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Ensure initial order

hey everyone it's sarah with register now sorry on comm and in this video we're going to go over a teaching tutorial specifically reconstituting drugs now these drug problems are a little bit more advanced and on my other teaching tutorials I've went over oral dosages IV bolus --is infusion rates and everything like that so be sure to check out those videos because they come with a free quiz now in this teaching tutorial I'm going to work five problems and then afterwards I highly encourage you to visit my website registered nurse or en comm a link should be popping up and take the free quiz that goes along with this teaching tutorial to test your knowledge to see how well you know this material now what we're going to do we're going to go over these drug problems and these drug problems tend to be a little bit more advanced compared to the other problems we worked in the past they're really long as you can tell they like to confuse you they'll throw numbers out there and you have to really ask yourself what is this problem asking me for and why information is important in that problem so let's get started my first problem is this it says typically this is what it's going to look like whenever you're getting it on an exam the doctor order says Benko myosin two thousand micrograms IV the label on the vial Vanko says to reconstitute with sterile water for a concentration of two milligrams per milliliter then dilute each two milligrams in 75 milliliters of sterile normal saline how many milliliters will you use to administer this ordered dose a lot of stuff so let's underline the most important things okay first of all ask yourself what is this question asking us for this question is asking a four milliliters per dose so let's just write that right here so we know what we're looking for okay and let's underline the important stuff okay Banco myosin 2,000 milligrams of e that's important that's what the doctors ordered so we're going to underline that and right here it's telling that the concentration of two milligrams per milliliter this is irrelevant this we don't need to know this what we need to know is after we dilute it with our saline what is the concentration going to be after that which is going to be two milligrams per 75 milliliters so for every 75 milliliters there's two milligrams of vancomycin in it that's what we're worrying about right now because this number right here the two milliliter two milligrams per milliliter that's just telling us what its concentrated at we want to know after we reconstitute it make it unconcentrated what is in this vial for us to give the patient so those are the important things that we need to know now let's solve our problem okay I always like to start out with what the doctor ordered he order he or she ordered two thousand micrograms and two thousand micrograms equals one dose and we're trying to get milliliters to dose right now we're in micrograms per dose okay now our information two milligrams in seventy-five CCS we've got to get this micro grams to milligrams so remember in the previous videos we talked about the metric table and converting so we're going to convert this how you know this is from memory and so we know that there are a thousand micrograms in one milligram that cancels out micrograms right now we're a milligrams per dose trying to get to milliliters per dose and now we can use the information that's in our problem and after it's reconstituted we get two milligrams for every seventy-five CCS or milliliters cc's Millers or same thing and Mark out milligrams and we our milliliters per dose so we are ready to solve so multiply everything at the top at the bottom and then divide and two thousand times one times 75 is a hundred and fifty thousand and one times a thousand times two is two thousand and we're going to divide one hundred and fifty thousand divided by two thousand is seventy-five so the answer to this problem is 75 milliliters per dose so let's solve next problem okay problem two says the following a vial of doxorubicin reads 0.5 grams per vial instructions say to reconstitute each 12 milligrams with 2.5 milliliters of normal saline how many milliliters of normal saline will be needed to reconstitute the vial of the recommended concentration so you've got to ask yourself what is this problem on the problem is wanting milliliters per vial how many milliliters are you going to have to draw up and inject into this file to equal the recommended dose so what we're looking for is milliliters per vial okay let's underline the most important things that we'll be plugging into a problem to use dimensional analysis and the first thing is the zero I mean the 0.5 grams per vial that's very important the next thing is 12 milligrams for every 2.5 milliliters of normal saline that we're going to inject it's going to make 12 milligrams so that is very in poor in so how many milliliters are we going to need total to equal these 0.5 grams so let's solve ok let's start out with what the vial is originally the vial is a 0.5 gram bile so we're going to put 0.5 grams is one vial now we are trying to get from milliliters to vial and we know from our information up here that the 12 milligrams is a milligrams and what our vial is is in grams so we've got to convert that to milligrams so you know this from the metric table this is from memory we know that there's 1 gram in every thousand milligrams so grams cancels out right now we're in milligrams for all we got to get to milliliters per ball now we can use the information that is in our problem so there are 12 milligrams and 2.5 milliliters from the problem that cancels out milligrams and we're stuck with milliliters per vial we're ready to solve because that's where we wanted to get so we're going to multiply everything this hot multiply everything I'm down the bottom then divide so 0.5 times 1,000 times two point five equals 1250 and then 1 times 1 times 12 is 12 and 12 1250 divided by 12 equals a hundred and 4.2 okay so one hundred and four point two milliliters per vial is what we would have to do in order to get that problem so let's work our next row column says instructions on a vial of one gram of doxorubicin instructs to reconstitute with normal saline to make a concentration of one milligram per milliliter after reconstituting two vials you would administer blank emails to administer a 500 milligram dose so let's look at and ask yourself what's its problem asking okay this problem is asking how many milliliters are we going to give per dose now what's the most important stuff in this problem okay well we need to first look and see what the doctor orders the doctor ordered 500 milligrams per dose see they just sort of threw that in at the end so you would have to know next you need to see what the concentration is what are you supplied with so you can give this 500 milligram dose and after you reconstitute it according to the problem you're going to get a concentration of one milligram per ml now you may be thrown off with the 1 gram up there that is just telling you how you got a vial of doxorubicin and it's one gram that's in there to throw you off what you're looking for is what the doctor ordered and what the concentration is going to be after you've reconstituted it because you have this one gram vial but you've added a normal saline to it and you've changed its makeup it's how concentrated it is to equal one milligram of one ml so that's in there throw you off so then the most another important part of it is this the two vials this problem is telling you hey you've already reconstituted two vials so you know you're going to have to double something since you're using two vials so that's another important part so let's plug this information into a problem and see what our answer is okay we're going to of course start out with what the doctor ordered they order 500 milligrams is one dose that's what the patient's getting and we're trying to get two milliliters per dose now says one milligram per ml is in one vial after you reconstitute it but according to the problem you gave two vials so we're going to double it so instead of putting one milligram equals one milliliter we're going to say 2 milligrams equals 2 milliliters because remember we have two vials so it would be 2 milligrams equals 2 milliliters now milligrams cancels out and we need to get 2 milliliters per dose which we have and so we're ready to solve so 500 times 2 equals a thousand and 2 times 1 is 2 and we're going to divide a thousand divided by 2 is 500 so the answer is 500 milliliters per dose okay let's do our last problem the problem says instructions on a 2 point 5 gram vial of horses on Reed's to reconstitute it with 20 emails of sterile water this will provide a concentration of how many milligrams per milliliter so in the previous problems we were already given that information but here what it's saying is you have a vial it's 2.5 grams and you're going to add 20 milliliters of saline to it so after you do that what's the new concentration going to be so that is what we are looking for so this part 2 point 5 milli grant a 2.5 grams is most important and 20 emails of normal site lengths and I support so and we're but we're trying to get 2 milligrams per milliliter so already looking at this problem we know that we have to take some extra steps and convert so first let's do what the vial is there is 2.5 grams and we're going to put 20 milliliters of saline in it okay now we're going to convert our milligrams milligrams we know that there is one gram for every thousand milligrams and that cancels out grams and we're done we have our mill milligrams per milliliter so 2.5 times a thousand is 2500 2500 and 20 times 1 is 20 in 2500 divided by 20 equals 125 milligrams per milliliter okay so that is how you solve those problems now I highly encourage you to go to my website register nurse Orion comm a link should be popping up and take the free quiz that goes along with these type of problems so you'll be prepared for your nursing cool school classes and you can never practice too many drug problems so thank you so much for watching and please subscribe to my youtube channel