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Critical Care CalculationsPhysicians ordering critical intravenous medications generally order them by flow rates in mL/h or gtt/min, or by dosage rate mg/kg/min or mcg/kg/min. This is the same calculations you have been doing all along with an additional step where you may have to convert or determine the dosage by weight.It is imperative that these calculations are correct because even small errors can be life threatening.Most critical care drugs require continuous or very close monitoring. All critical care drugs shouldbe administered via infusion pump. IV fluids with a critical medication added should never be administered by gravity. In the event that an electronic infusion pump is unavailable you must be efficient in calculating drop rate (gtt/min). Microdrip tubing (60 gtts/mL) is generally used for critical caremedication because it safer, delivering a smaller amount of medication in each drop.Please review examples on the following pages and complete the exercises.1
Example 1:The order is to infuse Dopamine 800 mg in 500 mL of D5W at 25 mL/hr. Calculate the dosage in mcg/minand mcg/hr.A. Determine concentration: 800mg÷500mL=1.6mg/mLB. Determine how many mg/hr:1.6mg/mL×25mL/hr=40mg/hrC. Convert to mcg:40mg/hr=40000mcg/hrD. Convert to minutes:40000mcg/hr ÷60min/hr=666.6mcg/minExample 2:A post-op cardiac bypass patient has Nipride infusing at 30 gtts/min. The solution hanging states 100 mg Nipride in 500 mL D5W. Calculate how many mg/min the patient is receiving and how many mg/hr. The