calculate with confidence

CHAPTER 19 Reconstitution of Solutions 437

Copyright © 2014 by Mosby, an imprint of Elsevier Inc. All rights reserved.

CHAPTER REVIEW

Use the labels where provided to obtain the necessary information; shade the dosage onsyringes where provided. Round the answers to the nearest tenth where indicated.

1. Order: Kefzol 250 mg IM q4h.

Available:

a. How much diluent must be added to the vial for IM administration? ___________________________________

b. What is the final concentration of the solution prepared for IM administration? ________________________________

c. How many milliliters will you administer to provide the ordered dosage? __________________________________

d. Shade the dosage calculated on the syringe provided.

11/ 2

21 /

2

1 /2

1 2 3 mL

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2. Order: methylprednisolone sodium succinate 165 mg IV daily.

Available:

a. How many milliliters will you administer? ______________________________

b. Shade the dosage calculated on the syringe provided.

3. Order: Ampicillin 375 mg IM q6h

Available:

a. How much diluent must be added to the vial for IM administration? ___________________________________

b. What is the final concentration of the solution prepared for IM administration? ________________________________

11/ 2

21 /

2

1 /2

1 2 3 mL

438 UNIT FOUR Oral and Parenteral Dosage Forms and Insulin


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c. How many milliliters will you administer? ______________________________


4. Order: Doxycycline 100 mg IVPB q12h.

Available:

How many milliliters will you administer? _________________________________

5. Order: Amoxicillin 0.4 g p.o. q8h.

Available:

a. How much diluent must be added to prepare the solution? _________________

b. What diluent is recommended for reconstitution? _________________________

c. What is the dosage strength of the reconstituted solution? __________________

d. How many milliliters will you administer? ______________________________

e. How long will the medication maintain its potency? ______________________

11/ 2

21 /

2

1 /2

1 2 3 mL

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6. Order: penicillin G potassium 275,000 units IM q6h.

Available:

a. Which dosage strength would be best to choose? _________________________

b. How many milliliters of diluent would beneeded to make the dosage strength? ___________________________________

c. How many milliliters will you administer? ______________________________


7. Order: Cytarabine 200 mg IV daily for 1 week.

Available:

a. What is the concentration of the reconstituted material? ___________________________________

b. How many milliliters will you add to the IV? ___________________________________

c. Shade the dosage calculated on the syringe provided.

11 / 2

21 /

2

1 /2

1 2 3 mL

11/ 2

21 /

2

1 /2

1 2 3 mL

ch19-413-464-9780323089319.qxd 8/19/13 6:24 PM 40

8. Order: Methylprednisolone Sodium Succinate 175 mg IV q6h.

Available:

a. What is the total dosage strength of Methylprednisolone Sodium Succinate in this vial? ___________________________________

b. What diluent is recommended for reconstitution? ___________________________________

c. How many milliliters will you add to the IV? ___________________________________


9. Order: Amoxicillin/clavulanate 0.5 g p.o. q12h (calculation based on Amoxicillin).

Available:

a. How many milliliters of diluent must be added? ___________________________________

b. What is the dosage strength after reconstitution? ___________________________________

c. How many milliliters are needed to administer the required dosage? ___________________________________

32 541 mL



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10. Order: Cefotan 1.2 g IM q12h.

Available: Read the medication label and portion of the package insert.

a. How many milliliters will you administer? ______________________________


11. Order: Nafcillin 0.5 g IM q6h.

Available:

a. What is the dosage strength of the reconstituted Nafcillin? __________________

b. How many milliliters will you administer? ______________________________

c. Shade the dosage calculated on the syringe provided.

11/ 2

21 /

2

1 /2

1 2 3 mL

11/ 2

21 /

2

1 /2

1 2 3 mL

Vial Size

1 gram

2 gram

Amount of DiluentAdded (mL)

2

3

ApproximateWithdrawable Vol (mL)

2.5

4

Approximate AverageConcentration (mg/mL)

400

500



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12. Order: Biaxin 350 mg p.o. q12h for 10 days.

Available:

a. How many milliliters of diluent must be added? __________________________

b. What is the dosage strength after reconstituion? __________________________

c. How many milliliters will you administer? ___________________________________

13. Order: Claforan 1 g IV q8h.

Available:

a. How much diluent must be added to the vial for IV administration? ___________________________________

b. What is the dosage strength of the solution prepared for IV administration? ___________________________________


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14. Order: Penicillin G potassium 400,000 units IM q4h.

Available:

a. How many milliliters will you administer? ___________________________________


15. Order: Ceftazidime 250 mg IM q12h.

Available:



11/ 2

21 /

2

1 /2

1 2 3 mL

11/ 2

21 /

2

1 /2

1 2 3 mL

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16. Order: Ticar 0.5 g IM q6h.

Available:



17. Order: Cytarabine 150 mg IV daily for 7 days.

Available:

a. How many milliliters will you administer? __________________________________


32 541 mL

11/ 2

21 /

2

1 /2

1 2 3 mL

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18. Order: Vancomycin 0.45 g IV q8h.

Use the directions from the insert below.

Available:

a. How many milliliters of diluent must be added to the vial? ___________________________________

b. What is the final concentration of the prepared solution? ___________________________________



PREPARATION AND STABILITYAt the time of use, reconstitute by adding either 10 mL ofSterile Water for Injection to the 500-mg vial or 20 mL of Sterile Water for Injection to the 1-g vial of dry, sterile van-comycin powder. Vials reconstituted in this manner will givea solution of 50 mg/mL. FURTHER DILUTION IS RE-QUIRED.After reconstitution, the vials may be stored in a refrigeratorfor 14 days without significant loss of potency. Reconstituted solutions containing 500 mg of vancomycin must be dilutedwith at least 100 mL of diluent. Reconstituted solutions con-taining 1 g of vancomycin must be diluted with at least 200mL of diluent. The desired dose, diluted in this manner,should be administered by intermittent intravenous infusion over a period of at least 60 minutes.

10 mL

2 41 3 6 8 95 7

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19. Order: Levothyroxine sodium 0.05 mg IV daily.

Available:

a. How many milliliters will you add to the IV? ____________________________


20. Order: Acyclovir 0.25 g IV q8h for 5 days.

Use the directions from the insert below.

Available:

a. How many milliliters will you add to the IV? ____________________________


11/ 2

21 /

2

1 /2

1 2 3 mL

10 mL

2 41 3 6 8 95 7



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21. Order: Vantin 200 mg p.o. q12h.

Available:

How many milliliters will you administer using an oral syringe? ___________________________________

22. Order: Cefazolin 0.5 g IM q8h.

Available:


b. Shade the dosage on the syringe provided.

11/ 2

21 /

2

1 /2

1 2 3 mL



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23. Order: Maxipime (Cefepime Hydrochloride) 1.5 g IV q12h.

Available:

a. How many milliliters will you add to the IV? ___________________________________


24. Order: Penicillin G Sodium 425,000 units IV daily.

Available:

a. Which dosage strength would be best to choose? ___________________________________

b. How many mL of diluent would be needed to make the dosage strength __________________________________

10 mL

2 41 3 6 8 95 7

Single-Dose Vials forIntravenous/IntramuscularAdministration

Amount ofDiluent to beadded (mL)

ApproximateAvailable

Volume (mL)

ApproximateCefepime

Concentration(mg/mL)

cefepime vial content

1 g (IV) 10 11.3 100

1 g (IM) 2.4 3.6 280

2 g (IV) 10 12.5 160



ch19-413-464-9780323089319.qxd 8/19/13 6:24 PM Page 449

c. How many milliters will you add to the IV? __________________________________


25. Order: Vfend 200 mg IV q12h.

Available:

a. How many milliliters of diluent must be added to the vial? __________________________________

b. How many milliliters will you add to the IV? ___________________________________

26. Order: Cefprozil 500 mg p.o. q12h for 10 days.

Available:

a. How many milliliters of diluent are recommended for reconstitution? ___________________________________

b. How many milliliters will the bottle contain after reconstitution? ___________________________________

c. How many milliliters will youadminister? ___________________________________

11/ 2

21 /

2

1 /2

1 2 3 mL



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27. Order: Zosyn 2.25 g q8h IV.

Available:

a. How many milliliters of diluent are recommended for reconstitution? ___________________________________

b. What is the dosage strength of the vial? _________________________________


28. Order: Zithromax 500 mg p.o. stat for 1 dose.

Available:

How many milliliters will you administer? ___________________________________

29. Order: Cefobid 1 g IM q12h for 5 days.

Available: Cefobid 1 g with directions to add 1.4 mL of sterile water for injection.Each 2 mL yields 1 g.



11/ 2

21 /

2

1 /2

1 2 3 mL

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30. Order: Unasyn 1.5 g IV q6h.

Available:

Refer to portion of package insert.

How many milliliters will you add to the IV? ___________________________________

31. Order: Pepcid 20 mg p.o. b.i.d.

Available:

How many milliliters will you administer using an oral syringe? ___________________________________

Unasyn Vial Size Volume of Diluent to Be Added Withdrawal Volume

1.5 g 3.2 mL

6.4 mL

4 mL

3 g 8 mL

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32. Order: Rocephin 125 mg IM stat.

Available:



11/ 2

21 /

2

1 /2

1 2 3 mL

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33. Order: Amphotericin B 45.5 mg IV every day.

Available:

Use the information from the partial package insert to answer the questions and cal-culate the number of milliliters you will administer.

a. How many milliliters of diluent must be added for the initial concentration? ___________________________________

b. What is the recommended diluent? ___________________________________

c. What is the final concentration of the prepared solution per milliliter? ___________________________________

d. How many milliliters will you administer? ___________________________________

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34. Order: Omnicef 300 mg p.o. q12h for 5 days.

Available:

a. How many milliliters of diluent must be added to the bottle for reconstitution? ___________________________________



35. Order: Zithromax 250 mg p.o. daily.

Available:

a. How many milliliters of diluent must be added to the bottle? ___________________________________



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