Turner take without exceeding the recommended maximum dosage?
HINT
There are 1000 mg in one gram.
SAMPLE SOLUTION
- Determine how many milligrams are in 4 grams.
4 g x 1000 mg = 4000 mg
1 g
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4. Problem type: Total
daily dose calculation
Medication:
acetaminophen @
hospital
PROBLEM
Suppose Mrs. Turner’s current temperature is 100.8 F. For temperatures greater than 100.5 F, the prescriber’s order allows acetaminophen, 325 mg, 2 tabs, by mouth, every 6 hours.
Assume that on her first day of hospitalization, Mrs. Turner’s temperature is greater than
100.5 F three times.
How many grams of acetaminophen will she have ingested on her first day ofhospitalization? Round your answer to hundredths.
HINT
Multiply the number of taken doses by the number of tablets.
SAMPLE SOLUTION
- Multiply the number of doses taken by the number of tablets per dose.
3 doses x 2 tablets = 6 tablets
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1 dose
- Multiply the dosage of acetaminophen by the number of tablets.
6 tablets x 325 mg = 1950 mg
1 tablet
- Convert the total daily milligrams to grams.
1950 mg x 1 g = 1.95 g
1000 mg
ANSWER
Number: 1. Units: g
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Number: 7. Units: mL / day
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6. Problem type: IV
flow + allergic reaction
Medication: ceftriaxone
- hypothetical
PROBLEM
Mrs. Turner’s original orders called for ceftriaxone, 1g, to be administered intravenouslydaily. The solution has been diluted to a concentration of 1 g / 50 mL to be administered over 30 minutes. Twenty minutes into the first infusion, Mrs. Turner reports an adverse reaction to the antibiotic and the infusion is stopped.
How many mL of concentration were administered before the infusion was stopped?Round your answer to the nearest whole number.
HINT
Divide the time elapsed by the infusion rate to determine the completion percentage of the infusion.
SAMPLE SOLUTION
- Determine the completion percentage of the infusion.
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7.Problem type: Dosage calculation
+ weight-based dosage
Medication: azithromycin @
hospital - hypothetical
According to the Davis’s Drug Guide, children sixmonthsold or younger with community-acquired pneumonia can be administered azithromycin orally using a weight-based dosage. Children in this age group can receive 10 mg/kg on the first day, then 5 mg/kg for four more days. Assume you need to administer this to a child weighing
20.3 lbs.
What is the total dose of azithromycin the child will receive over five days? Round your answer to the nearest whole number.
HINT
Convert pounds to kilograms, and multiply the weight by the dosage.
SAMPLE SOLUTION
- Convert pounds (lbs) to kilograms (kg).
20.3 lbs x 1 kg = 9.227 kg
2.20 lb
- Multiply the first day’s dosage by weight in kg.
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10 mg x 9.227 kg = 92.27 mgkg
- Multiply the dosage given for days 2-5 by weight in kg, and multiply by the number of days administered (4).
9.227 kg x 5 mg x 4 = 184.54 mg
kg
- Add the results from steps 2 and 3.
92.27 mg + 184.54 mg = 276.81 mg, rounded to 277 mgANSWER
Number: 277 mg Units: mg
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D = 0.05 mg H = 0.025 mg
Q = 1 tablet
- Plug into the equation and solve.
D (0.05 mg) x 1 tablet = X H (0.025 mg)
X = 2 tablets
ANSWER
Number: 2 Units: tablets
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9. Problem type: Total
daily dose calculation
Medication: Units of
insulin @ home
At home, Mrs. Turner takes 16 units of insulin aspart, twice a day with meals. She also takes 45 units of long-acting insulin glargine, daily.
How many total units of insulin does Mrs. Turner take daily?
HINT
Start by multiplying the dosage of insulin aspart by how often Mrs. Turner takes it. SAMPLE
SOLUTION
- Multiply the dosage by the number of units per dose.
16 units x 2 = 32 units
- Add the total number of insulin aspart units and the total number of insulin glargine units.
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10. Problem type: Dosage calculation
Medication: Insulin aspart @ hospital - hypothetical
The provider ordered insulin aspart on a sliding scale for 1 unit/10 g CHO subcutaneous
- 1 unit/50 points above 150 BG. Mrs. Turner will eat a meal that contains 40 g CHO and has a pre-meal BG level of 160.
How many units of insulin should be administered?HINT
Add the units calculated from the sliding scale to the units necessary for the patient’s current BG level.
SAMPLE SOLUTION
- Perform the sliding scale calculation (1 unit/10g CHO).
40 g CHO x 1 unit = 4 units
10 g CHO
- Subtract 150 from Mrs. Turner’s pre-meal BG.
160 BG - 150 BG = 10 points
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- Multiply 10 points by the number of units per 50 points.
10 points x 1 unit = 0.2 units 50 points
Round down to the next whole unit = 0 unit
- Add the units from the sliding scale to the additional units needed for every 50 points above 150 BG.
4 units + 0 unit = 4 units
ANSWER
Number: 4 Units: units
