Hey everyone! I need some help with this problem. I want to know how to work it out, not just the answer please! Any help would be very much appreciated! A 10 year old child is to receive Zosyn 750 mg IVPB q12h. The drug book states: dilute 10-20 mg/ml and administer over 30 minutes. The pharmacy has sent up Zosyn 800 mg in 15 ml. How should the nurse dilute and administer this medication?A. Add medication to a 25 ml bag of fluid and administer at 80 ml/hr with a VTBI of 40.B. Add medication to a 50 ml bag of fluid and administer at 100 ml/hr with a VTBI of 50.C. Add medication to a 100 ml bag of fluid and administer at 230 ml/hr with a VTBI of 115.
Music in My Heart 2 Articles; 4,102 Posts Specializes in being a Credible Source. Has 13 years experience. Jan 9, 2012 Hey everyone! I need some help with this problem. I want to know how to work it out, not just the answer please! Any help would be very much appreciated! A 10 year old child is to receive Zosyn 750 mg IVPB q12h. The drug book states: dilute 10-20 mg/ml and administer over 30 minutes. The pharmacy has sent up Zosyn 800 mg in 15 ml. How should the nurse dilute and administer this medication?A. Add medication to a 25 ml bag of fluid and administer at 80 ml/hr with a VTBI of 40.B. Add medication to a 50 ml bag of fluid and administer at 100 ml/hr with a VTBI of 50.C. Add medication to a 100 ml bag of fluid and administer at 230 ml/hr with a VTBI of 115.This is a lousy problem because none of the choices is actually correct... However, answer {C} is arguably the best of the three.For simplicity, I'll just brute-force it and solve each choice...{A}Find the concentration800 mg----------------15 mL + 25 mL800 mg/40 mL = 20 mg/mL (acceptable, at the high end of the range)Calculate the quantity (mass, actually) of medicine given:20 mg/mL x 40 mL = 800 mg (too much... by 7%)Calculate the administration time:40 mL-----------80 mL/hr40/80 = 0.5 hours or 30 mins (acceptable){B}Following same approach:Concentration = 800 / (50 + 15) = 12.3 mg/mL (acceptable)Quantity = 12.3 mg/mL x 50 mL = 615 mg (too low by 18%)50/100 = 30 min (acceptable){C}Following same approach:Concentration = 800 / (100 + 15) = 7 mg/mL (too low... though not really problematic)Quantity = 7 mg/mL x 115 mL = 805 mg (too high by 7%)230/115 = 30 min (acceptable)I pick choice {C} because the lower concentration is easier on the veins but still delivers the requisite amount of medication in the ordered time. One could argue in favor of {A} by stating that the smaller volume is preferable in a child but a 10-year-old probably weighs about 35 kg or so and a volume of 3 mL/kg is pretty minimal and not likely to create any issues in a kid without renal or cardiac problems.I wouldn't be cool giving a dose 7% higher than the one ordered, though... would have to seek MD clarification before I gave it... Or better yet, just add the 15 mL dose to a 50 mL bag and give 61 mL at 122 mL/hr... and say "pshaww" to stupid multiple-choice questions....
MrChicagoRN, RN 2,589 Posts Specializes in Leadership, Psych, HomeCare, Amb. Care. Has 30 years experience. Jan 9, 2012 a 10 year old child is to receive zosyn 750 mg ivpb q12h. the drug book states: dilute 10-20 mg/ml and administer over 30 minutes. the pharmacy has sent up zosyn 800 mg in 15 ml. how should the nurse dilute and administer this medication?a. add medication to a 25 ml bag of fluid and administer at 80 ml/hr with a vtbi of 40.b. add medication to a 50 ml bag of fluid and administer at 100 ml/hr with a vtbi of 50.c. add medication to a 100 ml bag of fluid and administer at 230 ml/hr with a vtbi of 115.not sure what is meant by the highlighted text, except as a primary dilutent (which the pharmacy does). official fda information is:"reconstituted zosyn solution should be further diluted (recommended volume per dose of 50 ml to 150 ml) in a compatible intravenous solution listed below. administer by infusion over a period of at least 30 minutes. during the infusion it is desirable to discontinue the primary infusion solution."[color=#333333]that information instantly eliminates one answer. of the other two choices, the rates would would infuse one in exactly 30 minutes, while the other would infuse in at a little more than 1/2 hours.is this question purely math,or does it involve critical thinking? i.e. how much & how fast do you want to infuse into a 10 year old?
