PCA Pump Calculation

[Sandrion]

Please, I need help with these 3 questions

PCA order as follows:

Medication: Morphine 1 mg/ml

Dosage: 1 mg

Interval: 8 minutes

Bolus Dose: 2 mg

a) When initially setting up the PCA pump for the infusion above, what will the total dosage be for the first hour?

b) During your assessment, the patient complains of moderate pain. Her injection history shows 6 injections/ 10 attempts. How many mg of Morphine has your patient received in this hour?

c) At minimum, how often do the injections/attempts need to be charted in the CliniComp record?

[LoveMyBugs, BSN, CNA, RN]

What are you needing help with, so far all I see is the homework questions.

What do you think is the answer?

What are your questions regarding the math and assessment of the patient?

Willing to help you, but not will to just give the answer

[KelRN215, BSN, RN]

Do you understand how a PCA works? When you say "dose" is 1 mg, do you mean the patient is on a continuous infusion of 1 mg/hr with 2 mg boluses available q 8 min?

[Here.I.Stand, BSN, RN]

So if I'm reading the information correctly, the RN sets up the PCA pump and gives the pt an initial 2 mg dose; after which the pt can dose him/herself 1 mg every 8 minutes?

First of all, you don't need every number given to solve every math problem. The concentration of 1 mg/ml is something that you need to verify when setting up the pump, but it doesn't tell you how much morphine the pt has received.

With that said,

a.) What is a PCA? Pt controlled analgesia, correct? You can figure out how much the pt *could* have possibly received, but to know how much s/he *did* receive, you need to check the pump. Just because a pt can push the button for a dose every 8 minutes, doesn't mean s/he did. But say they asked for how much s/he *could* have received. RN gave 2 mg, correct? With a lockout interval every 8 minutes and 1 mg per dose, how many doses *could* be given in one hour? Multiply the number of doses times mg per dose, and you'll find mg per hour...PLUS the bolus dose. Don't forget the bolus dose. :)

b.) Six injections/ten attempts. Again to find out how much morphine s/he's had, you don't need to know how many attempts. You need to know how many injections--then multiply the number of doses times the mg in each dose. A pt could get 6 doses and 10 attempts by pushing the button for a dose, then thinking "I'm not sure if I pushed the button all the way," and hits it again immediately. Or "Owwwww I'm hurting soooooo badly!!!!!! My pain is 20 out of 10!!!!!!" and pushes the button repeatedly, bumpbumpbumpbumpbumpbump!!! The pump will ONLY deliver one dose every 8 minutes. So once a dose has been given, the pump will NOT give another dose for 8 minutes, regardless how many times the button was pressed.

c.) This depends on hospital policy. Where I work we chart them every 4 hours--we chart the doses, attempts, and the total mg given, and then clear those numbers.

[Vardik Mkrtchyan]

hi guys I need a help with PCA problems. Here is the problem: patient returns from surgery with the following orders: Fentanyl PCA 10 mcg/hour continuously; PCA lock-out intervals 10 minutes; maximum dose including the continuous dose = 70 mcg/hr. The syringe holds 1000 mcg in 20 mL. In 4 hours, the patient received 260 mcg and pushed the button 37 times. How many times did the patient push the button and receive a dose?

[chare]

Why don't you start by showing us what you have already done?