Page 448 - Saunders Comprehensive Review For NCLEX-RN

2. For example, epinephrine 1:1000 is 1 g of pure
medication per 1000 mL of solution.
XI. Intravenous Flow Rates (Box 14-9)
A. Monitor IV flow rate frequently even if the IV solution is being
administered through an electronic infusion device (follow agency
policy regarding frequency).

B. If an IV is running behind schedule, collaborate with the

primary health care provider to determine the client’s ability to
tolerate an increased flow rate, particularly for older clients and
those with cardiac, pulmonary, renal, or neurological conditions.

The nurse should never increase the rate of (i.e., speed up) an IV infusion to

catch up if the infusion is running behind schedule. The nurse should include any IV fluid
administered in the intake portion of the client’s assessment.
C. Whenever a prescribed IV rate is increased, the nurse

should assess the client for increased heart rate, increased
respirations, and increased lung congestion, which could indicate
fluid overload.
D. Intravenously administered fluids are prescribed most frequently
based on milliliters per hour.
E. The volume per hour prescribed is administered by setting the
flow rate, which is counted in drops per minute.
F. Most flow rate calculations involve changing milliliters per hour
to drops per minute.
G. Intravenous tubing
1. IV tubing sets are calibrated in drops per milliliter; this
calibration is needed for calculating flow rates.
2. A standard or macrodrip set is used for routine adult
IV administrations; depending on the manufacturer
and type of tubing, the set will require 10 to 20 drops
(gtt) to equal 1 mL.
3. A minidrip or microdrip set is used when more exact
measurements are needed, such as in intensive care
units and pediatric units.
4. In a minidrip or microdrip set, 60 gtt is usually equal
to 1 mL.
5. The calibration, in drops per milliliter, is written on
the IV tubing package.
XII. Calculation of Infusions Prescribed by Unit Dosage per Hour
A. The most common medications that will be prescribed by unit
dosage per hour and run by continuous infusion are heparin
sodium and regular insulin.
B. Calculation of these infusions can be done using a 2-step process
(Box 14-10).

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