TAC REQUIREMENTS/SKILLS PRACTICE GUIDELINES

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Contents

Skills Practice Schedule

Verification Chart

Additional Learning Activities

SKILLS PRACTICE SCHEDULE

Week 4 Suctioning

Week 5 Changing IV to SL

SL Flushes

Week 6 Priming IV tubing/ Use of IV Pumps

Time Taping/drip factors

Week 7 Reconstitution of meds (with math problems)

Week 8 Mixing 2 medications in one syringe

Week 9 Pediatric med problems/Pediatric IV set up

Week 10 Use of IV pumps (hanging secondary IV's)

Week 11 Use of NG Tubes (meds and feedings)

Week 12 Priming IV tubing/Time taping/ drip factors

Week 13 Reconstitution of meds/mixing 2 meds

Week 14 Practice for Skills Appraisal

VERIFICATION CHART

EACH PRACTICE SESSION MUST BE SIGNED OFF BY THE SKILLS LABINSTRUCTOR IN ORDER FOR YOU TO RECEIVE CREDIT FOR COMPLETINGTHAT LEARNING REQUIREMENT. FAILURE TO COMPLETE THE ASSINGED

WEEKLY LEARNING REQUIREMENT WILL RESULT IN DISMISSAL FROMCLINICAL AND A CLINICAL ABSENCE WILL BE ISSUED.

WEEK/DATE ACTIVITY SIGNATURE

ADDITIONAL LEARNING ACTIVITIES

Medical/Surgical

MS VT 62 Respiratory alkalosis & Acidosis

MS VT 61 Ups & Downs of pH

MS VT 97 Diabetes Mellitus

DVD 1 Nasogastric Tubes

DVD 2 G- tubes

DVD 4 Suctioning

DVD 10 Sterile Technique CD-

ROM 20 Interpreting ABG's

Attached Reconstitution Math Problems

Obstetrics

DVD 24 From Conception to Birth

DVD 25 Exam of the Pregnant Woman

OB VT 14 Labor and Delivery

OB VT 15 Maternal Changes

OB VT 25 Postpartum

OB VT PE of the Newborn

OB DVD 19 Bundles of Blues

Ordered: Tazicef 250 mg IM q8h.Available: Tazicef 1 g for IM or IV use.Follow insert directions for reconstitution directions.a. How many mL of diluent will be added to the powder?b. How many mg/mL will this make?c. How many nil, will you give IM?

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Ordered: Cefadyl 700 mg IM q6h. Available: Cefadyl 1 g. Directions read: For IM use, add 2 mL sterile or bacteriostatic water for injection. USP. Each 1.2 mL contains 500 mg of cephapirin.a. How many milliliters will you administer per injection?b. How many milligrams will the patient receive in 24 hours?

c. How many vials will you need for a 24-hour period?

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Pediatric Medication Practice Problems

Converting Pounds to Kilograms

1. 30 lb = ____________2. 15 lb 5 oz =________3. 7 ' A l b = ____________4. 2 2 l b = _____________5. 4 lb 5 oz =_________6. 7 5 l b = _____________7. 10 ' /z lbs =_________

Answers:1. 13.63 kg 2. 15.31 lb = 6.95 kg 3. 7.25 lb = 3.29 kg 4. 10 kg5. 4.31 lb = 1.95 kg 6. 34.09 kg 7. 10.5 lb or 4.77 kg

NOTE DO NOT ROUND OR YOUR ANSWER WILL BE MARKED WRONG

Problem 1Child weighs 33 lbsPhysician order: Augmentin 150 mg po q 8 hours

Information from drug guide: children < 40 kg receive 6.7 to 13 mg/kg q 8 hours

Convert 33 lbs to kg__________

Calculate low and high dose _________low dose __________high dose

Is the dose in the safe range? _____________

The medication comes Augmentin 125 mg / 5 mL

How many mL would you need to draw up to equal 150 mg?___________

Answer problem 1:15 k g Low dose 100.5 mg (6.7 x 15 kg)High dose 199.5 mg (13.3 x 15 kg)Safe range (100.5 mg to 199.5 mg) 150 mg is a safe dose.You \ ould give 6 niL Calculation 125 mg 150 mg 750

5 mL x mL 125x

Problem 2Child weighs 16 lb 10 ozPhysician order: Lasix 15 mg po bid

Information from drug guide:The initial dose of Lasix (furosemide)for infants or children is 2 mg /kg /dose.If initial dose works dosage may be increased to 1 or 2 mg /kg /dose (maintenance dose).

Doses greater than 6 mg / kg / day are not recommended.

Convert 16 lb 10 oz to kg__________

Calculate initial and high dose _________ initial dose _______ high dose

Is the dose in the safe range? ____________

The medication comes: Furosemide 10 mg/mL

How many mL would you need to draw up to equal 15 mg?__________

Answer Problem 2

16.62 pounds to 7.556 kg or 7.56 kgSingle dose of Lasix 7.56 kg x 2 mg = 15.12 mg/dose High range daily dose 7.56 kg x 6 mg = 45.36 mg/dose Is the dosage of 15 mg bid or 30 mg / day safe? =How many mL? 1.5 mL Calculation: 10 mg = 15 mg

1 mL x mL

ProbChild weighs 66 lbsPhysician order: Epinephrine 0.3mg sub q x 1 dose for allergic reactionInformation from drug guide: 0.01 mg/kg every 20 minutes as needed. Not to exceed 0.5 mg in a single dose.

Convert 66 lbs to kg__________Calculate low and high dose _________low dose _________high doseIs the dose in the safe range? ____________The medication comes epinephrine 1 mg / mL

How many mL would you need to draw up to equal the minimum or low dose?

Answer 3Weight in kg: 30 kgLow dose 0.3 mg high dose 0.5 m Is dose safe? Yes0.3 mg = 0.3 mL

NOTE: .3 mL would be marked wrong — you need to always put zero before a decimal in drug calculations.

Fluid Calculations

100 mL x lst 10 kg50 mL x 2nd 10 kg20 mL x any additional kg

Practice problemsWeight 22 lb to______________kg_____________24 hour maintenance fluids

1 1/2 times maintenance

Weight 12 lb to______________kg_______________24 hour maintenance fluids

______________1 1/2 times maintenance

Weight 6 lb 4 oz _____________kg______________24 hour maintenance fluids

______________1 1/2 times maintenance

Weight 75 lb to______________kg______________24 hour maintenance fluids

______________1 1/2 times maintenance

Weight 42 lb to _____________kg______________24 hour maintenance fluids

1 1/2 times maintenance

Answers:

22 lb to 10 kg (10 x 100 m1_, = 1000 mL) 1000 mL / 24 hour (1000 x 1.5 = 1500 mL) 1500 mL / 24 hour for 1 1/2 maintenance fluids.

12 lb to 5.45 kg (5.45 x 100 mL = 545 inL) 545 / 24 hour (545 x 1.5 = 818 mL) or 818 1111./ 24 hour for 1 1/2 maintenance fluids.

6 lb 4 oz to 6.25 lb to 2.84 kg (2.84 x 100 mL = 284 ml) 284 mL / 24 hours (284 x 1.5 = 426 mL) 426 mL / 24 hour for 1 1/2 maintenance fluids.

75 lb = 34 kg100 mL x 10 kg = 1000 mL 50 mL x 10 kg = 500 mL 20 mL x 14 kg = 280 mL

1780 mL / 24 hours or 74 mL / hour

1 1/2 times maintenance would be (1780 x 1.5 = 2670) 2670 mL / 24 hours or 112 mL / hour.

42 lb to 19.09 kg100 mL x 10 kg = 1000 mL

50 mL x 9.09 kg = 454 mL1454 mL / 24 hours or 61 mL / hour

Parenteral Pediatric Medications

Order: ampicillin 100 mg IV q 6 hoursWeight: 9 lbs 6 ouncesDrug guide: safe dose 75 to 200 mg /kg/24 hoursConcentration of IV use: 50 mg/mL over 10 to 30 minutesSupplied as: vial of powder 500 mg. Directions: add 1.8 mL of sterile water to makes 250 mg / mL

Questions:Pounds to kg_____________Safe dose: low range____________ high rangeDose q 6 hours__________________mgMinimum safe dilution _____________

How many mL would you draw up from the re-constituted vial of ampicillin _________Inject the ampicillin into the volutrol and fill to 10mL.What would you need to set the pump at to deliver the 10 mL of medication + the 20 mL of flush over 30 minutes? ______________________

Answers:

911) 6of = 9.37 pounds converted to 4.259 or 4.26 kgSule dose for 24 hours: low ntilSi (4.26 x 75 nv i 3195 111,1

high range (4.26 x 200 mg) 852 mg Side dose Lor 6 hour: low fallgc: 319.5 / 4 = 79.8 mu,

high range 852 /4 = 214 im:r.

4

100 mg per dose would be a safe dose.Minimum safe dilution would be 100 / 50 = 2 mL

How many mL would you draw up from the re-constituted vial of ampicillin? 250 mg = 100 mg 100 lmL x mL 250 x You would draw up 0.4 mL of solution from the vial to

equal 100 mg of ampicillin.

The ampicillin 0.4 mL would be injected into the volutrol and fill to 10 mL with IV solution. 10 mL of medication followed by 20 mL flush would equal to 30 mL to be infused over 30 minutes. The pump would need to be set at 60 mL/hr.

-).

Infant 6 months; weight 17 lbs 6 ozOrder: Cefuroxime 185 mg IV q 6 hr in 10 mLDrug Guide: Safe dose is 50 to 100 mg/kg/24 hours. Medication can be safely infused over 30 minutes.Medication supplied as: 750 mg vial of powder. Directions: dilute with 8 mL sterile water to 90 mg / mL.Weight in kg_______________Safe range: low____________ and high__________________Is this a safe dose?_________How much medication do you need to draw up from the vial? _____________mLYou put the cefuroxime in the volutrol with 10mL of IV solution. Remembering the 20 mL flush. What would you need to set the pump at mL/hr to get the medication and flush in over 30 minutes? ______________

Answer to question 2Weight 17.375 lb = 7.89 kgSafe range: low range 394.5 mg high range 789 mg , divided by 4 = low range 98 kg to high range 197.25Safe dose? Yes

Draw up 90 mg = 38 mg 185 ImL x mL 90x = 2.05 mL

How fast would you set the pump to infuse medication followed by the flush in 30 minutes? 60 mL/hour

NG — cc/cc replacement every 4 hours.

1. NG output recorded by the night nurse is 176 mL. The maintenance IV isinfusing at 90 mL/hour. How much fluid would you infuse over the next four hours

5

2. NG output recorded over the next 4 hours is 125 mL. The maintenance IV isinfusing at 90 mL/hour. How much fluid would you infuse over the next four hours

Answers:1. 176 divided by 4 = 44 mL. Add to 90 mL per hour rate to equal 134 mL/hr to

infuse over the next 4 hours.2. 125 divided by 4 = 31.25 or 31. Add to 90 mL per hour rate to equal 121

mL/hr to infuse over the next 4 hours.

REMEMBER:

· Grains, grams, milligrams, micrograms· Teaspoons, tablespoons and ounces· Liquid medication calculations

6

Pediatrics

PD VT Administering IV Meds to

Children DVD 20 Child Abuse

DVD 21 Growth and Development

PD VT 6 Infant Development

DVD 22 PE of the Child

PD VT 14 Promoting Growth and

Development PD VT 22 Working with

Pediatric Patients Attached Pediatric Drug

Calculations Problems

** board Games Available in Skills Lab to review Mec1/5urg, 015 an !

Pediatric theory **