DRUGS and IVF

COMPUTATIONS

DOLLY DIANNE D. MIRAÑA, RN

Clinical Instructor
Nursing Education and Training Division
STOCK DOSES

Always compute
based on your stock
on hand.
COMPUTATION
FORMULA METHOD
used to identify the amount of drug to be administered

desired dose (D)

x Volume / quantity
stock (S) of stock

desired dose (D) volume of diluent

x solution
stock (S)
1. CEFTRIAXONE 750MG
Stock: 1gram powder for injection diluted in 10ml
sterile water

desired dose (D)

= x volume of diluent
stock (S) solution

750mg
= x 10ml
1000mg

= 7.5 ml
2. POTASSIUM CHLORIDE 7.5ML

desired volume (D)

= x dose of solution
stock (S)
7.5 ml
= x 5 meqs
5 ml

= 7.5 meqs
 DRUGS GIVEN
WITH STANDARD
DILUENT
Morphine Sulfate
Nalbuphine Hydrochloride
Midazolam
Digoxin
 Q (amount in ml) =
Desired dose (mg) x Volume of diluted
B. DRUGS GIVEN WITH Stock dose (mg)
STANDARD DILUENT solution (ml)

= 2 mg x 10 ml
MORPHINE SULFATE
Morphine Sulfate
10 mg
Stock dose of Morphine
= 2 ml sulfate = 10 mg/ml in 1 ml amp
Amount of diluent = 9ml sterile water for injection (for IV administration)
Diluted solution = 10 mg/ 10 ml

NALBUPHINE HYDROCHLORIDE
Nalbuphine Hydrochloride
Stock preparation: 10 mg/1 ml ampule
Amount of diluent: 9 ml sterile water for injection (for IV administration)
Diluted solution: 10 mg/10 ml

Midazolam
Stock preparation: 5 mg/1 ml ampule
Amount of Diluent: 4 ml Sterile water for injection (for IV administration)
Diluted solution: 5mg/ 5 ml
Midazolam
Nalbuphine Hydrochloride
Stock preparation:10
Stock preparation: 5 mg/1
mg/1 ml mlampule
ampule
Amount of diluent:
Amount of Diluent:94mlmlsterile
Sterile water
water for for injection
injection (for (for IV administration
IV administration)
Diluted solution:10
Diluted solution: 5mg/ 5 ml
mg/10 ml
MIDAZOLAM
Sodium Luminal*
Midazolam
Stockpreparation:
Stock preparation:5 130
mg/1mg/1 ml ampule
ml ampule
Amount
Amo n ofofDiluent:
dil en 4ma
ml Sterile water for injection
a depending on he (for
docIV
o administration)
o de .
Diluted solution: 5mg/ 5 ml
Digoxin
Sodium Luminal*
Stock preparation:
Stock preparation: 130 mg/1 ml ampule
DIGOXIN
Elixir: 0.05 mg/1 ml
Amo n of dil en ma a depending on he doc o o de .
Tablet: 0.25 mg/tablet
Ampule: 0.5 mg/2 ml (dilute Digoxin IV before administering by
Digoxin
adding 3 ml of triple distilled water to come up with a
Stock preparation:
Elixir:diluted solution
0.05 mg/1 ml of 0.5 mg/ 5 ml)
Tablet: 0.25 mg/tablet
Ampule: 0.5 mg/2 ml (dilute Digoxin IV before administering by
adding 3 ml of triple distilled water to come up with a
diluted solution of 0.5 mg/ 5 ml)
COMPUTATION

desired dose (D)

= x volume of diluted
stock (S) solution

Morphine Sulfate
Stock: 10 mg / 1 ml ampule
Preparation: 1 ml MoSO4 + 9ml diluent
Diluted Solution: 10 mg / 10 ml
5. MORPHINE 4MG

desired dose (D) volume of

= x
stock (S) solution

4 mg
= x 1 ml
10mg (Undiluted)

= 0.4 mL
5. MORPHINE 4MG

desired dose (D) volume of

= x
stock (S) solution

4 mg
= x 10 ml
10mg (Diluted)

= 4 mL
INTRAVENOUS
FLUIDS
INTRAVENUOUS FLUID
FLOW RATE

Milliliters in hour (ml/hr)

Total IVF volume (ml)

No. of hours (infusion time - hr)
INTRAVENUOUS FLUID
FLOW RATE

Macrodrops per minute (gtts / min)

Total IVF volume (ml) X 15 gtts / ml

No.of hours (infusion time) 60 min / hr
INTRAVENUOUS FLUID
FLOW RATE

Microdrops per minute (ugtts / min)

Total IVF volume (ml) X 60 mgtts / ml

No.of hours (infusion time) 60 min / hr
INTRAVENUOUS FLUID
FLOW RATE

Infusion time or No. of hours

Total IVF volume (ml) X 15 gtts / ml

Flow Rate (gtts / min) 60 min / hr
COMPUTATION

§ D5 Water to run at 10 ml / hour. How

many ml will be consumed in 1 day?
= 10ml/hour x 24 hours
= 240 ml

Note: Discard any unconsumed IVF after 24

hours.
INTRAVENUOUS FLUID
FLOW RATE

§ PNSS 1L to run for 12 hours. Flow rate?

Total IVF volume (1000 ml)

No. of hours (12 hours)

= 83 ml/hour
COMPUTATION

§ PNSS 1L to run for 12 hours. Flow rate?

(using macroset?)
Total IVF volume (1000ml) x 15 gtts / ml
No.of hours (12 hours) x 60 min /hr

= 20 gtts / min
COMPUTATION

§ PNSS 1L to run for 12 hours. Flow rate?

(using microset?)
Total IVF volume (1000ml) x 60 mgtts / ml
No.of hours (12 hours) x 60 min /hr

= 83 mgtts / min
 LANOXIN
DIGITALIZATION
DIGITALIZING DOSE

TOTAL DIGITALIZING DOSE (TDD)

TDD = Desired Dose * x Patient’s Weight

* For pediatric patients 2 years and below

= 0.03 – 0.04 mg / kg
* For patients more than 2 years
= 0.04 mg / kg
DIGITALIZING DOSE

Determine if to be given SLOW or FAST

DIGITALIZATION

Count Cardiac Rate of the patient in one full

minute and refer each dose to the doctor /
cardiologist before giving
DIGITALIZING DOSE

Fast Digitalization
•First loading dose = give ½ of the TDD
•8 hours after the loading dose = give ¼ of
the TDD
•8 hours after the 2nd loading dose = give ¼
of the TDD
DIGITALIZING DOSE

Slow Digitalization
• First loading dose = give ¼ of the TDD
• 6 hours after the loading dose = give ¼ of
the TDD
• 6 hours after the 2nd loading dose = give ¼
of the TDD
• 6 hours after the 3rd loading dose = give ¼
of the TDD
DIGITALIZING DOSE

Compute for the volume of Lanoxin to be

given per loading dose

desired dose (D) X volume of stock (diluent)

stock (S)
Preparation: 0.5 mg/2ml + 3ml diluent
Diluted Solution: 0.5 mg / 5 ml
DIGITALIZING DOSE

MAINTENANCE DOSE
1/10th of the TDD
given 12hours after the last dose and
every 12 hours thereafter

• Maintenance dose = TDD

10
DIGITALIZATION

§ Step 1: Compute for TDD

= 0.03 mg/kg x 6kg
= 0.18 mg
 SLOW DIGITALIZATION

§ Step 2: Compute for Loading Dose:

¼ of TDD every 6 hours for 4 doses
= 0.18mg / 4 doses
(for oral preparations only)

= 0.045 mg
 SLOW DIGITALIZATION

§ Step 2: Compute for Loading Dose:

¼ of TDD every 6 hours for 4 doses
= 0.18mg / 4 (for oral preparations only)

= 0.045 mg
0.045 mg
= x 1 ml
0.05 mg
= 0.9 ml every 6 hours for 4 doses only
 DIGITALIZATION

§ Step 3: Compute for Maintenance Dose

= 0.18 mg / 10
= 0.018 mg

0.018 mg
= x 1 ml
0.05 mg
= 0.36 ml
DIGITALIZATION

§ Step 1: Compute for TDD

= 0.04 mg/kg x 40 kg
= 1.6 mg
 FAST DIGITALIZATION

§ Step 2: Compute for Loading Dose:

FIRST LOADING DOSE: ½ of TDD
= 1.6 mg / 2
= 0.8 mg
0.8 mg
= x 5 ml
0.5 mg
= 8 ml FOR 1 DOSE only
 FAST DIGITALIZATION

§ Step 2: Compute for Loading Dose:

2nd and 3rd LOADING DOSE: ¼ of TDD
to start 8 hours after the first LD
= 1.6 mg / 4
= 0.4 mg
0.4 mg
= x 5 ml
0.5 mg
= 4 ml every 8 hours FOR 2 DOSES only
 DIGITALIZATION

§ Step 3: Compute for Maintenance Dose

= 1.6 mg / 10
= 0.16 mg

0.16 mg
= x 5 ml
0.5 mg
= 1.6 ml / IV
 DIGITALIZATION

§ Step 3: Compute for Maintenance Dose

= 1.6 mg / 10
= 0.16 mg

0.16 mg
= x 1 tablet
0.25 mg
= 0.64 tablet ?
Instead, request for 0.16mg papertablet
 CONTINOUS
INTRAVENUOUS
DRIP
CONCENTRATION

§The amount of a drug in a given dosage

form amount.

Stock
=
Volume of IVF
FLOW RATE

§The amount of a drug administered

in a given time.

Dose
=
Concentration
DOSE

§The amount of a medication which is

administered at one specific time.

= Flow Rate x Concentration

QUICK GUIDE

Dose

Flow Rate Concentration

 CONTINOUS
INTRAVENUOUS
DRIP
DOPAMINE
DOBUTAMINE
EPINEPHRINE
NOREPINEPHRINE
CONTINUOUS IV DRIP

Concentration (mcg/ml) =

Stock (mg) X 1000 mcg

Volume of IV Fluid (ml) 1 mg
CONTINUOUS IV DRIP

Flow Rate (ml/hr) =

Dose (mcg/kg/min) X Wt (kg) X 60 min/hr

Concentration(mcg/ml)
CONTINUOUS IV DRIP

Dose (mcg/kg/min) =

Flow Rate (ml/hr) X Concentration(mcg/ml)

kg Body Weight X 60 min/hr
COMPUTATION

§ Concentration of Dopamine 200mg in

250ml solution

= 200mg X 1000 mcg

250ml 1 mg

= 800 mcg/ml (single concentration)

COMPUTATION

§ DOUBLE Concentration

200mg (2) X 1000 mcg

=
250ml 1 mg

= 1600 mcg/ml
Prepare Dopamine with 800mcg/ml
concentration in 50ml solution

desired volume (D)

= x dose of solution
stock (S)
50ml
= x 800 mcg
1 ml

= 40000 mcg
PREPARATION:
Dopamine 800 mcg/mL

800 mcg 40000 mcg

=
mL 50 mL
desired
40000dose
mcg(D)
= x volume of diluent
stock (S) solution

1mg
= 40000 mcg x
1000 mcg
PREPARATION:
Dopamine 800 mcg/mL

desired dose (D)

= x volume of diluent
stock (S) solution

40 mg
= x 5 mL
200 mg

= 1 ml
PREPARATION:
Dopamine 800 mcg/mL

800 mcg 40000 mcg

=
mL 50 mL

1 mL Dopamine + 49 mL IVF
Compute for the DOSE.
Dobutamine 50mg/50ml, flow rate of 3
ml/hr Patient’s Wt =48 kgs

Flow Rate (ml/hr) X Concentration(mcg/ml)

kg Body Weight X 60 min/hr

3 ml/hr X 1000mcg/ml 50mg

= x 1000mcg/ml
48 kg X 60 min/hr 50ml

= 1000mcg/ml
= 1.04 mcg/kg/min
COMPUTATION

§ Epinephrine 1mg/50ml.
§ Dose: 0.2mcg/kg/min Patient’s Wt =16 kgs

0.2mcg/kg/min X 16kg X 60 min

= 20mcg/ml 1 hr

= 9.6 ml/hr
COMPUTATION

§ Norepinephrine 0.2mcg/kg/min
§ Flow Rate: 12ml/hr Patient’s Wt = 32 kgs

0.2mcg/kg/min X 32kg X 60 min

=
12ml/hr 1 hr

= 32 mcg/ml
 CONTINOUS
INTRAVENUOUS
DRIP
NITROGLYCERINE
NICARDIPINE
CONTINUOUS IV DRIP

Concentration (mg/ml) =

Stock (mg)
Volume of IV Fluid (ml)
CONTINUOUS IV DRIP

Flow Rate (ml/hr) =

Dose (mg/hr)
Concentration(mg/ml)
CONTINUOUS IV DRIP

Dose (mg/hr) =

Flow Rate (ml/hr) X Concentration (mg/ml)

CONTINUOUS IV DRIP

Concentration (mg/ml) =
Stock (mg)
Volume of IV Fluid (ml)
= 10 mg
100 mL
= 0.1 mg/mL (single concentration)
Prepare Isoket Drip single
concentration in 50 mL syringe

Concentration (mg/ml) =
Stock (mg)
Volume of IV Fluid (ml)
= 10 mg
100 mL
= 0.1 mg/mL (single concentration)
Prepare Isoket Drip single concentration
(0.1mg/mL) in 50 mL syringe

desired volume (D)

= x dose of solution
stock (S)
50ml
= x 0.1 mg
1 ml

= 5 mg
PREPARATION:
Isoket 0.1mg/mL

0.1 mg 5 mg
=
mL 50 mL

desired dose (D) volume of diluent

= x
stock (S) solution
PREPARATION:
Isoket 0.1mg/mL

desired dose (D)

= x volume of diluent
stock (S) solution

5 mg
= x 1 mL
1 mg

= 5 ml
PREPARATION:
Isoket 0.1mg/mL

0.1 mg 5 mg
=
mL 50 mL

5 mL Isoket + 45 mL IVF
Compute for the concentration.

§ NTG drip at 25ml/hr. Dose: 3mg/hr

Dose (mg/hr)
Flow Rate (ml/hr)
3 mg/hr
25 ml/hr
= 0.12 mg/ml
 Compute for the dose.

§Nicardipine 10mg in 50ml

§Flow Rate: 15 ml/hr

= Flow Rate (ml/hr) X Concentration (mg/ml)

= 15 ml/hr x 0.2mg/ml
= 3 mg/hr
Compute for the flow rate.

§ Isoket 5mg in 50ml. Dose: 2mg/hr

Dose (mg/hr)
Concentration(mg/ml)
2mg/hr
0.1mg/ml
= 20 ml/hr
 ANTI-
ARRYTHMICS
Lidocaine
Amiodarone
 LIDOCAINE DRIP

Concentration (mg/ml) =

Stock (mg)
Volume of IV Fluid (ml)
 LIDOCAINE DRIP

Flow Rate (ml/hr) =

Dose (mg/min) x 60min/hr
Concentration (mg/ml)
LIDOCAINE DRIP

Lidocaine (2%)
Stock: 1000mg / 50mL or
100 mg / 5 ml (poly ampule)
COMPUTATION

§Single Concentration
Concentration (mg/ml)
1000mg
=
250ml

= 4 mg/ml
PREPARATION:
Lidocaine 4mg/mL

desired volume (D)

= x dose of solution
stock (S)
50ml
= x 4 mg
1 ml

= 200 mg
PREPARATION:
Lidocaine 4mg/mL

4 mg 200 mg
=
mL 50 mL

desired dose (D) volume of diluent

= x
stock (S) solution
PREPARATION:
Lidocaine 4mg/mL

desired dose (D)

= x volume of diluent
stock (S) solution

200 mg
= x 1 mL
20 mg

= 10 ml
PREPARATION:
Lidocaine 4mg/mL

4 mg 200 mg
=
mL 50 mL

10 mL Lidocaine + 40 mL IVF
Compute for the concentration.

§ Lidocaine drip at 45ml/hr

§ Dose: 3mg/min
Dose (mg/min) x 60min/hr
Flow Rate (ml/hr)
3 mg/min x 60min/hr
45 ml/hr
= 4 mg/ml
 Compute for the dose

§ Amiodarone 120mg in 50ml.

Flow Rate: 20ml/hr
= Flow Rate (ml/hr) X Concentration (mg/ml)
60 mins / hr
= 20ml/hr x 2.4mg/ml
60 mins / hr
= 0.8 mg/min
Compute for the flow rate.

§ Lidocaine 200mg in 50ml

§ Dose: 2mg/min
Dose (mg/min) x 60min/hr
Concentration (mg/ml)
2 mg/min x 60min/hr
4 mg/ml
= 30 ml/hr
HEPARIN DRIP
1. HEPARIN IV BOLUS / push

§ Administer heparin 5000 u IV bolus /

push.
5000 units
= x 1 ml
1000 units
= 5 ml
HEPARIN DRIP

Heparin
Stock: 1000 u / ml
5000 u / ml

Determine the dose of Heparin to be

administered
HEPARIN DRIP

§Compute for the desired volume of Heparin

to be administered

1000 units/hr
= x 4 hours
1000 units/ml
HEPARIN DRIP

§Add IVF to the computed desired volume of

Heparin to make a total volume of 40 ml
(Heparin + IVF)

§Regulate the Heparin Drip (10 ml / hr)

2. HEPARIN IV DRIP

§ Run heparin drip at 1000 u per hour.

(Stock on hand: 1000 units per ml)

1000 units/hr
= x 4 hours
1000 units/ml

= 4 ml + 36 ml IVF
3. HEPARIN IV DRIP

§ Run heparin drip at 1000 u per hour.

(Stock on hand: 5000 units per ml)

1000 units/hr
= x 4 hours
5000 units/ml

= 0.8 ml + 39.2 ml IVF

REPLACEMENT OF
ELECTROLYTE
DEFICIT
POTASSIUM CORRECTION
 POTASSIUM CORRECTION

Compute for the Potassium Deficit

K+ deficit
= Normal Value – Patient’s value X kg BW X 0.3mg/kg

Pediatrics
= Normal Value – Patient’s value X kg BW X 0.6mg/kg

***Normal Value = 3.5 – 5.5meq/L = 4.0 meq/L

POTASSIUM CORRECTION

§Compute the volume of KCl to be

incorporated in the IV Fluid
Potassium Chloride
Stock: 40 meq / 20 ml
desired dose (D) volume of
= x
stock (S) solution

§Compute for the Flow Rate

 POTASSIUM CORRECTION

Compute for the Potassium Deficit

K+ deficit
= (Normal Value – Patient’s value) X kg BW X 0.3
= (4mEqs/L - 2.6mEqs/L) x 65kgs x 0.3mEqs/kg

= 27.3 mEqs
COMPUTATION

§ Compute the volume of KCl to be

incorporated in the IV Fluid
27.3 mEqs
= x 20 ml
40 mEqs

= 13.65 ml KCl + IVF

 COMPUTATION

§ Order: Correct Potassium Deficit in

100mL D5 Water to run for 8 hours
= 13.65 ml KCl + IVF
Volume of IVF =100 mL – 13.65 mL (KCl)
= 86.35 mL D5 Water
Flow Rate = 100mL / 8 hours
= 12.5 mL/hour
 POTASSIUM CORRECTION

Compute for the Potassium Deficit

K+ deficit (Pediatrics)
= Normal Value – Patient’s value X kg BW X 0.6
= 4mEqs/L - 2.8mEqs/L x 6kgs x 0.6mEqs/kg

= 4.32 mEqs
POTASSIUM CORRECTION

§ Compute the volume of KCl to be

incorporated in the IV Fluid
4.32 mEqs
= x 20 ml
40 mEqs

= 2.16 ml KCl + IVF

 COMPUTATION

§ Order: Correct Potassium Deficit in

100mL D5 Water to run for 12 hours
= 2.16 ml KCl + IVF
Volume of IVF =100 mL – 2.16 mL (KCl)
= 97.84 mL D5 Water
Flow Rate = 100mL / 12 hours
= 8.3 mL/hour
REPLACEMENT OF
ELECTROLYTE
DEFICIT
SODIUM CORRECTION
 SODIUM
g handbook CORRECTION
guide (revised AUG 2017)

B. HYPONATREMIA CORRECTION

+
Hyponatremia Na requirement (mmol) = total body water x
+ +
(desired Na - serum Na )

+
Rate of infusion (ml/hr) = Na requirement (mmol) x 1000 mL
+
Infusate Na (mmol/L) x time (hours)

Note:
• Normal value = 135- 145 mmol/L
+
*135 mmol/mL is taken as the Desired Na
 SODIUM
Rate of infusion CORRECTION
+
(ml/hr) = Na requirement (mmol) x 1000 mL
+
Infusate Na (mmol/L) x time (hours)

Note:
• Normal value = 135- 145 mmol/L
+
*135 mmol/mL is taken as the Desired Na

• Total body water (in liters):

Children = 0.6 x weight
Women = 0.5 x weight
Men = 0.6 x weight
Elderly women = 0.45 x weight
Elderly Men = 0.5 X weight

Note:
 Children = 0.6 x weight
Women = 0.5 x weight
Men = 0.6 x weight
SODIUM CORRECTION
Elderly women = 0.45 x weight
Elderly Men = 0.5 X weight

Note:
+
Infusate Infusate Na (mmol/L)
• 5% NaCl 855
• 3% NaCl 513
• 0.9 % NaCl (NS) 154
• Lactated Ringer’s 130
• 0.45% NaCl (1/2 NS) 77
1
• 0.2 % Nacl ( /4 NS) 34
• 5% Dextrose in water (D5W) 0

*** Note: 1mEq = 1mmol

SODIUM CORRECTION

§ Compute for the serum Na Requirement.

= total body water x (desired Na – serum Na)
= (0.5 mmol / kg x 65 kgs) x (135 mmol – 120 mmol)
= 32.5 mmol x 15 mmol

= 487.5 mmol
 • Total body water (in liters):
Children = 0.6 x weight
Women = 0.5 x weight
1. SODIUM MenCORRECTION = 0.6 x weight
Elderly women = 0.45 x weight
Elderly Men = 0.5 X weight

§ Compute the rate of infusion

(mL/hr) using PNSS 1000 mL
Note:
+
Infusate Infusate Na (mmol/L)
• 5% NaCl 855
• 3% NaCl 513
• 0.9 % NaCl (NS) 154
• Lactated Ringer’s Stock 130
• 0.45% NaCl (1/2 NS) Dose 77
1
• 0.2 % Nacl ( /4 NS) 34
• 5% Dextrose in water (D5W) 0
 SODIUM CORRECTION

§ Compute the rate of infusion (mL/hr)

using PNSS 1000 mL

Na deficit (mmol) 1000ml

=
Desired
x
Dose Na content per liter
Volume
24 hours
Stock Infusion
Dose time
SODIUM CORRECTION

§Compute the rate of infusion (mL/hr)

using PNSS 1000 mL
487.5 mmol
= x 1000ml
154 mmol
= 3165.58 ml / 24 hours

= 131.89 ml/hr
SODIUM CORRECTION

§Compute the rate of infusion (mL/hr)

using PNSS 1000 mL
487.5 mmol 1000ml
= x
154 mmol 24 hours

= 131.89 ml/hr
SODIUM CORRECTION

§Compute the rate of infusion (mL/hr)

using D5 Water 1000mL

Na deficit (mmol) 1000ml

= x
Na content per liter 24 hours
SODIUM CORRECTION

§Compute the rate of infusion (mL/hr)

using D5 Water 1000 mL
487.5 mmol
= x 1000ml
487.5 mmol
= 1000 ml / 24 hours

= 41.66 ml/hr
SODIUM CORRECTION

§Compute the rate of infusion (mL/hr)

using PNSS 1000 mL
487.5 mmol 1000ml
= x
154 mmol 24 hours

= 131.89 ml/hr
SODIUM CORRECTION

Compute for the Maintenance Dose

Maintenance Dose =
Patient’s Body Weight X 2 meq/kg/day

Compute for the volume of NaCl to be

incorporated with IV Fluid based on
computed maintenance dose
SODIUM CORRECTION

Compute for the Maintenance Dose

Maintenance Dose =
Patient’s Body Weight X 2 meq/kg/day

= 65 kgs x 2 mmol/kg/day
= 130 mmol/day
SODIUM CORRECTION

§Compute the rate of infusion (mL/hr)

according to the Na content of IVF

Maintenance (mmol) 1000ml

= x
Na content per liter 24 hours
SODIUM CORRECTION

Compute for the Total Sodium Replacement

for Pediatrics
Total Sodium Replacement
= Na Deficit + Maintenance Dose
* Administer in 24 hours
 SODIUM CORRECTION

Compute for the Sodium Deficit

Na deficit (Pediatrics)
= Normal Value – Patient’s value X kg BW X 0.6
= 135mEqs/L - 115mEqs/L x 6kgs x 0.6mEqs/kg

= 72 mEqs
COMPUTATION

§ Compute for the Maintenance Dose

Maintenance Dose:
= Patient’s Body Weight X 2 meq/kg/day
= 6 kgs x 2 mEqs / kg / day
= 12 mEqs / day
 COMPUTATION

Compute for the Total Sodium Replacement

Total Sodium Replacement
= Na Deficit + Maintenance Dose
= 72 mEqs + 12 mEqs
= 84 mEqs
 +
*135 mmol/mL is taken as the Desired Na

• Total body water (in liters):

SODIUM CORRECTION Children
Women
= 0.6 x weight
= 0.5 x weight
Men = 0.6 x weight
Elderly women = 0.45 x weight

§ Compute the rate of infusion (mL/hr)

Elderly Men = 0.5 X weight

using D5 Water 500 mL

Note:
+
Infusate Infusate Na (mmol/L)
• 5% NaCl 855
• 3% NaCl 513
• 0.9 % NaCl (NS) 154
• Lactated Ringer’s 130
• 0.45% NaCl (1/2 NS) 77
1
• 0.2 % Nacl ( /4 NS) 34
• 5% Dextrose in water (D5W) 0
SODIUM CORRECTION

Compute the volume of NaCl to be

incorporated in the IV Fluid
Sodium Chloride
Stock: 50 meq / 20 ml

desired dose (D) volume of

= x
stock (S) solution
COMPUTATION

§ Compute for the volume of NaCl to be

incorporated with D5 Water 500ml

84 meqs
= x 20 ml
50 meqs

= 33.6 ml NaCl + 466.4 D5 Water

= 84meqs / 500ml
 SODIUM CORRECTION

§ Compute the rate of infusion (mL/hr)

using D5 Water 500 mL

Na deficit (mmol) (ml)

=
Desired
x
Dose Na content per liter
Volume
24 hours
Stock Infusion
Dose time
 SODIUM CORRECTION

§ Compute the rate of infusion (mL/hr)

using D5 Water 500 mL

84 (mmol)
Na deficit (ml)
500ml
=
Desired
x
Dose Na 84
content
mmolper liter
Volume
24 hours
Stock Infusion
Dose time
SODIUM CORRECTION

§Compute the rate of infusion (mL/hr)

using D5 Water 500mL

84 mmol 500ml
= x
84 mmol 24 hours

= 20.83 ml/hr
 ACID-BASE
CORRECTION
SODIUM BICARBONATE
CORRECTION
SODIUM BICARBONATE
REPLACEMENT

Sodium Bicarbonate Correction based on

ABG’s result

Full Correction = Base Deficit X kg BW X 0.3

Half Correction = Base Deficit X kg BW X 0.3

2
SODIUM BICARBONATE
REPLACEMENT

Compute for the volume of Sodium

Bicarbonate to be given
Sodium Bicarbonate
Stock: 50 meq / 50 ml

desired dose (D)

= x volume of
stock (S) solution
COMPUTATION

§ Compute for the full NaHCO3 correction.

§ Base Deficit: – 4.2
§ Pt wt: 5 kgs
= 4.2 x 5 kgs x 0.6 mEqs/kg

= 12.6 mEqs
 COMPUTATION

§ 12.6 mEqs NaHCO3

12.6 mEqs
= x 50 ml
50 mEqs

= 12.6 mL NaHCO3 + 12.6 mL D5W

For pediatrics, dilute NaHCO3 with equal amount

of diluent (EAD), unless contraindicated.
 COMPUTATION

§ Compute for the half NaHCO3 correction.

§ Base Deficit: – 8
§ Pt wt: 110 lbs
= 8 x 50 kgs x 0.3 mEqs/kg
2
= 60 mEqs
COMPUTATION

§ 60 mEqs NaHCO3

60 mEqs
= x 50 ml
50 mEqs

= 60 mL NaHCO3