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Discussion

First Semester Student IV Fluid Orders

Hello!

I am a first semester student and I am having trouble reading the orders for IV fluids. Today I had a practice order that said:

Fortaz 2 grams IVPB every 12 hours

I know Fortaz is an antibiotic but my trouble is that it says "every 12 hours." Is "every 12 hours" the same as saying "over 24 hours." I'm having trouble doing IV fluid calculations and I'm just trying to make sure I'm reading the order right.

Thank you!

Featured Replies

  • Author

I meant to write:

Is "EVERY 12 hours" the same as saying "OVER 12 hours."

No. "EVERY" 12 hours is NOT the same as "OVER" 12 hours. "EVERY" suggests frequency, "OVER" suggests rate.

  • Author

Okay thats what I thought. So if the Practice MAR and doctor's order that we use in open lab doesn't state the infusion rate, I'm not able to calculate anything right? Because all of the orders just say:

Fortaz 2 grams IVPB every 12 hours

And thats all it gives me.

Thank you for your help! :)

Yes, you can calculate an infusion rate based on that info alone... if you have your drug book. The drug book will give you compatible solutions and volumes to reconstitute with, as well as the infusion time (AKA the time in which you give the medication "OVER" ;))

  • Experts
Okay thats what I thought. So if the Practice MAR and doctor's order that we use in open lab doesn't state the infusion rate, I'm not able to calculate anything right? Because all of the orders just say:

Fortaz 2 grams IVPB every 12 hours

And thats all it gives me.

Thank you for your help! :)

First define what an IVPB medicine is......these meds are given intermittently at scheduled intervals over a short period of time.

That time varies with each medicine but the "common amount" of time is to give over 15-30 min and some are up to an hour. LOOK UP YOUR MEDS

Now if all that you see on your MAR is

Fortaz 2 grams IVPB every 12 hours
You know that every 12 hours it will be time to give this med. Now look up Fortaz and find out how fast this medicaine can be given IVPB.......

CEFTAZIDIME (FORTAZ ®)Â* -Â* Intravenous (IV) Dilution

Standard Dilutions [Amount of drug] [infusion volume] [infusion rate]

[0 to 1 gram] [50 ml] [30 min]

[ Over 1 gram] [100 ml] [30 min]

now what would you set the pump at to infuse the fluid over a half hour.

http://www.dosagehelp.com/

  • Author

So you would just set the pump to infuse 100ml in 30 minutes right?

Thank you to the both who have replied!

  • Experts

Yes if it is mixed in 100ml's..:) You're welcome

incomplete order in my opinion. The MD should have included the rate. Basically the order would mean to mean that I hang it at 0800 and 2000. But I would have to "guess" what the rate should be, and it might differ from what the MD intends. I would clarify with MD and look up preferred dosage in a good reference then document why I did what I did.

Well technically the 7 rights of med admin does not address rate just frequency and time. Either the pharmacy or MD will set rate however I sometimes have to check the drug guide if not specified on the MAR but I ALWSYS check the drug guide any way of ALL IV meds for rate, reconstiution and compatability. I also check drug guide for PO meds I dont know

Our doc don't specific the rates of piggybacks. You go by standards set by the manufacturer. Smart pumps already have the infusion time plugged in or the drug guides have them the listed. The only time I've seen a doc write a rate order for a piggy back is when the infusion time is specifically different than what is recommended. I know one doc that likes Zosyn to infuse over 3 hrs. Other than that, all I see is the med, the dose, route, and how often.

Our doc don't specific the rates of piggybacks. You go by standards set by the manufacturer. Smart pumps already have the infusion time plugged in or the drug guides have them the listed. The only time I've seen a doc write a rate order for a piggy back is when the infusion time is specifically different than what is recommended. I know one doc that likes Zosyn to infuse over 3 hrs. Other than that, all I see is the med, the dose, route, and how often.

Same. The only time the rates were in the order when I worked in the hospital was when the pharmacy put them in. And even then they weren't always right. The computer order entry system sometimes automatically would populate that part of the order so for a patient on Vancomycin, the order always read "over 60 minutes". This was true even if the patient had a history of a Redman's reaction because the doctors rarely paid attention to that. We knew that it was the standard to infuse Vanco over 2 hours in a patient with a history of Redman's (at least at my hospital that was the standard), so we did what we knew was right.

OP, this is not an IV fluid order. This is an order for an intermittent IV antibiotic. Whether you have to set the pump to infuse 100 mL in 30 minutes or to infuse x mL/hr depends on the kind of pump you're using.

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