How should i round this based on the given rounding rules?

Nursing Students Student Assist

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Rounding Rules:

parenteral

Intravenous infusion by gravity (gtts/min): round to a whole number

Intravenous infusion by pump (mL/hr): round to the nearest tenth

Injectable medications:

  • For any volume less than 1 mL, round to the nearest hundredth
  • For any volume greater than 1 mL, round to the nearest tenth

ENTERAL

Oral/NGT/PEG/J Tube:

  • For any volume less than 1 mL, round to the nearest hundredth
  • For any volume greater then 1mL, round to the nearest tenth

WEIGHT:

POUNDS TO KILOGRAMS CONVERSIONS: round to the nearest tenth

___________________________________________

Question:

  1. The prescriber orders Nitroprusside 5 mcg/kg/min. The medication available is labeled Nitroprusside 200 mg /250 mL.

Patient weight: 205lbs

Calculate the rate on the pump.

Answer: 35.3 mL/hr (according to the answer key it says the answer is 35, but based on the rounding rules, wouldn't the answer be rounded to the tenth?)

@ loveofrn: How is 34.94 rounded to 35 if you are rounding to the tenths place?

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Again: how does 34.9 become 35 if you are rounding to the tenths place? 35 is not considered rounding to the tenths place and it is considered wrong on an exam, and I can only afford to get one wrong on this drug calc exam in order to pass and ROUNDING MATTERS. Tenths place is one spot to the right of the decimal so I am confused as to why people are rounding to 35. If the answer came to 34.95 I can understand why it would be rounded to 35...... but if the answer was 34.94, why are people rounding to 35???????

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Again: how does 34.9 become 35 if you are rounding to the tenths place? 35 is not considered rounding to the tenths place and it is considered wrong on an exam, and I can only afford to get one wrong on this drug calc exam in order to pass and ROUNDING MATTERS. Tenths place is one spot to the right of the decimal so I am confused as to why people are rounding to 35. If the answer came to 34.95 I can understand why it would be rounded to 35...... but if the answer was 34.94, why are people rounding to 35???????

That's correct, 34.94 would be 34.9 when rounding to the tenths place. 34.95 is 35 rounded to tenths place.

:)

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Specializes in SICU, trauma, neuro.
Actually, there are many pumps that allow you to do this and with infants and children it's important to have this ability.

Yup, and for vasoactive drips where your dose is titrated by hundredths. Granted we use the Dose Guard mode for critical care meds (where you program in the drug concentration, dosing weight, and dose--mcg/kg/min, units/hr, however the drug is dosed) and the pump calculates the drip rate. But for drugs that are titrated in tiny increments--such as Levo which you generally adjust by 0.01-0.03 mcg/kg/min, it's very important to be accurate.

As far as programming basic infusions in ml/hr, I know for sure we can enter at least tenths. I'm drawing a bit of a blank right now, but I want to say we can go down to hundredths.

I guess in practice, with a drug like Nipride I would want to be as precise as possible. So if the pump allows you to program tenths, I'd program tenths.

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Plus, the difference between 34.9 and 35 ml/hr is only 0.00287%

Almost... the difference is actually 0.287%...

Regardless:

and totals 2.4 ml over the entire 24 hours.

The difference is insignificant.

It seems that rational thought like MrChicago's is not emphasized in some nursing school math classes.

But since the teacher said:

Rounding Rules:

parenteral

Intravenous infusion by pump (mL/hr): round to the nearest tenth

DO NOT

round off to the nearest whole number.
Rather, parrot back what the teacher wants to hear... correct or not...

~~~

But of course, always

Remain calm
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