The physician orders vancomycin 500 mg in 250 mL of D5W IVPB daily to infuse over 2 hours. Tubing drop factor is 15 gtts/mL. Calculate the flow rate in drops per minute.
31 gtts/min
62 gtts/min
125 gtts/min
250 gtts/min
The Correct Answer is B
Choice A reason: 31 gtts/min assumes 250 mL over 4 hours with 15 gtts/mL; this halves the rate, underdelivering vancomycin, risking subtherapeutic levels and ineffective bacterial killing over the prescribed 2-hour infusion time.
Choice B reason: 62 gtts/min is correct; 250 mL over 2 hours is 125 mL/hr, times 15 gtts/mL equals 1875 gtts total, divided by 120 minutes yields 62 gtts/min, ensuring proper antibiotic delivery.
Choice C reason: 125 gtts/min doubles the rate; 250 mL in 1 hour with 15 gtts/mL is too fast, risking vancomycin toxicity, including renal damage, and exceeding safe infusion guidelines for IVPB.
Choice D reason: 250 gtts/min assumes 250 mL in 30 minutes; this dangerously rapid rate could cause vancomycin-induced red man syndrome or cardiovascular overload, far beyond the ordered 2-hour infusion duration.
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Correct Answer is C
Explanation
Choice A reason: Four times (6:00 a.m., noon, 6:00 p.m., midnight) is QID, not TID; TID means three times daily, and this schedule overdoses the patient unnecessarily.
Choice B reason: Six times daily is every 4 hours, not TID; this exceeds the three-dose requirement, risking toxicity or side effects from excessive administration frequency.
Choice C reason: 9:00 a.m., 1:00 p.m., 5:00 p.m. is TID; spaced 8 hours apart, it aligns with standard three-times-daily dosing, ensuring consistent therapeutic levels safely.
Choice D reason: Meal and bedtime timing is vague; without fixed hours, it risks uneven dosing intervals, potentially disrupting pharmacokinetics and efficacy of the medication.
Correct Answer is A
Explanation
Choice A reason: An applicator ensures precise vaginal delivery; it maintains sterility, controls depth, and optimizes medication contact with mucosa for effective absorption.
Choice B reason: Irrigation kits are for flushing; they’re inappropriate for solid or cream medications, risking uneven distribution or mucosal irritation in the canal.
Choice C reason: A finger risks contamination; without sterile technique, it introduces bacteria, and depth control is poor compared to a designed applicator.
Choice D reason: Gauze pads can’t deliver deeply; medication may stick or distribute poorly, reducing efficacy and comfort in vaginal administration settings.
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