# NR 340 Week 1 Medication Calculation Exam

Directions: The purpose of this packet is to prepare you for the medication calculation exam that is taken on the first day of class.  Complete the medication calculation practice exam prior to the first day of class if needed.  In critical care, amounts are specific.  If the calculation is not a whole number, then answers are rounded off to the nearest 10th decimal place.  Pumps can be programmed to allow for a 10th decimal place.  If the calculation is for drops per minute then it is rounded off to the nearest whole number because drops cannot be divided.  Good Luck!

1. Your patient is ordered a dopamine drip at 7mcg/kg/min. He weighs 120 pounds.  Your dopamine is supplied in a concentration of 400mg per 250ml D5W.
• – At how many ml/hr should the IV pump be set?
1. Your patient is on Nitroprusside (Nipride) to keep his systolic blood pressure less than 180mmHg. The physician orders state to begin the infusion at 0.1mcg/kg/min and to titrate up every 3 to 5 minutes to desired effect.  Maximum dose to be given is 5mcg/kg/min.  Your patient weighs 150 pounds.  The medication comes supplied as 50mg in 250ml D5W.
• – At how many ml/hr should the IV be started?
• – What is the maximum ml/hr that the nipride can be run at?
1. The physician orders Fentanyl 3mcg/kg IVP at a rate of 2mcg/kg/min for analgesia prior to inserting an endotracheal tube. The patient weighs 50 kg.  The Fentanyl is supplied as 100mcg/ml.
• – How many ml of Fentanyl will you give?
• – How long will it take you to push the medication?
1. Your patient is ordered heparin per heparin protocol. The patient has been receiving heparin at 1500 units/hour.  The PTT result is 40.  Per the heparin protocol you should increase the heparin drip by 2 units/kg/hr.  Your patient weighs 110 pounds.  The Heparin bag is labeled 25000 units in 500 ml D5W.
• – How many ml/hr is your patient currently receiving?
• – How many units/hour will the patient be receiving when you increase the rate?
• – At how many ml/hr will you set the pump at?
1. Your patient is placed on a Lidocaine drip at 3mg/min. The concentration is 2grams in 250ml.
• – At how many ml/hr will you set the pump?
1. Your patient was transferred from the floor to the ICU on a Dopamine drip. The IV bag that is running says 400mg in 250ml D5W.  The IV is running at 22ml/hr.  Your unit usually uses Dopamine 800mg in 250ml.  Your patient weights 180 pounds.
• – How many mcg/kg/min is your patient currently receiving?
• – How many ml/hr should the patient receive when you change to the more concentrated IV solution?
1. Digoxin 0.125 mg IV now has been ordered and the stock medication drawer has 0.25 mg per ml ampules. How much is given? What nursing judgments and actions are taken prior to giving this medication?
2. Keftab (cephalexin) is prescribed for an elderly patient who weighs 60 kilograms. The order is 50 mg per kg orally in two equally divided doses.  Each tablet contains 500 mg.  How many tablets of this medication will the patient receive per dose?
3. An IV bag has 400 ml remaining. It is infusing at 30 gtt/min, and a 10 gtt/ml set is being used.  How many minutes will it take for the IV infusion to finish?
4. The patient received 2 units (350 ml each) of packed RBCs; 150 mL 0.9% NS each 8 hour shift; a diltiazem drip at 25 mL/hr, a piggyback of Ancef  1 G in 50 ml q6hr and cimetidine 100 mL q8hr. Calculate the 24 hour IV intake.
5. The physician ordered 1,000 ml of D5W to infuse at 100 ml/hr.  The tubing is calibrated at 15 gtt/ml.  How many hours will it take for the infusion to finish?
6. The physician ordered 1000 ml of 0.9 normal saline IV for 8 hours. Calculate the flow rate in drops per minute.  The drop factor is 10gtt/ml.  (Round to the nearest whole number).

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