One confusion that could arise is to use cc vs ml
http://thecompounder.com/2015/04/13/cc-vs-ml-whats-the-difference/
the ordered rate was 600 cc/8 hours
= 75 cc/hour
The pharmacist erroneously calculated this to be
200 ml/hr or 200 cc/hr
I really don't know how to begin to approach this problem.
A 6-year-old patient underwent an outpatient tonsillectomy and adenoidectomy The surgeon ordered 1,000 cc D5W, dispensed at a rate of 600 cc every 8 hours, to maintain hydration levels. A pharmacist calculated the infusion rate for the IV drip to be administered. He used a calculator and checked his calculations twice. He then listed the infusion rate on the electronic medical chart as 200 mL/hr.
The nurse who started the infusion obtained a bag of D5W, which contains 1,000 cc of fluid, and administered the IV solution to the child. Like other nurses in her unit, she relied on the accuracy of the pharmacist since he had a reputation for correctness. Therefore, she did not check his calculations even though her job duties include verifying dosages. Once the first 1,000 cc bag of D5W was empty, she hung a second bag to infuse.
The child began vomiting frequently, which is not unusual in the recovery for this surgery. The child was given medicine to ease the vomiting. Forty minutes later the child exhibited seizure-like activity, which is unusual in the recovery from this type of surgery. This behavior increased over the course of the day, during which a third 1,000 cc bag of D5W was hung to dispense.
The pediatrician on call noticed the patient was experiencing hyponatremia and water intoxication due to the high IV infusion rate and lack of sodium chloride in the infused medicine. In fact, the child's sodium level was 107 mEq/L, whereas the normal range is 136-145 mEq/L. Despite treatment, the child did not survive.
Assuming all three bags were completely administered, how much D5W did the child actually receive compared to the amount ordered? Assuming the surgeon's orders were correct, what should the IV rate have been in cc/hour? How long should the IV have continued to administer the 1,000 cc ordered by the surgeon? By what percent was the child's sodium level beneath the normal range?
This is actually for a math class and not a medical class. I know nothing about medicine and am struggling with how to begin. Obviously this patient was not given the correct dose, but how can I prove this?
How would i put this into a paragraph form??
1 answer
4 answers