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.
In a medical math question you have to eliminated useless info and plug the necessary data into your equation. The parts of this problem you need are 125ml/hr and 24 hrs the 1000ml bag is useless info...clutter really, to distract you from what the problem is asking," How much fluid would your pt get in 24hrs if the pump were infusing at 125ml/hr? This is not a Dr order in this instance it is simply a math problem.
i see you're a nsg student?
yes, we nurses remember the distractors in nsg questions.
this was the exact 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?"
You are absolutely right. Many times our docs will order a slow fluid bolus-1L at 125 or 250cc/hr. They expect the IV to revert to the previously ordered rate (KVO) or be d/cd and capped off when that liter is done. The way the order in your test was written is exactly how they write it. Another fine example of: those who can-do,
those who can't-teach. Good luck with this author in the future.
I've also never seen a provider specify bag size, unless something was being added to the bag, and the size of the bag mattered for the concentration. We do a lot of replacement of NGT/ostomy drainage, so I wouldn't be shocked to see an order for a specific amount, which is how I read the question in the OP.
"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.
Oh my GOD, we had one who did this too. "Well, I happen to disagree with the text." Um, okay. How nice for you. Maybe you shouldn't teach from that particular book, then.
I recall working with Math for Meds - it appears there are several issues with some of the answers, so be careful when going through it - I went through the whole book and notified my instructor of the errors - I believe I caught 6 of them - and the software from the company stated my answers were incorrect, even though I could prove it wrong. Just be sure what you are doing and you will catch them as well. Good practice anyway.
I think the answer to this is simple. As a current student, I have similar challenges on what the Dr. ordered. N-Clex RN teaches to answer what is asked, do not read to much into the question. Per this MD order he or she wants to infuse 1000ml's of NS at a rate of 125ml's per hr. If you divide the 1000ml's by 125ml's per Hr, then your NS will be gone at the end of 8 hours. If the order is for continuous NS to run at 125ml's per hr, then you would have infused 3000 in 24 hours. (24divided by 8 = 3) ( 3 x 100 = 3000ml's). The order as stated is only for the 1000ml's So--- the client will receive 1000 ml's at the end of 24hrs, unless the order is changed. You cannot assume the MD wants to continue, you need an additional order as you might end up with a client that has a fluid overload etc... See my point. I believe you answered the question correctly! In the real world, I would clarify the order with the MD to see if he or she would like to continue the NS or D/C it nearing the end of the 8 hr mark.
Your math question was 1000 ml at 125ml/hour. Your starting factor is the 125 ml/hour X 24hours/one day. Your hours cancel out and you are left with an ending label of ml/day which = 3000. Even though the doctor orders 1000 ml of normal saline doesn't mean that all the patient is getting is 1000 ml and then its going to be discontinued. The real order was 125ml/hour until the doctor discontinues the order
In response to Jackson145, this is a MATH CALCULATION QUESTION-nothing more!! I have written several practice study guides and teach math, and contribute to several textbook publishing companies. The sole purpose of these types of questions is to determine if you can successfully complete the calculations-without reading into the question, and not if it is something that you have experience with, or would administer without more specific information.
As an instructor of nursing and dealing with students who have great difficulty with medmath, I would like to comment. I have to say that the BEST answer would be to clarify the order to make sure that it is continuous or whoever wrote it should have said a continuous IV order. Many times we put the 1000ml in because the question could have asked "How many hours would it take to infuse the bag? or we could have asked for a drip rate and some formulas that the students use require total volume over total time. I never say that I am totally correct-there is always room for discussion but you need to bring me evidence to support your arguement.
your math question was 1000 ml at 125ml/hour. your starting factor is the 125 ml/hour x 24hours/one day. your hours cancel out and you are left with an ending label of ml/day which = 3000. even though the doctor orders 1000 ml of normal saline doesn't mean that all the patient is getting is 1000 ml and then its going to be discontinued. the real order was 125ml/hour until the doctor discontinues the order
this is how i saw it too.
our docs would have written something to indicate they wanted it to stop at l000 ml.
otherwise it is a continuous drip.
considering this thread . . . . the real answer is make sure the order is what you think it is and ask the doc.
The one thing I learned in school is that the test questions do not always make sense. I understood the question and yes would have answered the 3000ml in 24 hours. But in real like I would call and get clarification. If the order was writen that way. Sometimes the test are not looking for a real life answer.
- and the software from the company stated my answers were incorrect, even though I could prove it wrong. Just be sure what you are doing and you will catch them as well. Good practice anyway. 
leslie :-D
11,191 Posts
i see you're a nsg student?
yes, we nurses remember the distractors in nsg questions.
this was the exact question:
the doctor ordered 1000ml- not a 1 liter bag.
there's a difference.
leslie