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.
Specializes in Jack of all trades, and still learning.
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...
Specializes in Jack of all trades, and still learning.
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."
Wow. :uhoh3:
If you can't follow your textbook, how can you read your lecturer's mind?
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.
LOL... me either! I thought it was such a simple question. I just did 125 x 24. But once I read the post I saw what the OPs were saying.
Specializes in Critical Care, Emergency, Education, Informatics.
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:
First of all this is a math test not a nursing test. At least the question is. Your reading way to much into it. And no the question isn't a med error. It simply states if you were running an IV at 125 an hour and they were 1000cc bags how much fluid in 24 hours.
It is however a bad question in that it SHOULD be more in tune with realities of nursing.
First of all this is a math test not a nursing test. At least the question is. Your reading way to much into it. And no the question isn't a med error. It simply states if you were running an IV at 125 an hour and they were 1000cc bags how much fluid in 24 hours.
It is however a bad question in that it SHOULD be more in tune with realities of nursing.
yup, it was a BADLY worded question, however, YOU are assuming facts not in evidence, shall we say......the question doesnt say "using 1000ml bags" how much would pt get....it says 1000 ml at 125 an hour......if any subject in nursing should be concrete it would be math, no?
Lol! Excellent eye for catching that! In the real world, if I saw an order written that way, the patient would get 1000 ml. Of course, depending on the patient's condition, I may get a clarification on the order. But you're right, it doesn't say "Q 8H". If I'm coming on duty, and the order has been checked off, then it appears that the amount was administered and it's done.
Regardless of what your instructors end up saying the right answer is...you know that "critical thinking" and "nursing judgement" that you hear so much about? Well, you just displayed it, and it's still early in your learning. Congrats! You're gonna do well. (And it will drive you crazy when you're looking at a test and one answer you know is right, while the other is the one you know they're looking for. Yeah, have fun with that! )
I do not find anything confusing with that order, and think that many of you are reading much more into it. Even if you contact most pharmacists in your facility, you would get the same answer that I am going to give to you.
Physicians or other providers are going to write for the maintenance fluids to run at 125 ml/hour until they stop it. If they wanted only one liter, then it would state x 1 liter, and then saline lock, etc.
You run fluids at 125/hr and over a 24 hour period that is 3000 ml or 3 liters. This is how you would answer it on the NCLEX exams as well. Same way when TPN is ordered, the additives are added and calculated per 1000 ml of fluid, you do not run 1000 ml and then stop it.
Nursing is based on common sense and that needs to be included as well. If the provider only wanted one bag here, then they would have included what they wanted next to be done, and the instructions would have been given for what was to follow such as lower rate to 60 ml/hr or saline lock the site, etc.
Unless it is given a specific time to stop it continues, and some facilities require that IV orders be rewritten every 24 hours, and then you would follow that, but in the real world of nursing, this order would continue, there is nothing there that states to stop it or that it was specifically for one bag only.
I do not find anything confusing with that order, and think that many of you are reading much more into it. Even if you contact most pharmacists in your facility, you would get the same answer that I am going to give to you.
Physicians or other providers are going to write for the maintenance fluids to run at 125 ml/hour until they stop it. If they wanted only one liter, then it would state x 1 liter, and then saline lock, etc.
You run fluids at 125/hr and over a 24 hour period that is 3000 ml or 3 liters. This is how you would answer it on the NCLEX exams as well. Same way when TPN is ordered, the additives are added and calculated per 1000 ml of fluid, you do not run 1000 ml and then stop it.
Nursing is based on common sense and that needs to be included as well. If the provider only wanted one bag here, then they would have included what they wanted next to be done, and the instructions would have been given for what was to follow such as lower rate to 60 ml/hr or saline lock the site, etc.
Unless it is given a specific time to stop it continues, and some facilities require that IV orders be rewritten every 24 hours, and then you would follow that, but in the real world of nursing, this order would continue, there is nothing there that states to stop it or that it was specifically for one bag only.
The question actually said, "the doctor has written an order for 1000ml for your patient". I always thought you had to follow the order that the doctor had written.
Apparently not though, cause I got that one wrong!
However, I asked our DON and she said giving the 3000mL would require reporting a med error to the patient's doctor.
Your not assuming what the Doc wrote, it's a Medical Math question and not a Nursing question.
craig.....it may be a math question, but as you quoted it is MEDICAL MATH. and by virtue of being in a NURSING course it is a nursing question....i have been reading orders for 20 plus years , and i would not execute this one as anything more than one liter...if they want more , WRITE IT THAT WAY
:uhoh3:
(And it will drive you crazy when you're looking at a test and one answer you know is right, while the other is the one you know they're looking for. Yeah, have fun with that! 
)
nyapa, RN
995 Posts
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...