Question

Ordered: IV KCl to infuse at 10 mEq per hour for a patient with hypokalemia Available: 500 mL NS with 40 mEq of KCl added premixed by pharmacy. Directions: "Recheck serum K levels when 40 mEq of KCI have been infused." a. What flow rate will you set on the infusion pump? DA equation: b. Evaluation: C. The IV was started at 1300 hours. At what time on the 24-hr clock would the nurse need to order and recheck a serum K level? - Infusing: regular insulin at 7 mL per hour IV. Available: Humulin regular insulin 100 units in 100 mL of NS. How many units per hour are infusing? a. Estimated units per hour: DA equation: b. Evaluation: C. What is the major potential adverse effect of an insulin overdose? Infusing: heparin at 30 mL per hour in an IV of D5W 250 mL containing heparin 10,000 units. a. How many units per hour are infusing? DA equation: b. Evaluation:

Answer 1

1. Ordered dose of IV KCL is 10mEq /hr

Available dose of KCL is 40mEq in 500ml NS

a) Using unitary method :

40 mEq of KCL is present in 500ml

1mEq of KCl will be present in 500ml/ 40mEq

Then 10mEq of KCL will be present in 500ml/40mEq × 10 mEq

= 500/40×10 = 500/4 ml

= 125 ml will have 10mEq of KCL

Flow rate to be set on the infusion pump is 125 ml /hour

b) Evaluation - Check the level of potassium after 4 hours to take actions if the potassium is not under normal reference range .

c) The IV infusion was started at 1300hrs, the nurse need to order and recheck a serum potassium levle at 1700 hrs.

2. Regular insulin infusion at 7ml /hr IV

Available dose of insulin (regular) is 100units in 100ml of NS

a) Units per hour :

Using unitary method :-

100ml of NS has 100units of regular insulin

1ml of NS will have 100units /100ml

Then 7ml of NS have 100ml/100units × 7ml

= 100/100× 7 = 7 units

b) Evaluation - check the blood sugar before having food and after administration of insulin ,after having food ,to ensure that blood sugar is under control or not .

c) The major potential adverse effect of insulin overdose is hypoglycemia .

3. Ordered dose of heparin 30ml /hr IV in D5W 250ml, containing heparin 10000units

a) Using unitary method :

250ml of D5W has 10000units of heparin

1ml of D5W will have 10000/250units of heparin

Then 30ml of D5W will have 10000/250 × 30 units

= 10000/250× 30

= 120units

b) Evaluation - Check the PT , INR ,PTT APT values