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.
BTW, I asked my instructors during the test if I was to take the doctors order for the 1000mL literally and they said they "couldn't answer that question".
"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?"
THIS is the question in the op's first post. Not ""the doctor has written an order for 1000ml for your patient".
The 1000 ml differentiates what size bag of NS to hang up . . . there are 100 mls, 250 mls, 500 mls. Not how much NS to infuse.
So, this order to me says to hang a one liter bag of NS at a rate of 125ml/hr. And it doesn't limit it to one liter. Otherwise the doc would have written "X 1 liter".
Always though, when things are confusing, call the doc and clarify.
in 12 yrs of nursing, not once have i ever had an md order what size bag to hang.
never.
leslie
me either,lol....had them order a lesser volume, and sometimes a bolus to be followed by a maintainence rate.....but never, "go hang a thousand cc bag of NS"
leslei....do you think it might be geographic? we arent so far apart.....
ive "pahked my cahr in hahvahd yahd" (actually near the coop)....
me either,lol....had them order a lesser volume, and sometimes a bolus to be followed by a maintainence rate.....but never, "go hang a thousand cc bag of NS"
leslei....do you think it might be geographic? we arent so far apart.....
ive "pahked my cahr in hahvahd yahd" (actually near the coop)....
Our docs always write the size of bag they want . . .
1 liter NS at 125 ml/hr . . . . .means an IV running at 125ml/hr until he says STOP. And it wouldn't make sense to hang a smaller bag because then you have to change it too often. If you have fluids ordered and they are going to continue, it makes no sense to hang whatever bag is available. You go with 1 liter.
Our docs always write the size of bag they want . . .
1 liter NS at 125 ml/hr . . . . .means an IV running at 125ml/hr until he says STOP. And it wouldn't make sense to hang a smaller bag because then you have to change it too often. If you have fluids ordered and they are going to continue, it makes no sense to hang whatever bag is available. You go with 1 liter.
steph
correct, but that would be a nsg judgment.
if a nurse is stupid enough to keep on changing bags, that's on her.
the md's concern is the pt gets what s/he needs.
i'd raise both my eyebrows if a doc ever told me what size bag to hang.
To me, 1000mL @125/hr. means 1 liter infused at the rate given.
"NS @ 125/hr" means maintenance fluids continuously until given a stop order.
Two different things.
I honestly think it was one of those questions where extraneous numbers are thrown in to make sure the student can identify exactly what the question is asking and answer it appropriately ... but in this case someone failed to see that the extra info changed the meaning of the statement.
What is done outside of a hospital setting is something that may be different, but in the realm of the hospitals and that is what I go by when training nurses as well is to follow the instructions that are given as they are written. And if an order for only one liter, then it would tell you what they want you to do next such as hep lock or saline lock the line, or run it at TKO, etc.
125 ml/hour is standard maintenance level of fluid and is not excessive by any means, if the patient was to get a bolus, then it would be written as such or a dialysis patient that is dry. The docs will write for one liter at what ever rate and it will state x one liter only.
The question is asking what you would run in over 24 hours and I still stick with the answer that was in that book, 3000 ml. And I have always passed my math questions with 100% correct.
If the instructor could not answer you immediately, then that is where the issue is as well. This is just something that is based on common sense.
:D
jackson145
598 Posts
BTW, I asked my instructors during the test if I was to take the doctors order for the 1000mL literally and they said they "couldn't answer that question".