IV Lab

Practice Problems KEY

January 2013
1. Your assigned labor patient is becoming increasingly uncomfortable with her contractions. She currently has an IV of
LR infusing at 125 mL/hour. The physician has ordered Stadol 1 mg IVP (IV push) every 2 hours as needed for pain.
Available is a vial labeled Stadol 2 mg/ml.
a. How many mL will the nurse need to draw up to administer?
Answer: 0.5 mL
b. What information specifically related to administration of an IV med in an existing line should be determined before
administration?
Answer: Review p. 39 in CSG
c. What is the rate of administration and how was that determined?
Answer: Review to OB textbook drug guide and Drug reference
d. Describe the technique the nurse would use to administer the IV push medication.
Answer: Review p. 49-51 in CSG
2. A patient is admitted to the labor unit with a history of hypertension. The physician has ordered an IV bolus of
Magnesium Sulfate 4 grams to be given over 20 minutes and then continue the Magnesium Sulfate at 2 grams per hour.
The solution available is Magnesium 20 grams in 500 mL of sterile water. Answer the following questions:
a. Is the 4 grams over 20 minutes a safe dose to deliver?
Answer: Yes it is a safe dose. Initial bolus is 4-6 grams
b. To administer the initial 4 grams ordered over 20 minutes, the infusion pump would need to be set at how many
mL/hr?
Answer: 300 mL/hr
c. After administering the bolus, the infusion rate on the pump would need to be changed to how many mL/hr to
deliver the ordered 2 grams per hour?
Answer: 50 mL/hr
3.

While receiving report at shift change, you were told that a patient was receiving 4 milliunits/minute of Pitocin. You
note that the bag infusing in the patient is labeled as Pitocin 10 units in 1000 mL LR and pump set at 12 mL per hour.
a. Was the information you received during report correct?
Answer: No. To deliver 4 mU/min the rate should be set at 24 mL/hr not the stated 12 mL/hr
b. If not, what should the milliunits/min be?
Answer: At the current rate (12 mL/hr) the patient would be receiving 2 mU/minute not the stated 4
mU/min

4. A labor patient is admitted for Pitocin induction. The physicians order reads: Pitocin 20 units in 500 mL Lactated
Ringers. Initiate Pitocin at 2 milliunits per minute and continue to increase by 1 milliunit every 15 minutes until labor
is established .
a. To deliver Pitocin at 2 mu/min the IV pump should be set at how many mL per hour?
Answer: 3 mL/hr
b. How many mL/hr will the nurse increase the Pitocin every 15 minutes?
Answer: 1.5 mL/hr
5. A labor patient has an order for IV Magnesium Sulfate to be initiated at 20 grams per hour. A vial of Magnesium
Sulfate 40 grams is available that will need to be added to a bag of IV solution in order to administer the medication.
a. How many mL of fluid will the nurse need and how did you determine this?

Answer: Refer to OB textbook med guide for Mag and Drug book reference-Usually dispensed as 40 gms
in 1000 mL Sterile Water. Bolus doses usually are dispensed as 4-6 gm/100 mL to infuse over 20 minutes
b. How many mL/hour would the IV pump need to be set at to infuse the ordered amount?
Answer: 500 mL/hour
c. After a little while, the patient starts to complain of feeling flushed, having sweats, blurry vision, and very tired.
What should the nurse do and why?
Answer: Refer to OB textbook med guide for Mag and Drug book reference for SE of drug
Should have already calculated safe dose and determined that 20 grams per hour IS NOT a safe
dose and 500 mL/hour is WAY TOO MUCH and you should have already called the physician and clarified
the order
Notify physician
May need to have order to draw lab for mag levels
6. A 68 year old frail, 110 pound patient is admitted to the hospital for dehydration. The physician has ordered an IV of
1000 ml of D5W to infuse at 100 mL/hr.
a. Based on the patients diagnosis, age, and weight what would be the most appropriate size IV catheter to use
assuming no other IVs or medications would be given?
Answer: 22 or 20 gauge
b. What site would be the most appropriate to initiate the IV considering the age and admitting diagnosis.
Answer: Dorsal metacarpal veins in the hand. Stay distal if possible
7. A patient is to have a blood draw for labs. On the image below:
a.

Label the veins next to the lines provided.

b. Draw a BOLD LINE where the tourniquet should be placed in preparation for the draw.
Answer: Note blue line belowc. Place an X mark to indicate where on the arm or hand you would obtain the blood specimen.
Answer: Note where arrow is pointing