Soalan untuk IVD admxture (06/07 Part 1 Question 1)

Yg bawah ni ak copy je apa yg Sis Khadijah emel kat ak....

Tp dia sms lak suh tuka Dextrose 10% in 0.9% Saline kepada Dextrose 5% in 0.9% Saline.

Sbb Mdm Halimah pun kata guna D5% in O.9%....

So korang edit la sendiri.

Malas nak taip balik...byk nak kena ubah tu...

Rx:

IVD ½ Dextrose Saline 500 ml

Add 40 mmol K⁺ per day

Add 2.2 mmol Ca²⁺ per day

Requirement	Quantity	Volume (mL)	Preparations Used
Dextrose (gm)	25.0 gm	50 mL	Dextrose 50%
NaCl (gm)	2.25 gm	75 mL	NaCl 3%
KCl (gm)	3.0 gm	30 mL	KCl 10%
Ca Gluconate (gm)	-	10 mL	Ca Gluconate 10%
WFI	-	335 mL	WFI
Final Volume		500 mL

1 gm KCl à 13.4 mmol K⁺

1 gm Ca Gluconate à 2.2 mmol Ca²⁺

KCl 10%: 1 mL à 1.34 mmol K⁺

Ca Gluconate 10%: 1 mL à 0.22 mmol Ca²⁺

NaCl 3%: 1 mL à 0.513 mmol Na⁺

Explanation & Calculation:

First of all, you have to understand the meaning of ‘1/2 Dextrose Saline’.

Normal Dextrose Saline means Dextrose 10% in 0.9% Saline.

Therefore, ½ Dextrose Saline means Dextrose 5 % in 0.45 % Saline (half of the original concentration).

Since the concentration of Dextrose preparation that we are using is D50%, so we need to make a dilution (from 50% to 5%) based on the final volume required, which is 500 mL.

1) Thus, the calculation for dilution of Dextrose 50% to Dextrose 5% required for the IVD preparation is as follow:

Final vol required = 500 mL

Dextrose 50% à 25 gm / 50 mL (need to be memorized)

M1V1 = M2V2

(50%) (x) = (5%) (500 mL)

(x) = (5%) (500 mL) / (50%)

(x) = 50 mL #

And we know that 50 mL Dextrose 50% preparation containing 25 g of dextrose, hence, the quantity needed is 25 gm.

2) Calculation for dilution of NaCl 3% to NaCl 0.45% required for the IVD:

Using the same concept and final volume requirement of 500 mL

NaCl 3% à 3gm/ 100 mL OR 30 gm/L (need to be memorized)

M1V1 = M2V2

(3%) (x) = (0.45%) (500 mL)

(x) = (0.45%) (500 mL) / (3%)

(x) = 75 mL #

Quantity of NaCl 3% needed for the IVD dilution to NaCl 0.45% is therefore:

3gm / 100 mL = (x) / 75 mL

(x) = (3 gm) (75 mL) / (100 mL)

(x) = 2.25 gm #

3) Calculation of K+ required:

K+ to be added à 40 mmol

We know that 1 mL of KCl 10% containing 1.34 mmol K+

Therefore, the vol of KCl 10 % to be added to the IVD preparation is:

1 mL / 1.34 mmol = (x) / 40 mmol

(x) = (1 mL) ( 40 mmol) / (1.34 mmol)

(x) = 29.85 mL

(x) ~ 30 mL (round-up) #

We also know that 1 gm KCl 10% à 13.4 mmol K+

Thus, using the same calculation as above,

1 gm / 13.4 mmol = (x) / 40 mmol

(x) = (1 gm) (40 mmol) / (13.4mmol)

(x) = 2.98 gm

(x) ~ 3.0 gm (round-up) #

4) Calculation of Ca2+ required:

Ca2+ to be added à 2.2 mmol

We know that 1 mL of Ca Gluconate 10% containing 0.22 mmol Ca2+

Therefore, the vol of Ca Gluconate 10% to be added to the IVD preparation is:

1 mL / 0.22 mmol = (x) / 2.2 mmol

(x) = (1 mL) ( 2.2 mmol) / (0.22 mmol)

(x) = 10 mL #

We also know that 1 gm Ca Gluconate 10% à 2.2 mmol Ca2+

Thus, using the same calculation as above,

1 gm / 2.2 mmol = (x) / 2.2 mmol

(x) = (1 gm) (2.2 mmol) / (2.2mmol)

(x) = 1 gm #

5) WFI to be added to the final preparation is:

Vol WFI = Final Vol – (Vol Dextrose50% + NaCl 3%+ KCl 10% + Ca Gluconate 10%)

= 500 mL – (50 mL + 75 mL + 30 mL + 10 mL)

= 335 mL #