Calculation of Basic IV

Drip Rates
Marion Technical College
NUR 1021
Spring 2016
 IV Therapy Fluids

• IV therapy fluids will come in sterile plastic bags or glass

bottles

• Physicians & Health Care Providers order IV fluids & flow

rates
 IV Orders
• The prescriber is responsible for writing the order
• Administering and monitoring an IV = nursing responsibility
• IV order must specify the following:
• Name of the IV solution
• Name of medication to be added if any
• Amount (volume) to be administered
• Time period during which the IV is to infuse
 Practice IV ORDERS:

• 1. Infuse 1000 mL D5W every 8 hours- Is it OK?

• 2. Infuse 0.9% NS @ 125ml- Is it OK?
• 3. Give 500 mL of 0.45% NS over 2 hours- Is it OK?
• 4. Give 0.9% NS with 20 mEq KCL every 8 hours- Is it OK?
 Review - Types of IV Fluids

• D5W = D5%W
• D5S = D5 %0.9NS
• D5½NS = D5 %0.45NS
• NS = 0.9%NS
• ½NS = 0.45% NS
• LR = Lactated Ringers
 IV Delivery Methods

• IV fluids & medications -administered by continuous &

intermittent infusion
• Continuous IV infusions replace or maintain fluids, and
electrolytes
• Continuous infusion -flows continuously until it is changed
 IVPB Set-Up

• Intermittent IV infusions (e.g., IV piggy back [IVPB], IV push)

• Used to administer medications and supplemental fluids
• Intermittent peripheral infusion devices- saline or heparin locks
• Used to maintain venous access without the need of continuous infusion
 IV BAG SIZES
• 1000 mL Routine IV’s

• 500 mL Medications or slow IV’s

• 250 mL Medications or NS for blood infusions.

• 100 mL Medications

• 50 mL Medications
 Kinds of IV Drip Factors

• IV fluids are administered through infusion sets

• Plastic tubing attached at one end to the IV bag
• The other end to a catheter inserted into a blood vessel

• Drop factor is # of gtts = 1 mL

• This is found on the IV tubing package
 IV Drip Factors

• Microdrip = 60 gtt/mL
• Macrodrip need to check package
• 10 gtt/mL
• 15 gtt/mL
• 20 gtt/mL
• To calculate IV drip rates, this information must be known.
Drip Chambers

• IV Sets with a small needle in the chamber

• Microdrip
• 1 mL = 60 gtts (60 gtts in drip chamber = 1 mL)
• IV Sets without a small needle
• Macrodrip
• Baxter tubing macrodrip / 1 mL = 10 gtts(10 gtts in drip chamber = 1 mL)
• Other companies tubing may be 15 gtt/mL or 20 gtts/mL
 Regulation of IV drip rate manually

• Tubing for these sets contain a

roller camp
• Can open or close & regulate
rate manually
• Use a watch with a second
hand to count number of drops
per minute in the chamber
 Electric Infusion Pumps
• IV Infusion pumps utilized to deliver IV fluids accurately- set at
mL/hour
• Need to enter the total number of milliliters to be infused
• Need to enter the number of milliliters per hour
 Labeling IV’s
• Every IV must be labeled so any
professional can check :
• The fluid infusing is correct
• The rate of infusion is correct
• Label:
• Patient name
• Room/bed #
• Date & time
• IV order
 Practice Label
Order: 1000 mL 0.9% NS at 125 mL per hour

Patient: Jane Doe

Room#: 2140
Date/Time: 10/10/2014
IV Order: 1000 mL 0.9% NS
Rate: 125 mL per hour
Signature: M. Baxter, RN
 Calculating Basic IV Drip Rates

• IV Drip Rate
• No Pump = rate will be gtt/min- also known as Gravity Drip

• Formula for gtt/min: mL/hr X drop factor = gtt/min

60 (minutes)
 Example of calculating gtts/min:
• Order: 1000 mLof D5/W to infuse 130 mL /hr.
• Drop factor of tubing is 20 gtts = 1 mL
• Formula:
• mL/hr X drop factor = gtt/min
• 60 minutes
• 130mL/hr x 20 gtt/min = 2600 = 43 gtt/min
60 minutes = 1 hr
• Manually would have to count drops as you watch the clock for one minute
• HINT: Count for 15 seconds and multiply by 4 = 60 seconds
 Practice:

A 20 gtt/mL set is to be used to infuse an IV at a rate of 90 mL/hr.

Calculate the gtt/min flow rate.

• Set it up: 90 mL/hr x 20 gtt/mL = ____ gtt/min

60 min

• Answer: 30 gtt/min
 Practice:

Calculate the gtt/min flow rate to administer an IV at 100 mL/hr

using a set calibrated at 15 gtt/mL.

• Set it up:
100 ml/hr x 15 gtt/mL = ___________gtt/min.
60 minutes

Answer: 25 gtt/min
 Practice:
Dr. Order: Adm 125 mL/hr; gtt factor is 10 gtt/mL.
How many gtt’s per minute will this infuse at?
• Set it up:
125ml/hr x 10gt/ml = ______gtt/min
60 min

Answer: 20. 8 gtt/min = 21 gtts/min

*Always round off since the pump cannot be set at decimals
 NCLEX Practice Question

• Order: 1000 mL D5W at 120 mL/hour . Available macrodrip tubing of 15

gtt/mL
• What is the drip factor in drops per minute?
• A. 30 gtt/minute
• B. 31 gtt/minute
• C. 32 gtt/minute
• D. 33 gtt/minute
 Answer

• A. 30 gtt/minute
• Formula:ml/hr x gtt factor = gtt/minute
120 mL x 15 gtt/mL = 30 gtt/minute
60 minutes
 PRACTICE:

Doctor’s order: Infuse 500 mL D5 W over next 12 hours. Use a

microdrip tubing. What is the drop per minute rate?

Set it up: Requires 2 steps

1. 500mL ÷ 12 hrs = 41.67 = 42 mL/hr
2. 42 mL/hr x 60 gtts/mL = _______gtts/min
60 minutes
Answer: 42 gtts/min
HINT: Note the 60’s cancel out and the remaining number is always the answer with
microdrip tubing
 Electronic Volumetric Pumps

• Infuse fluids into the vein under pressure & against resistance
• Do not depend on gravity
• Pumps are programmed to deliver a set amount of fluid per hour
• Milliliters per hour (mL/hr)
• Milliliter calculation that results in a decimal fraction -round to a whole
milliliter
• Pumps in ICU may have decimal capability and may use fractions
 Smart Pumps

• Smart pumps have customized software

• Has a reference library of medications- indicates the minimum
and maximum rates at which medications should safely infuse
• Select medication dosage and rate automatically is
programmed
 IV Pump using Controller

• IV Pump = rate will be mL/hr

• Formula:
Total # of mL ordered = mL/hr
Total # of hours ordered
•Example of calculating mL/hr to set the pump at:
• FORMULA:
Total number of milliliters ordered = mL/hour
Number of hours to run

• Order: 2000 mL LR to infuse in 10 hours

• Using formula for setting up calculation:

• Determine the amount of IV fluid ordered and divide this by the number
of hours
2000 mL = 200 mL/hr
10 hr
• Answer: Set the IV Pump controller at 200 mL/hr
 Practice
• Order: 400 mL LR to infuse for 4
hours, then 600 mL LR to infuse for a. 400 mL
8 hours.
4 hrs = 100 mL/Hr
• Use the formula to set the problem (set pump at 100/hr for 4 hours)
up: Then calculate second amount
Total number of milliliters ordered = b. 600 mL
mL/hour 8 hrs = 75 mL/hr

Number of hours to run (set pump now at 75 mL/hr for 8 hours)

Calculating the Rate/Hr for an IVPB
Practice
Doctor’s order: Keflin 2 g IVPB over 30 min. Keflin is in 100mL bag and drop factor is 15
gtt/mL. At what rate should the IV be regulated?

HINT: Need to find out what to set the pump at per hour
• Set it up:
• Total number of mL = X mL
Infusion time (minutes) 60 minutes

• 100 mL = X mL
30 min 60 min

Answer: 200 mL/hr

HINT: DO NOT NEED TO USE THE DROP FACTOR FOR CALCULATION OF IV RATE WITH
INFUSION PUMP
 IVPB : Calculate the rate to set the pump at

• Order: Keflex 250 mg IV every 12 hrs.

• Keflex 250 mg comes from pharmacy in a bag of 100 cc 5D/W; directions are infuse
over 1 hr. per IV pump
• Set it up:

100 mL = x mL
60 min 60 min
x = 100 mL
• Answer: Set pump at 100 mL/hr
 IVPB : Calculate the rate to set the pump at
• Order: Floxin 600 mg IVPB every 8 hrs.

• Available: Floxin 600 mg in a 50 cc bag of 5D/W. Infuse over 30 minutes

• Set it up:

50 mL = x mL
30 min 60 min (Use 60 minutes since the IV pump can only be set by the hour)
x = 100 mL
• Answer: Set pump at 100 mL/hr
 Determining the Number of Hours an IV Will Run

Formula:
Number of milliliters ordered = Number of hours to run
Number of milliliters per hour
Example of how to calculate how long IV will run

• How many hours will 500 mL of D5½NS run at 125 mL/hour?

Number of milliliters ordered = Number of hours to run

Number of milliliters per hour
500 mL = 4 hours
125 mL/hour
Calculate the number of hours the IV will run

• PRACTICE:
• Order= LR 1000 mL IV at 125 mL/hour

• Calculation:
1000mL = 8 hours
125 mL
 Safety Alert !

• Several electronic devices are on the market for infusing IV solutions

• Always familiarize yourself with the equipment before use
• Follow the institution's protocol for IV administration
• Nurses have the primary responsibility for monitoring the client during IV
therapy
• Nurses are responsible for any errors that occur in administration of IV fluids
(e.g., inadequate dilution, too rapid infusion)
• Pay close attention to IV abbreviations
What have you learned?
• What are the 2 types of IV tubing? Microdrip & Macro drip

• What are drop factors ? IV tubing package- # of gtts = 1 mL

• How do you calculate the IV rate for gtts/min?

• Formula:
mL/hr X drop factor = gtt/min
60 minutes
 What else have you learned?
• What is the formula for mL/hr?
Total number of milliliters ordered = mL/hour
Number of hours to run

• How do you calculate how long an IV will run?

Number of milliliters ordered = Number of hours to run
Number of milliliters per hour

• How do you calculate the ml/hr to set the IV pump?

Total number of milliliters ordered = mL/hour
Number of hours to run
The “BENEFITS” of IV Therapy