A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (DW) 200 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

To calculate the infusion rate in gtt/min, you can use the following formula:

Infusion rate (gtt/min) = (Volume to be infused (mL) / Time of infusion (min)) x Drop factor (gtt/mL)

In this case:

Volume to be infused = 500 mL

Time of infusion = 2 hours = 120 minutes (since 1 hour = 60 minutes)

Drop factor = 10 gtt/mL

Now, plug these values into the formula:

Infusion rate (gtt/min) = (500 mL / 120 min) x 10 gtt/mL

Infusion rate (gtt/min) = (5/12) x 10

Infusion rate (gtt/min) = 50/12

Infusion rate (gtt/min) ≈ 4.17 gtt/min

Rounded to the nearest whole number, the nurse should regulate the infusion at approximately 4 gtt/min.

A. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication:

This timing doesn't align with the standard practice of drawing peak levels immediately after the IV dose is completed.

The trough level should be taken just before the next dose, not 30 minutes before.

B. Two hours after completion of the IV dose and 1 hour before the next administration of the medication:

Waiting for two hours after the dose to draw the peak level is too long. Peak levels are typically drawn immediately after completion.

Drawing the trough level one hour before the next dose doesn't provide an accurate assessment of the lowest drug concentration just before the next administration.

C. One hour after completion of the IV dose and one hour before the next administration of the medication:

Similar to choice B, waiting one hour after the dose to draw the peak level is not in line with standard practice.

Drawing the trough level one hour before the next dose is administered is too early to accurately represent the lowest concentration.

The best collection times for determining the peak and trough levels of intravenous (IV) vancomycin are:

D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Explanation:

Peak Level: Peak levels of vancomycin are drawn immediately after the completion of the IV dose. This is done to assess the highest concentration of the drug in the bloodstream, which is important for ensuring its therapeutic efficacy and monitoring for potential toxicity.

Trough Level: Trough levels are drawn just before the next dose is administered. A trough level represents the lowest concentration of the drug in the bloodstream, ensuring that the drug is still present at a therapeutic level before the next dose is given. Taking the trough level 30 minutes before the next administration is appropriate, as it allows time for the drug to reach its lowest concentration before receiving the next dose.