Question

"Pica," is a 43 lb. Labrador Retriever puppy weighing 42 lb. He is post-operative for a foreign body but continues to vomit despite receiving several different drugs to decrease vomiting. At 8 AM rounds, the veterinarian orders you to begin a CRI of metoclopramide at a dosage of 2 mg/kg/day after administering a loading dose of 0.4 mg/kg IV. The concentration of metoclopramide is 5 mg/mL. Pica is receiving 0.9% NaCl IV currently. He is still 6% dehydrated and vomited 5 cups overnight. By the time you have completed the calculations, he will be ready for a new 1 L bag of fluids. a. What is the general name for the group of drugs that prevent vomiting? b. Why is sodium chloride a better choice for this puppy than a balanced electrolyte solution? c. Since it is the start of a new 24 hour cycle, calculate Pica's fluid requirement for the next 24 hours. d. What is his rate per hour? e. What is his flow rate? f. Calculate the loading dose of metoclopramide g. Calculate how much metoclopramide you will add to the new bag of fluids.

Health and Science Medical Mathamatics course. For Vetrinary Nursing /Technicians course. We are learning Constant Rate Infusion. I need help. Thanks in advance.

Answer 1

a) Antiemetic- is the general name of the drugs that prevent vomiting.

b)NaCl is better because NaCl is a isotonic drug which has equal concentration as body fluid.

c)Fluid requirement = Body weight(lb) × dehydration (decimal)×500

So, 43 × 0.06× 500=1290ml

d) Rate per hour=volume of fluid ÷ no of hours

1290÷24=53.75 or 54 drops per minute

e)Flow rate = (total fluid × drop factor )÷ time in minutes

    (1290×54)÷ 24×60=54.42 ml/min or 54 ml/min

f)Loading dose- a dose of drug sufficient to produce a plasma concentration that fall within therapeutic effect .

Loading dose is already giving 0.4ml/kg

g)Metaclopramide need to add in bag =

(Desired dose × quantity) ÷ available dose

= (2 ×1)÷ 5 = 0.4 ml

h) Tachypneic - it is the increase of breath rate fast and shallow ,over 35-40breaths /min

Tachycardic-it is the increase in the heart rate ,usually more than 140bpm.

j) Tachycardia and Tachypneic is associated with dehydration in the body .It is the body response against dehydration . More borborygmus sounds present.

k) Morphine volume = desirable dose × quantity in available dose ÷ available dose

=(4×1)÷15=0.25 ml

L)Special consideration while giving morphine is to continuously check respiratory rate as it causes respiratory distress.

M)No , Metaclopramide and morphine are not compatible as they both decrease their therapeutic effects of drugs using them simultaneously