Complex / Doris Turner Med Math Questions 1. Problem type: IV infusion rate + infusion pump Medication: azithromycin PROBLEM Suppose Mrs. Turner’s orders call for 500 mg of azithromycin to be administered intravenously for community­acquired pneumonia. The solution has been diluted to a concentration of 2 mg/mL and needs to be administered over 1 hour. 2. Problem type: Dosage calculation + Stock on hand Medication: venlafaxine PROBLEM Mrs. Turner’s daily medications include venlafaxine extended­release, 150 mg, by mouth, once a day. However, the hospital pharmacy only carries 75 mg extended­release tablets. 1. Problem type: Total daily dosage Medication: Acetaminophen @ hospital ­ hypothetical Suppose Mrs. Turner’s provider updated her order for 325 mg, 2 tabs, by mouth q6h PRN temp. > 100.5 F to 325 mg, 2 tabs, by mouth q4h PRN temp. > 100.5 F. The Davis’s Drug Guide reports that acetaminophen has a maximum recommended dosage of 4 g/day. How many doses can Mrs. Turner take without exceeding the recommended maximum dosage? 2. Problem type: Total daily dose calculation Medication: acetaminophen @ hospital PROBLEM Suppose Mrs. Turner’s current temperature is 100.8 F. For temperatures greater than 100.5 F, the prescriber’s order allows acetaminophen, 325 mg, 2 tabs, by mouth, every 6 hours. Assume that on her first day of hospitalization, Mrs. Turner’s temperature is greater than 100.5 F three times. How many grams of acetaminophen will she have ingested on her first day of hospitalization? Round your answer to hundredths. 3. Problem type: Dosage calculation + Stock on hand Medication: potassium chloride PROBLEM Mrs. Turner’s daily medications include potassium chloride, 10 mEq tablet by mouth once daily. The hospital pharmacy will dispense potassium chloride liquid 10% (1.5 gram or 20 mEq per 15 mL). The KCl liquid will be further diluted in a 6 oz glass of water or juice for administration. What volume of the KCl 10% liquid should be used for Mrs. Turner’s usual daily dose? 4. Problem type: IV flow + allergic reaction Medication: ceftriaxone ­ hypothetical PROBLEM Mrs. Turner’s original orders called for ceftriaxone, 1g, to be administered intravenously daily. The solution has been diluted to a concentration of 1 g / 50 mL to be administered over 30 minutes. Twenty minutes into the first infusion, Mrs. Turner reports an adverse reaction to the antibiotic and the infusion is stopped. How many mL of concentration were administered before the infusion was stopped? Round your answer to the nearest whole number. 5. Problem type: Dosage calculation + weight­based dosage Medication: azithromycin @ hospital ­ hypothetical According to the Davis’s Drug Guide, children six­months­old or younger with community­acquired pneumonia can be administered azithromycin orally using a weight­based dosage. Children in this age group can receive 10 mg/kg on the first day, then 5 mg/kg for four more days. Assume you need to administer this to a child weighing 20.3 lbs. What is the total dose of azithromycin the child will receive over five days? Round your answer to the nearest whole number. 6. Problem type: Unit conversation + stock on hand Medication: levothyroxine @ hospital Mrs. Turner’s orders called for 50 mcg of levothyroxine, by mouth, daily. The pharmacy stocks the medication in 0.025 mg tablets. 7. Problem type: Total daily dose calculation Medication: Units of insulin @ home At home, Mrs. Turner takes 16 units of insulin aspart, twice a day with meals. She also takes 45 units of long­acting insulin glargine, daily. How many total units of insulin does Mrs. Turner take daily? 8. Problem type: Dosage calculation Medication: Insulin aspart @ hospital ­ hypothetical The provider ordered insulin aspart on a sliding scale for 1 unit/10 g CHO subcutaneous + 1 unit/50 points above 150 BG. Mrs. Turner will eat a meal that contains 40 g CHO and has a pre­meal BG level of 160. How many units of insulin should be administered? 9. Problem type: Unit conversion + orders correction Medication: levothyroxine @ hospital ­ hypothetical Suppose Mrs. Turner’s provider writes a revised order of 25 mg of her daily levothyroxine. Given that her original order was in micrograms, you suspect this new order contains an error. You take the appropriate measures to get the orders corrected in order to avoid administering an overdose. If the error had not been caught, how many times more levothyroxine would have been given? 10. Problem type: IV flow rate + drop factor Medication: azithromycin @ hospital ­ hypothetical Suppose Mrs. Turner’s provider orders 500 mg of azithromycin to be delivered in a 250 mL IV solution over 3 hours. The dose will be delivered using IV tubing with a drop factor of 15 (15 gtt (drops) = 1 mL) What is the appropriate rate of flow for the IV, in drops per minute? Round your answer to the nearest whole number. 11. Problem type: IV flow rate + drop factor Medication: azithromycin @ hospital ­ hypothetical On the second day of hospitalization, Mrs. Turner’s orders call for 500 mg of azithromycin to be delivered in a 250 mL IV solution over 3 hours. The dose will be delivered using IV tubing with a drop factor of 10 (10 gtt (drops) = 1 mL). What is the appropriate rate of flow for the IV in drops per minute? Round your answer to the nearest whole number. 12. Problem type: Correct days’ supply Medication: Insulin @ primary care ­ hypothetical Mrs. Turner is prescribed insulin aspart, 16 units, SC TID at mealtimes. When Mrs. Turner returns home, the provider would like to switch her meal­time insulin administration to a pen delivery device instead of insulin syringes. The provider will keep the same dose. Assume that Mrs. Turner eats three meals a day. If the pen cartridges contain 3 mL of U­100 insulin aspart, how often will Doris need to replace the cartridge? Round your answer down to the nearest whole day. 13. Problem type: Correct days’ supply Medication: Insulin @ primary care ­ hypothetical Assume that Mrs .Turner’s provider decides to prescribe insulin aspart, 16 units SC TID at mealtimes, and Mrs. Turner receives a U­100, 10 mL vial of insulin aspart. Assume that Mrs. Turner eats three meals a day. How long would a U­100, 10 mL vial of insulin aspart last at this dosage? Round your down answer to the nearest whole day.