Dosing and rate question

[speakurmind]

I work in home health and my patient gets formula via peg tube. Now he's suppose to get 240ml per hour of formula which would be at a rate of 240 since it has to infuse for one hour. Now the question. The mom increased the rate to 360, she has permission per the child's nutritionist, so now the formula will infuse in about 40 to 45 minutes. How would you write this in your nurses note. Not the increase of rate, but the child getting 240ml of forumula at a rate of 360. Also, is that 360 per hour, or 360 per 45 minutes? Come on all you smart nurses, join in and help me out here.

[SandyKRN]

ok... Here we go... Ratio / proportion.. 240 cc is to be infused over 60 min. If the Rate is changed to 360 then it will only take 40 min. To infuse 240 cc.

My note would say...240cc of Formula infusing at 360cc/hr. per orders . Then of course you would chart what kind, potency of line and tolerance of the patient. hope this helped you! Sandy

[speakurmind]

Thank you, Sandy, that was a big help.

[Jhawka19]

One thing to be careful about this issue is that you do not have a physician's order for this change. I would think that it places you in a liability situation. Even though most physicians follow the directions of the nutritionist, it is my understanding that the provider must still place the order. At least the states that I have worked in. Sometimes the facilities I have worked in did ot follow this, but it still is a legally touchy situation.

[SandyKRN]

Thank you, Sandy, that was a big help.

Anytime! I love to help others, hence... I guess that's why I'm a nurse!! Lol!! Always chart the changes , who made them, and make sure it is all legit. CYA.... But the patient and their tolerance to this change is first and foremost!!!

[Blue-Sky]

Get an MD order.