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Clinical Case Study, Chapter 7, Special Types of IV Calculations Madison Smith, age 35, is on the oncology unit awaiting treatment for stage III breast cancer. Medical history: Type 1 diabetes. Ms. R weighs 154 pounds, height: 65 inches, BSA 1.8. (Topics covered: IV medications based on BSA, weight based calculations, insulin drip calculations.) Medication orders: · If blood glucose >150, give IV regular insulin dose-bolus or loading dose of 0.2 units/kg · Insulin drip: (BG-60) × 0.02 = units insulin/hr · paclitaxel 315 mg in 500 mL D5W over 3 hours · carboplatin 540 mg in 500 mL D5W over 1 hour · ondansetron 10 mg IV 30 min prior to chemotherapy, repeated 4 and 8 hours later. Dilute in 50 mL of NS and infuse over 15 minutes. · Cyclophosphamide 280 mg in 250 mL of D5W and infuse over 3 hours. Calculate the doses (do not round unless directed): 1. BG is 200. What is the bolus dose of insulin? (Round to a whole number.) 2. BG is 200. What is the rate of infusion of insulin on the IV infusion pump? Supply: regular insulin 250 units/250 mL. 3. BG in one hour is 220. Insulin protocol:
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