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In Critical Care Nursing, often medications are ordered as IV continuous drips.

These medications are potent and the nurse must maintain constant monitoring to assess for desired effect and potential side effects. The physician may order to “titrate” an IV medicated drip. To “titrate” a drip is to increase or decrease a drip to achieve the desired effect. Such drugs may be ! "asi#, $! %opamine, &! %obutamine, '! Nipride, (! Nitroglycerin, )! *eparin, and +! Insulin. ,s an e#ample, the nurse may “titrate” an Insulin drip and increase the rate to bring the serum blood glucose levels do-n to the normal range. .nce this range is met, the nurse may then maintain that rate or decrease the rate to prevent hypoglycemia. /any drugs are administered IV route in the Critical Care 0nit.

Medications may be ordered in:
“mg1hr”2 "asi#, Cardi3em , ,minophylline “units1hr”2 *eparin and Insulin “mcg1min”2 Nitroglycerin “mcg14g1min”2 %opamine and %obutamine “mg1min”2 "idocaine

Two Formulas can be used:
“5ormula /ethod” % * # V 6 flo- rate 7ml1hr!

“8atio 9 :roportion” 7%! osage on hand 7*! Solution on hand 6 %osage prescribed 7;! < 7ml1hr -e are solving for!

NS IN “/C>1/IN” ?.rate 7ml1hr! .NSA=82 & ml1hr Ratio – Proportion Method: $DDmg DDml < )mg1hr < 6 $DD#6)DD # 6 &ml1hr /=%IC. @ou receive a "asi# IV bag of $DDmg in DDml of D.S= ST0%@2 /r.EF NaCl to infuse at $DD units1hr.DDDunits in (DDml of D.TI. .many ml1hr -ill you infuse the drip atG Formula Method: )mg1hr $DDmg < DDml 6 flo. Ahat -ill be the rate in ml1hrG Formula Method: $DD units1hr < $(.DDD #6$'ml1hr (DDml 6 flo. The /% ordered for *eparin $(. *o.S= ST0%@2 /rs. *e -as started on a *eparin drip.TI.NS IN “0NITS1*8” ?. C.T. V.NSA=82 $' ml1hr Ratio – Proportion Method: $(. These medication calculations add one e#tra step.EF NaCl. Ailma Aetlung has been admitted -ith C*5 and reBuires a "asi# drip.NS IN “/>1*8” ?.rate 7ml1hr! /=%IC.DDD units .DDD# 6 )DD. C. The /% has ordered "asi# C )mg1hr. Tee came into the =8 c1o shortness of breath and -as found to have a pulmonary embolism./=%IC. This step is to multiply by )D at the end because your order is “per minute” and your IV pump infuses “per hour”. %.DDD units (DD ml < $DDunits1hr 6 < $(.

.S= ST0%@2 /r. *o. . ml1min # )Dmin 6 )ml1hr Ratio – Proportion Method: (Dmg $(Dml < $Dmcg1min < 6 Ne#t2 Convert (Dmg to mcg ? (D. ml1min # )Dmin 6 )ml1hr /=%IC.rdered! 7... The patient is admitted to the CC0 and placed on a Nitroglycerin IV drip to titrate for chest pain and to maintain a SI: JEDK 'D.DDDmcg $(Dml < $Dmcg1min < 6 (D.$”. $Dmcg1min (D. The /% orders to start it at $Dmcg1min. D. Hlusion came into the =8 -ith chest pain. If the patientLs -eight is provided in pounds.DDDmcg # $(Dml 6 D. ml1min 5inally2 /ultiply # )Dminutes ?. then you must convert it to 4g by dividing by “$. @ou hang a bottle of (Dmg in $(Dml %(A. ml1min 5inally2 /ultiply # )Dmintes ? D.n *and! $Dmcg1min # $(Dml (Dmg Ne#t2 Convert (Dmg to mcg ?.many ml1hr -ill it be infusedG Formula Method: 7.NS IN /C> 1 H> 1 /IN ? These formulas are the same e#cept that you must also multiply by the patientLs -eight in 4g.DDD #6D.TI.DDD# 6 (.C.

EF NaCl. >. @.A ?.Common medications ordered this -ay are %opamine and %obutamine. The drug is supplied in (DDmg in $(Dml of D. "etLs try one. The morning -eight -as D4g.NSA=8 S*.% N.DD$(ml1min < MD4g 6 D. . . %obutamine to infuse at (mcg14g1min.0"% I=2 D.0 T8@ . The Cardiologist -ants to start the patient on %obutamine drip and orders it to start at (mcg14g1min.DD$( ml1min 7per 4g! Ne#t.$ml1min < )D 6 $ml1hr 7final ans-er! N.&ml1hr .A. The vital signs and urine output are decreasing. D. Calculate your rate 7ml1hr! for the IV pump. multiply by )Dminutes to give your hourly rate ?.S= ST0%@2 @our patient in the CC0 -ho endured an /I is having decreased cardiac output.*=. @ou have a bag of MDDmg1$(Dml NS.N=N C. convert (DDmg to mcg ? (mcg14g1min < (DD. multiply by 4g ? D. The patient -eighs MD4g.DDDmcg $(Dml 6 D.$ml1min "astly. Formula Method: (mcg14g1min < (DDmg $(Dml 6 Ne#t.

NSA=8S2 ! $! &! '! (! )! +! M! Cardi3em C Dml1hr *eparin C $&ml1hr Insulin C $ml1hr "asi# C ml1hr %opamine C (.EF NaCl to infuse at (Dunits1hr &! Insulin $DD units in DDml of D.! Cardi3em $(Dmg in $(Dml of "idocaine C &Dml1hr Nitroglycerine C &ml1hr I.)ml1hr %obutamine C &+.>= .EF NaCl to infuse at $mg1hr (! %opamine MDDmg in $(Dml of %(FA to infuse at Dmcg14g1min.$ml. )! %obutamine $(Dmg in $(Dml of %(FA to infuse at Dmcg14g1min. The patient -eighs M&4g./=:. N$'D *.EF NaCl to infuse at Dmg1hr $! *eparin $(. +! "idocaine > in $(Dml of %(FA to infuse at $mg1min M! Nitroglycerine (Dmg in $(Dml %(FA to infuse at Dmcg1min .DDD units in (DDml D.EF NaCl to infuse at 'units1hr '! "asi# $DDmg in DDml of D. The patient -eighs )$4g.CH T.