Answer the following problems. Show computations for each question.

For creatinine clearance, use: https://www.kidney.org/professionals/kdoqi/gfr_calculator

All references are sent via Gmail.

1.
Patient: BNGJ
Age: 5yo
Weight: 23kg 3.
Allergies: NKA Patient: MNGO
Age: 10yo
Order: Ceftriaxone 690mg IV every 12hrs Weight: 36kg
ANST Allergies: Cllindamcyin

a) Is the order within the recommended range? If Order:

not, explain referrals. Cefuroxime 960mg IV every 8hrs
b) Stock: Ceftriaxone (Keptrix) 1g vial a) Is the order within the recommended range? If
Reference: not, give referrals.
Stock Dose: 1g/vial b) Can you give Cefuroxime if patient has
Reconstitute 1g in 10mL SWFI. Solution is allergy on Clindamycin? Explain.
stable for 6hrs at RT, and 24hrs at 5°C. c) Stock: Cefuroxime (Zegen) 750mg vial
Reference:
Aspirate _ml (_mg) and further dilute with Stock dose: 750mg vial
NSS to make a concentration of 10-40mg/ml Reconstitute with 7.5mL SWFI. Solution
to run for 30mins. stable for 24 hours at room temperature and
48 hours under refrigeration.
Show the dilution, stability, and running time of
said antibiotic. Aspirate _mL (_mg) then dilute further with
NSS to make a concentration of 1-30mg/ml to
run for 30 minutes.
2. Further diluted solution stable for 24 hours at
Patient: EJYB RT or 7 days under refrigeration.
Age: 67yo
Gender: Male Show the dilution, stability, and running time of
Serum creatinine: 2.05mg/dl said antibiotic.

Order: 4.
Piperacillin-Tazobactam 4.5g IV every 6hrs Order: Levophed 16mg in 250ml NSS to run at
0.8mcg/kg/min
a) Compute for the creatinine clearance of the Weight: 67kg
patient
b) Is the order appropriate for the creatinine Compute for the flow rate (ml/hr).
clearance of the patient? If not, what is the
recommended dose and frequency for the 5.
patient’s creatinine clearance Order: Nicardipine 40mg in 100ml D5W to run
c) Explain the dilution of Piperacillin- at 3mg/hr
tazobactam based on your answer in letter B Weight: 54kg
Compute for the flow rate (ml/hr). a) Is the order within the recommended range? If
not, give referrals.
6. b) Does this antibiotic need ID referral or not?
Order: Precedex 400mcg in 100ml NSS to run at c) Stock: Axera 2g vial
0.6mcg/kg/hr Reference:
Weight: 58kg Reconstitute 2g vial with 10ml SWFI/NSS
(160mg/ml). Should be used immediately
Compute for the flow rate (ml/hr). after reconstitution. (if reconstituted in 20mL
SWFI/NSS conc of 100mg/ml, stable for 24
hours at room temp or 7 days if refrigerated)
7.
Order: Potassium chloride 40mEqs in 250ml Aspirate _ml (_mg) then further dilute in NSS
NSS to run for 8hrs to make a concentration of 1-40mg/ml to run
for 30minutes
Compute for the flow rate (ml/hr).
Show the dilution, stability, and running time of
said antibiotic.
8.
Patient: ABCD 10.
Age: 10yo Order: Ceftriaxone 400mg IM once
Weight: 24kg
Order: Ampicillin-Sulbactam 600mg IV every a) Stock: Keptrix 1g vial
6hrs (Ampicillin based) Show the dilution of the order to be given via IM

a) Is the order within the recommended range? If

not, give referrals. 11.
b) Stock: Unasyn 750mg vial Order: Octreotide 600mcg in 1250ml NSS to run
Reference: for 50mcg/hr
Stock dose: 750mg vial (Sulbactam Na 250
mg, ampicillin Na 500 mg) Compute for the flow rate (ml/hr).
Reconstitute 1vial with 1.6 mL SWFI.
Further dilute with NSS/SWFI to make 25ml. 12.
Diluted solution stable for 72 hrs at 4°C. Pantoprazole drip 80mg in 100ml NSS to run for
8mg/hr
Aspirate __ml (_mg Ampicillin) of solution
then administer for 15-30 minutes. Compute for the flow rate (ml/hr)

Show the dilution, stability, and running time of 13.

said antibiotic. Patient: ASD
Age: 3yo
9. Weight: 11.7kg
Patient: SMUW Order: Paracetamol 250mg/5ml give 2.8ml every
Age: 12yo 4hrs as needed for fever >37.8
Weight: 34kg
Order: Cefepime 1700mg IV every 8hrs a) Is the order within the recommended range?
b) BUD of Paracetamol syrup.
 Meds brought and inspected.

14. Admitting orders:

Patient: AGH For laparascopic appendectomy
Age: 74yo NPO
Gender: Female
Serum creatinine: 14.1mg/dl Continue patient’s own medications:
Patient is undergoing hemodialysis Atorvastatin 20mg by mouth daily at bedtime
Folic acid 5mg by mouth daily
Orders: Apixaban 2.5mg by mouth once daily
 Piperacillin-tazobactam 4.5g IV every 6hrs
 Levofloxacin 750mg IV every 24hrs Cefoxitin 2g IV now then 1g IV every 6hrs
 Epoetin alfa 4000 units subcutaneously ANST
2x/week (Mon and Fri) Omeprazole (Prosec) 40mg IV daily while on
 Nebivolol 5mg 1 tab by mouth daily NPO
 ISMN 60mg 1 tab by mouth daily
 Atorvastatin 20mg 1 tab by mouth daily a) List all the referrals for this patient.
b) Explain to the nurse the dilution of Cefoxitin
 Clopidogrel 75mg 1 tab by mouth daily
(may use Forgram)
 Vildagliptin 50mg 1 tab by mouth daily
 Levothyroxine 25mcg 1 tab by mouth daily
 Sevelamer 800mg 2 tablets by mouth 3x a
day
 Febuxostat 40mg 1 tab by mouth daily
 Trimetazidine 35mg 1 tab by mouth daily

a) Compute for the creatinine clearance of the

patient
b) List all the referrals for patient’s AGH orders
c) Explain to the nurse how to give Piptazo and
Levofloxacin (may use brand Piptaz and
Levocin)

15.
Date: 5/23/2023 1855H
Patient: BNG
Age: 37yo
Gender: Male
Serum creatinine: 0.78mg/dl

MIAD:
Atorvastatin 20mg by mouth daily at bedtime
(5/22PM)
Amlodipine 5mg by mouth once daily (5/23AM)
Folic acid 5mg by mouth daily (5/23AM)
Apixaban 2.5mg by mouth once daily (5/22AM)