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Basic Intravenous Calculations

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11 views19 pages

Basic Intravenous Calculations

Uploaded by

rlala98
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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Basic Intravenous

Calculations
Calculating IV Rates

• Most IV’s are infused through an electronic pump (IV


controller). Some IV’s run by gravity.
• What would be a benefit of using an electronic device?

• Each IV pump can be very different. You will need


instruction on each pump.

• To calculate a flow rate you need to know 2 things.

• 1 - total volume to be infused


• 2 - the total time over which the volume is to be infused
Milliliters per hour (mL/h)
• This calculation is needed for ALL infusions

• Examples of IV orders:
• 1000 mL D5W/ 0.45NS @ 125 mL/h
• 1 L 2/3 1/3 q8h

• The first example is self-evident


• The second example requires a simple calculation

mL = 1000 mL = 125 mL/h


h 8h
• Round the rates to the nearest whole number. Why?
Calculating Flow Rate (mL/h)

• Order: NS 2000 mL IV over 24 hrs. How many mL per


hour do you administer?

• mL : 2000 mL = 83 mL/h
h 24 h

• Order : D5W 1L IV over 8 hrs. How many mL per hour do


you administer?

• mL: 1L X 1000 mL = 125 mL/h


h 8h 1L
Practice Flow Rate

• Order: D5W 1000 mL over 5 h. How many mL/h do you


administer?

• Order: NS 1L over 6h. How many mL/h do you administer?


Electronic Infusion Devices
• When electronic pumps are used for IV infusion, the nurse
must enter the ordered flow rate in mL/h on the digital
device

• The LED screen displays the number of milliliters being


infused/hour, the total number of milliliters that have been
infused (TVI) and the volume remaining to be infused (TBI)

• Hospital policies dictate which IV infusions MUST be


administered on a pump.

• Examples??
Gravity Infusions
• Some agencies use simple gravity devices with manual rate
controllers for temporary emergency purposes, for
administering unmedicated solutions, and for maintenance
of unmedicated IV therapy (TKVO)

• Gravity infusions are hung from a pole approximately 36


inches above heart level

• The flow rate is dependent on the flow rate control clamp


adjustment, positioning of solution, tubing patency and the
patient’s position
Types of Gravity Infusion
Administration Sets
• The DF (drop factor) is available on the tubing administration
set.

• Macrodrip (large-diameter) tubing with a DF of 10, 15 or 20


gtt/mL

• Microdrip tubing (also known as pediatric tubing) has a DF of


60 and narrow tubing that delivers tiny drops from a needle-
like projection to achieve 60 gtt/mL
Images for IV Administration Sets
With Drop Factor
Calculating Flow Rates for Gravity
Infusion Devices
• The flow rate for simple gravity devices is delivered in drops
per minute (gtt/min)
• The nurse adjusts the flow rate with a hand-operated slide
pinch or roller clamp
• To convert mL/h to drops per minute, identify the following
factors:
1. Number of mL/h
2. Calibration (DF or gtt/mL) of the selected tubing
administration set, stated on the administration set
package: 10, 15, 20 or 60
Calculation of Gravity Infusion Rates
(DA)
Desired Answer DF Conversion Order Hours to Min Answer
Units Formula Conversion
drops 10 drops X 100 mL X 1h 100 drops
min 1 mL 1h 60 min 6 min
= 16.666 drops/min
rounded to 17
drops/min
Estimating the Number of Drops/Min
for a Drop Factor of 60
• Drop factors of 60 for microdrop administration sets do not
require equations when the number of mL/h is known

• Because a DF of 60 divided by 60 minutes provides a factor


of 1, the number of mL/h = the number of drops per minute

• As a student, you will not be estimating drops/min. You will


need to complete the calculation and show your clinical
instructor.
Estimating the Number of Drops/Min
for a Drop Factor of 60
• E.g. IV order of 30 mL/h with a DF of 60. How many
drops/min?

Desired Answer DF Conversion Order Hours to Min Answer


Units Formula Conversion
drops 60 drops X 30 mL X 1h 30 drops
min 1 mL 1h 60 min min
= 30 gtts/min
Intravenous Piggyback Infusions
(IVPB)
• For intermittent use, medicated piggyback solutions are
often prepared in the pharmacy and supplied in small
volumes of 50 or 100 mL to be administered through a
secondary line for 20, 30 or 60 min.

• These solutions frequently contain antibiotics that may be


infused intermittently (e.g. q6h or q8h) to maintain
therapeutic blood levels of the medication

• They are connected (piggybacked) to a primary line port


through a shorter secondary tubing set.
Image of IVPB
Calculating Flow Rates (mL/h)
for IVPB Infusions

• Ordered: IVPB antibiotic 50 mL in 30 min. How many mL/h


will be set on the infusion pump?

mL = 50 mL X 60 min = 100 mL
h 30 min 1h h
Simplified Piggyback Calculations
for mL/h Settings
• Because small-volume intermittent piggyback infusions are
usually administered over 20, 30 0r 60 min on a secondary
line, the nurse can perform mental calculations to obtain the
flow rate in mL/h

• For 60 min infusions, volume = mL/h

• For 30 min infusions, double the amount of mL ordered


for 30 min to obtain the 60 mL (hourly) rate

• For 20 min infusions, triple the amount of mL ordered for


20 min to obtain the 60 mL (hourly) rate
Calculating the Flow Rates for IVPB
Gravity Infusions in Drops/Min
• If an IVPB order is for 50 mL over 30 min with a DF
administration set of 10. How many drops/min?

Desired Answer DF Conversion Order Answer


Units Formula
drops 10 drops X 50 mL 16.66 drops
min 1 mL 30 min min
= 17 gtts/min

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