Reconstitution Medications and Dosages

[techraider77, ADN, BSN]

Started a Dosages class today and was wondering how often reconstitution medications are prescribed to patients in hospitals? Do nurses do most of the calculations for these as well as other dosages, or are there quicker devices used to give out the correct doses? thanks

[Be_Moore]

While all hospitals are different, the vast majority of them are doing away with nurses actually performing dosage calculations and instead leaving it up to pharmacists and pharmacy techs for liability purposes. That's not to say that you won't reconstitute things, however. At my facility, most of our antibiotics come in vials that have to be reconstituted...but there isn't a lot of calculation involved. For example, Cefipime 1gm gets mixed with a 50ml reconsitution 0.9 % NaCl bag, Cefipime 2gm gets mixed in a 100ml bag. And we have a chart that indicates 50 or 100ml.

Knowing how to do dosage calculations is useful, but no longer terribly practical other than the check up behind the pharmacy. In fact, the last time I remember HAVING to do a dosage calculation was a patient that the MD's wanted on a continuous FFP infusion. At my facility we don't use IV pumps for blood products, so I actually calculated a gtt rate to figure ho to infuse FFP over 4 hours continuously.

[techraider77, ADN, BSN]

Thats what I figured, anything to make less room for errors is the name of the game these days.

[perfectbluebuildings, BSN, RN]

If you work in peds things may get a little more complicated, as for many antibiotics & other meds the dosages are calculated by weight, and when you dilute it, that's another step of division/multiplication (however you do your med math), but once you do it a few times it becomes second nature. They are starting to go with more premixed antibiotics at our hospital now, but of course some things do have to be mixed just before being administered.

[chenoaspirit, ASN, RN]

Most of ours were the "advantage" bottles (I think thats what they were called". It was a bottle of powder that you screw onto a NS bag that fit the bottle and it then reconstituted. But I did however reconstitute amoxicillin many times with peds. The bottles usually tell you how much NS or sterile water to mix it with (IM rocephin was mixed with lidocaine). It then also tells you how many mg per ml after being mixed. It isnt that hard to do, really. Dont worry. And like the others said, once you do it a few times, it does become second nature. But most of ours were already mixed before arriving on the floor and I think most hospitals are trying to go with premixed so nurses dont have to calculate. It reduces risk of med errors.

[netglow, ASN, RN]

OP, in clinical you might be called upon to calculate all you give. This to show you can do it. Gonna be on every lecture test as well. Was for us.

[MichelleB34]

Our pharmacists mix the majority of our meds for us or the meds come in unit dose vials. The pharmacist also does the calculations for us. However I did have to learn how to do the calculations in school and I do still like to double check the calculations myself. I figure I am the last check before the patient gets the medication. If I have any questions at all that I can't look up I don't hesitate to call the pharmacist.

[blondy2061h, MSN, RN]

We reconstitute almost all abx ourselves and have to do the dosing ourselves, but it's pretty straight forward- IE 1gm of Meropenem diluted with 20 ml NS, pt needs 500 mg, draw up 10 ml.