Please Help!!!!

[AH_AH_86]

Hi everyone! I am currently doing my pediatric clinical and I have a dosage calculation that is driving me crazy. I have clinical tomorrow and if I dont have this correct, my instructor will send me home with a zero!

My patient is a 12 yr old with an INT IV in his left hand.

Here is what the order reads:

IV sodium chloride 0.9% 50 mL 100 mL/hr

Clindamycin 580 mg IV q 6 hours

I have already figured out my safe dose range and it is within safe range.

The recommended final concentraion is 18 mg/mL

The dilution calculation I came up with is 32 mL

According to my handbook, the drug should be infused over 10-60 minutes

HERES My questions I cant figure out.... 1. What rate will be set on the pump and 2. What volume will be set on the pump?

The normal saline part of the order has totally thrown me off!!!!! Please help!! Thank you so much!!!!

[NotReady4PrimeTime, RN]

The NS order makes no sense and I would be getting it clarified if I saw it written on a chart. If they want 50 mL of NS to run at 100 mL/hr, then they need to make that clear. (50 mL for a 12 year old would be the equivalent of a mouthful of water.)

The clindamycin order is pretty straightforward. To obtain the recommended final concentration, you would mix it in IV fluid to equal no less than 32 mL. (I personally would run it on a syringe pump, but that might not be an available option for you.) The most straightforward calculation for this dose would be for you to run it over an hour. VTBI = 32 mL. Rate = 32 mL. (That's if you ignore the dead space in the tubing.) If you choose any interval shorter than an hour, you would calculate the fraction of the hour then multiply your VTBI by that factor to get your rate.

10 min = 1/6 of an hour therefore 32 X 6 = 192 mL/hr

15 min = 1/4 of an hour therefore 32 X 4 = 128 mL/hr

20 min = 1/3 of an hour therefore 32 X 3 = 96 mL/hr and so on.

Just to confuse you even more... unless you use a syringe pump, you're not going to have exactly 32 mL of fluid. So you might want to dilute your med in another fixed volume, say 50 mL, and base your math on that.

[AH_AH_86]

Thank you for your help!! My patient went home before I got to clinical today so I didn't have to give it anyways. Thanks again, I will keep that in mind for next time!! :wink2: