math help

[cybergal]

Our teachers threw this out to us and noone has a clue : it is not in our book....go figure

1. a. An adult patient has an order for Vancomycin 160 mg q 8h. The patient's IV access is a central line. According to the medication manual what is the maximum concentration that should be administered?

b. What is the minimum amount of fluid the nurse should mix the ordered dosage in to infuse at the proper dilution? Is it 500mg/100mL

c. What is the recommended rate at which the medication should be delivered? is it 3.2mL

2. Robert has an IV order of 8mg Lasix (furosemide) for an adult patient now.

Which of these demonstrates correct implementation of this order?

a. Dilute in 8mL NS and infuse over 30 min.

b. Give IVP over 3-5 min.

c. Dilute in 4 mL NS and give over 1 hr.

d. Give IVP at

[Daytonite, BSN, RN]

most everywhere i've worked vancomycin was mixed in 250cc of normal saline or d5w. vancomycin is pretty irritating to the peripheral veins. i don't know which medication manual your instructor is referring to, however, with a central line, assuming the tip of it is in the vena cava of the heart, you should be able to safely mix 160mg of vancomycin in 100cc of normal saline of d5w and infuse it over 60 minutes. also, in most facilities i've worked therapeutic vancomycin levels were drawn from time to time and the lab was very picky about the vancomycin being infused over a 60 minute period of time, that it has something to do with the blood levels of the drug. vancomycin produces a very distinct adverse effect called "red man syndrome" if infused too rapidly. i have nothing in writing to back all of that infusion time information up. i'm trying to find it on the internet and not being successful.

http://www.musc.edu/pharmacyservices/ - this is a chart of iv push medications from the medical university of south carolina - you will see that it advises that lasix (furosemide) should not be pushed any faster than 10mg per minute. it states "furosemide doses of 100 mg or less should not exceed 10 mg/minute. doses greater than 100 mg should not exceed 4 mg/minute." i would push this medication directly into the patient's iv over a one minute period. however, that is not one of your answer choices. i don't know what source your instructor is using. so, i would say, yes, d is the probably the answer.