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RN Nursing · Medication Administration and Dosage Calculations · Practice question

An adolescent with meningococcal meningitis is receiving a continuous IV infusion of penicillin G which is prescribed as 20 million units in a total volume of 2 liters of normal saline every 24 hours The pharmacy delivers 10 million units/liter of normal saline How many mL/hour should the nurse program the infusion pump Enter numeric value only If rounding is required round to the nearest whole number

Answer & explanation

Correct: 83 mL/hr

To calculate the infusion rate, the total volume to be infused over 24 hours must be determined. The prescription calls for 20 million units in a total volume of 2 liters (2000 mL) of normal saline over 24 hours. The pharmacy delivers the medication at 10 million units per liter, so 20 million units requires 2 liters total, confirming the total volume is 2000 mL. Dividing 2000 mL by 24 hours gives 83.33 mL per hour, which rounds to 83 mL per hour. The pump should be programmed to deliver 83 mL/hr. Common errors include using only 1 liter (one bag's volume) and dividing by 24, which would yield approximately 42 mL/hr, or failing to account for the full 2-liter total volume. Another mistake is not rounding correctly. Since the total prescribed volume is 2000 mL over 24 hours, the straightforward division 2000 ÷ 24 = 83.33, rounded to the nearest whole number, gives 83 mL/hr. The answer of 80 mL/hr is too low and 90 mL/hr is too high; 75 mL/hr would only be correct if a smaller volume were used. Accurate pump programming is essential in pediatric and neurological infections where consistent antibiotic levels are critical for treatment efficacy.

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