Nursing Students Student Assist
Published Aug 13, 2013
Problem: Give magnesium sulfate5 grams deep IM in each buttocks. The stock is 10ml ampule at 250 mg/ml. How much will you prepare for each buttocks?
Esme12, ASN, BSN, RN
1 Article; 20,908 Posts
It drove me crazy all the way through Esme, both because they stressed giving the correct dose, AND gave us these crazy questions where we had no way to actually learn what the correct dose was. I look everything up now but it would have been nice to at least have an idea of what average doses were for meds.
Thank you for affirming what I have known all along...they should be ashamed....
RLtinker, LPN
282 Posts
I have to agree with Esme and Grntea. 5g is not a normal IM dosage of Magnesium (1g IM is a normal adult dosage), besides after looking up this medication it is supplied as 5g/10ml. Higher dosages like this are usually given in an IV solution.
MendedHeart
663 Posts
^^^That is not true at all. Reference a drug guide, it states that it is an appropriate dose
CountryMomma, ASN, RN
589 Posts
This is what drives me NUTS!!!!!!!!Nursing programs have every opportunity to teach proper pharmacology in the dosages class by emphasizing the proper dosing of meds instead of these bizarre math questions. It shows me one of two things1) The nursing instructors are too lazy to ensure correct dosage is applied to the problem AND2) The nursing instructors despite their advanced degrees lack the clinical expertise to know the correct/real life dosage themselves which is sad......OR MAYBE3) They are trying to teach you critical thinking skills to know when to say,,,this isn't right. OP ......... we are happy to help with homework but we will NOT do it for you. Our goal is to help you understand the math......NOT give you the answer. I need to see what you don't understand.Show us your work and we will be happy to help.
Nursing programs have every opportunity to teach proper pharmacology in the dosages class by emphasizing the proper dosing of meds instead of these bizarre math questions. It shows me one of two things
1) The nursing instructors are too lazy to ensure correct dosage is applied to the problem
AND
2) The nursing instructors despite their advanced degrees lack the clinical expertise to know the correct/real life dosage themselves
which is sad......
OR MAYBE
3) They are trying to teach you critical thinking skills to know when to say,,,this isn't right.
OP ......... we are happy to help with homework but we will NOT do it for you. Our goal is to help you understand the math......NOT give you the answer. I need to see what you don't understand.
Show us your work and we will be happy to help.
Actually we had a couple of questions like this in my Medical-Surgical class quizzes and exams. It wasn't laziness on my instructors' parts (at least I don't think so...) as the answer they were looking for was "This is a suspect dose, I would verify the order and my math". Then the typical dosage range and why that answer was suspect was clarified in the rationale.
I agree that is the case sometimes...I have always hoped that was the case....and I believed it was all about the math....however I have found during tutoring that is not always the case....I believe you need to teach the normals so that when something unusual crosses one's path...alarm bells go off.
While 5gms of MGSO4 can be given IM the total dose it broken into 2 IM injections......the total mL's here is too great for even that.
[TABLE=class: formula]
[TR]
[TD][TABLE=class: fraction]
[TD=class: numerator]Ordered
[/TD]
[/TR]
[TD=class: denominator] Have [/TD]
[/TABLE]
[TD] x Volume Per Have [/TD]
[TD] = Y (Liquid Required)[/TD]
http://www.dosagehelp.com/liquid.html
Jill2Shay
131 Posts
Which muscle is this supposed to go in? We've learned to NEVER EVER EVER give IM injections in the Dorsal Gluteal.
I know that these days it is not a "favored" site
4 Risks associated with dorsogluteal site•Must avoid the sciatic nerve•Must avoid the superior gluteal artery•Increased incidence of injecting into fatty tissue•Not used in infants •Not used in toddlers until walking
•Must avoid the sciatic nerve
•Must avoid the superior gluteal artery
•Increased incidence of injecting into fatty
tissue
•Not used in infants
•Not used in toddlers until walking
Interesting. Our instructors were ADAMANT to NEVER give an injection there and that we should never let anyone give us an injection there. We didn't even learn the landmarks.
They said the evidence for causing permanent damage was too great.
We learned Ventrogluteal instead.
NRSKarenRN, BSN, RN
10 Articles; 18,355 Posts
Gave Dorsal Gluteal IM x 25 years, especially Bicillian LA as needs deep muscle.
It is an acceptable site for adults, especially for thick highly irritant meds.
Evidence based practice suggests using other sites first, but still can be used.
Interesting. Our instructors were ADAMANT to NEVER give an injection there and that we should never let anyone give us an injection there. We didn't even learn the landmarks. They said the evidence for causing permanent damage was too great. We learned Ventrogluteal instead.
Then that is your schools choice....however it remains an acceptable injection site for deep IM.
Evidenced based practice research studies do suggest ventrogluteal site as having least reported complications.
Site selections for IM medications involve more than "just use ventrogluteal site"
Injection considerations:
a. client age
b. body size
c. muscle wasting /skin disruption/decubitus ulcers
d. Drug viscosity/irritants
e. Drug volume
f. Needle size recommended for site + needle availability
Great powerpoint: Best practice in intramuscular injections
Regarding drug problem: don't give amount of drug being requested in ONE or even TWO injections as volume too large.