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Chapter 2Ratios and Percents

MULTIPLE CHOICE

- A medical unit has 24 patients and 4 nurses to provide care. What is the patient to nurse ratio in lowest terms?
- 24:4
- 6:1
- 12:2
- 18:3

ANS: B PTS: 1 REF: Pages 40-41 BLM: Higher Order

- Which percentage is the equivalent of a 1:1000 epinephrine solution?
- 0.1%
- 10%
- 0.001%
- 0.01%

ANS: A PTS: 1 REF: Page 42-43 BLM: Remember

- Which intravenous solution has the lowest concentration?
- 5% dextrose in 0.45% saline
- 5% dextrose in water
- 0.9% normal saline
- 0.45% normal saline

ANS: D PTS: 1 REF: Page 43-44 BLM: Higher Order

- Which of the following is the strongest solution?
- 1:10
- 1:50
- 1:1
- 1:25

ANS: C PTS: 1 REF: Page 43-44 BLM: Higher Order

- What is 0.37% of 352?
- 0.10
- 5.9
- 9.5
- 1.3

ANS: A PTS: 1 REF: Pages 45-46 BLM: Higher Order

SHORT ANSWER

Percent Ratio

- 45%

Complete row 1 in the table above.

ANS:

9:20

PTS: 1 REF: Pages 43-44

Percent Ratio

- 45%

Complete row 2 in the table above.

ANS:

30%

PTS: 1 REF: Pages 43-44

- A class of students consists of 9 men and 51 women. Write a proper fraction to represent the part of the total class that is women. Reduce the fraction. Change the fraction to a percent.

Reduced fraction: _____ Percent: _____

ANS:

17/20; 85%

There are 51 women and 9 men for a total of 60 students in the class..

PTS: 1 REF: Pages 42-43

- A student received a score of 48 points on a test that was worth 60 points. Write a fraction to represent the portion of the test the student answered correctly. Reduce the fraction. Change the fraction to a percent.

Reduced fraction: _____ Percent: _____

ANS:

4/5; 80%

PTS: 1 REF: Pages 42-43

- To pass a chapter test, a student must answer 80% or more of the questions correctly. If a chapter test has 25 questions, what is the smallest number of questions that the student must answer correctly in order to pass the test?

ANS:

20

At least 80% of 25 questions must be answered correctly.

The student must answer at least 20 questions correctly.

PTS: 1 REF: Pages 45-46

- To pass a unit test, a student must answer 80% or more of the questions correctly. If a unit test has 75 questions, what is the largest number of questions that the student could answer incorrectly, but still pass the unit test?

ANS:

15

At least 80% of 75 questions must be answered correctly.

At least 60 questions must be answered correctly

The largest number of questions that the student could answer incorrectly, but still pass the test, is 15 questions.

PTS: 1 REF: 45-46

- Convert the following. Reduce fractions and ratios to the lowest term. Round decimals and percents to 3 decimal places (thousandths):

Decimal Fraction Percent Ratio

0.125

ANS:

1/8; 12.5%; 1:8

PTS: 1 REF: Pages 42-43

- Convert the following. Reduce fractions and ratios to the lowest term. Round decimals and percents to 3 decimal places (thousandths):

Decimal Fraction Percent Ratio

0.25%

ANS:

0.0025; 1/400; 1:400

PTS: 1 REF: Pages 42-43

Chapter 14Advanced Adult Intravenous Calculations

MULTIPLE CHOICE

HEPARIN

A client presented to the emergency department with a DVT of left leg. The physician orders heparin bolus of 90 units/kg IV, then initiate heparin infusion at 18 units/kg/h from a concentration of heparin 25 000 units in 250 mL 1/2 NS. Bolus should be given from the concentration on heparin label below. The client weighs 187 lbs.

- What is the bolus dose of heparin in units and millilitres that the client will receive?
- 16 830 units in 16.83 mL
- 100 units in 1 mL
- 1530 units in 1.53 mL
- 7650 units in 7.65 mL

ANS: D

1872.2 = 85 kg

85 kg 90 units/kg = 7650 units heparin bolus

PTS: 1 REF: Pages379-387 MSC: Higher Order

- How many units/h of heparin will the client receive?
- 5000
- 1000
- 1530
- 1030

ANS: C

85 kg x 18 units/kg/h = 1530 units/h

PTS: 1 REF: Page379-387 MSC: Higher Order

- At what flow rate in mL/h should the nurse program the infusion pump to administer the clients prescribed heparin infusion dosage?
- 13.5
- 1.5
- 7
- 15

ANS: D

85 kg x 18 units/kg/h = 1530 units/h

PTS: 1 REF: Page 379-387 MSC: Higher Order

DOPAMINE

A client weighs 165 lbs. The physician orders dopamine 400 mg/500 mL D5W at 5 mcg/kg/min to start and titrated to 10 mcg/kg/min to stabilize blood pressure.

- What is the clients starting dosage of dopamine in mL/min?
- 1
- 2
- 0.27
- 0.47

ANS: D

165 lbs 2.2 = 75 kg

400 mg 1000 = 400 000 mcg

PTS: 1 REF: Page 398-399 MSC: Higher Order

- At what rate in mL/h should the nurse program the infusion pump to start administering the dopamine?
- 120
- 16
- 28
- 60

ANS: C

= = 28 mL/h

PTS: 1 REF: Page 398-399 MSC: Higher Order

SHORT ANSWER

- 1 L D5W with 10 000 units heparin to infuse at 1000 units/h

The drop factor is 20 gtt/mL. Flow rate: __________ gtt/min

ANS:

PTS: 1 REF: Pages 379-387

- 1000 mL NS with 10 000 units heparin to infuse at 750 units/h

The drop factor is 12 gtt/mL. Flow rate: __________ gtt/min

ANS:

PTS: 1 REF: Pages 379-387

- A patient has an IV that is flowing at a rate of 10 gtt/min. The IV bag contains a solution of 500 mL NS with 20 000 units of heparin. The drop factor is 15 gtt/mL.

How many units is the patient receiving in 24 hours? __________ units/24 h

ANS:

Patient is receiving 40 mL/h.

The patient is receiving 38 400 units/24 h.

PTS: 1 REF: Pages 379-387

LIDOCAINE

Compute the answers to the following questions based on this information.

A patients IV order for lidocaine states that he should receive an IV bolus of 50 mg over 1 minute, using a supply of 1% lidocaine.

- What is the supply dosage of the lidocaine in mg/mL? __________ mg/mL

ANS:

1% supply

PTS: 1 REF: Pages 397-398

- How many millilitres will you administer for this order, using the available supply? _________ mL

ANS:

PTS: 1 REF: Pages 397-398

- A patients order for famotidine (Pepcid) states that she should receive an IV bolus of 20 mg famotidine (Pepcid) diluted in NS to a total volume of 10 mL, which is to be injected over 2 minutes. The supply is famotidine (Pepcid) 10 mg/mL.

Compute the volume of famotidine (Pepcid) and the volume of NS.

Pepcid: __________ mL NS: __________ mL

ANS:

10 mL total IV solution 2 mL famotidine (Pepcid) solution 8 mL NS.

PTS: 1 REF: Pages 397-398

- Order: famotidine (Pepcid) 20 mg added to 100 mL D5W IV in 30 min q.12h

An infusion pump will be used.

Supply: famotidine (Pepcid) 10 mg/mL

Compute the volume of famotidine (Pepcid) to be added to the 100 mL D5W.

Compute the flow rate.

famotidine (Pepcid): __________ mL Flow rate: __________ mL/h

ANS:

200 mL/60 min 200 mL/h

PTS: 1 REF: Pages 397-398

DOBUTAMINE

Compute the answers to the following questions based on this information.

A critical care patient who weighs 80 kg has an order for 10 mcg/kg/min of dobutamine to be administered IV and regulated by an electronic pump. The supply of dobutamine is 500 mg in 250 mL of D5W.

- Compute the number of micrograms and the number of milligrams per minute that the patient will receive.

micrograms per minute: __________ milligrams per minute: __________

ANS:

Per minute,

The patient will receive 800 mcg/min or 0.8 mg/min.

PTS: 1 REF: Pages 398-399

- Compute the volume of millilitres infused per minute. __________ mL/min

ANS:

There are 2 mg/mL or 2000 mcg/mL of medication supply

800 mcg of dobutamine are in 0.4 mL of IV solution.

800 mcg/min is delivered by a rate of 0.4 mL/min.

PTS: 1 REF: Pages 398-399

- Compute the flow rate in mL/h. __________ mL/h

ANS:

PTS: 1 REF: Pages 398-399

IVPD

Compute the answers to the following questions based on this information.

A patients IV fluids are to be limited. His continuous IV order is for 2000 mL of NS every 24 hours. He is to receive an IVPB of 150 mg of netromycin in 100 mL NS infused in 2 hours, every 8 hours. His IV flow rate is controlled by an infusion pump.

Answer the following questions about his IVPB.

- What is the flow rate of his IVPB? __________ mL/h

ANS:

PTS: 1 REF: Pages 405-407

- How many millilitres per day flow for his IVPB? __________ mL/day

ANS:

Every 8 hours is 3 administrations/day

PTS: 1 REF: Pages 405-407

- How many hours per day does his IVPB flow?

ANS:

PTS: 1 REF: Pages 405-407

- Answer the following questions about his continuous IV.

How many millilitres per day will he receive with his regular IV? __________ mL/day

How many hours will his continuous IV flow per 24 hours? __________ hours/day

What will his regular IV flow rate be, in mL/hour? __________ mL/h

ANS:

PTS: 1 REF: Pages 405-407

Standard Weight Heparin

The following questions refer to a patient who is on IV heparin therapy according to the Standard Weight Based Heparin Protocol noted below. The patient weighs 144 pounds. On admission the patients aPTT is 30 seconds. IV heparin therapy is initiated at 1130 on 06/06/XX. Record your answers in the spaces below unless provided with the Standard Weight Based Heparin Protocol Worksheet by your instructor.

Standard Weight Based Heparin Protocol

For all patients on heparin drips:

- Weight in KILOGRAMS. Required for order to be processed: ______ kg
- Heparin 25 000 units in 250 mL of 1/2 NS. Boluses to be given as 1000 units/mL.
- aPTT q6h or 6 hours after rate change; daily after two consecutive therapeutic aPTTs.
- CBC initially and repeat every ______ day(s).
- Obtain aPTT and PT/INR on day one prior to initiation of therapy.
- Guaiac stool initially then every ______ day(s) until heparin discontinued. Notify if positive.
- Neuro checks every ______ hours while on heparin. Notify physician of any changes.
- D/C aPTT and CBC once heparin drip is discontinued unless otherwise ordered.
- Notify physician of any bleeding problems.
- Bolus with 80 units/kg. Start drip at 18 units/kg/h.
- If aPTT is < 35 secs: Rebolus with 80 units/kg and increase rate by 4 units/kg/h
- If aPTT is 3644 secs: Rebolus with 40 units/kg and increase rate by 2 units/kg/h
- If aPTT is 4575 secs: Continue current rate
- If aPTT is 7690 secs: Decrease rate by 2 units/kg/h
- If aPTT is > 90 secs: Hold heparin for 1 hour and decrease rate by 3 units/kg/h

- What is the patients weight as measured in kilograms? (Round to the nearest 10 kg.)

__________ kg

What do the protocol/sample orders indicate for the standard bolus dosage of heparin for this patient?

__________ U/kg

ANS:

PTS: 1 REF: Pages 379-387

- Calculate the dosage of heparin that should be administered for the bolus for this patient.

__________ units

What does the protocol indicate as the required solution concentration (supply dosage) of heparin to use for the bolus?

__________ units/mL

Calculate the dose volume of heparin that should be administered for the bolus for this patient.

__________ mL

ANS:

PTS: 1 REF: Pages 379-387

- What do the protocol/sample orders indicate for the initial infusion rate for this patient?

__________ units/kg/h

Calculate the dosage of heparin this patient should receive each hour.

__________ units/h

What do the protocol/sample orders indicate as the required solution concentration (supply dosage) of heparin to use for the initial infusion?

__________ units/mL

Calculate the heparin solution volume this patient should receive each hour to provide correct infusion for the patients weight.

__________ mL/h

ANS:

PTS: 1 REF: Pages 379-387

- According to the protocol/sample orders, how often should the patients aPPT be checked? q__________h

At 1730, the patients aPPT is 38 seconds. Rebolus with heparin

__________ units (__________ mL)

How much should you change the infusion rate?

__________ increase or __________ decrease heparin __________ units/h and __________ mL/h

The new infusion rate will be heparin __________ mL/h.

ANS:

6 h

PTS: 1 REF: Pages 379-387

- At 2345, the patients aPPT is 46 seconds. What should you do now?

ANS:

Maintain rate at 14 mL/h

PTS: 1 REF: Pages 379-387

- At 0600 on 06/07/XX, the patients aPPT is 50 seconds. What should you do now?

When should the aPPT be checked again? __________ (hours) on __________ (date)

ANS:

Maintain rate at 14 mL/h

Recheck aPPT at 0600 on 06/08/XX

PTS: 1 REF: Pages 379-387

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