IV Flow Rate Calculation (Nursing)

00:00 Now, let's talk about the fun step. Here is where the math comes in.

00:05 The size of the IV drop is regulated by the IV tubing set being used.

00:10 Okay. That means that in that drip chamber when you see those drops come down, the volume of how much fluid is in that drop, the size of that drop is regulated by the tubing set that you're using.

00:25 Now, you don't have to memorize this but most hospitals have more than 1 size of infusion tubing.

00:31 You'll just have to see when you get to the hospital and you're working in that setting.

00:35 The cool part is you don't have to memorize it.

00:38 The drip rate. Now, see that word gtt? That's drip. And that's how we abbreviate that.

00:45 So when we say a drip rate, we also see gtt. The drips per mL is printed on each IV tubing package.

00:53 Let's take a look. You have macrodrip tubing and microdrip tubing.

00:59 Now we use macrodrip tubing with adults.

01:03 Now, look at that box right there with a number 10 in it. It says "10." That means it takes 10 drops in this particular tubing to make 1 mL.

01:16 So that's a drop factor of the tubing. 10 drops to make 1 mL.

01:22 That means when I am counting how much volume the patient is getting and I'm setting the rate manually, I'd look at the drops and I would have to count 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. That would equal 1 mL.

01:43 Now, you noticed when I did that counting, it may have been annoying for you, but sometimes it was slow and sometimes it was fast.

01:50 That's what happens when you adjust the roller clamp.

01:54 The tighter the roller clamp, the more pressure it's putting on the tubing, the slower the drops will go.

02:02 You back off on that roller clamp and you have less pressure on the tubing, the faster the drops will go.

02:07 Okay, so that's what you want to know that you control the drop rate by how tight the roller clamp is or how loose that roller clamp is.

02:16 If the roller clamp is backed all the way up, it's going to flow really fast.

02:20 You probably won't be able to count the drops because there's going to be a solid stream.

02:25 So we have macrodrip tubing and microdrip tubing.

02:30 Now, macrodrip sets have 10 drops per mL, 15 drops per mL, or 20 drops per mL. Remember, gtt means drops.

02:40 So, this example we have in the big box, so you see 10, that would be 10 drops per mL but other sets can be 15 or 20.

02:49 You just have to look at the package that the tubing comes in to. This is what we predominantly use for adults.

02:55 Now, we have microdrip tubing. It's 60 drops per mL.

03:01 Wow, I would hate to count this. But it's 60 drops per mL.

03:05 You'll see this if it's really crucial medication or with our pediatric patients because they are so sensitive to volume.

03:13 Now, the practice questions we give you are not going to be 60 drops per mL. Thank goodness.

03:18 We're going to stick with the macrodrip, but we wanted you to know that that type of tubing is out there and used with very special populations.

03:26 Now, let's look at some IV fluid order examples.

03:30 Most often an IV order will be written with an hourly rate for the IV fluid.

03:34 I'm going to show you 3 examples of what you might see in a patient's chart. 0.9% normal saline at 125 mL per hour.

03:45 That means I'm going to hang a bag of normal saline, 0.9%, and I want it to run at 125 mL in an hour.

03:55 So if I want that patient to receive 125 mL of normal saline every hour, I'll hang it and it will just continue to flow.

04:07 It doesn't give me any type of time limit, how much to put in.

04:10 It just says "start an IV going at 125 an hour." Now, as a responsible nurse, I'm going to keep communicating with the healthcare provider and see how long the patient needs to continue this level of therapy.

04:23 But let's look at a different order. Ahhh, what's different about this one is it tells us "just for 8 hours." Now if you multiply 125 x 8, that should come up to 1000 mL.

04:38 Well, this indicates the healthcare provider wants this patient to just get 125 mL per hour for 8 hours, roughly they're going to get 1000 mL of fluid in.

04:51 After the 8 hours, the IV should be discontinued if the healthcare provider has not ordered additional fluids.

04:59 Now, look at the 3rd order. This one says "0.9% normal saline at 125 mL per hour for a total of 2000 mL or 2 L." Okay, so these are just 3 different formats of how you might see an IV order.

05:16 The first one I'm going to hang the IV and it's going to continue at 125 mL an hour.

05:22 I'm going to keep a really close eye on my patient because any time I hang IV fluid, we're risking fluid volume overload and I'm going to keep communicating with the healthcare provider to see if we need to continue at this rate.

05:34 Orders number 2 and 3 tell me exactly how long the healthcare provider wants that IV to continue.

05:41 The 2nd order for 8 hours and the 3rd order says 125 mL an hour til 2 liters or 2000 mL have been infused into my patient.