Desperate Nursing Student! Help! On The Break Of Giving Up...

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Hello all!

I am having alot of trouble with med cal right now. I am a second semester BSN student and we have two med cal exams on the first day of school which is in a week and a half. I have done all the psych review problems as well as most of the med surg problems. However, their is a couple of the med surg problems I just can't get. I have tried over and over again and just can't get the right answer. I'm beyond frustrated. I have asked my professor for help and she just says look in the book which is no help either. I have looked through the books, my old notes and everything. Some of my classmates and I even tried to figure them out together and still had no luck. So, any help would be greatly appreciated!

The questions are:

1)You have Nexium (pantroprazole) 40 mg mixed in 250 ml of NS. The pump is set at 75 ml/hr. How long will it take for the medication to infuse?

2)The heparin protocol at your institution is: Bolus clients with 24 units/kg of body weight and start drip at 4 units/kg/hr. The client weighs 242 lbs.

A) Calculate the heparin bolus dosage.

B) Calculate the infusion rate for the heparin IV drip.

3)MD orders 2.5 L of D5W to infuse 150 ml/hr. Determine the infusion time.

4)Vancomycin 200 mg/250 ml NS is to be infused over 2 hours. How many ml/hr will the patient receive?

5) Cezol 1gm/100 ml is to be infused over 30 mins. How many ml/hr will you set the pump?

I'm at the point of giving up and the semester hasn't even officially started yet. :no::mad:

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Specializes in Pediatric Hematology/Oncology.

Show your work first. Most of these are no-brainer questions and it seems very likely that you're overthinking them (i.e. question 1 just wants a rate - how many hours would it take for 250 ml to run out when it is flowing out at 75 ml/hr - hint: the Nexium has nothing to do with the answer). Look at what it is really asking you to do.

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Specializes in Hospice, Palliative Care.

Good day, UofLRN16:

Can you show us what math you used for each question along with your answer to each question? Answer to question 1 is 3 hours, 20 minutes. 2A is 2,640 units. I can show you the math if you show me yours ;-)

Thank you.

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Specializes in NICU.

HINT: Just because there is a value (number) in a problem, does not mean that you need to use it to solve the problem.

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Pantoprazole is not Nexium... here's me hoping it was your mistake and NOT your instructors mistake!

Let me rephrase the question. 40 mg of Protonix (Pantoprazole) is mixed in with 250 mL of NS. Every HOUR 75 mL of those 250 mL will go into your pt. So how long will it take for it to infuse?

Both Protonix and Nexium are PPIs though. =)

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

These are very basic calculations please show us your work and we will jump right in. DosageHelp.com - Helping Nursing Students Learn Dosage Calculations

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Specializes in Neuroscience.

Esme has given you the best advice. Go to dosagehelp.com and practice until you understand these basic math problems.

I understand the fear and frustration that comes with math, but I assure you with enough practice you will have both the confidence and ability to do these math questions. Best of luck!

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Specializes in MICU.

1)You have Nexium (pantroprazole) 40 mg mixed in 250 ml of NS. The pump is set at 75 ml/hr. How long will it take for the medication to infuse

(250/75)=

2)The heparin protocol at your institution is: Bolus clients with 24 units/kg of body weight and start drip at 4 units/kg/hr. The client weighs 242 lbs.

A) Calculate the heparin bolus dosage.

(24 units/kg)*(242/2.2)=

B) Calculate the infusion rate for the heparin IV drip.

(4units/kg/hr)×(242/2.2)=

3)MD orders 2.5 L of D5W to infuse 150 ml/hr. Determine the infusion time.

(2500)×(1hr/250ml)*(60min/1hr)=

4)Vancomycin 200 mg/250 ml NS is to be infused over 2 hours. How many ml/hr will the patient receive?

(250ml/2hr)=

5) Cezol 1gm/100 ml is to be infused over 30 mins. How many ml/hr will you set the pump?

(100ml/30min)×(60min/1hr)=

Dont give up. Just keep practicing and pls buy this book.."calculate with confidence 6th edition by gray morris. I hope that helps to solve any other questions that is making you go gaga

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Specializes in Hospice, Palliative Care.

Good day, LoveOfRN:

For 2B with your advice of "(4units/kg/hr)×(242/2.2)=" would the answer units be in units/kg/hr? Should it not be in just units per hour since the weight is already being converted in the "×(242/2.2)" portion?

Thank you.

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Specializes in MICU.

Yeah thats a typo

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Specializes in Hospice, Palliative Care.

Hi LoveOfRN:

So what would be the correct version of the formula?

Thank you.

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For the Heparin drip question, it might be easiest to break the problem down into pieces:

A.) The question asks for units per kilogram so the very first thing you must do is convert weight 242 lbs into kilograms. How do you do that?

Do that problem.

Then, once you've got your answer, throw away the number 242. It no longer has any place at all in the problem. Forget it existed.

Now, it's as easy as multiplying the units of heparin by the weight in kg.

24 units x ? kg = ANSWER

kg

Notice how the units cancel out (the kg in this case).

*****If you have the problems set up correctly, the units should always cancel out to give you the answer in the units you need. If they don't, you know you've done the problem wrong.*****

Easy, right?

Now on to question 2B:

You know the weight in kg from your very first calculation.

You need to know units per kg per hour.

So:

4 units x ? kg = ? units

kg

That's how many units you need per hour.

Again, notice how the kg cancel out.

Now you have the answer to 2B. Hoorah!

For the other questions (which are all pretty basic division), imagine yourself holding a bag of fluid as big as the one in the question. For example, let's do question #1:

Say to yourself, "I've got a bag of 250ml of fluid. I'm going to run it at 75ml/hr."

After one hour I will have 175ml left (250ml-75ml).

After two hours I will have 100 ml left

(175ml left after 1st hour - 75ml).

After three hours I will have 25ml left

(100ml left after second hour - 75ml).

25ml left will take a third of an hour which equals twenty minutes.

So, it will take 3 hr. and 20 mins.

Of course, dividing 250ml by 75ml/hr is easier but thinking about it the above way might make it click for you.

Like some of the other posters mentioned, often times there is data mentioned that you don't need at all to figure out the problem (like the 40mg of Protonix). Try to figure out what data you need and what data you don't before even starting to figure out the answer. Don't let extraneous information confuse you.

Hope this helps.

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