CHAPTER 10 I N T R AV E N O U S M E D I C AT I O N S Learning Outcomes 10-1 Identify the components and concentrations of IV solutions. 10-2 Distinguish basic types of IV equipment. 10-3 Calculate IV flow rates for both electronically controlled and manually controlled IV devices.

2. Obtain IV catheters of various gauges and lengths for students to view and compare. Pass samples around the room and talk about the situations where larger diameter (smaller gauge) is needed. For example, a 14 gauge (larger) would be put in if possible during a trauma situation in case the patient needed blood. A 20 gauge (smaller) would be used for fluid replacement for a child or an elderly person. 3. Set up an administration set and have students practice regulating it with gravity flow and the manual clamp. Have students adjust the clamp to set different flow rates—for example 44 gtt/ min and 60 gtt/min. Students should also practice priming the tubing, if enough equipment is available.

10-4 Adjust the flow rate for IV infusions. 10-5 Calculate infusion time based on volume and flow rate. 10-6 Calculate volume based on infusion time and flow rate. 10-7 Reconstitute and calculate medications for intermittent IV infusions.

Chapter Outline

Teaching Strategies • Assign and collect the homework for Chapter 10. Check the student’s answers to discover the topics within the chapter that require the most focused attention during class time. • Have a health care professional visit the class and discuss their role in dosage calculations as well as the importance of math accuracy and preventing medication errors in the health care profession. • Have students review the key terms for Chapter 10 using the Audio glossary and Key Term Concentration game on the student CD.

10-1 IV Equipment 10-2 Calculating Flow Rates

• Have students in groups of three; review their basic math skills using the “Math Challenge” game on the student CD.

10-3 Infusion Time and Volume 10-4 Intermittent IV Infusions

Lesson Plan Anticipatory Set Introduce students to Intravenous Supplies and Equipment using the following techniques: 1. Start a discussion about the types of equipment needed for an IV. Let students talk about any IV therapy experience they have, including the type of equipment that was used. Discuss the equipment needed for IV therapy starting at the IV site and working to the fluid that is infused. Make a point of identifying that IV therapy is a closed system to prevent infection. Again stress the need for accuracy in all calculations.

• Encourage students to complete each review and practice section in the text/workbook and check their answers. You can also remove the answers from the back of the book and use the review and practice questions as a graded assignment. • Use the Critical Thinking on the Job Activities from Chapter 10 as Think-Pair-Share assignments in class. Have student groups discuss their answers and present to the rest of the class. • Use the PowerPoint® presentation for Chapter 10, found on the student and instructor resource CD-ROM, for a class lecture and/or review. Use the “Test Your Knowledge” questions for discussion.

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• The online learning center at www.mhhe.com/ MathDosage3e contains additional activities for each chapter. Links for the Internet activities from at the end of this chapter are provided on this site. Have students navigate to this site to complete the Internet activities. • Play the Spin the Wheel on the student CD with individual, small groups or within the classroom in preparation for the final evaluation.

REVIEW AND PRACTICE: 10-1 IV Equipment 1. Injection port 2. Roller or screw clamp 3. Slide clamp 4. Infusion pump

Assess • Use the Additional Exercises for Chapter 10 found at the end of this document for reinforcement of chapter concepts. These exercises can also be used as chapter quizzes. • Students should complete each student CD activity when directed within the text. Have students save, print, or email their completed “Progress Report” from the student CD for Chapter 10. • The chapter review should be completed and checked in preparation for the final chapter evaluation. • Using the EZTest test bank for Chapter 10, create a written test in two versions for a final evaluation of student’s proficiency. • Access the Instructor’s Manual documents in electronic format and modify to match your curriculum needs. • Use the chapter images and labels to create your own worksheets, tests, or PowerPoint® presentations.

5. Microdrip tubing 6. PCA pump 7. Syringe pump 8. Burette 9. Central IV therapy would be used if a patient needed large amount of fluids, a rapid infusion of medication, an infusion of highly concentrated solutions, or long-term IV therapy. 10. When monitoring IV equipment, you observe the flow rate, whether an ordered medication has been infused properly, times at which an IV bag needs to be changed, and signs of infiltration or phlebitis. 11. Swelling, coolness, or discomfort at the IV site 12. Irritation of the vein by IV additives, movement of the needle or catheter, and long-term IV therapy 13. The bag should be 36 inches above the patient’s heart.

CHAPTER 10 Solutions Critical Thinking on the Job: Checking Compatibility: The health care professional suspects that the additive is not compatible with the IV solution. She stops the administration, then uses a compatibility chart to verify her suspicions. After which, she calls the physician to obtain a new order. In this case, the health care professional was fortunate that a change in the fluid’s appearance alerted her to the problem. However, in many cases, failing to verify compatibility before introducing an additive can have severe consequences for the patient, including death.

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14. Rate controllers, infusion pumps, syringe pumps, and patient-controlled analgesia devices 15. To add a dose of medication to an existing line Critical Thinking on the Job: Adjusting the Flow Rate: Pat’s error could have serious consequences for the patient by providing far too much solution in a limited time period. The new flow rate of 28 gtt/min is a 75 percent increase over the original flow rate of 16 gtt/min, well beyond facility guidelines. Instead of making up the entire schedule in 1 h, Pat should have adjusted the remainder of the entire schedule. The IV bag still had 450 mL

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of fluid with 4 h of infusion time remaining. The calculation should be 10 gtt __ 18.75 gtt 1 h  __ __  450 mL  __  19 gtt/min 1mL 60 min 1 min 4h The increase from 16 gtt/min to 19 gtt/min is a 19 percent increase, within the acceptable amount of change.

9. First convert 1 day to 24 h. 1800 mL  __ 75 mL __ 24 h 1h The flow rate is 75 mL/h. 250 mL  __ 83.3 mL 10. __ 3h 1h The flow rate is 83 mL/h. 20 gtt 1000 mL __ 11. __  __  1h F 1 mL 60 min 24 h

REVIEW AND PRACTICE: 10-2 Calculating Flow Rates 1000 mL  __ 166.7 mL  166.7 mL/h 1. __ 6h h The flow rate is 167 mL/h.

1 125 13.89 gtt 20 gtt ___ 1 h  __ __  1000 mL  __ min 1 mL 60 min 24 h 3 3

The flow rate is 14 gtt/min. 10 gtt 400 mL __ 12. __  __  1h F 1 mL 60 min 8h

300 mL  __ 150 mL  150 mL/h 2. __ 2h 1h

1 50 8.33 gtt 10 gtt __ 1 h  __ __  400 mL  __ min 1 mL 60 min 8 h 6 1

The flow rate is 150 mL/h.

The flow rate is 8 gtt/min. 125 mL  125 mL/h 3000 mL  __ 3. __ 24 h h The flow rate is 125 mL/h.

1 125 15 gtt ___ 31.25 gtt 1 h  __ __  1500 mL  __ min 1 mL 60 min 12 h 4 1

4. 45 min  0.75 h

The flow rate is 31 gtt/min.

100 mL  __ 133.3 mL  133.3 mL/h. __ 0.75 h h The flow rate is 133 mL/h. 1500 mL  __ 125 mL 5. __ 12 h 1h The flow rate is 125 mL/h. 1000 mL  __ 83.3 mL 6. __ 12 h 1h The flow rate is 83 mL/h.

15 gtt 1500 mL __  1h F 13. __  __ 1 mL 60 min 12 h

10 gtt 250 mL __  1h F 14. __  __ 1 mL 60 min 3h 1 125 10 gtt __ 13.89 gtt 1h __  250 mL  __  __ min 1 mL 60 min 3h 6 3

The flow rate is 14 gtt/min. 20 gtt 100 mL 15. __  __ F 1 mL 40 min 1 20 gtt __ 100 gtt 50 gtt __  100 mL  __  __ min 1 mL 40 min 2 min 2

The flow rate is 50 gtt/min. 750 mL  __ 93.75 mL 7. __ 8h 1h The flow rate is 94 mL/h. 8. First convert 30 min to 0.5 h. 50 mL  __ 100 mL __ 0.5 h 1h The flow rate is 100 mL/h.

15 gtt 500 mL __ 16. __  __  1h F 1 mL 60 min 8h 1 125 15 gtt __ 15.625 gtt 1h __  500 mL  __  __ min 1 mL 60 min 8h 4 1

The flow rate is 16 gtt/min. 10 gtt 3000 mL __ 17. __  __  1h F mL 60 min 24 h 1 125 10 gtt ___ 20.83 gtt 1 h  __ __  3000 mL  __ min 1 mL 60 min 24 h 6 1

The flow rate is 21 gtt/min.

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60 gtt 50 mL __ 18. __  __  1h F 60 min 1 ml 1h 1 50 gtt 60 gtt __ 1 h  __ __  50 mL  __ min 1 mL 60 min 1h 1

The flow rate is 50 gtt/min. 20 gtt 750 mL __ 19. __  __  1h F 1 mL 60 min 5h 4 25 20 gtt __ 100 gtt 1 h  __ __  750 mL  __ 1 mL 60 min 2 min 5 h 2 1

50 gtt  __ min The flow rate is 50 gtt/min. 15 gtt 100 mL 20. __  __ F 1 mL 30 min

The flow rate is 50 gtt/min. 15 gtt __ 1000 mL  __ 21. __  1h F 1 mL 60 min 9h 1

15 gtt __ 27.77 gtt 1000 mL  __ 1h ___   __ min 1 mL 60 min 9h 4 1

The flow rate is 28 gtt/min. 15 gtt __ 750 mL  __ 22. __  1h F 1 mL 60 min 8h 15 gtt __ 23.4 gtt 750 mL  __ __  1 h  __ min 1 mL 60 min 8h 2 25

The flow rate is 23 gtt/min. 10 gtt 375 mL __ 23. __  __  1h F 1 mL 60 min 3h 1 125 10 gtt __ 20.83 gtt 1 h  __ __  375 mL  __ min 1 mL 60 min 3 h 6 1

The original flow rate is 21 gtt/min. The amount that should have infused in the first hour is 21 gtt __ 60 min  __  1 mL  126 mL 1 h  __ 1 min 10 gtt 1h The solution has been infusing too quickly and needs to be adjusted. The amount of solution remaining is 375 mL  175 mL  200 mL Recalculate the flow rate for 200 mL over 2 h.

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25%  21  5.25 Because 17 gtt/min is only 4 gtt/min less than the original flow rate, 17 gtt/min is acceptable. 20 gtt 1000 mL __ 24. __  __  1h F 1 mL 60 min 8h 1 100 20 gtt ___ 41.66 gtt 1 h  __ __  1000 mL  __ min 1 mL 60 min 8h 3 1

The original flow rate is 42 gtt/min. Five hours has passed. Five-eighths of 1000 mL, or 625 mL, should have infused. If 550 mL remains, then the amount that did infuse is 1000 mL  550 mL  450 mL

1 15 gtt __ 100 gtt 50 gtt __  100 mL  __  __ min 1 mL 30 min 2 min 2

250

The adjusted flow rate should be 17 gtt/min. Checking if it is within 25% of the original flow rate,

The solution has been infusing too slowly and needs to be adjusted. Recalculate the flow rate for 550 mL over 5 h 20 gtt __ 1h F __  550 mL  __ mL 60 min 5h 1 110 20 gtt __ 36.67 gtt 1 h  __ __  550 mL  __ min 1 mL 60 min 5 h 3 1

The adjusted flow rate should be 37 gtt/min. Checking if it is within 25% of the original flow rate, 25%  33  8.25 Because 37 gtt/min is only 4 gtt/min greater than the original flow rate, 37 gtt/min is acceptable. 15 gtt 500 mL __ 31.25 gtt  1 h  F  __ 25. __  __ min 1 mL 60 min 4h The original flow rate is 31 gtt/min. Half of the 500 mL, or 250 mL should have infused. Since only 150 mL has infused, the remaining 350 mL must be infused over the final 2 hours. 15 gtt __ 43.75 gtt 1 h  __ __  350 mL  __ min 1 mL 60 min 2h The adjusted flow rate should be 44 gtt/min. Checking if it is within 25% of the original flow rate, 25%  31  7.75 Since 44 gtt/min is 13 gtt/min greater than the original flow rate, the new rate is not within the acceptable limits. Contact the physician.

10 gtt __ 1h F __  200 mL  __ mL 60 min 2h

10 gtt 200 mL __ 26. F  __  __  1 h  33.33 gtt/min mL 60 min h

1 100 10 gtt __ 16.67 gtt 1 h  __ __  200 mL  __ min 1 mL 60 min 2 h 6 1

15 gtt 125 mL __  1 h  31.25 gtt/min 27. F  __  __ mL 60 min h

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15 gtt 50 mL __ 28. F  __  __  1 h  37.5 gtt/min mL 60 min h 60 gtt 75 mL  __ 1 h  75 gtt/min 29. F  __  __ mL 60 min h 10 gtt 100 mL __ 30. F  __  __  1 h  16.7 gtt/min mL 60 min h

1000  1500  2500 2500  2400  100 The infusion will finish at 0100 or 1:00 A.M. the next day. 250 mL  6.25 9. T h  __ 40 mL/h

REVIEW AND PRACTICE:

0.25  60  15

10-3 Infusion Time and Volume 1000 mL  12.05 h 1. T h  __ 83 mL/h

Total hours  6 hours 15 min 9:45 pm  2145

0.05 h  0.05  60  3 min

1

2145  0615 2760  2400 360 or 0400 or 4 A.M.

T h  12 h 3 min 500 mL  4 h 2. T h  __ 125 mL/h 750 mL  24.19 h 3. T h  __ 31 mL/h

500 mL  6.67 h 10. T h  __ 75 mL/h

0.19 h  0.19  60  11.4

0.67 h  0.67  60  40 min

T h  24 h 11 min

T h  6 h 40 min 1645  0640  2325

1000 mL  5 h 4. T h  __ 200 mL/h

The infusion will finish at 11:25 P.M.

250 mL  2.5 h 5. T h  __ 100 mL/h

11. 2 h 30 min  2.5 h

0.5 h  0.5  60  30 min

2.5 h  __ 75 mL  187.5 mL V mL  _ 1 h

T h  2 h 30 min

8 h  __ 100 mL  800 mL 12. V mL  _ 1 h

1500 mL  20 h 6. T n  __ 75 mL/h 1200  2000  3200

125 mL  1500 mL 12 h  __ 13. V mL  _ 1 h

3200  2400  0800

75 mL  150 mL 2 h  __ 14. V mL  _ 1 h

The infusion will finish at 8:00 A.M. the next day.

REVIEW AND PRACTICE: 10-4 Intermittent IV Infusions

2000 mL  20 h 7. T h  __ 100 mL/h 1530  2000  3530

1. B

3530  2400  1130

2. A

The infusion will finish at 11:30 A.M. the next day. 750 mL  15 h 8. T h  __ 50 mL/h

3. 3 mL 4. 2 mL

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5. According to package insert, you should add 5 mL of NSS to the 200 mg vial. That resulting solution is 38 mg per mL. 150 mg  1 mL A  ___ 38 mg A  3.9 mL added to 500 mL of NSS 500 mL  _ ? 6. __ 2h 1h 250 mL  ? Flow rate  250 mL/h 15 gtt 500 mL __ 7. F  __  __  1 h  62.5 gtt/min mL 60 min 2h  .63 gtt/min 75 mg  1 mL 8. A  ___ 10 mg A  7.5 mL 9. 107.5 mL/1 h  107.5 mL rounded to 108 mL/h 10. 10 gtt/mL  108 mL/h  1 h/60 min  17 to 18 gtt/min

6. Rate controllers, infusion pumps, syringe pumps, and patient-controlled analgesia pumps are four types of electronic infusion devices. 7. A patient would most likely need central line IV therapy for large amounts of fluid, a rapid infusion of medication, highly concentrated solutions, or long-term IV therapy. 8. 60 gtt/mL is the drop factor for microdrip tubing. 9. The flow rate is measured in mL/hour for an infusion pump. 10. Two types of intermittent IV infusion methods include secondary lines (piggy-back) and intermittent peripheral infusion devices (heparin lock or saline lock). 10 gtt 1000 mL __ 11. __  __  1h F 1 mL 60 min 12 h 10 gtt __ 1 h  13.88 gtt/min __  1000 mL  __ 1 mL 60 min 12 h The flow rate is 14 gtt/min 60 gtt 50 mL  F 12. __  __ 1 mL 90 min

C HAPTER 10 H OMEWORK S OLUTIONS 1. Replacement fluids, maintenance fluids, KVO fluids, and therapeutic fluids are four functional categories of IV solutions. 2. The 5 in the IV label D5W identifies the concentration level. 3. isotonic—does not affect the fluid balance in the cells hypertonic—draws fluid from the cells into the blood stream hypotonic—moves into the cell membrane and restores proper fluid level

33.3 gtt/min  F The flow rate is 33 gtt/min __

500 mL  3.3 h 13. T h  __ 150 mL/h 0.33 h  0.33  60  19.8 min T h  3 h 20 min 20 gtt 60 min  __ 1 mL  60 mL/h 14. __  __ 1 min 20 gtt 1h __ 500 mL  8.3 h T h  __ 60 mL/h T h  8 h 20 min 15 gtt 60 min  __ 1 min  90 mL/h 15. __  __ 1 min 10 gtt 1h __ 500 mL  5.5 h T h  __ 90 mL/h

4. Compatibility must be verified first before combining any medication with an IV solution.

0.55  60  33 min

5. Three parts of a primary IV line include solution bag, injection port, drip chamber, and tubing

1100 AM  533 1633 or 433 PM

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T h  5 h 33 min

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3000 mL  _ V 8. __ 24 h 1h

250 mL ⬃ _ ? mL 16. __ 3h 1h 83.3 mL/h per infusion pump rounded to 83 mL/h

3000 mL  1 h  24 h  V 125 mL  V

17. 30 min  0.5 h

The flow rate is 125 mL/h.

150 mL ⬃ __ X mL __ 0.5 h 1h

500 mL  _ V 9. __ 8h 1h

300 mL/h by infusion pump

500 mL  1 h  8 h  V

18. 80 mL/h  6 h  480 mL

62.5  V

total volume to be infused

The flow rate is 62.5 mL/h.

20 gtt 60 min  __ 1 mL  120 mL/h 19. __  __ 1 min 10 gtt 1h 120 mL/h  4 h  480 mL

1200 mL  _ V 10. __ 12 h 1h 1200  1 h  12 h  V

total volume infused at the end of 4 hours

100 mL  V The flow rate is 100 mL/h.

500 mL ⬃ _ ? mL 20. __ 4h 1h

250 mL  _ V 11. __ 4h 1h

125 mL/h 500  125  375 mL Remaining in IV bag

250 mL  1 h  4 h  V 62.5 mL  V

C HAPTER 10 R EVIEW

The flow rate is 62.5 mL/h. 12. 90 min  1.5 h

Check Up 1. Roller clamp—g. used to control the rate of an IV infusion 2. KVO fluids—d. provide access to the vascular system for emergency situations 3. Hypertonic—a. type of fluid given to a patient with a severe burn 4. Phlebitis—e. redness, swelling, and pain at an IV site

100 mL  _ V __ 1.5 h 1h 100 mL  1 h  1.5 h  V 66.7 mL  V The flow rate is 66.7 mL/h. 13. 30 min  0.5 h 50 mL  _ V __ 0.5 h 1h

5. PCA—c. the patient is in charge of delivering his/her own pain medications

50 mL  1 h  0.5 h  V

6. Infusion pump—f. applies pressure to administer an IV fluid

The flow rate is 100 mL/h.

7. Hypotonic—b. type of fluid given to a patient who is dehydrated

100 mL  V

15 gtt 2200 mL __ 22.9 gtt 14. __  __  1 h  __ min 1 mL 60 min 24 h  23 gtt/min

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10 gtt 300 mL __ 6.25 gtt 15. __  __  1 h  __ min 1 mL 60 min 8h  6 gtt/min 15 gtt 1000 mL __ 41.7 gtt 16. __  __  1 h  __ min 1 mL 60 min 6h  42 gtt/min 0 gtt 50 gtt 1800 mL  __ 1 h  __ 17. 2_  __ min 1 mL 60 min 12 h  50 gtt/min 10 gtt 1500 mL __ 31.25 gtt 18. __  __  1 h  __ min 1 mL 60 min 8h  31 gtt/min 60 gtt 300 mL __ 50 gtt 19. __  __  1 h  __ 1 mL 60 min 1 min 6h  50 gtt/min 15 gtt 1000 mL __ 31 gtt  1 h  __ 20. __  __ min 1 mL 60 min 8h The original flow rate was 31 gtt/min. Finding the amount that should have infused in 2 h, 31 gtt __ 60 min  __ 2 h  __  1 mL  248 mL 1 min 15 gtt 1h Only 125 mL, not 248 mL, has infused. The solution has been flowing too slowly. A total of 875 mL and 6 h remain. 15 gtt __ 36 gtt 1 h  __ __  875 mL  __ min 1 mL 60 min 6h The adjusted flow rate should be 36 gtt/min. Checking if it is within 25% of the original flow rate, 25%  31 gtt/min  7.75 gtt/min The new rate, 36 gtt/min, is an increase of only 5 gtt/min and falls within this range.

The adjusted flow rate should be 18 gtt/min, an increase of only 1 gtt/min. Because 25%  17 gtt/ min  4.25 gtt/min, the adjusted rate is within 25% of the original flow rate. 60 gtt 500 mL __ 62.5 gtt 22. __  __  1 h  __ mL min 60 min 8h Original flow rate  63 gtt/min Amount that should have infused over 2 hours is 1/4 of the original volume, or 125 mL. Only 50 mL have infused, so the solution has been flowing too slowly. A total of 450 mL and 6 hours remain. 60 gtt __ 75 gtt 1 h  __ __  450 mL  __ min min 60 min 6h The adjusted flow rate is 75 gtt/min. Checking if it is within 25% of the original. 25%  62  15.5 The new rate is 13 gtt/min faster than the original, and falls within 25%. 1000 mL  8 h 23. T h  __ 125 mL/h 800 mL  16 h 24. T h  __ 50 mL/h 600 mL  24 h 25. T h  __ 25 mL/h 1200 mL  17.14 h 26. T h  __ 70 mL/h 0.14 h  60  8 min T h  17 h 8 min 800 mL  8.89 h 27. T h  __ 90 mL/h 0.89 h  60  53 min T h  8 h 53 min

10 gtt 2500 mL __ 17.4 gtt 21. __  __  1 h  __ min 1 mL 60 min 24 h The original flow rate was 17 gtt/min. Finding the amount that should have infused in 3 h, 17 gtt __ 60 min  __ 3 h  __  1 mL  306 mL 1 min 10 gtt 1h Only 200 mL, not 306 mL, has infused. The solution has been flowing too slowly. A total of 2300 mL and 21 h remain.

0820  0853  1713 Infusion completed at 1713 1000 mL  8 h 28. T h  __ 125 mL/h 1300  0800  2100 Infusion completed at 2100 or 9 PM

18 gtt 10 gtt __ 1 h  __ __  2300 mL  __ min 1 mL 60 min 21 h

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500 mL  2.86 h 29. T h  __ 175 mL/h

T h  2 h 52 min

3. No. For pneumonia, the package insert suggests the patient should receive 2400 to 2700 mg per day. The order is for 500 mg three times a day (1500 mg), which is less than the lowest recommended dose.

2230  252  2522

4. Any product that contains benzyl alcohol.

0.86  60  52 min

2522  2400  0122 Infusion completed at 0122 tomorrow 750 mL  21.42 h 30. T h  __ 35 mL/h 0.42  60  25 min

6. According to the package insert you should administer the 100 mL bag of fluid over 20 minutes.

T h  21 h 25 min 1600  2125  3725 3725  2400  1325 Infusion completed at 1325 tomorrow 31. 5 h 30 min  5.5 h

Case Study 272 mL  227 mL  45 mL

32. 12 h  25 mL/h  300 mL

50 mg ? mg __  __ 500 mL 45 mL

33. 7 h 30 min  7.5 h

50 mg  45 mL  500 mL  ? mg

7.5 h  125 mL/h  937.5 round to 938 mL

4.5  ? The patient received 4.5 mg of morphine sulfate during the shift.

34. 8 h 20 min  8.33 h 8.33 h  80 mL/h  666 or 667 mL

Critical Thinking 1. You use 2 mL of medication from one vial (300 mg) and 1.3 mL (200 mg) from a second vial of Clindamycin for a total of 3.3 mL. Add this to 100 mL of diluent.

300X mL  1000

? mL 100 mL  __ __ 20 min 60 min 300 mL or __ 300 mL __ 60 min h

Total volume of medication received is

125 mL  688 mL 5.5 h  __ 1h

300 mg 500 mg 2. __  __ 2 mL X mL

5. According to the package insert, the medication can be used for up to 24 h with no refrigeration. You should label the IV bag with the date and time of expiration, the solution strength, and your initials.

Internet Activity Internet sites include various IV fluids and equipment. Try the following sites as part of your research. http://gucfm.georgetown.edu/welchjj/netscut/fen/ ivfluids.html www.nursewise.com/courses/IV_hour.htm www.tpub.com/content/medical/14274/css/ 14274_204.htm www.worldhistory,com/wiki/L /Intravenous-therapy.htm

1000 X mL  _ 300 X  3.3 mL

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