Hospital Operations II Rotation

Franciscan Health Lafayette

Question Packet #1 ANSWERS
1. What is REMS? Name one medication that a hospital pharmacist should be worried about as it pertains to REMS.
 REMS = Risk Evaluation and Mitigation Strategies Program
 Medications under REMS = clozapine

2. A nurse asks you to confirm a drip rate for dopamine. The order is for dopamine 3 mcg/kg/min. The patient weighs
186 lbs. Using the hospital’s standard concentration of 800mg/250mL D5W, what is the correct rate in mL/hr?
186 lbs
=84.5 kg
2.2lbs/kg

3 mcg/kg/min x 84.5 kg = 253.5 mcg/min

mcg 250 mL 1mg 60 min

253.5 x x =4.75 mL/hour
min 800 mg 1000 mcg 1hr

3. A nurse calls the pharmacy and states she has a peripheral IV line in a patient receiving piperacillin/tazobactam
every 8 hours via extended infusion and vancomycin IV every 12 hours. Are these compatible? If yes, how would
you tell the nurse to administer the 2 drugs? If not, what would you tell the nurse?
 No, piperacillin/tazobactam and vancomycin are NOT compatible.
 Have the nurse infusion the piperacillin/tazobactam over 30 minutes. (Standard infusion instead of
extended infusion.)

4. A nurse calls the IV room from the ICU. Her patient has a double lumen PICC and one peripheral IV line. She needs
to run four continuous infusions and two piggybacks. Map out for her which drugs should run in which lines. The
drugs are as follows: amiodarone (D5W), norepinephrine (D5W), 1/2NS, TPN, meropenem (NS) q12h, and
micafungin (NS) q24h.
 PICC #1: TPN
 PICC #2: Norepinephrine, Micafungin, Meropenem, ½NS
 Peripheral IV: Amiodarone

5. Answer the following questions regarding potassium for injection:

Question Answer
What is the maximum rate that potassium may be
10 mEq/hour
safely infused through a peripheral line?
What is the maximum rate that potassium may be
20 mEq/hour
safely infused through a central line?
What must a patient have in order to receive
Central access and telemetry monitoring
potassium at a higher rate?
Storage of KCl in hospital: central pharmacy
Where is concentrated potassium chloride stored in
the hospital, and why does the hospital have this
Purpose of policy: safety concerns of potassium infusing
policy?
too quickly, medication errors
Hospital Operations II Rotation
Franciscan Health Lafayette
Question Packet #1