# Math Again

- 2Jan 22, '12 by RNrerunI'm doing some practice problems, and this is from nursesaregreat.com:

A procainamide drip is ordered (2 gm in 250 cc of D5W) to infuse at 4mg/kg/min. The patient weighs 165 lbs. Calculate the drip rate in cc/hr for which the infusion pump will be set at.

165 lbs = 75 kg

2gm = 200,000 mcg

4mg = .004 mcg

I'm trying to do the formula like this:

solution cc

__________ X 60min/hr X kg X mcg/kg/min = cc/hr

drug mcg

Am I doing this right? The answer should be 30, but that's not what I'm getting. I'm sort of hoping this problem has a mistake in it because it has fried my brain! I did, however, catch the preposition at the end of the sentence, so maybe I should have majored in English.GrnTea and oklahomagal like this. - 1Jan 22, '12 by jmdRN4mg = .004 mcg

4 MILIgrams (mg) = 4000 MICROgrams (mcg)

And.. why are you working it down to mcg when the question is asking for mg/kg/min?

Is it really suggesting you run it at 4mg/kg/min (which is a very HIGH dose) or did you have a typo there?

When you break down numbers/values to smaller-than-required values, you introduce a greater risk of decimal place errors.Last edit by jmdRN on Jan 22, '12GrnTea likes this. - 0Procainamide is administered intravenously or orally. When administered intravenously, a loading dose should first be given, though care should be taken not to cause hypotension. Procainamide's major active metabolite is N-acetyl procainamide (NAPA), which is approximately equipotent with the parent drug as an antiarrhythmic agent. NAPA has an elimination half-life about twice that of procainamide, and it can reach somewhat higher plasma levels during chronic procainamide administration. Loading dose is 100 mg IV bolus given slowly over 5 minutes. Max dose is 17 mg/kg. Use is discontinued when dysrhythmia is suppressed, or if hypotension ensues, QRS complex widens by 50% or more, or maximum dose is achieved.

Now the math.....you will find these very valuable

DosageHelp.com - Helping Nursing Students Learn Dosage Calculations

http://www.davesems.com/files/drug_d...lculations.pdf - 0Jan 22, '12 by JROregonI like dosagehelp.com. Simplifies the questions. Like jmdRN says don't "over" convert your grams and milligrams. If you have a problem with both mg and gm, just convert one to the other. When you are taking a test, make sure that you remember which is a larger mass. If you have 1 gram of something, it's going to be 1,000,000 mcg. I think you found a problem with a typo.
- 0Jan 22, '12 by KelRN215, BSN, RNWell, in your problem, you say the dose is in mg/kg/min and then you're trying to work out the answer in mcg/kg/min. So there's problem #1. 4 mg/kg/min seems like an extremely high dose of procainamide... 300 mg/min? Seems unlikely.
- 0Jan 22, '12 by RNrerunWow. Thanks for all the help. I'm going to assume there's something wrong with this problem. I'm trying to re-learn all these calculations that I haven't done in years and years, and it doesn't take much to confuse me. I have been using dosagehelp.com to practice, and I'll check out the other one that Esmel reccommended. I'll have to take a medications test at the hospital, and I'm trying to get all this straight in my head before I go in there!

Thanks!