Instructor’s Solutions Manual to Accompany Dosage Calculations, Fourth Canadian Edition

Chapter 10: Reconstitution of Solutions

Review Set 10-1 (pages 264–273)

1. 3; 280 mg/mL
Order: 200 mg
Supply: 280 mg/mL
× Q= × 1 mL = 0.714 = 0.7 mL

1000 mg/vial ÷ 200 mg/dose = 5 doses/vial or 5 full doses available in vial

06/02/XX, 0800,
reconstituted as 280 mg/mL.
Expires 08/02/XX, 0800.
Keep refrigerated. B.S.

Reconstituted solutions must be used within 48 hours when refrigerated.

2. 9.8; 5000 units/mL

Order: 2500 units
Supply: 5000 units/mL
1
D 2500 units
× Q= × 1 mL = 0.5 mL
H 5000 units
2

50 000 units/vial ÷ 2500 units/dose = 20 full doses available in vial

06/02/XX, 0800,
reconstituted as 5000 units/mL.
Expires 13/02/XX, 0800.
Keep refrigerated. B.S.

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Instructor’s Solutions Manual to Accompany Dosage Calculations, Fourth Canadian Edition

3. 1.1 mL; 90 mg/mL; give 1 mL

Order: 90 mg
Supply: 108 mg/vial
The vial is for single-use only. The vial contains 108 mg of enfuvirtide for delivery of
90 mg/mL when reconstituted. No reconstitution label is needed.

4. 4.8; 100 mg/mL

Order: 0.5 g = 500 mg
Supply: 100 mg/mL
5

× Q= × 1 mL =
1

One dose in vial. No reconstitution label is required; all the medication will be used for
one dose.

5. 2.2; 0.35 g or 350 mg/mL

Order: 750 mg
Supply: 350 mg/mL

× Q= × 1 mL = 2.1 mL 2.14
350 750.00
700
500
350
1500
1400
100

One dose in vial.

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6. 8.2; 500 000 units/mL

Order: 1 000 000 units/mL
Supply: 500 000 units/mL
2

× Q= × 1 mL =
1

3.1; 1 000 000 units/mL

Order: 1 000 000 units
Supply: 1 000 000 units/mL

× Q= × 1 mL =

Select 500 000 units/mL and give 2 mL. Either 1 mL or 2 mL is an appropriate amount
to give IM depending on reconstitution, but 500 000 units/mL is less concentrated than
1 000 000 units/mL and is therefore less irritating to the muscle.
5 000 000 units/vial ÷ 1 000 000 units/dose = 5 full doses/vial

06/02/XX, 0800, reconstituted

as 500 000 units/mL.
Expires 11/02/XX, 0800.
Keep refrigerated. B.S.

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7. 7.8; 62.5 mg/mL

Order: 175 mg
Supply: 62.5 mg/mL

× Q= × 1 mL = 2.8 mL 2.8
.
62.5 175.0
125
500
500
0

There are two doses available. The solution must be used within 24 hours. Unused
solution is discarded.

06/02/XX, 0800, reconstituted

as 62.5 mg/mL.
Expires 07/04/XX, 0800.
Keep refrigerated. B.S.

8. 4; 2 g/5 mL; 400 mg/mL

Order: 200 mg
Supply: 400 mg/mL
1

× Q= × 1 mL = 0.5 mL
2

One dose in vial; the unused portion is discarded.

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9. 1.8; 500 000 units/mL

Order: 500 000 units
Supply: 500 000 units/mL
1

× Q= × 1 mL =
1

3.8; 250 000units/mL

Order: 500 000 units
Supply: 250 000 units/mL
× Q = × 1 mL = 2 mL

Either 1 mL or 2 mL is an appropriate amount to give IM depending on reconstitution.

However, 500 000 units/mL is the lesser amount and may be less irritating to the
muscle. Two doses are available in vial.
Select 500 000 units/mL and give 1 mL.

06/02/XX, 0800, reconstituted

as 500 000 units/mL.
Expires 11/02/XX, 0800.
Keep refrigerated. B.S.

10. 10; 1.8 g/10 mL; 180 mg/mL; 2.8 mL; 4 doses
Order: 500 mg
Supply: 180 mg/mL
× Q= × 1 mL = 2.77 mL = 2.8 mL

2000 mg ÷ 500 mg = 4 full doses available (reconstituted, ampicillin is stable for 72 h)

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11. 1; 40 mg/mL
Order: 24 mg
Supply: 40 mg/mL
6

×Q= × 1 mL = 0.6 mL
10

40 mg/vial ÷ 24 mg/dose = 1.6 dose/vial = 1 full dose available

12. 10 mL; 1800 mg/10 mL; 180 mg/mL

Order: 250 mg
Supply: 180 mg/mL
× Q= × 1 mL = = 1.38 = 1.4 mL

10 mL solution for doses/vial ÷ 1.4 mL dose = 7.1 doses/vial = 7 full doses per vial
No; the drug is ordered for administration twice a day; however, the solution is stable
for 48 hours under refrigeration. Therefore, only 4 doses can be used from this vial.
06/02/XX, 0800, reconstituted
as 180 mg/mL.
Expires 08/02/XX, 0800.
Keep refrigerated. B.S.

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13. 9.6; 100 mg/mL

Order: 750 mg
Supply: 100 mg/mL
7.5

× Q= × 1 mL = 7.5 mL
1

1000 mg/vial ÷ 750 mg/dose = 1.3 doses/vial = 1 full dose per vial (no reconstitution label
is needed)

14. 30; 40 mg/mL

Order: 80 mg
Supply: 40 mg/mL
2
D 80 mg
× Q= × 1 mL =
H 40 mg
1

The solution should be used within 8 hours and the remaining unused portion
discarded. No reconstitution label. One dose per vial.

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15. 2 mL; 225 mg/mL

Order: 250 mg
Supply: 225 mg/mL
10

×Q= × 1 mL = 1.1 mL
9

500 mg/vial ÷ 250 mg/dose = 2 full doses per vial

06/02/XX, 0800, reconstituted

as 225 mg/mL. Expires
07/02/XX, 0800 when kept at
room temperature. B.S.

Review Set 10-2 (pages 278–279)

1. 300 mL Ensure + 600 mL water = 900 mL -strength Ensure; 2 cans; discard 170 mL.

D × Q= × 900 mL = 300 mL Ensure

900 mL total solution – 300 mL Ensure = 600 mL water (solvent)

one can = 235 mL
470 mL (two full cans) – 300 mL (Ensure needed) = 170 mL (discarded)

2. 180 mL Isomil + 540 mL water = 720 mL -strength Isomil; one 235-mL can;
discard 55 mL.
120 mL q4h = 120 mL/feeding × 6 feedings = 720 mL total
D × Q = × 720 mL = 180 mL Isomil (solute)

720 mL (solution) – 180 mL (Isomil or solute) = 540 mL (solvent)

Use one 235-mL can; discard 235 mL – 180 mL = 55 mL

3. 800 mL Boost Plus + 400 mL water = 1200 mL -strength Boost Plus; 4 bottles;
discard 148 mL.
300 mL QID = 300 mL × 4 feedings = 1200 mL total
D × Q = × 1200 mL = 800 mL solute

1200 mL (quantity desired) – 800 mL (solute) = 400 mL (water or solvent)

one bottle = 237 mL
948 mL (four full bottles) – 800 mL = 148 mL (discard)

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4. 390 mL Ensure + 390 mL water = 780 mL -strength Ensure; 2 cans; discard 80 mL

D × Q = × 780 mL = 390 mL Ensure (solute)

780 mL (quantity desired) – 390 mL (solute) = 390 mL (water or solvent)

one can = 235 mL
470 mL (two full cans) – 390 mL = 80 mL (discard)

5. 500 mL Boost Plus + 500 mL water =1000 mL -strength Boost Plus; three 237-mL bottles;
discard 211 mL
250 mL QID = 250 mL × 4 = 1000 mL
D × Q = × 1000 mL = 500 mL Boost Plus

1000 mL (total solution) – 500 mL (Boost Plus) = 500 mL (water or solvent)

one bottle = 237 mL
711 mL (three full bottles) – 500 mL = 211 mL (discarded)

6. 1080 mL Isomil + 360 mL water = 1440 -strength Isomil; use 5 cans; discard 95 mL
240 mL q4h = 240 mL × 6 = 1440 mL Isomil

D × Q= × 1440 mL = = 1080 mL

1440 mL (solution) – 1080 mL (Isomil) = 360 mL (water or solvent)

one can = 235 mL
1175 mL (five cans) – 1080 mL = 95 mL (discarded)

7. 120 mL Ensure + 60 water =180 -strength Ensure; use one 235-mL can; discard 115 mL
60

D × Q = × 180 mL = × 180 = 120 mL Ensure

1

180 mL total – 120 mL Ensure = 60 mL water

one can =235 mL
235 mL – 120 mL = 115 mL (discarded)

8. 120 mL Ensure + 360 mL water = 480 mL -strength Ensure; use one can; discard 115 mL

D × Q = × 480 mL = 120 mL Ensure

480 mL total – 120 mL Ensure = 360 mL (water or solvent)

one can = 235 mL Ensure
235 mL – 120mL = 115 mL (discarded)

9. 35 mL mouthwash + 15 mL water
D×Q= × 50 mL = 35 mL mouthwash

50 mL – 35 mL = 15 mL water

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10. 16 mL skin cleanser + 64 mL water

D×Q= × 80 mL = = 16 mL skin cleanser

80 mL – 16 mL = 64 mL water

11. 0.1 mL sodium bicarbonate + 4.9 mL water

D× Q= × 5 mL = = 0.1 mL sodium bicarbonate

5 mL – 0.1 mL = 4.9 mL water

12. 120 mL hydrogen peroxide + 120 mL water

D× Q= × 240 mL hydrogen peroxide = 120 mL hydrogen peroxide

240 mL – 120 mL = 120 mL water

Practice Problems—Chapter 10 (pages 280–286)

1. 0.194 g/mL; 12.9 mL; 20 mL or two syringes: 10 mL plus 3 mL (note that piperacillin
sodium/tazobactam sodium is further diluted for intravenous administration)
Order: 2.5 g or 2500 mg
Supply: 0.194 g
.
× Q= × 1 mL = 12.88 = 12.9 mL
.

12.88
0.194 2.500.00
194
560
388
1720
1552
1680
1552
128

2. Order: 500 mg
Supply: 250 mg/mL
2

× Q= × 1 mL =
1

Select 3-mL syringe.

3. Order: 500 mg
Supply: 330 mg/mL
× Q= × 1 mL = 1.51 mL = .

Select 3-mL syringe.

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4. Vial dosage size is 1 g. Add 9.6 mL diluent to the vial for IV administration; concentration is
100 mg/mL.
Order: 750 mg
Supply: 100 mg/mL
× Q= × 1 mL = .

One full dose is available (1000 mg – 750 mg = 250 mg).

Select 10-mL syringe.

5. Order: 500 mg
Supply: 280 mg/mL
× Q= × 1 mL = 1.78 = .

Select 3-mL syringe.

Two full doses are available.

06/02/XX, 0800, reconstituted

as 280 mg/mL.
Expires 09/02/XX, 0800.
Keep refrigerated. B.S.

6. Order: 100 mg IV x 1 dose followed by 50 mg IV q12h administered over 30 to 60 min

Supply: 10 mg/mL
× Q= × 1 mL =

Select one 10-mL syringe for the initial 100 mg dose.

Supply: 10 mg/mL
D 50 mg
× Q= × 1 mL = 5 mL
H 10 mg
Select one 5-mL syringe for the second dose to be administered Q12H

7. 2 mL; 225 mg/mL

Order: 300 mg
Supply: 225 mg/mL
× Q= × 1 mL = 1.33 = .

Select 3-mL syringe.

One full dose is available. No reconstitution label is required.

8. 15.6; 62.5 mg/mL

Order: 200 mg
Supply: 62.5 mg/mL
× Q= × 1 mL = .
.

Select 10-mL syringe.

The vial is a 1-dose vial, no reconstitution label is required.

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9. 2.5 mL; 334 mg/mL

Order: 350 mg
Supply: 334 mg/mL
× Q= × 1 mL = . =

Select 3-mL syringe.

1000 mg/vial ÷ 350 mg/dose = 2.9 doses/vial = 2 full doses/vial available
Two full doses are available; a reconstitution label is required.

10. 9.8 mL; 5000 units/mL

Order: 7500 units
Supply: 5000 units/mL
3

× Q= × 1 mL = .
2

Select 3-mL syringe.

There is 50 000 units/vial ÷ 7500 units/dose = 6.7 doses = 6 full doses.
Six full doses are available; reconstitution label is required.

11. 10 mL; 180 mg/mL

Order: 1.25 g
Supply: 2 g/11.2 mL
5.6
.
× Q= × 11.2 mL = .
1

Select 10-mL syringe.

One full dose available (2 g – 1.25 g = 0.75 g remaining). No reconstitution label is
required.

12. 30 mL; 40 mg/mL

Order: 60 mg
Supply: 40 mg/mL
× Q= × 1 mL = .

Select 3-mL syringe.

Potentially 20 full doses are available (1200 mg/vial ÷ 60 mg/dose = 20 doses).
However, this solution once reconstituted must be used within 8 h so no label.

13. 3.1 mL; 1 000 000 units/mL

Order: 2 000 000 units
Supply: 1 000 000 units/mL
2

× Q= × 1 mL =
1

Select 3-mL syringe.

Two full doses available (5 000 000 units/vial ÷ 2 000 000 units/dose = 2.5 doses).
Reconstitution label is required.

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14. 1.8 mL; 500 000 units/mL

Order: 1 000 000 units
Supply: 500 000 units/mL
2

× Q= × 1 mL =
1

Select 3-mL syringe.

One full dose is available.

15. 2 mL; 225 mg/mL

Order: 400 mg
Supply: 225 mg/mL
16

× Q= × 1 mL = 1.77 = .
9

Select 3-mL syringe.

One full dose is available (500 mg/vial ÷ 400 mg/dose = 100 mg).
No reconstitution label is required.

16. D × Q = × 480 mL = × 480 =

480 mL total – 60 mL hydrogen peroxide = 420 mL normal saline

40

17. D × Q = × 320 mL = × 320 =

1

320 mL total – 120 mL hydrogen peroxide = 200 mL normal saline

10

18. D × Q = × 80 mL = × 80 =
1

80 mL total – 50 mL hydrogen peroxide = 30 mL normal saline

19. D × Q = × 540 mL =
540 mL total – 360 mL hydrogen peroxide = 180 mL normal saline

20. D × Q = × 500 mL = = . hydrogen peroxide

500 mL total – 437.5 mL hydrogen peroxide = 62.5 mL normal saline

21. 1 L = 1000 mL
250

D × Q = × 1000 mL = × 1000 =
1

1000 mL total – 250 mL hydrogen peroxide = 750 normal saline

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22. 30 mL Enfamil + 90 mL water = 120 mL -strength Enfamil; one 235-mL can;

discard 205 mL
12 mL/h for 10 h = 12 × 10 = 120 mL total
30

D × Q = × 120 mL = 30 mL Enfamil
1

120 mL (solution) – 30 mL (Enfamil) = 90 mL (water)

One 235-mL can – 30 mL Enfamil needed = 205 mL discarded

23. 270 mL Boost Plus + 90 mL water = 360 mL -strength Boost Plus; two 237-mL bottles;
discard 204 mL
90

D × Q = × 360 mL = × 360 = 270 mL Boost Plus

1

360 mL total – 270 mL Boost Plus = 90 mL water

Two bottles 237-mL Boost Plus; 474 mL – 270 mL = 204 mL discarded

24. 300 mL Ensure + 150 mL water = 450 mL -strength Ensure; two 235-mL cans;
discard 170 mL

90 mL/h for 5 h = 90 mL × 5 feedings = 450 mL total

150

D × Q = × 450 mL = × 450 = 300 mL Ensure

1

450 mL total – 300 mL Ensure = 150 mL water

Two 235-mL cans = 470 mL – 300 mL = 170 mL discarded

25. 2880 mL Enfamil – 1800 mL water = 1080 mL -strength Enfamil; five 235-mL cans;
discard 95 mL
3 patients × = 2880 mL total
360

D × Q = × 2880 mL = × 2880 = 1080 mL Enfamil

1

2880 mL total – 1080 mL Enfamil = 1800 mL water

Five 235-mL cans = 1175 mL Enfamil; 1175 mL – 1080 mL = 95 mL discarded

26. 20 mL Ensure + 140 mL water = 160 mL -strength Ensure; one 235-mL can;
discard 215 mL
20

D × Q = × 160 mL = × 160 = 20 mL Ensure

1

160 mL total – 20 mL Ensure = 140 mL water

One 235-mL can; 235 mL – 20 mL = 215 mL discarded

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27. 225 mL Ensure + 225 mL water = 550 mL -strength Ensure; one 235-mL can;
discard 10 mL
55 mL/h for 10 h = × 10 feedings = 550 mL total

D × Q = × 550 mL = 225 mL Ensure

550 mL total – 225 mL Ensure = 225 mL water

One 235-mL can; 235 mL – 225 mL = 10 mL discarded

28. Use 2 cans; 120 mL discarded

350

D × Q = × 1400 mL = 350 mL Enfamil

1

Available 235-mL can; use 2 cans; 470 mL – 350 mL = 120 mL discarded

29. 1400 mL – 350 mL Enfamil = 1050 mL water

Application of Clinical Reasoning (pages 286–287)

10.1 Prevention—This type of patient safety incident could have been prevented had the nurse
read the label carefully for the correct amount of diluent for the dosage of medication to be
prepared. Had the nurse read the label carefully before the medication was prepared, the
incorrect medication, loss of valuable time, misuse of healthcare resources, and potential
harm to the patient would have been avoided.

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