Intravenous Solutions, Equipment, and Calculations Part 1 Chapter 15 Intravenous Solutions, Equipment, and Calculations Part 1 © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV Components Abbreviation Solution Component D Dextrose W Water S Saline NS Normal Saline (0.9% NaCl) NaCl Sodium Chloride RL Ringer’s Lactate LR Lactated Ringer’s © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

On D5W label the 5 is telling you about the percentage of Dextrose there is in the bag which is 5 grams per 100 mL. On 0.9% Sodium Chloride you will look at the 0.9% which comes out to 0.9 grams per 100 mL Remember that there is X grams per 100 mL

Normal Serum Osmolarity Hypotonic Used to dilute excess serum electrolytes Example: 0.45 percent Saline Isotonic Used to expand volume and maintain normal tonicity Example: 0.9 percent Saline, Lactated Ringer’s, 5 percent Dextrose © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Normal Serum Osmolarity (Continued) Hypertonic Used to correct electrolyte imbalances Example: 5 percent Dextrose and 0.9 percent Saline 5 percent Dextrose and Lactated Ringer’s © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV Sites Peripheral Central line Rate of infusion should not exceed 200 mL in one hour Central line Accommodates larger concentrations and volumes of fluid © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV Sites (Continued) Complications Phlebitis Infiltration Infection © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Standard Straight Gravity Flow IV © Cengage Learning 2013 © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV with Piggyback (IV PB) © Cengage Learning 2013 © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV Flow Rate Ordered by physician Nurse’s responsibility to regulate, monitor, and maintain flow rate © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV Flow Rate: mL per hour Regulate an IV volume by electronic infusion pump or controller calibrated in mL per hour © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Calculation of IV Flow Rate: mL per hour Order: D5W 250 mL IV over the next two hours by infusion pump Step 1: Think If 250 mL is to be infused in two hours, how much will be infused per hour? © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Calculation of IV Flow Rate: mL per hour (Continued) Step 2: Use the formula Set pump at 125 mL per hour © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV Flow Rate in mL per hour: Infusion Rate is less than 1 hour (rounded to a whole number) Order: Ampicillin 500 mg IV in 50 mL D5NS in 30 min by controller © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV Flow Rate in mL per hour: Infusion Rate is less than 1 hour (Continued) Step 1: Think Controller is set by the rate of mL per hour If 50 mL is to be infused in 30 minutes 100 mL will be infused in 60 minutes Set rate of controller at 100 mL per hour to infuse 50 mL per 30 min © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV Flow Rate in mL per hour: Infusion Rate is less than 1 hour (Continued) Step 2: Calculate © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV Flow Rate: Drops per min Formula for IV flow rate for manually regulated IVs ordered in mL per hour or for minutes Calibration or drop factor (drops per mL) Volume (mL) Time (min) gtt per min © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

IV Flow Rate: Drops per min (Continued) Carry calculations to one decimal Round drops per min to the nearest whole number Watch Count only whole drops © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Calculation of Drops per min Physician orders D5W IV at 125 mL per hour Infusion set is calibrated for a drop factor of 10 drops per mL Calculate IV flow rate in drops per min Notice that the mL cancel out, leaving drops per min © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Calculation of Drops per min (Continued) Use your watch to count drops and adjust roller clamp to deliver 21 drops per min © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Calculation of Drops per min: Microdrop Drop Factor When IV drop factor is 60 drops per mL (microdrop sets) Flow rate in drops per min is same as volume ordered in mL per hour © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Calculation of Drops per min: Microdrop Drop Factor (Continued) Order: D5W NS IV at 50 mL per h Drop factor is 60 drops per mL Notice order, 50 mL per hour, is the same as the flow rate of 50 drops per min when drop factor is 60 drops per mL © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.

Calculation of gtt per min: Microdrop Drop Factor © 2013 Delmar Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part.