Med Math Matters: A Case Study

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Specializes in Med-Tele; ED; ICU.

This is summarized from a case I had yesterday. I present it just to tell you that 'med math' does matter and that you can't always rely on the pharmacy or an IV pump.

Don't just get through the class, learn the topic... it matters.

The patient is a 57 year old male with a priapism in its 40th hour of duration. The initial treatment plan is for the physician to administer up to three injections of phenylephrine into the man's member. Each dose is 0.2 milligrams. What the pharmacy has supplied is a vial of phenylephrine, 10 milligrams in 1 milliliter. Your doc is very busy and is expecting you to supply him with what he needs in order to walk in to the room and do what needs doing.

Here are your questions:

1) What is the expected action of phenylephrine in this case?

2) Does the use of phenylephrine give you any pause?

3) What would you draw up?

4) What type of needle would you supply?

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3) What would you draw up?

I wouldn't draw up any until the doc is there to watch. Why? Because I would never, never, never administer any med that I didn't draw up myself or watch it being done (unless it came from the pharmacy suitably labeled or came in a premix from the manufacturer).

(I leave it to others to discover the other answers, LOL)

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Specializes in Med-Tele; ED; ICU.
I wouldn't draw up any until the doc is there to watch. Why? Because I would never, never, never administer any med that I didn't draw up myself or watch it being done (unless it came from the pharmacy suitably labeled or came in a premix from the manufacturer)

Interesting...

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Specializes in SICU, trauma, neuro.

I'm confused...based on the title I was expecting a story of an error based on erroneous math, and the consequences to the pt.

No disagreement, though. I've told this story on here before, but I once received a prefilled oral syringe from the pharmacy that based on the stated concentration and ordered dose, had 2x the ordered dose of Tegretol. The barcode scanned with no warning becasue the system "assumed" that the dose listed on the label was correct. Well the label WAS correct--the contents of the syringe was not.

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Interesting topic and gave me the opportunity to read up on something unfamiliar to me.

And what gave me pause was "40 hours" :dead:

I'll wait a couple of days and see if anyone else offers up answers. Meanwhile I'll keep my little piece of paper with my answers :)

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
This is summarized from a case I had yesterday. I present it just to tell you that 'med math' does matter and that you can't always rely on the pharmacy or an IV pump.

Don't just get through the class, learn the topic... it matters.

The patient is a 57 year old male with a priapism in its 40th hour of duration. The initial treatment plan is for the physician to administer up to three injections of phenylephrine into the man's member. Each dose is 0.2 milligrams. What the pharmacy has supplied is a vial of phenylephrine, 10 milligrams in 1 milliliter. Your doc is very busy and is expecting you to supply him with what he needs in order to walk in to the room and do what needs doing.

Here are your questions:

1) What is the expected action of phenylephrine in this case?

2) Does the use of phenylephrine give you any pause?

3) What would you draw up?

4) What type of needle would you supply?

Even if you are "teaching us"....seasoned nurses know the answer.

Please share with us what you think and we will jump right in. What has your research of phenylephrine reveal to you?

In reality...I would not draw up anything. I would assemble all the necessary things and a variety of needle sizes, calculate in my head what the appropriate dose would be, and await the MD's presence.

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