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The intravenous fluid of 1000ml of lactated Ringer's injection was started in a patient at 8am and was scheduled to run for 12hrs. At 3pm, 800ml of the fluid remained in the bottle. At what rate of fl

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4 parts
1

40 drops/min\textbf{40 drops/min}

b(i)

14.4 mg/hour\textbf{14.4 mg/hour}

b(ii)

72 drops/min\textbf{72 drops/min}

c

31 gtt/min\textbf{31 gtt/min}

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Part 1· 4 steps

a. The intravenous fluid of 1000ml of lactated Ringer's injection was started in a patient at 8am and was scheduled to run for 12hrs. At 3pm, 800ml of the fluid remained in the bottle. At what rate of flow should the remaining fluid be regulated using an IV set that delivers 15 drops/ml to complete the administration of the fluid in the scheduled time?

  1. Calculate the time elapsed from start to 3 pm.

    Time elapsed=3 pm−8 am=7 hours\text{Time elapsed} = 3\text{ pm} - 8\text{ am} = 7\text{ hours}

  2. Calculate the remaining time for the infusion.

    Remaining time=Scheduled duration−Time elapsed\text{Remaining time} = \text{Scheduled duration} - \text{Time elapsed} Remaining time=12 hours−7 hours=5 hours\text{Remaining time} = 12\text{ hours} - 7\text{ hours} = 5\text{ hours}

  3. Calculate the required flow rate in mL/hour for the remaining fluid.

    Flow rate (mL/hr)=Remaining fluid volumeRemaining time\text{Flow rate (mL/hr)} = \frac{\text{Remaining fluid volume}}{\text{Remaining time}} Flow rate (mL/hr)=800 mL5 hours=160mLhr\text{Flow rate (mL/hr)} = \frac{800\text{ mL}}{5\text{ hours}} = 160 \frac{\text{mL}}{\text{hr}}

  4. Convert the flow rate to drops per minute (gtt/min).

    Flow rate (gtt/min)=Flow rate (mL/hr)×Drop factor60 min/hr\text{Flow rate (gtt/min)} = \frac{\text{Flow rate (mL/hr)} \times \text{Drop factor}}{\text{60 min/hr}} Flow rate (gtt/min)=160mLhr×15dropsmL60minhr\text{Flow rate (gtt/min)} = \frac{160 \frac{\text{mL}}{\text{hr}} \times 15 \frac{\text{drops}}{\text{mL}}}{60 \frac{\text{min}}{\text{hr}}} Flow rate (gtt/min)=240060dropsmin=40dropsmin\text{Flow rate (gtt/min)} = \frac{2400}{60} \frac{\text{drops}}{\text{min}} = 40 \frac{\text{drops}}{\text{min}}

    The remaining fluid should be regulated at 40 drops/min\boxed{\textbf{40 drops/min}}.

Part b(i)

14.4 mg/hour\textbf{14.4 mg/hour}

How many milligrams of nitroglycerin would be delivered per hour?

A patient is to receive 3 mcg/kg/min of nitroglycerin from a solution containing 100mg of the drug in 500ml of D5W. If the patient weighs 176lb, and the infusion set delivers 60drops/ml.

  1. Convert the patient's weight from pounds to kilograms.

    Weight in kg=176 lb2.2 lb/kg=80 kg\text{Weight in kg} = \frac{176\text{ lb}}{2.2\text{ lb/kg}} = 80\text{ kg}

  2. Calculate the total dose of nitroglycerin per minute.

    Dose per minute=3μgkg⋅min×80 kg=240μgmin\text{Dose per minute} = 3 \frac{\mu\text{g}}{\text{kg} \cdot \text{min}} \times 80\text{ kg} = 240 \frac{\mu\text{g}}{\text{min}}

  3. Convert the dose from micrograms per minute to milligrams per hour.

    Dose per hour=240μgmin×1 mg1000 μg×60 min1 hr\text{Dose per hour} = 240 \frac{\mu\text{g}}{\text{min}} \times \frac{1\text{ mg}}{1000\text{ }\mu\text{g}} \times \frac{60\text{ min}}{1\text{ hr}} Dose per hour=240×601000mghr=144001000mghr=14.4mghr\text{Dose per hour} = \frac{240 \times 60}{1000} \frac{\text{mg}}{\text{hr}} = \frac{14400}{1000} \frac{\text{mg}}{\text{hr}} = 14.4 \frac{\text{mg}}{\text{hr}}

    The patient would receive 14.4 mg/hour\boxed{\textbf{14.4 mg/hour}} of nitroglycerin.

Part b(ii)

72 drops/min\textbf{72 drops/min}

How many drops per minute would be delivered?

  1. Determine the concentration of the nitroglycerin solution.

    Concentration=100 mg500 mL=0.2mgmL\text{Concentration} = \frac{100\text{ mg}}{500\text{ mL}} = 0.2 \frac{\text{mg}}{\text{mL}}

  2. Calculate the volume of solution to be delivered per hour.

    Volume per hour=Dose per hourConcentration\text{Volume per hour} = \frac{\text{Dose per hour}}{\text{Concentration}} Volume per hour=14.4mghr0.2mgmL=72mLhr\text{Volume per hour} = \frac{14.4 \frac{\text{mg}}{\text{hr}}}{0.2 \frac{\text{mg}}{\text{mL}}} = 72 \frac{\text{mL}}{\text{hr}}

  3. Convert the volume per hour to drops per minute.

    Drops per minute=Volume per hour×Drop factor60 min/hr\text{Drops per minute} = \frac{\text{Volume per hour} \times \text{Drop factor}}{\text{60 min/hr}} Drops per minute=72mLhr×60dropsmL60minhr=72dropsmin\text{Drops per minute} = \frac{72 \frac{\text{mL}}{\text{hr}} \times 60 \frac{\text{drops}}{\text{mL}}}{60 \frac{\text{min}}{\text{hr}}} = 72 \frac{\text{drops}}{\text{min}}

    The infusion would deliver 72 drops/min\boxed{\textbf{72 drops/min}}.

Part c

31 gtt/min\textbf{31 gtt/min}

A nurse has ordered 1,000 mL Lactated Ringers to infuse over 8 hours. You have a macro drip tubing with a drop factor of 15 gtt/mL. Calculate how many gtt/min to set as the IV flow rate.

  1. Calculate the total infusion time in minutes.

    Total time in minutes=8 hours×60 minhr=480 minutes\text{Total time in minutes} = 8\text{ hours} \times 60\frac{\text{ min}}{\text{hr}} = 480\text{ minutes}

  2. Calculate the flow rate in drops per minute (gtt/min).

    Flow rate (gtt/min)=Total volume (mL)×Drop factor (gtt/mL)Total time (min)\text{Flow rate (gtt/min)} = \frac{\text{Total volume (mL)} \times \text{Drop factor (gtt/mL)}}{\text{Total time (min)}} Flow rate (gtt/min)=1000 mL×15gttmL480 min\text{Flow rate (gtt/min)} = \frac{1000\text{ mL} \times 15 \frac{\text{gtt}}{\text{mL}}}{480\text{ min}} Flow rate (gtt/min)=15000480gttmin≈31.25gttmin\text{Flow rate (gtt/min)} = \frac{15000}{480} \frac{\text{gtt}}{\text{min}} \approx 31.25 \frac{\text{gtt}}{\text{min}}

    Rounding to a practical whole number for drops, the IV flow rate should be set to 31 gtt/min\boxed{\textbf{31 gtt/min}}.

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