Medication Practice Patient info and background Betty

Medication Practice Patient info and background Betty Seize was admitted last night for shortness of breath and was admitted with a diagnosis of PNA. She has been coughing dark tan sputum and requiring 2L of oxygen. Her history includes: COPD, DM, CHF, and alcohol abuse. Medications Tylenol 325 mg tabs Oxycodone 5 mg tabs Vitamin B12 1000mg/3 ml vial Solumedrol 50mg/1ml vial Heparin 5000units/0.5ml vial Insulin Glargine Pen Zofran 4mg/2mL vial Furosemide 40mg/2mL vial Insulin Orders Insulin lispro: 1 unit per 10 grams of carbs Insulin Lispro: 1 unit for sugar 180-230 2 units for sugar 231-260 3 units for sugar 261-310 Use this information to answer the following questions about Mrs. Seize’s day! Betty has just woken up for breakfast. She is reporting mild back pain 3/10. Her blood sugar is 240 and her meal ticket shows 45 carbs. She also needs her basal insulin before eating. *What medication on her list is her basal insulin? *How much prandial insulin would you administer? Correctional? Can correctional and prandial insulin be combined in the same syringe? *How many tabs of Tylenol would you need to give her ordered dose of 975 mg? Betty is now ready for her 9 AM meds. Please administer the following: *500 mg of vitamin B12 IV push *250 mg of solumedrol IV push *Heparin 5000 units subQ *How many mL of each medication do you need to draw up? *What information is needed on each IV label? *B12 can be administered at an IV push rate of 1000mg over 2 mins. How many minutes will you administer your B12 over? *Solumedrol can be given at an IV push rate of 1000mg per minute. How many minutes will you administer your solumedrol over? Its 10 AM and Betty is now saying her Tylenol isn’t working. She has an order for 2.5 mg of oxycodone Q6 hours. It was last given at 0100. *Can you safely administer the medication now? *How many tabs will you give? Its 1115 AM and Betty is now struggling to breathe and is nauseous. You assess her and find crackles in her lungs and an O2 sat of 85% on her 2L. The doctor gives you the following orders: *Administer oxygen to maintain sats >90% *Administer IV Zofran 8mg and IV furosemide 80 mg *What oxygen delivery device are you going to choose for Betty right now? What flow rate will you set her O2 at? *How many mL of Zofran will you draw up? *Zofran can be pushed at a rate of 4 mg per 2 mins. How many mins will you give your Zofran over? *How many mL of furosemide will you draw up? *Furosemide can be given at a rate of 40 mg over 1 min. How many mins will you give your furosemide over? Betty is feeling much better and orders lunch. Her sugar is now 150 and she eats 70 carbs. *How much correctional insulin will you give? Prandial? Betty has additional orders for the following: Cefepime 2 gms in 100 mL saline. You can administer 2000mg over 30 mins. *What is your VTBI? *What is your pump rate? Vancomycin 750 mg in 250 mL saline. You can administer 750 mg over 90 mins. *What is your VTBI? *What is your pump rate? Zosyn 3.375 mg in 100 mL Saline. You may give 3.375 mg over 4 hours. *What is your VTBI? *What is your pump rate?

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