Chapter 015 Med Mat.ppt
Transcript of Chapter 015 Med Mat.ppt
3/20/2016
1
1Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Chapter 15
Reconstitution and Dosages Measured in Units
2Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Objectives
Calculating drug dosage problems that first require reconstitution of a powdered drug into a liquid form
Using a proportion to solve problems involving drugs measured in unit dosages
Drawing a line through an insulin syringe to indicate the number of units desired
3/20/2016
2
3Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Units
A unit is the amount of a drug needed to produce a given result.
Common drugs measured in units. Epogen: a drug that increases the production of red blood
cells. Helps to combat the effects of anemia.
Fragmin: An anticoagulant that prevents the clotting of
blood. Used to prevent deep vein thrombosis. (DVT)
4Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
UnitsCommon drugs measured in units:
Penicillin: an antibiotic that reduces organisms within the
body that cause infection. (bacterial infection)
Heparin: an anticoagulant that inhibits clotting of the
blood. (a blood thinner)
Insulin: a hormone secreted by the pancreas that lowers
blood glucose. Used to treat Insulin dependent diabetes mellitus.
3/20/2016
3
5Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Administration Considerations: Penicillin
Ask patients whether they have had previous allergic reactions to penicillin.
Observe patients for signs of allergic reactions.
6Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Administration Considerations:Heparin
Doses that are too large might cause hemorrhage.
Doses that are too small might not produce the desired result.
3/20/2016
4
7Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Administration Considerations:Insulin
Doses that are too large might cause insulin shock.
Doses that are too small might result in a diabetic coma.
Available in prefilled insulin pens.
medcinenet
8Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Powder Reconstitution
Required when medication is unstable over long periods of time in its liquid form.
Must be performed before administration using a sterile diluent.• Diluent = a diluting
substance. Common diluents are sterile water, normal saline, dextrose solutions.
3/20/2016
5
9Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Powder Reconstitution (cont’d)
Method: Read information and directions on drug label
carefully.
Identify the type of diluent, amount of diluent, and route of administration.
Note the drug strength or concentration after reconstitution.
10Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Powder Reconstitution (cont’d)
Method (cont’d): Note the length of time that medication is usable
after reconstitution.
Note the directions for storage of reconstituted medication.
Video on desk top -- Reconstitution of a powder
3/20/2016
6
11Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Powder Reconstitution (cont’d)
Place on drug label after reconstituting: Your initials
Date and time of preparation
Date and time of expiration
12Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Oral-Dosage Problems (Dosages Measured in Units)
Example: Someone volunteer to go over this.
The physician orders penicillin V 300,000 units po four times a day. Penicillin V 500,000 units/2 mL is available. How many milliliters of penicillin V will be administered?
500,000units : 2mL :: 300,000unit : xmL
x = 1.2mL
3/20/2016
7
13Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Parenteral-Dosage Problems (Dosages Measured in Units)
Example: Another volunteer
The order states heparin 8000 units subcutaneous q8 h. Heparin 6500 units/mL is available. How many milliliters of heparin will be administered?
6500 units : 1 mL :: 8000units : xmL
x= 1.23 mL
14Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Reconstitution and Dosages Measured in Units
You have a vial of Penicillin opened and reconstituted with 4.6mL of solution. You receive an order for your patient to receive penicillin 300,00units now. How many mL will you give? Read the label carefully.
3/20/2016
8
15Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Monocid 975 mg IM every 6 hours has been ordered for a patient with colitis. How much diluent will be added to the bottle? What is the concentration after reconstitution? How many milliliters will the nurse administer?
16Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Insulin Given with a Lo-Dose Insulin Syringe
Example:
The order states Lantus U-100 insulin 36 units subcutaneous in AM. You have 10 mL of Lantus U-100 insulin and a U-100 Lo-Dose syringe. Draw a vertical line through the syringe to indicate the correct dose.
3/20/2016
9
17Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Insulin Given with a Lo-Dose Insulin Syringe (cont’d)
5 15 25 35 45 cc
10 20 30 40 50 units
1⁄2Lo-DoseLo-Dose
5 15 25 35 45 0.5 mL
10 20 30 40 50 units
18Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Mixed Insulin Administration
Guidelines: Inject air into each vial.
Draw insulin from regular insulin bottle first.
The practice of mixing insulins is decreasing with the rise in use of Lantus insulin.
“Clear before Cloudy”
http://www.youtube.com/watch?v=gizYDn2_0Io
3/20/2016
10
19Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Mixed Insulin Administration (cont’d)
Guidelines (cont’d): Remove any air bubbles found in syringe.
Draw insulin from cloudy insulin bottle.
Have another nurse check your insulin.
20Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Mixed Insulin Administration (cont’d)
Example:
Physician orders Humulin L Lente U-100 insulin 46 units plus regular Humulin R U-100 20 units subcutaneous every morning. You have 10 mL of Humulin L Lente insulin and 10 mL of regular Humulin R insulin. A U-100 insulin syringe is available. Draw vertical lines through the syringe to indicate the correct doses.
3/20/2016
11
21Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Mixed Insulin Administration (cont’d)
20 40 60 80 100 units
10
Insulin
30 50 70 90
Insulin
20 40 60 80 100 units
10 30 50 70 90
22Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
The physician has ordered 500,00 units of IV Pfizerpen every 4 hours. How much diluent will you add for a concentration of 500,000 units/mL?___________ How many milliliters will you administer?___________
3/20/2016
12
23Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
A physician orders penicillin G 750,000u IV for your patient with a bacterial infection. How many mL you give if you reconstitute this medicine with 33mL of solution?
1.5mL
24Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
The physician orders Cefobid 1000mg IV every 12 hours for a patient with an infection. How much diluent will be added to the bottle? What is the concentration after reconstitution? How many milliliters will the nurse administer?
3/20/2016
13
25Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Epogen 20,000units SQ is ordered for your patient with anemia. How many mL will you give?
2mL