MedMath answer a med error?

Maybe a trick question? I'd only infuse what was ordered!

This is a question from a MedMath test I just took. I think the correct answer is actually a med error. I just wanted to see what others thought.

"Your patient has a doctor's order for 1000mL of NS to run at 125mL/hr. How many mL will your patient receive after 24 hrs?"

I answered 1000mL but the correct answer was 3000mL.

If the doctor orders 1000mL and you give the patient 3000mL wouldn't you have to report to the doctor that you gave their patient 3X's the prescribed dose?

To me it doesn't matter that the 1000mL would be totally infused in 8 hrs. If the order is for 1000mL then the patient should only receive 1000mL.

Can anyone explain this one to me? :nuke:

Interesting. I would think that if the physician wanted the NSS to run constantly, the order would read "Normal Saline IV @ 125 mL an hour to KVO." The 1000 mL is a specific dosage.

But you know, sometimes the people writing this material are rather uninformed. Academia doesn't always display common sense.

You are correct. As written, the order would automatically terminate after the first liter. Continuous infusions should be written as "NS @ 125ml/hr."

Good eye. Never assume anything beyond the order as written.

Oh, and I'd write the authors and ask them to change this one.

1000 mL is specific.

If the doctor wanted it to be continuous then it would have been ordered "125 mL per hour"

From my experience -- orders always read "NS @ 125 ml/hr - 1000 mL" and it is a given to change the bag as it runs out unless the doctor has written an order to discontinue the fluids.

You may only infuse 1000ml on your shift, but the question asked how many ml's would the pt receive in 24hrs. I beleive you read into the question to much.

i would have to agree with the OP, i think you cant ASSUME what the doc meant....and perhaps the real world answer would be to clarify the order...

You may only infuse 1000ml on your shift, but the question asked how many ml's would the pt receive in 24hrs. I beleive you read into the question to much.

Yeah, I think that's what the instructor will say.

I asked how the 3000mL was correct if the order stated 1000ml ordered and was told, "I'll have to get back to you on that".

By the way, I think our test questions on this MedMath test were written by our instructors. I don't think they pull them from a textbook.

We were also told early in the program that they wouldn't discuss answers with us. Whatever they say is correct will be considered correct.

From my experience -- orders always read "NS @ 125 ml/hr - 1000 mL" and it is a given to change the bag as it runs out unless the doctor has written an order to discontinue the fluids.

But what if the doctor wrote:

"NS @ 125 ml/hr - 250ml"

or

"NS @ 125 ml/hr - 2L"?

What purpose is served by specifying an amount if the amount is irrelevant?

You may only infuse 1000ml on your shift, but the question asked how many ml's would the pt receive in 24hrs. I beleive you read into the question to much.

yes, but the order was for 1000mL. that's it. unless the order was renewed or repeated, I would think that means the pt only gets 1000mL, what is ordered. hmmm.

so did you get that one right? what was the answer, according to instructor?

We were also told early in the program that they wouldn't discuss answers with us. Whatever they say is correct will be considered correct.

Welcome to nursing school. Rule #1: Learn what your instructors want and give it to them.

It can be frustrating when you are given a message like this. Critical thinking is one of the things drilled into you in nursing school, and then you'll get conflicting messages like this one.

I will never forget one of my first tests in nursing school. There was a question:

Caring requires action. True or False?

I answered false. I was told I was wrong, that caring always required action. I opened my textbook and read from the page: "Caring may or may not require action or verbal communication. The most caring act may be nonaction as desired by the client." My instructor looked at me, in front of the whole class, and said "Well, that's not what I believe." I learned that moment that I not only needed to know the material as presented in my text, but I also needed to know how my instructor felt about everything in my text. A tall order, indeed.

By the way, I found out from the next year's class that the question was still on that test, verbatim. Go figure.

I agree witht the original poster, though I have to be honest, I wouldn't have been clever enough to pick that up in an exam question. I would have made the assumption that the patient was receiving three litres over 24 hours.

Yet the OP is entirely correct. In the real world situation, the second bag could have been 4/24, and the third bag may have been 2/24. Who knows? Each bag is ordered separately!

I'd love to see what the instructor said. They cannot mark you wrong on your answer, surely...