{"id":109,"date":"2022-01-10T18:25:38","date_gmt":"2022-01-10T23:25:38","guid":{"rendered":"https:\/\/opentextbc.ca\/nursingnumeracy\/chapter\/administering-medications-iv-direct\/"},"modified":"2023-06-28T13:02:48","modified_gmt":"2023-06-28T17:02:48","slug":"administering-medications-iv-direct","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/nursingnumeracy\/chapter\/administering-medications-iv-direct\/","title":{"raw":"Administering Medications IV Direct","rendered":"Administering Medications IV Direct"},"content":{"raw":"

Lesson<\/h1>\n
\n

Learning Outcomes<\/p>\n\n<\/header>\n

\n\nBy the end of this chapter, learners will be able to:\n
    \n \t
  • identify factors which affect the rate of administration of IV direct medications,<\/li>\n \t
  • create a dose, volume, time table for use in administration of IV direct medications, and<\/li>\n \t
  • label a syringe to help keep track of medication delivery rate.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n

    IV Direct Administration Rates<\/h2>\nIt is essential for medications administered directly into an IV line to be given at the correct rate to prevent complications. Information describing the appropriate rate will be available in the health agency's drug reference manual. Ensure all factors about the patient's context are considered when reviewing rate information in the reference manual. For instance, the rate may be different for a neonate versus an adult. In some cases, a variable rate is given and you will need to use critical thinking skills to determine the most appropriate rate, often in discussion with your nursing instructor or the most responsible nurse for the patient.\n\nTo determine how fast to administer an IV direct medication, you will need the following information:\n
      \n \t
    • the medication order<\/li>\n \t
    • information about the patient's context (eg. age, reason for medication order, hepatic function...)<\/li>\n \t
    • the administration information from the drug reference manual<\/li>\n \t
    • the total volume of medication to be administered<\/li>\n<\/ul>\nOnce the rate of administration of the drug is determined, the actual administration of the drug must be timed to ensure it is given at the correct rate. In order to administer the drug evenly over a particular period of time, nurses often calculate a volume of medication to be given over specific time intervals (for example, every 15 seconds) during the administration period. The drug information in the text box below will be used to exemplify this process. It is important to note the information presented here should not be used for direct patient care, always review your agency's drug reference manual for up to date information regarding the drug and the administration policy of your institution.\n
      \n\ndiazepam\n\nStatus Epilepticus: 5-10 mg IV\/IM q5-10min; not to exceed 30 mg, OR <\/span>0.5 mg\/kg PR (using parenteral solution), THEN 0.25 mg\/kg in 10 minutes PRN\nIV Direct: Administer undiluted over 3 min; no more than 5 mg\/min\n\nhttps:\/\/reference.medscape.com\/drug\/valium-diastat-diazepam-342902\n\n<\/div>\n

      1. Gather the information which will affect the rate of administration.<\/h3>\n
      <\/div>\n
      Medication order: diazepam 10 mg<\/div>\n
      Rate information: over 3 min; no more than 5mg\/min\nSupply: the concentration of diazepam in a vial is 5 mg : 1 mL<\/div>\n
      Calculate the total volume to be administered:<\/span><\/div>\n

      [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{5 mg}}\\times\\text{10 mg}[\/latex]<\/p>\n

      [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{5\\cancel{\\text{ mg}}}\\times10\\cancel{\\text{ mg}}[\/latex]<\/p>\n

      [latex]x\\text{ mL}=\\dfrac{1\\text{ mL}\\times{10}}{{5}}[\/latex]<\/p>\n

      [latex]x\\text{ mL}=2\\text{ mL}[\/latex]<\/p>\n\n

      2. Determine what volume of medication will be given in each time interval:<\/h3>\n
      <\/div>\n
      When beginning to administer IV direct medications, it can be hard to ensure you are maintaining an even speed of delivery<\/div>\n
      over the whole time period. To stay within a consistent delivery speed, you can create a table to determine how much of the syringe volume should be given over smaller time intervals to ensure you have an even speed over the duration of the injection. This can be called a dose, volume, time table. Including the amount, volume and time interval in the table is helpful when checking to ensure you are meeting the criteria as laid out in the drug reference manual as rate information is often given in an amount (usually mg or mcg) per time interval (usually min or sec).<\/div>\n
      <\/div>\n
      In this dose, volume and time table, the total amount, volume and time period is entered into the second row. Each subsequent value has been cut in half from the value above.<\/div>\n
      \n\n\n\n\n\n\n\n
      Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
      10<\/em><\/td>\n2<\/em><\/td>\n3 min (180 sec)<\/em><\/td>\n<\/tr>\n
      5<\/em><\/td>\n1<\/em><\/td>\n90 sec<\/em><\/td>\n<\/tr>\n
      2.5<\/em><\/td>\n0.5<\/em><\/td>\n45 sec<\/em><\/td>\n<\/tr>\n
      1.25<\/em><\/td>\n0.25<\/em><\/td>\n22.5 sec<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
      This is not the only way to set up the table. Here is an alternate table in which each value has been divided by 3:<\/div>\n
      \n\n\n\n\n\n\n
      Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
      10<\/em><\/td>\n2<\/em><\/td>\n3 min<\/em><\/td>\n<\/tr>\n
      3.33<\/em><\/td>\n0.66\u00a0<\/em><\/td>\n1 min (60 sec)<\/em><\/td>\n<\/tr>\n
      1.11<\/em><\/td>\n0.22<\/em><\/td>\n20 sec<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
      And finally, a table where each value has been divided by 5:<\/div>\n
      \n\n\n\n\n\n\n
      Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
      10<\/em><\/td>\n2<\/em><\/td>\n3 min (180 sec)<\/em><\/td>\n<\/tr>\n
      2 mg<\/em><\/td>\n0.4<\/em><\/td>\n36 sec<\/em><\/td>\n<\/tr>\n
      1 mg<\/em><\/td>\n0.2<\/em><\/td>\n18 sec<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\nIn this example, clinical judgement must be used to determine which one will give a volume and time interval easiest for a nurse to follow. The middle table might be the easiest to use in practice, as watching a timer and noting how much you have given every 20 seconds is easier to follow than watching for every 22.5 or 18 seconds. You may also find any number you divide by gives a difficult number to measure with the available syringes. In this case, you will need to round the number so the volume can be measured easily on the syringe. For example, if you calculated the final volume to be 1.08 mL you could round to 1 mL. If you are rounding down, you are giving slightly less volume over the allotted time and should be safe for the client to receive. You must be very cautious about rounding up, as the medication would be given slightly faster. Make sure to discuss rationale for rounding with your preceptor or instructor to ensure you are making appropriate decisions.\n
      \n

      Sample Exercise 17.1<\/p>\n\n<\/header>\n

      \n\nComplete a dose, volume, time table when administering the following medication:\n\nMedication Order: ketorlac 30 mg IV prn q8h\nRate Information: undiluted over 1-2 minutes\nSupply: ketorlac 30 mg\/mL\n\n
      Answer:<\/strong><\/summary>\n\n\n\n\n\n\n
      Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
      30<\/td>\n1<\/td>\n2 min<\/td>\n<\/tr>\n
      15<\/td>\n0.5<\/td>\n1 min<\/td>\n<\/tr>\n
      7.5<\/td>\n0.25<\/td>\n30 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/details><\/div>\n<\/div>\n
      \n

      Sample Exercise 17.2<\/p>\n\n<\/header>\n

      \n\nCreate a dose, volume, time chart for the following medication order.\n\nMedication Order: furosemide 40 mg IV BID\nRate Information: administer undiluted at a rate of 20 mg\/min\nSupply: 20 mg\/1 mL ampule\n\n
      Answer:<\/strong><\/summary>First, calculate the total volume of the injection.\n\n[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{20 mg}}\\times\\text{40 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{20\\cancel{\\text{ mg}}}\\times40\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{40 mL}}{20}\\\\[\/latex][latex]x\\text{ mL}=\\text{2 mL}[\/latex]\n\nEnter the total amount, volume and period of time in the first row. In this case, the recommended rate of 20 mg\/min is represented in the third row of the chart, and thus meets criteria for safe administration.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n
      Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
      40<\/td>\n2<\/td>\n2 min<\/td>\n<\/tr>\n
      20<\/td>\n1<\/td>\n1 min<\/td>\n<\/tr>\n
      10<\/td>\n0.5<\/td>\n30 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/details><\/div>\n<\/div>\n

      Syringe Labels for IV Direct Administration<\/h2>\nIt can be challenging for some people to focus on the amount of volume being administered in each short time interval while in the practice setting, even while watching a timer. Distractions such as alarms, conversation and\/or questions from the patient or family and other interruptions can break the focus of the nurse during this process. When beginning to administer IV direct medications, it may be helpful to add a visual cue to the syringe label to help keep on track. In the image below, two components have been added to a syringe label for administration of furosemide. Lines to indicate every 0.5 mL on the syringe and numbers representing the seconds remaining at each interval are added. These correspond to the dose, volume, time table created in the sample exercise above, in which 0.5 mL is given every 30 seconds.\n\n\"\"\n
      \n

      Critical Thinking Question<\/p>\n\n<\/header>\n

      \n\nWhen comparing the same dose of a particular medication given by IV direct versus an intermittent IV infusion, do you anticipate any differences in the onset, peak and duration of the medication?\n\nAnswer:<\/strong>\n\nThe onset occurs when the medication enters the bloodstream and is able to take effect in the body. It varies with mechanism of action, dosage, and individual patient factors. The IV direct route is often delivered over a total shorter time than the intermittent IV route. If the medication is delivered into the vein more quickly, it is likely the onset will be earlier for IV direct than IV intermittent. It may effect the peak for some medications as well. The duration of effect is more variable. It's possible the duration of IV intermittent is longer, especially for infusions which are given over longer periods of time. If you think variations in onset, peak and duration of various routes will affect the choice of route given to a patient, you should check the parenteral manual for guidelines on specific medications when preparing the medication.\n\n<\/div>\n<\/div>\n

      Practice Set 17.1: Creating Dose, Volume, Time Tables<\/h1>\n
      \n

      Practice Set 17.1: Creating Dose, Volume, Time Tables<\/p>\n\n<\/header>\n

      \n\nCreate a dose, volume, time table for the following scenarios.\n
        \n \t
      1. Medication Order: dexamethasone 4 mg IV q6h\nRate Information: administer undiluted, no more than 8mg\/min\nSupply: 20 mg\/5 mL vial<\/li>\n \t
      2. Medication Order: pantoprazole 40 mg IV OD\nRate Information: administer over 2 minutes\nSupply: 40 mg powder in medication vial, to be reconstituted with 10 mL NS<\/li>\n \t
      3. Medication Order: benzotropine 2 mg IV now\nRate Information: administer undiluted over 1 minute\nSupply: 2 mg\/2 mL ampule<\/li>\n \t
      4. Medication Order: morphine 2 mg IV q2h prn\nRate Information: dilute with 9 mL NS or SW for injection to give 1 mg\/mL and give at a maximum rate of 2 mg\/min\nSupply: 10 mg\/mL ampule<\/li>\n \t
      5. Medication Order: digoxin 0.25 mg IV once daily\nRate Information: dilute each 1 mL with at least 4 mL NS and give over at least 5 minutes\nSupply: 0.25 mg\/mL ampule<\/li>\n \t
      6. Medication Order: furosemide 40 mg IV once daily\nRate Information: give undiluted; doses 120 mg or less over 1-2 minutes\nSupply: 10 mg\/mL ampule<\/li>\n \t
      7. Medication Order: lorazepam 3 mg IV 20 minutes prior to surgery\nRate Information: dilute with equal volume D5W, NS, or SW; give over 1 minute, max of 2 mg\/min\nSupply: 4 mg\/mL vial<\/li>\n \t
      8. Medication Order: naloxine 0.2 mg IV q2-3 minutes until respiratory rate depression is resolved\nRate Information: give undiluted over 30-60 seconds\nSupply: 0.4 mg\/mL<\/li>\n \t
      9. Medication Order: oxytocin 8 units once postpartum bolus\nRate Information: may dilute with 3 mL NS, given slowly over at least 1 minute\nSupply: 10 units\/mL vial<\/li>\n \t
      10. Medication Order: haloperidol 2 mg IV push PRN.\nRate Information: dilute with 5 mL SW and give rapid IV push over at least 1 minute.\nSupply: 5 mg\/mL (1 mL) ampule.<\/li>\n<\/ol>\n
        Answers:<\/strong><\/summary>\n
          \n \t
        1. First, calculate the total volume of the injection.\n[latex]x\\text{ mL}=\\dfrac{\\text{5 mL}}{\\text{20 mg}}\\times\\text{4 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{5 mL}}{20\\cancel{\\text{ mg}}}\\times4\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{20 mL}}{20}\\\\[\/latex][latex]x\\text{ mL}=\\text{1 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row. Choosing to give 4 mg in 1 minute is giving the medication slower than the maximum rate of 8 mg\/min, and meets criteria for safe administration.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n
          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          4<\/td>\n1<\/td>\n1 min<\/td>\n<\/tr>\n
          2<\/td>\n0.5<\/td>\n30 sec<\/td>\n<\/tr>\n
          1<\/td>\n0.25<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
        2. First, note the total volume of the injection (40 mg in 10 mL).\nEnter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          40<\/td>\n10<\/td>\n2 min<\/td>\n<\/tr>\n
          20<\/td>\n5<\/td>\n1 min<\/td>\n<\/tr>\n
          10<\/td>\n2.5<\/td>\n30 sec<\/td>\n<\/tr>\n
          5<\/td>\n1.25<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
        3. First, note the total volume of the injection (2 mg in 2 mL).\nEnter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n
          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          2<\/td>\n2<\/td>\n1 min<\/td>\n<\/tr>\n
          1<\/td>\n1<\/td>\n30 sec<\/td>\n<\/tr>\n
          0.5<\/td>\n0.5<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
        4. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{\\text{10 mg}}\\times\\text{2 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{10\\cancel{\\text{ mg}}}\\times2\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{20 mL}}{10}\\\\[\/latex][latex]x\\text{ mL}=\\text{2 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row. Safety note: In this situation, you may have recognized the morphine is supplied in an ampule. Morphine is diluted by drawing up 9 ml of NS in a 10 mL syringe and then the 1 mL of morphine from the ampule. Before administering, the extra volume in the syringe must be wasted so only the calculated volume of 2 mL remains.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n
          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          2<\/td>\n2<\/td>\n1 min (60 sec)<\/td>\n<\/tr>\n
          1<\/td>\n1<\/td>\n30 sec<\/td>\n<\/tr>\n
          0.5<\/td>\n0.5<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nAlternately, if the decision is made to administer the morphine slower than the maximum rate, the following table could be set up:\n\n\n\n\n\n\n\n
          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          2<\/td>\n2<\/td>\n2 min (120 sec)<\/td>\n<\/tr>\n
          1<\/td>\n1<\/td>\n1 min (60 sec)<\/td>\n<\/tr>\n
          0.5<\/td>\n0.5<\/td>\n30 sec<\/td>\n<\/tr>\n
          0.25<\/td>\n0.25<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
        5. First, calculate the total volume of the injection. [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{0.25 mg}}\\times\\text{0.25 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{0.25\\cancel{\\text{ mg}}}\\times0.25\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{0.25 mL}}{\\text{0.25}}\\\\[\/latex][latex]x\\text{ mL}=\\text{1 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 5 to start and then by 2 to get down to 15 second increments.\n\n\n\n\n\n\n
          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          0.25<\/td>\n1<\/td>\n5 min<\/td>\n<\/tr>\n
          0.05<\/td>\n0.2<\/td>\n1 min<\/td>\n<\/tr>\n
          0.025<\/td>\n0.1<\/td>\n30 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
        6. First, calculate the total volume of the injection. [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{10 mg}}\\times\\text{40 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{10\\cancel{\\text{ mg}}}\\times40\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{40 mL}}{10}\\\\[\/latex][latex]x\\text{ mL}=\\text{4 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          40<\/td>\n4<\/td>\n2 min<\/td>\n<\/tr>\n
          20<\/td>\n2<\/td>\n1 min<\/td>\n<\/tr>\n
          10<\/td>\n1<\/td>\n30 sec<\/td>\n<\/tr>\n
          5<\/td>\n0.5<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
        7. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{4 mg}}\\times\\text{3 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{4\\cancel{\\text{ mg}}}\\times3\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{3 mL}}{4}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.75 mL}\\\\[\/latex]Due to how this medication needs to be diluted, the total volume that will be give needs to be doubled.\n[latex]\\text{0.75 mL}\\times2=\\text{1.5 mL}[\/latex]\nEnter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n
          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          3<\/td>\n1.5<\/td>\n1 min<\/td>\n<\/tr>\n
          1.5<\/td>\n0.75<\/td>\n30 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
        8. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{0.4 mg}}\\times\\text{0.2 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{0.4\\cancel{\\text{ mg}}}\\times0.2\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{0.2 mL}}{\\text{0.4}}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.5 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n
          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          0.2<\/td>\n0.5<\/td>\n60 sec<\/td>\n<\/tr>\n
          0.1<\/td>\n0.25<\/td>\n30 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
        9. First, calculate the total volume of the injection. [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{10 units}}\\times\\text{8 units}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{10\\cancel{\\text{ units}}}\\times8\\cancel{\\text{ units}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{8 mL}}{10}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.8 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n
          Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          8<\/td>\n0.8<\/td>\n1 min<\/td>\n<\/tr>\n
          4<\/td>\n0.4<\/td>\n30 sec<\/td>\n<\/tr>\n
          2<\/td>\n0.2<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
        10. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{6 mL}}{\\text{5 mg}}\\times\\text{2 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{6 mL}}{5\\cancel{\\text{ mg}}}\\times2\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{12 mL}}{5}\\\\[\/latex][latex]x\\text{ mL}=\\text{2.4 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n
          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
          2<\/td>\n2.4<\/td>\n1 min<\/td>\n<\/tr>\n
          1<\/td>\n1.2<\/td>\n30 sec<\/td>\n<\/tr>\n
          0.5<\/td>\n0.6<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n<\/ol>\n<\/details><\/div>\n<\/div>\n

          Practice Set 17.2: Creating Dose, Volume, Time Tables<\/h1>\n
          \n

          Practice Set 17.2: Creating Dose, Volume, Time Tables<\/p>\n\n<\/header>\n

          \n\nCreate a dose, volume, time table for the following scenarios. Identify the final volume and time interval you would use when administering the medication.\n
            \n \t
          1. Medication Order: dexamethasone 15 mg IV once\nRate Information: max rate of 8 mg\/min\nSupply: 4 mg\/mL vial<\/li>\n \t
          2. Medication Order: diphenhydrinate 35 mg IV push q4h.\nRate Information: dilute every 50 mg with 10 mL NS and administer over 2-4 minutes.\nSupply: 50 mg\/mL (1 mL) vial.<\/li>\n \t
          3. Medication Order: meropenum 600 mg IV q8h.\nRate Information: reconstitute with 20 mL NS or D5W and give over 3-5 minutes.\nSupply: 1 g (powdered) vial.<\/li>\n \t
          4. Medication Order: thiamine 100 mg IV push once daily for 5 days.\nRate Information: give undiluted over 1 minute.\nSupply: 100 mg\/mL (1 mL) vial.<\/li>\n \t
          5. Medication Order: morphine 2.5 mg IV push q4h.\nRate Information: max rate of 2 mg\/mL, diluted to 1 mg\/mL with NS (10 mL of fluids).\nSupply: 10 mg\/mL<\/li>\n \t
          6. Medication Order: flumezanil 0.2 mg for suspected benzo overdose, possibly giving additional doses if inadequate results.\nRate Information: give over 30 seconds.\nSupply: 0.1 mg\/mL (5 mL) vial.<\/li>\n \t
          7. Medication Order: ampicillin 25 mg\/kg\/dose, for a 15 kg child, IV push for a mild infection.\nRate Information: give over 4 minutes at a max rate of 100 mg\/minute, diluted to 250 mg\/2.5 mL.\nSupply: 250 mg (powdered) vial.<\/li>\n \t
          8. Medication Order: ketorolac 20 mg q4h IV push.\nRate Information: give over 1-2 minutes undiluted.\nSupply: 30 mg\/mL (1 mL) vial.<\/li>\n \t
          9. Medication Order: diazepam 8 mg q3h.\nRate Information: give undiluted 2-5 mg\/minute.\nSupply: 5 mg\/mL (2 mL) ampule.<\/li>\n \t
          10. Medication Order: midazolam 0.2 mg\/kg IV push loading dose, repeating q5 minute until seizure stops. This is for a 65 kg adult.\nRate Information: given at a rate of 2 mg\/minute.\nSupply: 1 mg\/mL<\/li>\n<\/ol>\n
            Answers:<\/strong><\/summary>\n
              \n \t
            1. First, calculate the total volume of the injection. [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{4 mg}}\\times\\text{15 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{4\\cancel{\\text{ mg}}}\\times15\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{15 mL}}{4}\\\\[\/latex][latex]x\\text{ mL}=\\text{3.75 mL}\\\\[\/latex]In this answer, in the table set up, each value has been divided by 2.\nWhen you calculate a volume that is not a round decimal number, round to the the number that you can measure in the syringe that you are using.\n\n\n\n\n\n\n\n
              Amount (mg)<\/th>\nVolume (mL)<\/th>\nRounded Volume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
              15<\/td>\n3.75<\/td>\n3.8<\/td>\n2 min<\/td>\n<\/tr>\n
              7.5<\/td>\n1.875<\/td>\n1.9<\/td>\n1 min<\/td>\n<\/tr>\n
              3.75<\/td>\n0.9375<\/td>\n1.0<\/td>\n30 sec<\/td>\n<\/tr>\n
              1.875<\/td>\n0.46875<\/td>\n0.5<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
            2. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{\\text{50 mg}}\\times\\text{35 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{50\\cancel{\\text{ mg}}}\\times35\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{350 mL}}{\\text{50}}\\\\[\/latex][latex]x\\text{ mL}=\\text{7 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n\n
              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
              35<\/td>\n7<\/td>\n4 min<\/td>\n<\/tr>\n
              17.5<\/td>\n3.5<\/td>\n2 min<\/td>\n<\/tr>\n
              8.7<\/td>\n1.75<\/td>\n1 min<\/td>\n<\/tr>\n
              4.4<\/td>\n0.88<\/td>\n30 sec<\/td>\n<\/tr>\n
              2.2<\/td>\n0.44<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nFrom the table, 0.44 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.4 to track the volume your are giving better.<\/li>\n \t
            3. First, calculate the total volume of the injection. [latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{\\text{500 mg}}\\times\\text{600 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{500\\cancel{\\text{ mg}}}\\times600\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{6000 mL}}{\\text{500}}\\\\[\/latex][latex]x\\text{ mL}=\\text{12 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 5 to start and then by 2 to get to 15 second increments.\n\n\n\n\n\n\n\n
              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
              600<\/td>\n12<\/td>\n5<\/td>\n<\/tr>\n
              120<\/td>\n2.4<\/td>\n1<\/td>\n<\/tr>\n
              60<\/td>\n1.2<\/td>\n30 sec<\/td>\n<\/tr>\n
              30<\/td>\n0.6<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
            4. First, we know the volume of the dose due to the supply and we will enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n
              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
              100<\/td>\n1<\/td>\n1 min<\/td>\n<\/tr>\n
              50<\/td>\n0.5<\/td>\n30 sec<\/td>\n<\/tr>\n
              25<\/td>\n0.25<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
            5. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{1 mg}}\\times\\text{2.5 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{1\\cancel{\\text{ mg}}}\\times2.5\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{2.5 mL}}{1}\\\\[\/latex][latex]x\\text{ mL}=\\text{2.5 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 3 to start and then divided by 2 to get to 15 second increments.\n\n\n\n\n\n\n
              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
              2.5<\/td>\n2.5<\/td>\n1.5 min<\/td>\n<\/tr>\n
              0.8<\/td>\n0.8<\/td>\n30 sec<\/td>\n<\/tr>\n
              0.4<\/td>\n0.4<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
            6. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{0.1 mg}}\\times\\text{0.2 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{0.1\\cancel{\\text{ mg}}}\\times0.2\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{0.2 mL}}{\\text{0.1}}\\\\[\/latex][latex]x\\text{ mL}=\\text{2 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n
              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
              0.2<\/td>\n2<\/td>\n30 sec<\/td>\n<\/tr>\n
              0.1<\/td>\n1<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
            7. First, calculate the dose in mg from the weight of the patient given. [latex]\\text{25 mg}\\times\\text{15 kg}=\\text{375 mg\/dose}[\/latex]\nThen, calculate the total volume of the injection.\n[latex]x\\text{ mL}=\\dfrac{\\text{2.5 mL}}{\\text{250 mg}}\\times\\text{375 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{2.5 mL}}{250\\cancel{\\text{ mg}}}\\times375\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{937.5 mL}}{\\text{250}}\\\\[\/latex][latex]x\\text{ mL}=\\text{3.75 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 4 to start and then by 2 to get to 15 second increments.\n\n\n\n\n\n\n\n
              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
              375<\/td>\n3.75<\/td>\n4 min<\/td>\n<\/tr>\n
              93.75<\/td>\n0.94<\/td>\n1 min<\/td>\n<\/tr>\n
              46.9<\/td>\n0.47<\/td>\n30 sec<\/td>\n<\/tr>\n
              23.4<\/td>\n0.23<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nFrom the table, 0.23 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.2 to track the volume your are giving better.<\/li>\n \t
            8. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{30 mg}}\\times\\text{20 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{30\\cancel{\\text{ mg}}}\\times20\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{20 mL}}{\\text{30}}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.67 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
              Amount (mg)<\/th>\nVolume (mL)<\/th>\nRounded Volume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
              20<\/td>\n0.67<\/td>\n0.7<\/td>\n2 min<\/td>\n<\/tr>\n
              10<\/td>\n0.33<\/td>\n0.3<\/td>\n1 min<\/td>\n<\/tr>\n
              5<\/td>\n0.16<\/td>\n0.2<\/td>\n30 sec<\/td>\n<\/tr>\n
              2.5<\/td>\n0.08<\/td>\n0.1<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
            9. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{5 mg}}\\times\\text{8 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{5\\cancel{\\text{ mg}}}\\times8\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{8 mL}}{5}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.6 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
              8<\/td>\n1.6<\/td>\n2 min<\/td>\n<\/tr>\n
              4<\/td>\n0.8<\/td>\n1 min<\/td>\n<\/tr>\n
              2<\/td>\n0.4<\/td>\n30 sec<\/td>\n<\/tr>\n
              1<\/td>\n0.2<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
            10. First, calculate the dose in mg from the weight of the patient given. [latex]\\text{0.2 mg}\\times\\text{65 kg}=\\text{13 mg\/dose}[\/latex]\nThen, calculate the total volume of the injection.\n[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{1 mg}}\\times\\text{13 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{1\\cancel{\\text{ mg}}}\\times13\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{13 mL}}{1}\\\\[\/latex][latex]x\\text{ mL}=\\text{13 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 13 to start and then by 2 to get to 15 second increments.\n\n\n\n\n\n\n
              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
              13<\/td>\n13<\/td>\n6.5 min<\/td>\n<\/tr>\n
              1<\/td>\n1<\/td>\n30 sec<\/td>\n<\/tr>\n
              0.5<\/td>\n0.5<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n<\/ol>\n<\/details><\/div>\n<\/div>\n

              Practice Set 17.3: Creating Dose, Volume, Time Tables<\/h1>\n
              \n

              Practice Set 17.3: Creating Dose, Volume, Time Tables<\/p>\n\n<\/header>\n

              \n\nCreate a dose, volume, time table for the following scenarios. Identify the final volume and time interval you would use when administering the medication.\n
                \n \t
              1. Medication Order: diltiazem 0.25 mg\/kg IV direct for a 55kg adult.\nRate Information: give undiluted over 2 minutes.\nSupply: 5 mg\/mL (10 mL) vial.<\/li>\n \t
              2. Medication Order: hydromorphone 0.5 mg IV direct q6h.\nRate Information: dilute to 5 mL with NS administer slowly over 2 minutes.\nSupply: 2 mg\/mL vial.<\/li>\n \t
              3. Medication Order: labetalol 7 mg IV initial dose in a hypertensive emergency.\nRate Information: give over 2 minutes.\nSupply: 5 mg\/mL (20 mL) vial.<\/li>\n \t
              4. Medication Order: propofol 18 mg IV direct bolus.\nRate Information: given over 3 minutes.\nSupply: 10 mg\/mL (20 mL) ampule.<\/li>\n \t
              5. Medication Order: metoclopramide 10 mg IV for prophylactic postoperative vomiting.\nRate Information: given over 2 minutes.\nSupply: 5 mg\/mL (2 mL) vial.<\/li>\n \t
              6. Medication Order: hydrocortisone 200 mg IV direct.\nRate Information: dilute with 2 mL SW (diluted to 125 mg\/mL), given over 1.5 minutes.\nSupply: 250 mg vial.<\/li>\n \t
              7. Medication Order: ephedrine 20 mg IV repeat q5-10 minutes according to blood pressure response.\nRate Information: given over 10 mg\/minute as a max rate.\nSupply: 50 mg\/mL (1 mL) vial.<\/li>\n \t
              8. Medication Order: meperidine 15 mg IV direct q4h PRN for severe pain.\nRate Information: diluted to 10 mg\/mL, given over 5 minutes.\nSupply: 50 mg\/mL (1 mL) ampule.<\/li>\n \t
              9. Medication Order: fentynal 75 mcg intrapartum q30 minutes IV direct.\nRate Information: given undiluted over 2 minutes.\nSupply: 50 mcg\/mL (5 mL) ampule.<\/li>\n \t
              10. Medication Order: octreotide 2 mg\/kg\/dose IV direct bolus for a 20 kg toddler with a severe gastrointestinal bleed.\nRate Information: given undiluted over 2 minutes.\nSupply: 100 mcg\/mL (1 mL) ampule.<\/li>\n<\/ol>\n
                Answers:<\/strong><\/summary>\n
                  \n \t
                1. First, calculate the dose in mg from the weight of the patient given.\n[latex]\\text{0.25 mg}\\times\\text{55 kg}=\\text{13.75 mg}[\/latex]\nThen, calculate the total volume of the injection.\n[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{5 mg}}\\times\\text{13.75 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{5\\cancel{\\text{ mg}}}\\times13.75\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{13.75 mL}}{5}\\\\[\/latex][latex]x\\text{ mL}=\\text{2.75 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
                  Amount (units)<\/th>\nVolume (mL)<\/th>\nRounded Volume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                  13.75<\/td>\n2.75<\/td>\n2.75<\/td>\n2 min<\/td>\n<\/tr>\n
                  6.875<\/td>\n1.37<\/td>\n1.4<\/td>\n1 min<\/td>\n<\/tr>\n
                  3.437<\/td>\n0.68<\/td>\n0.7<\/td>\n30 sec<\/td>\n<\/tr>\n
                  1.718<\/td>\n0.34<\/td>\n0.3<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
                2. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{5 mL}}{\\text{2 mg}}\\times\\text{0.5 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{5 mL}}{\\cancel{2\\text{ mg}}}\\times0.5\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{2.5 mL}}{2}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.25 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                  0.5<\/td>\n1.25<\/td>\n2 min<\/td>\n<\/tr>\n
                  0.25<\/td>\n0.63<\/td>\n1 min<\/td>\n<\/tr>\n
                  0.125<\/td>\n0.31<\/td>\n30 sec<\/td>\n<\/tr>\n
                  0.0625<\/td>\n0.16<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nFrom the table, 0.16 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.2 to track the volume your are giving better.<\/li>\n \t
                3. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{5 mg}}\\times\\text{7 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{5\\cancel{\\text{ mg}}}\\times7\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{7 mL}}{5}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.4 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                  7<\/td>\n1.4<\/td>\n2 min<\/td>\n<\/tr>\n
                  3.5<\/td>\n0.7<\/td>\n1 min<\/td>\n<\/tr>\n
                  1.75<\/td>\n0.35<\/td>\n30 sec<\/td>\n<\/tr>\n
                  0.875<\/td>\n0.175<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nFrom the table, 0.175 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.2 to track the volume your are giving better.<\/li>\n \t
                4. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{10 mg}}\\times\\text{18 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{10\\cancel{\\text{ mg}}}\\times18\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{18 mL}}{10}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.8 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 3 to start and then divided by 2 to reach 15 second increments.\n\n\n\n\n\n\n\n
                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                  18<\/td>\n1.8<\/td>\n3 min<\/td>\n<\/tr>\n
                  3<\/td>\n0.6<\/td>\n1 min<\/td>\n<\/tr>\n
                  3<\/td>\n0.3<\/td>\n30 sec<\/td>\n<\/tr>\n
                  1.5<\/td>\n0.15<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
                5. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{5 mg}}\\times\\text{10 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{5\\cancel{\\text{ mg}}}\\times10\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{5}\\\\[\/latex][latex]x\\text{ mL}=\\text{2 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                  10<\/td>\n2<\/td>\n2 min<\/td>\n<\/tr>\n
                  5<\/td>\n1<\/td>\n1 min<\/td>\n<\/tr>\n
                  2.5<\/td>\n0.5<\/td>\n30 sec<\/td>\n<\/tr>\n
                  1.25<\/td>\n0.25<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
                6. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{2 mL}}{\\text{250 mg}}\\times\\text{200 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{2 mL}}{250\\cancel{\\text{ mg}}}\\times200\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{400 mL}}{\\text{250}}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.6 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2 and then divided by 3 to reach 15 second increments.\n\n\n\n\n\n\n
                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                  200<\/td>\n1.6<\/td>\n1.5 min<\/td>\n<\/tr>\n
                  100<\/td>\n0.8<\/td>\n45 sec<\/td>\n<\/tr>\n
                  33.3<\/td>\n0.27<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nFrom the table, 0.27 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.3 to track the volume your are giving better.<\/li>\n \t
                7. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{50 mg}}\\times\\text{20 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{50\\cancel{\\text{ mg}}}\\times20\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{20 mL}}{\\text{50}}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.4 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                  20<\/td>\n0.4<\/td>\n2 min<\/td>\n<\/tr>\n
                  10<\/td>\n0.2<\/td>\n1 min<\/td>\n<\/tr>\n
                  5<\/td>\n0.1<\/td>\n30 sec<\/td>\n<\/tr>\n
                  2.5<\/td>\n0.05<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n \t
                8. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{10 mg}}\\times\\text{15 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{10\\cancel{\\text{ mg}}}\\times15\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{15 mL}}{10}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.5 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 5 to start and then divided by 2 to reach 15 second increments.\n\n\n\n\n\n\n\n
                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                  15<\/td>\n1.5<\/td>\n5 min<\/td>\n<\/tr>\n
                  3<\/td>\n0.3<\/td>\n1 min<\/td>\n<\/tr>\n
                  1.5<\/td>\n0.15<\/td>\n30 sec<\/td>\n<\/tr>\n
                  0.75<\/td>\n0.075<\/td>\n15<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nFrom the table, 0.075 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.1 to track the volume your are giving better.<\/li>\n \t
                9. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{50 mg}}\\times\\text{75 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{50\\cancel{\\text{ mg}}}\\times75\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{75 mL}}{\\text{50}}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.5 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                  75<\/td>\n1.5<\/td>\n2 min<\/td>\n<\/tr>\n
                  37.5<\/td>\n0.75<\/td>\n1 min<\/td>\n<\/tr>\n
                  18.75<\/td>\n0.375<\/td>\n30 sec<\/td>\n<\/tr>\n
                  9.375<\/td>\n0.1875<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nFrom the table, 0.1875 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.2 to track the volume your are giving better.<\/li>\n \t
                10. First, calculate the dose in mg from the weight of the patient given.\n[latex]\\text{2 mcg}\\times\\text{20 kg}=\\text{40 mcg\/dose}[\/latex]\nThen, calculate the total volume of the injection.\n[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{100 mcg}}\\times\\text{40 mcg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{100\\cancel{\\text{ mcg}}}\\times40\\cancel{\\text{ mcg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{40 mL}}{\\text{100}}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.4 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.\nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.\n\n\n\n\n\n\n\n
                  Amount (mcg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                  40<\/td>\n0.4<\/td>\n2 min<\/td>\n<\/tr>\n
                  20<\/td>\n0.2<\/td>\n1 min<\/td>\n<\/tr>\n
                  10<\/td>\n0.1<\/td>\n30 sec<\/td>\n<\/tr>\n
                  5<\/td>\n0.05<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n<\/ol>\n<\/details><\/div>\n<\/div>","rendered":"

                  Lesson<\/h1>\n
                  \n
                  \n

                  Learning Outcomes<\/p>\n<\/header>\n

                  \n

                  By the end of this chapter, learners will be able to:<\/p>\n

                    \n
                  • identify factors which affect the rate of administration of IV direct medications,<\/li>\n
                  • create a dose, volume, time table for use in administration of IV direct medications, and<\/li>\n
                  • label a syringe to help keep track of medication delivery rate.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n

                    IV Direct Administration Rates<\/h2>\n

                    It is essential for medications administered directly into an IV line to be given at the correct rate to prevent complications. Information describing the appropriate rate will be available in the health agency’s drug reference manual. Ensure all factors about the patient’s context are considered when reviewing rate information in the reference manual. For instance, the rate may be different for a neonate versus an adult. In some cases, a variable rate is given and you will need to use critical thinking skills to determine the most appropriate rate, often in discussion with your nursing instructor or the most responsible nurse for the patient.<\/p>\n

                    To determine how fast to administer an IV direct medication, you will need the following information:<\/p>\n

                      \n
                    • the medication order<\/li>\n
                    • information about the patient’s context (eg. age, reason for medication order, hepatic function…)<\/li>\n
                    • the administration information from the drug reference manual<\/li>\n
                    • the total volume of medication to be administered<\/li>\n<\/ul>\n

                      Once the rate of administration of the drug is determined, the actual administration of the drug must be timed to ensure it is given at the correct rate. In order to administer the drug evenly over a particular period of time, nurses often calculate a volume of medication to be given over specific time intervals (for example, every 15 seconds) during the administration period. The drug information in the text box below will be used to exemplify this process. It is important to note the information presented here should not be used for direct patient care, always review your agency’s drug reference manual for up to date information regarding the drug and the administration policy of your institution.<\/p>\n

                      \n

                      diazepam<\/p>\n

                      Status Epilepticus: 5-10 mg IV\/IM q5-10min; not to exceed 30 mg, OR <\/span>0.5 mg\/kg PR (using parenteral solution), THEN 0.25 mg\/kg in 10 minutes PRN
                      \nIV Direct: Administer undiluted over 3 min; no more than 5 mg\/min<\/p>\n

                      https:\/\/reference.medscape.com\/drug\/valium-diastat-diazepam-342902<\/p>\n<\/div>\n

                      1. Gather the information which will affect the rate of administration.<\/h3>\n
                      <\/div>\n
                      Medication order: diazepam 10 mg<\/div>\n
                      Rate information: over 3 min; no more than 5mg\/min
                      \nSupply: the concentration of diazepam in a vial is 5 mg : 1 mL<\/div>\n
                      Calculate the total volume to be administered:<\/span><\/div>\n

                      [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{5 mg}}\\times\\text{10 mg}[\/latex]<\/p>\n

                      [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{5\\cancel{\\text{ mg}}}\\times10\\cancel{\\text{ mg}}[\/latex]<\/p>\n

                      [latex]x\\text{ mL}=\\dfrac{1\\text{ mL}\\times{10}}{{5}}[\/latex]<\/p>\n

                      [latex]x\\text{ mL}=2\\text{ mL}[\/latex]<\/p>\n

                      2. Determine what volume of medication will be given in each time interval:<\/h3>\n
                      <\/div>\n
                      When beginning to administer IV direct medications, it can be hard to ensure you are maintaining an even speed of delivery<\/div>\n
                      over the whole time period. To stay within a consistent delivery speed, you can create a table to determine how much of the syringe volume should be given over smaller time intervals to ensure you have an even speed over the duration of the injection. This can be called a dose, volume, time table. Including the amount, volume and time interval in the table is helpful when checking to ensure you are meeting the criteria as laid out in the drug reference manual as rate information is often given in an amount (usually mg or mcg) per time interval (usually min or sec).<\/div>\n
                      <\/div>\n
                      In this dose, volume and time table, the total amount, volume and time period is entered into the second row. Each subsequent value has been cut in half from the value above.<\/div>\n
                      \n\n\n\n\n\n\n\n
                      Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                      10<\/em><\/td>\n2<\/em><\/td>\n3 min (180 sec)<\/em><\/td>\n<\/tr>\n
                      5<\/em><\/td>\n1<\/em><\/td>\n90 sec<\/em><\/td>\n<\/tr>\n
                      2.5<\/em><\/td>\n0.5<\/em><\/td>\n45 sec<\/em><\/td>\n<\/tr>\n
                      1.25<\/em><\/td>\n0.25<\/em><\/td>\n22.5 sec<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
                      This is not the only way to set up the table. Here is an alternate table in which each value has been divided by 3:<\/div>\n
                      \n\n\n\n\n\n\n
                      Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                      10<\/em><\/td>\n2<\/em><\/td>\n3 min<\/em><\/td>\n<\/tr>\n
                      3.33<\/em><\/td>\n0.66\u00a0<\/em><\/td>\n1 min (60 sec)<\/em><\/td>\n<\/tr>\n
                      1.11<\/em><\/td>\n0.22<\/em><\/td>\n20 sec<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
                      And finally, a table where each value has been divided by 5:<\/div>\n
                      \n\n\n\n\n\n\n
                      Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                      10<\/em><\/td>\n2<\/em><\/td>\n3 min (180 sec)<\/em><\/td>\n<\/tr>\n
                      2 mg<\/em><\/td>\n0.4<\/em><\/td>\n36 sec<\/em><\/td>\n<\/tr>\n
                      1 mg<\/em><\/td>\n0.2<\/em><\/td>\n18 sec<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

                      In this example, clinical judgement must be used to determine which one will give a volume and time interval easiest for a nurse to follow. The middle table might be the easiest to use in practice, as watching a timer and noting how much you have given every 20 seconds is easier to follow than watching for every 22.5 or 18 seconds. You may also find any number you divide by gives a difficult number to measure with the available syringes. In this case, you will need to round the number so the volume can be measured easily on the syringe. For example, if you calculated the final volume to be 1.08 mL you could round to 1 mL. If you are rounding down, you are giving slightly less volume over the allotted time and should be safe for the client to receive. You must be very cautious about rounding up, as the medication would be given slightly faster. Make sure to discuss rationale for rounding with your preceptor or instructor to ensure you are making appropriate decisions.<\/p>\n

                      \n
                      \n

                      Sample Exercise 17.1<\/p>\n<\/header>\n

                      \n

                      Complete a dose, volume, time table when administering the following medication:<\/p>\n

                      Medication Order: ketorlac 30 mg IV prn q8h
                      \nRate Information: undiluted over 1-2 minutes
                      \nSupply: ketorlac 30 mg\/mL<\/p>\n

                      \nAnswer:<\/strong><\/summary>\n\n\n\n\n\n\n
                      Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                      30<\/td>\n1<\/td>\n2 min<\/td>\n<\/tr>\n
                      15<\/td>\n0.5<\/td>\n1 min<\/td>\n<\/tr>\n
                      7.5<\/td>\n0.25<\/td>\n30 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/details>\n<\/div>\n<\/div>\n
                      \n
                      \n

                      Sample Exercise 17.2<\/p>\n<\/header>\n

                      \n

                      Create a dose, volume, time chart for the following medication order.<\/p>\n

                      Medication Order: furosemide 40 mg IV BID
                      \nRate Information: administer undiluted at a rate of 20 mg\/min
                      \nSupply: 20 mg\/1 mL ampule<\/p>\n

                      \nAnswer:<\/strong><\/summary>\n

                      First, calculate the total volume of the injection.<\/p>\n

                      [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{20 mg}}\\times\\text{40 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{20\\cancel{\\text{ mg}}}\\times40\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{40 mL}}{20}\\\\[\/latex][latex]x\\text{ mL}=\\text{2 mL}[\/latex]<\/p>\n

                      Enter the total amount, volume and period of time in the first row. In this case, the recommended rate of 20 mg\/min is represented in the third row of the chart, and thus meets criteria for safe administration.
                      \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n
                      Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                      40<\/td>\n2<\/td>\n2 min<\/td>\n<\/tr>\n
                      20<\/td>\n1<\/td>\n1 min<\/td>\n<\/tr>\n
                      10<\/td>\n0.5<\/td>\n30 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/details>\n<\/div>\n<\/div>\n

                      Syringe Labels for IV Direct Administration<\/h2>\n

                      It can be challenging for some people to focus on the amount of volume being administered in each short time interval while in the practice setting, even while watching a timer. Distractions such as alarms, conversation and\/or questions from the patient or family and other interruptions can break the focus of the nurse during this process. When beginning to administer IV direct medications, it may be helpful to add a visual cue to the syringe label to help keep on track. In the image below, two components have been added to a syringe label for administration of furosemide. Lines to indicate every 0.5 mL on the syringe and numbers representing the seconds remaining at each interval are added. These correspond to the dose, volume, time table created in the sample exercise above, in which 0.5 mL is given every 30 seconds.<\/p>\n

                      \"\"<\/p>\n

                      \n
                      \n

                      Critical Thinking Question<\/p>\n<\/header>\n

                      \n

                      When comparing the same dose of a particular medication given by IV direct versus an intermittent IV infusion, do you anticipate any differences in the onset, peak and duration of the medication?<\/p>\n

                      Answer:<\/strong><\/p>\n

                      The onset occurs when the medication enters the bloodstream and is able to take effect in the body. It varies with mechanism of action, dosage, and individual patient factors. The IV direct route is often delivered over a total shorter time than the intermittent IV route. If the medication is delivered into the vein more quickly, it is likely the onset will be earlier for IV direct than IV intermittent. It may effect the peak for some medications as well. The duration of effect is more variable. It’s possible the duration of IV intermittent is longer, especially for infusions which are given over longer periods of time. If you think variations in onset, peak and duration of various routes will affect the choice of route given to a patient, you should check the parenteral manual for guidelines on specific medications when preparing the medication.<\/p>\n<\/div>\n<\/div>\n

                      Practice Set 17.1: Creating Dose, Volume, Time Tables<\/h1>\n
                      \n
                      \n

                      Practice Set 17.1: Creating Dose, Volume, Time Tables<\/p>\n<\/header>\n

                      \n

                      Create a dose, volume, time table for the following scenarios.<\/p>\n

                        \n
                      1. Medication Order: dexamethasone 4 mg IV q6h
                        \nRate Information: administer undiluted, no more than 8mg\/min
                        \nSupply: 20 mg\/5 mL vial<\/li>\n
                      2. Medication Order: pantoprazole 40 mg IV OD
                        \nRate Information: administer over 2 minutes
                        \nSupply: 40 mg powder in medication vial, to be reconstituted with 10 mL NS<\/li>\n
                      3. Medication Order: benzotropine 2 mg IV now
                        \nRate Information: administer undiluted over 1 minute
                        \nSupply: 2 mg\/2 mL ampule<\/li>\n
                      4. Medication Order: morphine 2 mg IV q2h prn
                        \nRate Information: dilute with 9 mL NS or SW for injection to give 1 mg\/mL and give at a maximum rate of 2 mg\/min
                        \nSupply: 10 mg\/mL ampule<\/li>\n
                      5. Medication Order: digoxin 0.25 mg IV once daily
                        \nRate Information: dilute each 1 mL with at least 4 mL NS and give over at least 5 minutes
                        \nSupply: 0.25 mg\/mL ampule<\/li>\n
                      6. Medication Order: furosemide 40 mg IV once daily
                        \nRate Information: give undiluted; doses 120 mg or less over 1-2 minutes
                        \nSupply: 10 mg\/mL ampule<\/li>\n
                      7. Medication Order: lorazepam 3 mg IV 20 minutes prior to surgery
                        \nRate Information: dilute with equal volume D5W, NS, or SW; give over 1 minute, max of 2 mg\/min
                        \nSupply: 4 mg\/mL vial<\/li>\n
                      8. Medication Order: naloxine 0.2 mg IV q2-3 minutes until respiratory rate depression is resolved
                        \nRate Information: give undiluted over 30-60 seconds
                        \nSupply: 0.4 mg\/mL<\/li>\n
                      9. Medication Order: oxytocin 8 units once postpartum bolus
                        \nRate Information: may dilute with 3 mL NS, given slowly over at least 1 minute
                        \nSupply: 10 units\/mL vial<\/li>\n
                      10. Medication Order: haloperidol 2 mg IV push PRN.
                        \nRate Information: dilute with 5 mL SW and give rapid IV push over at least 1 minute.
                        \nSupply: 5 mg\/mL (1 mL) ampule.<\/li>\n<\/ol>\n
                        \nAnswers:<\/strong><\/summary>\n
                          \n
                        1. First, calculate the total volume of the injection.
                          \n[latex]x\\text{ mL}=\\dfrac{\\text{5 mL}}{\\text{20 mg}}\\times\\text{4 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{5 mL}}{20\\cancel{\\text{ mg}}}\\times4\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{20 mL}}{20}\\\\[\/latex][latex]x\\text{ mL}=\\text{1 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row. Choosing to give 4 mg in 1 minute is giving the medication slower than the maximum rate of 8 mg\/min, and meets criteria for safe administration.
                          \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n
                          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          4<\/td>\n1<\/td>\n1 min<\/td>\n<\/tr>\n
                          2<\/td>\n0.5<\/td>\n30 sec<\/td>\n<\/tr>\n
                          1<\/td>\n0.25<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                        2. First, note the total volume of the injection (40 mg in 10 mL).
                          \nEnter the total amount, volume and period of time in the first row.
                          \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          40<\/td>\n10<\/td>\n2 min<\/td>\n<\/tr>\n
                          20<\/td>\n5<\/td>\n1 min<\/td>\n<\/tr>\n
                          10<\/td>\n2.5<\/td>\n30 sec<\/td>\n<\/tr>\n
                          5<\/td>\n1.25<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                        3. First, note the total volume of the injection (2 mg in 2 mL).
                          \nEnter the total amount, volume and period of time in the first row.
                          \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n
                          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          2<\/td>\n2<\/td>\n1 min<\/td>\n<\/tr>\n
                          1<\/td>\n1<\/td>\n30 sec<\/td>\n<\/tr>\n
                          0.5<\/td>\n0.5<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                        4. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{\\text{10 mg}}\\times\\text{2 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{10\\cancel{\\text{ mg}}}\\times2\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{20 mL}}{10}\\\\[\/latex][latex]x\\text{ mL}=\\text{2 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row. Safety note: In this situation, you may have recognized the morphine is supplied in an ampule. Morphine is diluted by drawing up 9 ml of NS in a 10 mL syringe and then the 1 mL of morphine from the ampule. Before administering, the extra volume in the syringe must be wasted so only the calculated volume of 2 mL remains.
                          \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n
                          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          2<\/td>\n2<\/td>\n1 min (60 sec)<\/td>\n<\/tr>\n
                          1<\/td>\n1<\/td>\n30 sec<\/td>\n<\/tr>\n
                          0.5<\/td>\n0.5<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                          Alternately, if the decision is made to administer the morphine slower than the maximum rate, the following table could be set up:<\/p>\n\n\n\n\n\n\n\n
                          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          2<\/td>\n2<\/td>\n2 min (120 sec)<\/td>\n<\/tr>\n
                          1<\/td>\n1<\/td>\n1 min (60 sec)<\/td>\n<\/tr>\n
                          0.5<\/td>\n0.5<\/td>\n30 sec<\/td>\n<\/tr>\n
                          0.25<\/td>\n0.25<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                        5. First, calculate the total volume of the injection. [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{0.25 mg}}\\times\\text{0.25 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{0.25\\cancel{\\text{ mg}}}\\times0.25\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{0.25 mL}}{\\text{0.25}}\\\\[\/latex][latex]x\\text{ mL}=\\text{1 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                          \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 5 to start and then by 2 to get down to 15 second increments.<\/p>\n\n\n\n\n\n\n
                          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          0.25<\/td>\n1<\/td>\n5 min<\/td>\n<\/tr>\n
                          0.05<\/td>\n0.2<\/td>\n1 min<\/td>\n<\/tr>\n
                          0.025<\/td>\n0.1<\/td>\n30 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                        6. First, calculate the total volume of the injection. [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{10 mg}}\\times\\text{40 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{10\\cancel{\\text{ mg}}}\\times40\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{40 mL}}{10}\\\\[\/latex][latex]x\\text{ mL}=\\text{4 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                          \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          40<\/td>\n4<\/td>\n2 min<\/td>\n<\/tr>\n
                          20<\/td>\n2<\/td>\n1 min<\/td>\n<\/tr>\n
                          10<\/td>\n1<\/td>\n30 sec<\/td>\n<\/tr>\n
                          5<\/td>\n0.5<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                        7. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{4 mg}}\\times\\text{3 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{4\\cancel{\\text{ mg}}}\\times3\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{3 mL}}{4}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.75 mL}\\\\[\/latex]Due to how this medication needs to be diluted, the total volume that will be give needs to be doubled.
                          \n[latex]\\text{0.75 mL}\\times2=\\text{1.5 mL}[\/latex]
                          \nEnter the total amount, volume and period of time in the first row.
                          \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n
                          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          3<\/td>\n1.5<\/td>\n1 min<\/td>\n<\/tr>\n
                          1.5<\/td>\n0.75<\/td>\n30 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                        8. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{0.4 mg}}\\times\\text{0.2 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{0.4\\cancel{\\text{ mg}}}\\times0.2\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{0.2 mL}}{\\text{0.4}}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.5 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                          \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n
                          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          0.2<\/td>\n0.5<\/td>\n60 sec<\/td>\n<\/tr>\n
                          0.1<\/td>\n0.25<\/td>\n30 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                        9. First, calculate the total volume of the injection. [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{10 units}}\\times\\text{8 units}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{10\\cancel{\\text{ units}}}\\times8\\cancel{\\text{ units}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{8 mL}}{10}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.8 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                          \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n
                          Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          8<\/td>\n0.8<\/td>\n1 min<\/td>\n<\/tr>\n
                          4<\/td>\n0.4<\/td>\n30 sec<\/td>\n<\/tr>\n
                          2<\/td>\n0.2<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                        10. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{6 mL}}{\\text{5 mg}}\\times\\text{2 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{6 mL}}{5\\cancel{\\text{ mg}}}\\times2\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{12 mL}}{5}\\\\[\/latex][latex]x\\text{ mL}=\\text{2.4 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                          \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n
                          Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                          2<\/td>\n2.4<\/td>\n1 min<\/td>\n<\/tr>\n
                          1<\/td>\n1.2<\/td>\n30 sec<\/td>\n<\/tr>\n
                          0.5<\/td>\n0.6<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n<\/ol>\n<\/details>\n<\/div>\n<\/div>\n

                          Practice Set 17.2: Creating Dose, Volume, Time Tables<\/h1>\n
                          \n
                          \n

                          Practice Set 17.2: Creating Dose, Volume, Time Tables<\/p>\n<\/header>\n

                          \n

                          Create a dose, volume, time table for the following scenarios. Identify the final volume and time interval you would use when administering the medication.<\/p>\n

                            \n
                          1. Medication Order: dexamethasone 15 mg IV once
                            \nRate Information: max rate of 8 mg\/min
                            \nSupply: 4 mg\/mL vial<\/li>\n
                          2. Medication Order: diphenhydrinate 35 mg IV push q4h.
                            \nRate Information: dilute every 50 mg with 10 mL NS and administer over 2-4 minutes.
                            \nSupply: 50 mg\/mL (1 mL) vial.<\/li>\n
                          3. Medication Order: meropenum 600 mg IV q8h.
                            \nRate Information: reconstitute with 20 mL NS or D5W and give over 3-5 minutes.
                            \nSupply: 1 g (powdered) vial.<\/li>\n
                          4. Medication Order: thiamine 100 mg IV push once daily for 5 days.
                            \nRate Information: give undiluted over 1 minute.
                            \nSupply: 100 mg\/mL (1 mL) vial.<\/li>\n
                          5. Medication Order: morphine 2.5 mg IV push q4h.
                            \nRate Information: max rate of 2 mg\/mL, diluted to 1 mg\/mL with NS (10 mL of fluids).
                            \nSupply: 10 mg\/mL<\/li>\n
                          6. Medication Order: flumezanil 0.2 mg for suspected benzo overdose, possibly giving additional doses if inadequate results.
                            \nRate Information: give over 30 seconds.
                            \nSupply: 0.1 mg\/mL (5 mL) vial.<\/li>\n
                          7. Medication Order: ampicillin 25 mg\/kg\/dose, for a 15 kg child, IV push for a mild infection.
                            \nRate Information: give over 4 minutes at a max rate of 100 mg\/minute, diluted to 250 mg\/2.5 mL.
                            \nSupply: 250 mg (powdered) vial.<\/li>\n
                          8. Medication Order: ketorolac 20 mg q4h IV push.
                            \nRate Information: give over 1-2 minutes undiluted.
                            \nSupply: 30 mg\/mL (1 mL) vial.<\/li>\n
                          9. Medication Order: diazepam 8 mg q3h.
                            \nRate Information: give undiluted 2-5 mg\/minute.
                            \nSupply: 5 mg\/mL (2 mL) ampule.<\/li>\n
                          10. Medication Order: midazolam 0.2 mg\/kg IV push loading dose, repeating q5 minute until seizure stops. This is for a 65 kg adult.
                            \nRate Information: given at a rate of 2 mg\/minute.
                            \nSupply: 1 mg\/mL<\/li>\n<\/ol>\n
                            \nAnswers:<\/strong><\/summary>\n
                              \n
                            1. First, calculate the total volume of the injection. [latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{4 mg}}\\times\\text{15 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{4\\cancel{\\text{ mg}}}\\times15\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{15 mL}}{4}\\\\[\/latex][latex]x\\text{ mL}=\\text{3.75 mL}\\\\[\/latex]In this answer, in the table set up, each value has been divided by 2.
                              \nWhen you calculate a volume that is not a round decimal number, round to the the number that you can measure in the syringe that you are using.<\/p>\n\n\n\n\n\n\n\n
                              Amount (mg)<\/th>\nVolume (mL)<\/th>\nRounded Volume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                              15<\/td>\n3.75<\/td>\n3.8<\/td>\n2 min<\/td>\n<\/tr>\n
                              7.5<\/td>\n1.875<\/td>\n1.9<\/td>\n1 min<\/td>\n<\/tr>\n
                              3.75<\/td>\n0.9375<\/td>\n1.0<\/td>\n30 sec<\/td>\n<\/tr>\n
                              1.875<\/td>\n0.46875<\/td>\n0.5<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                            2. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{\\text{50 mg}}\\times\\text{35 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{50\\cancel{\\text{ mg}}}\\times35\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{350 mL}}{\\text{50}}\\\\[\/latex][latex]x\\text{ mL}=\\text{7 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                              \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n\n
                              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                              35<\/td>\n7<\/td>\n4 min<\/td>\n<\/tr>\n
                              17.5<\/td>\n3.5<\/td>\n2 min<\/td>\n<\/tr>\n
                              8.7<\/td>\n1.75<\/td>\n1 min<\/td>\n<\/tr>\n
                              4.4<\/td>\n0.88<\/td>\n30 sec<\/td>\n<\/tr>\n
                              2.2<\/td>\n0.44<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                              From the table, 0.44 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.4 to track the volume your are giving better.<\/li>\n

                            3. First, calculate the total volume of the injection. [latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{\\text{500 mg}}\\times\\text{600 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{500\\cancel{\\text{ mg}}}\\times600\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{6000 mL}}{\\text{500}}\\\\[\/latex][latex]x\\text{ mL}=\\text{12 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                              \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 5 to start and then by 2 to get to 15 second increments.<\/p>\n\n\n\n\n\n\n\n
                              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                              600<\/td>\n12<\/td>\n5<\/td>\n<\/tr>\n
                              120<\/td>\n2.4<\/td>\n1<\/td>\n<\/tr>\n
                              60<\/td>\n1.2<\/td>\n30 sec<\/td>\n<\/tr>\n
                              30<\/td>\n0.6<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                            4. First, we know the volume of the dose due to the supply and we will enter the total amount, volume and period of time in the first row.
                              \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n
                              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                              100<\/td>\n1<\/td>\n1 min<\/td>\n<\/tr>\n
                              50<\/td>\n0.5<\/td>\n30 sec<\/td>\n<\/tr>\n
                              25<\/td>\n0.25<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                            5. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{1 mg}}\\times\\text{2.5 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{1\\cancel{\\text{ mg}}}\\times2.5\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{2.5 mL}}{1}\\\\[\/latex][latex]x\\text{ mL}=\\text{2.5 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                              \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 3 to start and then divided by 2 to get to 15 second increments.<\/p>\n\n\n\n\n\n\n
                              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                              2.5<\/td>\n2.5<\/td>\n1.5 min<\/td>\n<\/tr>\n
                              0.8<\/td>\n0.8<\/td>\n30 sec<\/td>\n<\/tr>\n
                              0.4<\/td>\n0.4<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                            6. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{0.1 mg}}\\times\\text{0.2 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{0.1\\cancel{\\text{ mg}}}\\times0.2\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{0.2 mL}}{\\text{0.1}}\\\\[\/latex][latex]x\\text{ mL}=\\text{2 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                              \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n
                              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                              0.2<\/td>\n2<\/td>\n30 sec<\/td>\n<\/tr>\n
                              0.1<\/td>\n1<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                            7. First, calculate the dose in mg from the weight of the patient given. [latex]\\text{25 mg}\\times\\text{15 kg}=\\text{375 mg\/dose}[\/latex]
                              \nThen, calculate the total volume of the injection.
                              \n[latex]x\\text{ mL}=\\dfrac{\\text{2.5 mL}}{\\text{250 mg}}\\times\\text{375 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{2.5 mL}}{250\\cancel{\\text{ mg}}}\\times375\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{937.5 mL}}{\\text{250}}\\\\[\/latex][latex]x\\text{ mL}=\\text{3.75 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                              \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 4 to start and then by 2 to get to 15 second increments.<\/p>\n\n\n\n\n\n\n\n
                              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                              375<\/td>\n3.75<\/td>\n4 min<\/td>\n<\/tr>\n
                              93.75<\/td>\n0.94<\/td>\n1 min<\/td>\n<\/tr>\n
                              46.9<\/td>\n0.47<\/td>\n30 sec<\/td>\n<\/tr>\n
                              23.4<\/td>\n0.23<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                              From the table, 0.23 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.2 to track the volume your are giving better.<\/li>\n

                            8. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{30 mg}}\\times\\text{20 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{30\\cancel{\\text{ mg}}}\\times20\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{20 mL}}{\\text{30}}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.67 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                              \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                              Amount (mg)<\/th>\nVolume (mL)<\/th>\nRounded Volume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                              20<\/td>\n0.67<\/td>\n0.7<\/td>\n2 min<\/td>\n<\/tr>\n
                              10<\/td>\n0.33<\/td>\n0.3<\/td>\n1 min<\/td>\n<\/tr>\n
                              5<\/td>\n0.16<\/td>\n0.2<\/td>\n30 sec<\/td>\n<\/tr>\n
                              2.5<\/td>\n0.08<\/td>\n0.1<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                            9. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{5 mg}}\\times\\text{8 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{5\\cancel{\\text{ mg}}}\\times8\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{8 mL}}{5}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.6 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                              \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                              8<\/td>\n1.6<\/td>\n2 min<\/td>\n<\/tr>\n
                              4<\/td>\n0.8<\/td>\n1 min<\/td>\n<\/tr>\n
                              2<\/td>\n0.4<\/td>\n30 sec<\/td>\n<\/tr>\n
                              1<\/td>\n0.2<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                            10. First, calculate the dose in mg from the weight of the patient given. [latex]\\text{0.2 mg}\\times\\text{65 kg}=\\text{13 mg\/dose}[\/latex]
                              \nThen, calculate the total volume of the injection.
                              \n[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{1 mg}}\\times\\text{13 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{1\\cancel{\\text{ mg}}}\\times13\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{13 mL}}{1}\\\\[\/latex][latex]x\\text{ mL}=\\text{13 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                              \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 13 to start and then by 2 to get to 15 second increments.<\/p>\n\n\n\n\n\n\n
                              Amount (mg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                              13<\/td>\n13<\/td>\n6.5 min<\/td>\n<\/tr>\n
                              1<\/td>\n1<\/td>\n30 sec<\/td>\n<\/tr>\n
                              0.5<\/td>\n0.5<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n<\/ol>\n<\/details>\n<\/div>\n<\/div>\n

                              Practice Set 17.3: Creating Dose, Volume, Time Tables<\/h1>\n
                              \n
                              \n

                              Practice Set 17.3: Creating Dose, Volume, Time Tables<\/p>\n<\/header>\n

                              \n

                              Create a dose, volume, time table for the following scenarios. Identify the final volume and time interval you would use when administering the medication.<\/p>\n

                                \n
                              1. Medication Order: diltiazem 0.25 mg\/kg IV direct for a 55kg adult.
                                \nRate Information: give undiluted over 2 minutes.
                                \nSupply: 5 mg\/mL (10 mL) vial.<\/li>\n
                              2. Medication Order: hydromorphone 0.5 mg IV direct q6h.
                                \nRate Information: dilute to 5 mL with NS administer slowly over 2 minutes.
                                \nSupply: 2 mg\/mL vial.<\/li>\n
                              3. Medication Order: labetalol 7 mg IV initial dose in a hypertensive emergency.
                                \nRate Information: give over 2 minutes.
                                \nSupply: 5 mg\/mL (20 mL) vial.<\/li>\n
                              4. Medication Order: propofol 18 mg IV direct bolus.
                                \nRate Information: given over 3 minutes.
                                \nSupply: 10 mg\/mL (20 mL) ampule.<\/li>\n
                              5. Medication Order: metoclopramide 10 mg IV for prophylactic postoperative vomiting.
                                \nRate Information: given over 2 minutes.
                                \nSupply: 5 mg\/mL (2 mL) vial.<\/li>\n
                              6. Medication Order: hydrocortisone 200 mg IV direct.
                                \nRate Information: dilute with 2 mL SW (diluted to 125 mg\/mL), given over 1.5 minutes.
                                \nSupply: 250 mg vial.<\/li>\n
                              7. Medication Order: ephedrine 20 mg IV repeat q5-10 minutes according to blood pressure response.
                                \nRate Information: given over 10 mg\/minute as a max rate.
                                \nSupply: 50 mg\/mL (1 mL) vial.<\/li>\n
                              8. Medication Order: meperidine 15 mg IV direct q4h PRN for severe pain.
                                \nRate Information: diluted to 10 mg\/mL, given over 5 minutes.
                                \nSupply: 50 mg\/mL (1 mL) ampule.<\/li>\n
                              9. Medication Order: fentynal 75 mcg intrapartum q30 minutes IV direct.
                                \nRate Information: given undiluted over 2 minutes.
                                \nSupply: 50 mcg\/mL (5 mL) ampule.<\/li>\n
                              10. Medication Order: octreotide 2 mg\/kg\/dose IV direct bolus for a 20 kg toddler with a severe gastrointestinal bleed.
                                \nRate Information: given undiluted over 2 minutes.
                                \nSupply: 100 mcg\/mL (1 mL) ampule.<\/li>\n<\/ol>\n
                                \nAnswers:<\/strong><\/summary>\n
                                  \n
                                1. First, calculate the dose in mg from the weight of the patient given.
                                  \n[latex]\\text{0.25 mg}\\times\\text{55 kg}=\\text{13.75 mg}[\/latex]
                                  \nThen, calculate the total volume of the injection.
                                  \n[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{5 mg}}\\times\\text{13.75 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{5\\cancel{\\text{ mg}}}\\times13.75\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{13.75 mL}}{5}\\\\[\/latex][latex]x\\text{ mL}=\\text{2.75 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                                  \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                                  Amount (units)<\/th>\nVolume (mL)<\/th>\nRounded Volume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                                  13.75<\/td>\n2.75<\/td>\n2.75<\/td>\n2 min<\/td>\n<\/tr>\n
                                  6.875<\/td>\n1.37<\/td>\n1.4<\/td>\n1 min<\/td>\n<\/tr>\n
                                  3.437<\/td>\n0.68<\/td>\n0.7<\/td>\n30 sec<\/td>\n<\/tr>\n
                                  1.718<\/td>\n0.34<\/td>\n0.3<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                                2. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{5 mL}}{\\text{2 mg}}\\times\\text{0.5 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{5 mL}}{\\cancel{2\\text{ mg}}}\\times0.5\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{2.5 mL}}{2}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.25 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                                  \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                                  0.5<\/td>\n1.25<\/td>\n2 min<\/td>\n<\/tr>\n
                                  0.25<\/td>\n0.63<\/td>\n1 min<\/td>\n<\/tr>\n
                                  0.125<\/td>\n0.31<\/td>\n30 sec<\/td>\n<\/tr>\n
                                  0.0625<\/td>\n0.16<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                                  From the table, 0.16 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.2 to track the volume your are giving better.<\/li>\n

                                3. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{5 mg}}\\times\\text{7 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{5\\cancel{\\text{ mg}}}\\times7\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{7 mL}}{5}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.4 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                                  \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                                  7<\/td>\n1.4<\/td>\n2 min<\/td>\n<\/tr>\n
                                  3.5<\/td>\n0.7<\/td>\n1 min<\/td>\n<\/tr>\n
                                  1.75<\/td>\n0.35<\/td>\n30 sec<\/td>\n<\/tr>\n
                                  0.875<\/td>\n0.175<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                                  From the table, 0.175 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.2 to track the volume your are giving better.<\/li>\n

                                4. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{10 mg}}\\times\\text{18 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{10\\cancel{\\text{ mg}}}\\times18\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{18 mL}}{10}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.8 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                                  \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 3 to start and then divided by 2 to reach 15 second increments.<\/p>\n\n\n\n\n\n\n\n
                                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                                  18<\/td>\n1.8<\/td>\n3 min<\/td>\n<\/tr>\n
                                  3<\/td>\n0.6<\/td>\n1 min<\/td>\n<\/tr>\n
                                  3<\/td>\n0.3<\/td>\n30 sec<\/td>\n<\/tr>\n
                                  1.5<\/td>\n0.15<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                                5. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{5 mg}}\\times\\text{10 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{5\\cancel{\\text{ mg}}}\\times10\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{10 mL}}{5}\\\\[\/latex][latex]x\\text{ mL}=\\text{2 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                                  \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                                  10<\/td>\n2<\/td>\n2 min<\/td>\n<\/tr>\n
                                  5<\/td>\n1<\/td>\n1 min<\/td>\n<\/tr>\n
                                  2.5<\/td>\n0.5<\/td>\n30 sec<\/td>\n<\/tr>\n
                                  1.25<\/td>\n0.25<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                                6. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{2 mL}}{\\text{250 mg}}\\times\\text{200 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{2 mL}}{250\\cancel{\\text{ mg}}}\\times200\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{400 mL}}{\\text{250}}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.6 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                                  \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2 and then divided by 3 to reach 15 second increments.<\/p>\n\n\n\n\n\n\n
                                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                                  200<\/td>\n1.6<\/td>\n1.5 min<\/td>\n<\/tr>\n
                                  100<\/td>\n0.8<\/td>\n45 sec<\/td>\n<\/tr>\n
                                  33.3<\/td>\n0.27<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                                  From the table, 0.27 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.3 to track the volume your are giving better.<\/li>\n

                                7. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{50 mg}}\\times\\text{20 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{50\\cancel{\\text{ mg}}}\\times20\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{20 mL}}{\\text{50}}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.4 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                                  \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                                  20<\/td>\n0.4<\/td>\n2 min<\/td>\n<\/tr>\n
                                  10<\/td>\n0.2<\/td>\n1 min<\/td>\n<\/tr>\n
                                  5<\/td>\n0.1<\/td>\n30 sec<\/td>\n<\/tr>\n
                                  2.5<\/td>\n0.05<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n
                                8. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{10 mg}}\\times\\text{15 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{10\\cancel{\\text{ mg}}}\\times15\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{15 mL}}{10}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.5 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                                  \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 5 to start and then divided by 2 to reach 15 second increments.<\/p>\n\n\n\n\n\n\n\n
                                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                                  15<\/td>\n1.5<\/td>\n5 min<\/td>\n<\/tr>\n
                                  3<\/td>\n0.3<\/td>\n1 min<\/td>\n<\/tr>\n
                                  1.5<\/td>\n0.15<\/td>\n30 sec<\/td>\n<\/tr>\n
                                  0.75<\/td>\n0.075<\/td>\n15<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                                  From the table, 0.075 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.1 to track the volume your are giving better.<\/li>\n

                                9. First, calculate the total volume of the injection.[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{50 mg}}\\times\\text{75 mg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{50\\cancel{\\text{ mg}}}\\times75\\cancel{\\text{ mg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{75 mL}}{\\text{50}}\\\\[\/latex][latex]x\\text{ mL}=\\text{1.5 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                                  \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                                  Amount (units)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                                  75<\/td>\n1.5<\/td>\n2 min<\/td>\n<\/tr>\n
                                  37.5<\/td>\n0.75<\/td>\n1 min<\/td>\n<\/tr>\n
                                  18.75<\/td>\n0.375<\/td>\n30 sec<\/td>\n<\/tr>\n
                                  9.375<\/td>\n0.1875<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                                  From the table, 0.1875 is not an easy volume to track over 15 seconds when giving a direct IV. Instead, you can round this number to 0.2 to track the volume your are giving better.<\/li>\n

                                10. First, calculate the dose in mg from the weight of the patient given.
                                  \n[latex]\\text{2 mcg}\\times\\text{20 kg}=\\text{40 mcg\/dose}[\/latex]
                                  \nThen, calculate the total volume of the injection.
                                  \n[latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{\\text{100 mcg}}\\times\\text{40 mcg}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{1 mL}}{100\\cancel{\\text{ mcg}}}\\times40\\cancel{\\text{ mcg}}\\\\[\/latex][latex]x\\text{ mL}=\\dfrac{\\text{40 mL}}{\\text{100}}\\\\[\/latex][latex]x\\text{ mL}=\\text{0.4 mL}\\\\[\/latex]Enter the total amount, volume and period of time in the first row.
                                  \nNext, choose an amount to divide each value by. In this answer, each value has been divided by 2.<\/p>\n\n\n\n\n\n\n\n
                                  Amount (mcg)<\/th>\nVolume (mL)<\/th>\nTime Interval<\/th>\n<\/tr>\n
                                  40<\/td>\n0.4<\/td>\n2 min<\/td>\n<\/tr>\n
                                  20<\/td>\n0.2<\/td>\n1 min<\/td>\n<\/tr>\n
                                  10<\/td>\n0.1<\/td>\n30 sec<\/td>\n<\/tr>\n
                                  5<\/td>\n0.05<\/td>\n15 sec<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/li>\n<\/ol>\n<\/details>\n<\/div>\n<\/div>\n","protected":false},"author":90,"menu_order":6,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by"},"chapter-type":[],"contributor":[],"license":[53],"class_list":["post-109","chapter","type-chapter","status-publish","hentry","license-cc-by"],"part":68,"_links":{"self":[{"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/pressbooks\/v2\/chapters\/109","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/wp\/v2\/users\/90"}],"version-history":[{"count":1,"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/pressbooks\/v2\/chapters\/109\/revisions"}],"predecessor-version":[{"id":110,"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/pressbooks\/v2\/chapters\/109\/revisions\/110"}],"part":[{"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/pressbooks\/v2\/parts\/68"}],"metadata":[{"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/pressbooks\/v2\/chapters\/109\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/wp\/v2\/media?parent=109"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/pressbooks\/v2\/chapter-type?post=109"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/wp\/v2\/contributor?post=109"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingnumeracy\/wp-json\/wp\/v2\/license?post=109"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}