Lvl4andcounting

The only textbook we have that talks about IVPB is our clinical calculations book that says IVPB is a secondary line that overrides the primary line. Didn’t help me though when I pointed that out and seemed to annoy this professor who later told me adamantly I was taught wrong and the IVPB run together. I agree we need to know how to calculate drips manually. I’m not concerned with the math. I can do the math if it’s set up simultaneous or not I just need to know how it is to be set up. If both are to run simultaneously, I would set them up on primary lines and y-site them. Whether or not they are y-site compatible is in my IV meds book, or I would look it up in the hospital reference manual online or I would ask the pharmacy if I were unsure. At the end of the day, my concern here is how to be a safe nurse, not whether I can do a simple math problem (because I can) though I find it irritating I got docked for this. Oh well. Life goes on… as long as I know how to set up IV meds appropriately! LOL

I could push the envelope on this, but the politics at this small school are pretty remarkable. I’m an older student changing from a 25 year career with enough of years of experience to know better than to fight those politics. Not worth filing a grievance to achieve that. And besides, I spoke with another professor who explained to me that Vanco would have to be on a separate pump to be sure it infused at the correct rate, that you would never use gravity for this drug …. And told me I was wrong because two primary lines y-sited are still considered IVPB. I was also told I’m thinking about this concept “too black and white.” Which I suppose would be helpful criticism if it were true, but since you’re all telling me this is incorrect, I’m not oblivious to what appears to be shutting me down. I’m guessing if I pushed it, I wouldn’t win the battle anyway. Better to just know what I need to know to be a nurse and get through nursing school in one piece. It is however ironic and unfortunate one of the most important qualities that will make us good nurses is to remain teachable, admitting error when it occurs, but it’s often not demonstrated by those teaching us. Ah, life. LOL I do appreciate the clarity offered here so I have a good understanding of these concepts, which is the most important point for me.

Thank you so much for taking the time to respond. I’m not going to get credit for this problem - I could probably fight it but I don’t think it’s worth it in the long run… I’ll just have to take another math exam. But it was driving me crazy that I may have misunderstood the difference between IVPB and y-sites. The professor is always right even when they are wrong. Ha ha

The wording above is the exact and complete wording. It specifically says IVPB... which is why I am so confused that I was told the problem was wrong. Trying to sort out how I may have misread the question as my professor claims. I certainly couldn't claim to know everything about IVs, but I was pretty certain I understood this fundamental concept, and I don't know how other schools work, but we are REQUIRED to get 100% on our math exams, so this is kind of a big deal and the first I've not passed. The explanation I was given of how an IVPB can run simultaneously was to consider what I am currently seeing in the ICU clinicals where Versed, Fentanyl, and Levaphed are being run on separate lines through separate pumps that all eventually converge via stopcocks to a central line. Am I just confused about the definition of an IVPB? Did I do something else wrong with the math that I'm just not seeing? Thanks for your help!

We've been lucky that our school has been able to get us into all our clinicals except one set; however, I do know our state board of nursing approved 70% sim lab being an acceptable ratio. I've heard of this in other states. Seems crazy, but.... COVID.

So I took a math exam yesterday and I'm confused on the result. 32 yo male admitted for leg wound that cultured +MRSA Provider orders: Vancomycin 1g/250mL over 2 hr IVPB q12hr 1 Liter Normal Saline over 8 hr IV x 3 What is the total volume infused in 4 1/2 hours? As we're talking about an IVPB, I set up my problem with the Vanco IVPB infusing first on the secondary line, and then when it finishes, the normal saline starts infusing. This gives me 250ml in the first 2 hours (of Vanco) + 312.5 Normal Saline in the subsequent 2.5 hours for a total of 562.5mL I was told this was wrong because they would infuse simultaneously. I made the case that normally IVPB infuse separately but I conceded it is possible to infuse simultaneously; however, nothing in this problems defines that so it's "more correct" to assume they are infusing separately. No dice. Still wrong. Am I incorrect in my logic/knowledge of IVPB infusions or are there really two possible ways to set up this problem given the information provided? Thanks.