Question

Calculate the IV flow rate in \(\mathrm{gtt} / \mathrm{min}\) for the following IV administrations, unless another unit of measure is stated. An IV of D5W \(500 \mathrm{~mL}\) was ordered to infuse over \(10 \mathrm{hr}\) at a rate of \(13 \mathrm{gtt} / \mathrm{min}(13\) macrogtt \(/ \mathrm{min})\) Drop factor: \(15 \mathrm{gtt} / \mathrm{mL}\) After \(3 \mathrm{hr}\), you notice that \(300 \mathrm{~mL}\) of IV solution is left. Recalculate the rate in \(\mathrm{gtt} / \mathrm{min}\) for the remaining solution. Determine the percentage of change in IV rate, and state your course of action.

Short answer

Recalculate drop rate as 10.72 gtt/min; it's a 17.54% decrease. Adjust and monitor as needed.

Step-by-step solution

Determine Initial IV Fluid Administered

First, calculate how much fluid has already been administered during the first 3 hours. The initial order was for 500 mL of D5W to be infused over 10 hours. Since there are 300 mL remaining, the amount of fluid administered in the first 3 hours is 500 mL - 300 mL = 200 mL.

Determine Time Remaining

Since 3 hours have passed and the original total time was 10 hours, the remaining time for the infusion is 10 hours - 3 hours = 7 hours.

Calculate Updated Flow Rate in mL/hr

To find the updated flow rate in mL/hr, take the remaining 300 mL and divide it by the 7 hours of remaining time. This gives 300 mL / 7 hrs = 42.86 mL/hr.

Convert Updated Flow Rate to gtt/min

Using the updated flow rate, calculate the drops per minute (gtt/min) using the drop factor of 15 gtt/mL. To do this, first calculate the total drops per hour: 42.86 mL/hr * 15 gtt/mL = 642.9 gtt/hr. Then, convert this to gtt/min by dividing by 60: 642.9 gtt/hr ÷ 60 = 10.715 gtt/min. Round to two decimal places to get 10.72 gtt/min.

Calculate Percentage Change in IV Rate

Calculate the percentage change in the IV rate compared to the initial rate. The initial rate was 13 gtt/min. The formula for percentage change is \( \frac{\text{New Rate} - \text{Old Rate}}{\text{Old Rate}} \times 100 \). So, \( \frac{10.72 - 13}{13} \times 100 = -17.54 \% \).

State Course of Action

Since there was a decrease of approximately 17.54% in the IV rate, inform the healthcare team about the change in rate and consider readjusting the flow rate to ensure the patient receives the complete infusion as intended within the remaining time. Monitoring the patient’s fluid status may be necessary.

Key concepts

IV fluid administration

Administering IV fluids is a crucial part of hospital care as it ensures that a patient receives necessary fluids and medications directly into their bloodstream. The volume of fluid that needs to be administered and the time over which it should be infused are key factors to consider. In the initial scenario provided, 500 mL of a solution called D5W was ordered to be infused over a total of 10 hours. Understanding how to manage and recalculate these administration rates is essential when care plans change, such as noticing a remaining volume of fluid after a specific time frame has passed. Intravenous (IV) fluid administration requires close attention to detail and frequent monitoring to ensure patient safety and the effectiveness of the therapy.
When administering IV fluids, health professionals use devices like infusion pumps or manual drip sets to manage the flow of the solution into the patient's vein. This ensures precise delivery of the fluid over a predefined period. It's important to consider factors like the patient's fluid status, the rate of infusion, and any necessary rate adjustments that may be required based on the situation. This vigilance helps avoid complications such as overhydration or dehydration, which can have immediate adverse effects on the patient's health.

gtt (drops per minute)

In medical terms, "gtt" is an abbreviation for "guttae," which translates to drops. The concept of drops per minute (gtt/min) is pivotal in IV administration as it determines how fast the fluid will be infused into the patient. The drop rate is usually calculated based on the prescribed fluid volume, the time over which the total volume is to be infused, and the specific drop factor provided by the drip set. In the current exercise, the initial rate was set at 13 gtt/min using a macrogtt tubing with a drop factor of 15 gtt/mL.
To correctly calculate gtt/min, it's crucial first to determine the total volume of fluid that needs to be delivered and the total time for infusion. Once these variables are known, the flow rate in mL/hr can be calculated, which then gets converted into gtt/min by using the formula: \ \[ \text{gtt/min} = \left( \frac{\text{mL/hr} \times \text{gtt/mL}}{60} \right) \ \]. This conversion allows healthcare providers to set the IV drip manually if needed and ensures precision in delivery.

infusion rate adjustment

Infusion rate adjustment is necessary when the initial conditions for administering IV fluids change. In our provided scenario, an when unexpected observation was made after 3 hours. There were 300mL left out of the 500mL initially administered, necessitating a recalibration of the infusion rate. Such adjustments ensure that the patient receives the exact volume prescribed, without extending the overall infusion period longer than necessary.
To adjust the infusion rate, calculate how much fluid has already been administered, then determine the remaining time left for infusion. Using these values, compute a new rate in mL/hr. For example, if 200mL has been administered over the initial 3 hours, leaving 300mL to go, with 7 hours left, the new rate becomes \ \[ 300 \text{ mL} \div 7 \text{ hrs} = 42.86 \text{ mL/hr} \]. Turning mL/hr into gtt/min using this new rate and drop factor provides the updated drop rate, which needs to be monitored until the end of the infusion.

percentage change in IV rate

Percentage change in the IV rate reflects how much the flow rate has varied from its initial set point. This calculation helps in assessing the impact of adjustments made during ongoing treatment. To find this percentage change, subtract the initial rate from the new adjusted rate, divide by the initial rate, and then multiply by 100 to convert it into a percentage. In our given problem, the original rate was 13 gtt/min, but after re-calculation based on the remaining volume and time, the new rate was found to be about 10.72 gtt/min.
The formula for percentage change is: \ \[ \frac{\text{New Rate} - \text{Old Rate}}{\text{Old Rate}} \times 100 \] \ Applying this, we find about a \(-17.54\%\) decrease. Such a notable change in the rate would necessitate further investigation or adjustment to ensure therapy goals are met. Communicating these changes to the healthcare team is an essential step in adjusting care strategy to maintain effective and safe patient outcomes.