I hope someone can help me, IVPB intake calculation

[studentmom77]

Hi, I really hope someone can help me, I have a quiz tomorrow and thought I knew what I was doing but now I'm not so sure.... It seems simple enough to calculate intake of IV fluids but I am confused regarding IVPB. As I understood it from class when you hang a piggy back the other fluid stops running, the piggy back runs, then it automatically switches back (assuming of course you are using a pump). So here are the practice problems our instructor gave us

1. An IV is infusing at 125mL/hr from 0700 to 1000. At 1000, the physician lowers the rate to 75mL/hr. The pt recieves the following IVPB medications: vancomycin 1g in 100 mL NS q8h and pantoprazole 80 mg in 100mL at 1100 & 2300.

Answer per instructor's answer sheet: IV intake was 950 for the 0700-1500 shift

I tried every combination and cannot for the life of me figure out how it's 950mL

2. pt is NPO. An IV of 1L D5/0.45 NS is infusing at 60ml/hr into one lumen of the pt triple lumen line. TNP is infusing into another lumen of the central line at 42mL/hr. The orders for IVPB include 2 medications during the day shift: one in 50mL D5W and one in 100mL D5W. What is the pt's intake for the 0700-1500 shift?

Answer per instructor's answer sheet: 966mL

So in this case I can see that it's the 8(60+42) plus the 100+50 D5W in which the medications were administered, but would the meds run in at the same time as the other 2 lines continue to infuse is it running into the 3rd lumen?

Is it possible that her answer is wrong for the 1st one? do you think it is safe to assume that the meds will not cause the other fluids to stop infusing unless it is stated otherwise? All the examples I can find in my dosage book state a time over which the meds will infuse and the other fluid will be suspended. Any insight is greatly appreciated, thank you.

[chare]

You don't provide administration time for the vancomycin in case 1, however if one dose was administered during this time then 950 mL is the correct answer.

If you are infusing the secondary infusion via gravity and roller clamp then the primary infusion is going to pause itself until the secondary infusion is completed.

If you are infusing the secondary medications via an infusion device, many devices allow you the option of administering the secondary medication either concurrently with the primary infusion or pausing the primary infusion and infusing the medication as a piggyback infusion.

[nikisashabell]

I calculated the 1st problem and did get 950ml. Usually the problem would state that via pb would halt primary but I guess not in this case. these are tricky!!!!

[studentmom77]

"You don’t provide administration time for the vancomycin in case 1, however if one dose was administered during this time then 950 mL is the correct answer."

That was how she wrote the problem, I'll take another look at that one, I guess I didn't realize that the devices let you run the 2 solutions concurrently so that answers my question Thanks a million!

[Esme12, ASN, BSN, RN]

especialy in hte case of a multilumen......all three can infuse simultaneously without interuption

This is the best dosage site I have ever found!

http://www.dosagehelp.com/

[studentmom77]

great site thanks! of course on our quiz today she stated that the meds were running simultanious with the other fluid so i was all set, thanks for all the help, i think i did pretty well on the whole quiz:)

[Esme12, ASN, BSN, RN]

great site thanks! of course on our quiz today she stated that the meds were running simultanious with the other fluid so i was all set, thanks for all the help, i think i did pretty well on the whole quiz:)

your welcome!

[marissa1981]

An IV is infusing at 125mL/hr from 0700 to 1000. At 1000, the physician lowers the rate to 75mL/hr. The pt recieves the following IVPB medications: vancomycin 1g in 100 mL NS q8h and pantoprazole 80 mg in 100mL at 1100 & 2300.

Answer per instructor's answer sheet: IV intake was 950 for the 0700-1500 shift

125mL x 3 hrs (0700-1000)

75mL x 5 (1000-1500)

100mL (the 1g vanco is in the 100mL NS and is given once during the 8 hr shift)

100mL (the 80mg is in the 100mL and is given 1 time during the 0700-1500 shift at 1100)

Add the numbers together and 950 is the answer!

[marissa1981]

pt is NPO. An IV of 1L D5/0.45 NS is infusing at 60ml/hr into one lumen of the pt triple lumen line. TNP is infusing into another lumen of the central line at 42mL/hr. The orders for IVPB include 2 medications during the day shift: one in 50mL D5W and one in 100mL D5W. What is the pt's intake for the 0700-1500 shift?

Answer per instructor's answer sheet: 966mL

480mL (60mL x 8 hr)

336mL (42mL x 8 hr)

50mL (given once during the day shift)

100mL (given once during the day shift)

Add them all together and 966mL for the day shift is the answer. Hope this helps a bit. Just look at the numbers to be added and ignore all irrelevant information.