Please let me know if the answers don’t add up!

# Archive for the ‘Math’ Category

## More math answers…

Posted by Laura on February 2, 2011

Posted in Day-to-Day, Math, Resources | Comments Off on More math answers…

## TPN questions

Posted by Laura on January 31, 2011

1. You are hanging a 1 L bag of TPN which contains 40% Dextrose, 8.25% Aminosyn which is supplied in a 50/50 ratio. You are infusing it at a rate of 100 mL/hr. You put the bag up at 0900 but had to stop the feeding at 1100 to 1200 due to other procedures for your patient. The feeding continues through the day. Your shift ends at 1900 and you need to figure out your I/Os. How many mL of TPN did they get? What was their caloric intake? If the doctor had prescribed some 10% Lipids to run for 12 hrs at 40mL/hr starting at 1300, what is the total caloric intake now at the end of your shift?

2. If you hang a 1L bag of TPN which includes 8.25% protein, 30% dextrose and 20 % lipids all running at 45ml/hr and is at a 40/40/20 ratio, what is your total calories for the bag?

(hint: 40/40/20 means 40% of the bag is protein, 40% is dextrose and 20% is lipids. 40% of 1000mL is 400mL)

## Math answers cont…

Posted by Laura on January 31, 2011

Posted in Math, NS 240 - Professional IV, Resources, Semester IV | Comments Off on Math answers cont…

## Math answers as I do them. From NS240

Posted by Laura on January 30, 2011

Posted in Math, Resources, Semester IV | Comments Off on Math answers as I do them. From NS240

## It’s math week again!

Posted by Laura on January 30, 2011

Question: How many grams of Dextrose are in 100mL of water for a D5W solution?

Posted in Day-to-Day, Math, Resources | Comments Off on It’s math week again!

## IV Push Math

Posted by Laura on January 30, 2011

Posted in IVP Medications, Math, Resources, Semester IV | Comments Off on IV Push Math

## Holliday-Segar

Posted by Laura on November 2, 2010

If a baby is at 9kg, what is the fluid maintenance requirement needed in a day, and what would you set the rate on the pump to be?

100mL/kg for first 10 kg = 900mL

50mL/kg for 2^{nd} 20 kg = 0

20mL/kg for remainder of wt in kg = 0

Total for this example = 900mL in a day

1000mL divided by 24 hrs = 37.5 mL/hr

(A shorter way to see this: For the first 10 kg of weight, give 100 mL/kg fluid. For 11-20 kg, give 1000 mL + 50 mL/kg for each kg over 10 kg. For a child over 20kg, give 1500mL + 20mL/kg for each kg over 20 kg)

Maintenance requirements for water of individuals is determined by their caloric expenditure.

Problem: The infant on the floor is currently producing 1 diarrheal stool q 3 h and refusing to drink. Clinical findings of dry mucous membranes, poor skin turgor, markedly decreased urine output, and tachycardia with normal BP and capillary refill suggest 10% fluid deficit. Rectal temperature is 37° C; serum Na, 136 mEq/L; K, 4 mEq/L; Cl, 104 mEq/L; and HCO_{3}, 20 mEq/L. The doctor has ordered fluid volume replacement for this 25kg child. What would the IVF maintenance rate be set at?

Posted in Math, NS 231 - Peds, Resources, Semester III | 2 Comments »

## Warm-ups for TPN Calculations

Posted by Laura on August 20, 2010

Total Parental Nutrition (TPN) solutions are intravenous fluids (IVFs) that provide nutrition to clients who can’t eat normally for many different reasons. Different additives placed in the bag are modified for the patient’s particular needs.

Dextrose & amino acids are usually the base of the fluids. They represent the carbohydrates and proteins in our normal diet. How much is in your TPN is determined by lab draws and nutrition requirements of your patient with consideration to the length of time they are on this type of therapy.

http://grey.colorado.edu/shortgut/index.php/MaxCares_TPN_Tubing

The above site provides great info on TPN bags and tubing.

- You have mixture of Glucose (200 g) Fat (55 g) and Protein. The mixture provides 2000 kcal, how many grams of protein are in the mixture?
- If the daily calorie requirements for your patient is 2600 kcal, and they have a daily intake of 300 g glucose and 200 g protein, how much fat is needed to meet the requirements?
- What is your intake of fat if you were to consume 10 g, then 20g, then 30g of fat in one day?
- How many calories will your patient receive if you infuse 2.5 liters of 5% dextrose?
- With 8% fats, 10% protein and 15% dextrose, how many calories are in 1 Liter?
- What would the kcals be of a liter of 10% dextrose and 8.5% amino acids?
- Your patient receiving TPN has a solution consisting of 500mL of 25% dextrose and 500mL of 10% amino acids. What are the total calories in the preparation?
- Your patient received 1000mL of the following mixture every 8 hours: 50% dextrose in water 500mL and 8.5% Fre-Amine 500mL. Calculate the glucose calories per day. What are the grams of protein received per day?

9. A 250mL solution of 2% fat, 5.5% protein, and 25% dextrose will give ___ calories?

10. How many mL of 20% dextrose solution or 5% protein are required to get 50kcals of energy?

11. What is the protein-calorie percentage of a 500 mL solution of 10% dextrose and 20% protein?

12. What is the protein in a solution , whose protein-calorie percentage is 20% and which contains 400 g of dextrose?

Posted in Day-to-Day, Math | Comments Off on Warm-ups for TPN Calculations

## Do these quickly!

Posted by Laura on August 19, 2010

Don’t read these simple math equivalents yet!! Set your timer to 4 minutes and do these quickly! Ready, set, go!

## __ g = |
## 1 oz |

## __ mL = |
## 1 pt |

## __ mg = |
## 1 gr |

## __ Tbsp = |
## 1 oz |

## __ mL = |
## 1 tsp |

## __ mL = |
## 1 fl. Oz |

## __ lb = |
## 1 kg |

## __ tsp = |
## 1 Tbsp |

## __ Tbsp = |
## 3 tsp |

## __ tsp = |
## 5 mL |

## __ fl oz = |
## 30 ml |

## __ kg = |
## 2.2 lb |

## __ oz = |
## 2 Tbsp |

## __ gr = |
## 60 mg |

## __ oz = |
## 30 g |

## __ pt = |
## 500 mLthe answers are in the problems. |

Posted in Math, Resources | Tagged: Equivalents, math, Nursing | Comments Off on Do these quickly!

## Units

Posted by Laura on August 16, 2010

Unit Calculations

- When charting never use ‘U’, always write out ‘Units’.

1A. The doctor orders heparin of 800 units/hr. The solution available is 40,000 units in 1000/mL of D5W. (40,000U/1000mL of D5W). Calculate the flow rate.

1B. What are the heparin units infusing when an IV bag of 1000 mL D5W containing 40,000 units has been ordered, and you notice it is infusing at 30 mL and hour?

1 C. Is the amount infusing an hour within normal limits?

2. Laura was told to give 2500 units of heparin to her patient in an IV solution. After checking the doctor’s order she went to get the medication and found she needed to prepare her syringe with the correct amount first. The vial said 5000 units/ml for IV or SC use. In large letters it says 10 mL, multiple dose vial. How many mLs does she need to pull in order to give 2500 units to the IV solution running at 40 mL/hr? The drop rate is 60gtt/min.

3. Brandi is preparing a solution for her patient. She has a multiple dose vial labeled 5,000,000 units. The directions say “add 3.2 mL diluent to make 1,000,000 units per mL”. After she prepares this correctly, and we know she will, she gives her patient 1.7 mL of this solution. How many units did she give?

Posted in Math | Comments Off on Units

## Okay, I lied.

Posted by Laura on August 11, 2010

Really, didn’t mean to. Did you see the movie with Bob Hope the other night on saying the truth for one day?

Its just I’m doing a little math everyday now until our test. So – Maybe a little math.

These math problems are on the volume of diluent and the flow rate for the infusion. (round mL to tenth if over 1)

1. An IV of an antibiotic of 750 mg in 3 mL was ordered by the doctor to be diluted to a total of 25 mL of NS to infuse over 40 minutes.

What is the volume of diluent __________ mL

What is the flow rate ___________ mL/hr

2. 1.5 grams/2mL of an antibiotic is to be diluted to a total of 40 mL of NS and administered over 40 minutes.

What is the volume of diluent __________ mL

What is the flow rate ___________ mL/hr

3. Over 35 minutes, a dosage of 20 mg in 2 mL has been ordered and must be diluted to 30 mL.

What is the volume of diluent __________ mL

What is the flow rate ___________ mL/hr

4. 500,000 U of an antibiotic preparation with a volume of 4 mL is ordered by the doctor. It must be diluted to 50 ML D5 ½ NS to infuse in 1 hr.

What is the volume of diluent __________ mL

What is the flow rate ___________ mL/hr

5. 200 mg in 4 mL is to be diluted to 50 mL and administered over 70 minutes.

What is the volume of diluent __________ mL

What is the flow rate ___________ mL/hr

6. A dosage of 25 mg in 5 mL is ordered diluted to 40 mL and needs to be administered in 50 min.

What is the volume of diluent __________ mL

What is the flow rate ___________ mL/hr

Posted in Day-to-Day, Math | Comments Off on Okay, I lied.

## TPN Math Problems

Posted by Laura on May 13, 2010

Answers – work shown. I didn’t halve the D5/1/2 NS, problem # 5. The answer is:

CHO/Dex 4/1 5/100 62.5/1hr 24/1 day = 30,000/100 = **300**

All the rest of the problems are correct.

Practice TPN with answers –

Beatty’s Answers.

Posted in Day-to-Day, Math, Resources | Tagged: TPN Math Problems | 3 Comments »

## Do the Math

Posted by Laura on March 21, 2010

If the outlet of the pelvis is WNL, will a NB with a Biparital of 10.5 be a SVBD?

The marked variability of a FHR BL at 139 is ________to ______.

If you have 2 accelerations of less than 15 bpm for at least 15 seconds, is it considered to be a reactive trace?

If your patient/mom is on MgSo4 with a lab level of 10, what is your concern?

An doctor orders the patient to receive 2 mU per minute. What do you set the IV infusion rate at?

Posted in Day-to-Day, Math, NS 121 - OB, Semester II | Comments Off on Do the Math

## Math – APGAR

Posted by Laura on February 20, 2010

APGAR = **A**ppearance, **P**ulse, **G**rimace, **A**ctivity, **R**espiration – for my spanish speaking friends (* Apariencia, Pulso, Gesticulación, Actividad, Respiración*) – or as figured by my friend Kendra CHaRRM (color, heart rate, respiratory rate, reflex irritability, muscle tone).

The apgar score was created by a Doctor Virginia Apgar, an anesthesiologist, to assess the health of the newborns immediately after being born. Using the APGAR Score sheet (mine here), figure the score of this newborn.

A newborn was assessment was noted: Acrocyanosis, good cry but only grimacing when applying stimulation to infant. Some muscle tone is noted with an apical heart rate of 101. What is the score?

Posted in Day-to-Day, Math, NS 121 - OB, Semester II | Tagged: APGAR | Comments Off on Math – APGAR

## GPTAL – Math

Posted by Laura on February 20, 2010

- G – gravida or # of pregnancies
- T – term or # of deliveries after 37 weeks
- P – preterm or # of deliveries after 20 weeks but before 38 weeks
- A – abortion or # of deliveries before 20 weeks, either spontaneous or induced
- L – living or # of living children

A prenatal woman states having 3 young children at home. She says her daughter was born right on time, but her sons were both a month early. Sadly, she lost a baby in her second month. What is her GTPAL?

Posted in Math, NS 121 - OB, Semester II | Tagged: GTPAL | 3 Comments »

## Saturday Math

Posted by Laura on February 20, 2010

Posted in Math, NS 121 - OB, Semester II | Tagged: EDC math, Nagele's Rule | 2 Comments »

## Math Review

Posted by Laura on February 4, 2010

If you had the math questions from the workshop on Jan 28th, but need the answers – go to Resources/Semester 2 and you will find them!

Adjustments to Questions/Answers

#2 – If you use the conversion of 1 g = gr 15 or the conversion of 60 mg = gr 1, your answer can come out differently.

#27 – My answer is 40.9 mL/hr as we have learned to go to the tenths. But with pumps we may be rounding. I suggest for our test, go to the tenths place.

#30 – The answer I came up with is 47 gtt/min.

#31c – I used 20% lipids.

Posted in Day-to-Day, Math, Semester II | Comments Off on Math Review

## IV Math

Posted by Laura on January 28, 2010

1. The doctor’s order is for an intravenous infusion of one liter of 5% Dextrose with Lactated Ringers (D5LR) to infuse at 125 ml/hr. How many hours will it take for the IV bag to infuse?

Since we are talking about infusion I would automatically start thinking what I am looking for is Hrs.

Hrs |

So I know my first conversion factor must have hrs as the numerator, and I like to start usually with what the doctor wants or what is on hand.

2. The physician’s new order is to infuse 1000 ml 5% Dextrose and 0.45 Normal Saline (D5 1/2 NS) with 40 mEq KCL, over 10 hours. (a) what will the rate be using an infusion pump? (b) How many milliliters will the patient receive in one day?

Here I think “rate” is always ml/hr. I’m also thinking infusion which is again Hrs. So I would start with Hrs or look for the mL/hr. Remember from the answer above, infusions are total volume divided by mL/hr.

3. You are to infuse an antibiotic via IVPB. The order is for Cefazolin one-gram q 8 hrs. The medication book recommends the the infusion time of 30 minutes. The drug is supplied in 50 ml of NS. The tubing drip factor is 15 gtt/mL. (a) what will the drip rate be for the infusion? (b) What will the rate be using an infusion pump?

Drip rate? Well, we know that means gtts/min right?

4. The order is for Erythromycin 750 mg in 250 mL of 5% D5W to infuse over 1.5 hours. The tubing drop factor is 15. (a. ) what will the drip rate be for the infusion? (b) What will the rate be using an infusion pump?

This one gets tricky. Drip rate again means gtts/min we are looking for, but you think where is the gtt conversion? When it says factor, know it means per min or hr. If we are talking drops it will be per min, so use the 15gtts/min.

5. The physician’s order is to infuse a continuous IV of 1 liter or 1000 mL of NS with 20 mEq of KCL at 75 mL/Hr. (a) How many mL will the patient receive per day? (b) If the infusion was started at 1:30 pm, at what exact time will the bag be totally infused?

This one is fun. I think the question (a) is a little off. You figure it will get infused before a full 24 hrs is complete. So then figure out how many hours it will take. For (b) I changed my hours to military or 2400 hrs, and added the total time. Make sure you have changed the part of an hour into minutes by multiplying the .33 of an hour by 60 to get you true minutes.

Posted in IV, Math, Semester II | Tagged: IV Math | Comments Off on IV Math

## Math Practice

Posted by Laura on December 31, 2009

To see the answer to the question,** just hover your mouse** over the *ANSWER*

1. Doctor orders carbamazepine 19 mg/kg/day to be divided into 2 doses. Your patient weighs 55 lbs. You have Carbamazepine of 50 mg on hand. How many mg of carbamazepine do you administer for each dose?

2. Doctor orders ceftibuten 270 mg PO. The nurse has 90 mg/5 mL suspension of ceftibuten available. How many mL of ceftibuten suspension does the nurse administer?

3. You need to know how many gtts/min are infusing by IV. The order was for LR at 85 mL/hr. The tubing factor is 20 gtts/mL.

4. You need to infuse an IV of 1 L of D5NS over 6 hrs. The drip rate is 16 gtts/min. How many mL an hour do you administer the UV fluids?

5. The med chart says to give azithromycin 2 g PO once a day. You have unscored tablets of 500 mg each. How many tablets do you give the patient?

*These questions were modified from Taylor’s.*

Posted in Math, Semester II | Comments Off on Math Practice