1

Med-Math Calculations for SJC

Nursing Students
A Dimensional Analysis Approach
Variety of calculation types
Varying levels of difficulty
Must (re)test every semester; usually 10-30 calculations
Passing grade is defined as: 90%; no partial credit
Prerequisite for giving medications in a clinical setting

B. Glick: 03/23/2009 @ 23:00
Copyright 2009


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Table of Contents

Introductory text . . . . . . . . . . . . . . . . . . . . . . . . 1
Problems solved in class . . . . . . . . . . . . . . . . . 19
Easily solved problems (outside class). . . . . . 66
More solved problems (outside class). . . . . . 68
Answers to More solved problems . . . . . . . . 93
3
Why are you learning to make these
calculations?
It is physically impossible to stock every
medication in every possible dosage.
APRNs & physicians dont know (or care) what
is in your medication inventory.
Nurse must ACCURATELY do the arithmetic
to use what is in the inventory and convert it to
what the physician or APRN ordered.

4
The nurses most important role in
medicating a patient

The nurse is the patients last line of defense
against receiving an inappropriate medication.

Right patient? Right medication? Right time?
Right route? Right dose? Right form?
Expiration date?
5
Arguments for/against using
dimensional analysis
For: Formulas are derived from dimensional
analysis. If you forget the formula, you have no
rational backup. Guessing is not rational!
For: By canceling the excess labels before doing
the arithmetic, the problem setup is very likely
to be correct. (Avoids the generation of an
inappropriate or nonsense answer such as: mL
2
)
Against: Dimensional analysis is more work
than using formulas.
6
Med-Math question types & sample
units of measure
Intake/output
Counting (tablets, units of medication)
Mass (weight)
Volume (mL, Liter)
Rate (drops/min, mL/hr, mg/min, units/hr)
Time-based (what time will the IV bag empty?)
Reconstitution Junior level nursing students
IV rate changes - Junior level nursing students

7
Time Abbreviations Use of the q
abbreviation is discouraged, but
remains prevalent.
q4h every 4 hours
q8h every 8 hours
q12h every 12 hours
qd every day (1 time/day)
bid every 12 hours (two times a day)
tid every 8 hours (three times a day)
8
Other Abbreviations
Mass (weight): microgam (mcg)
milligram (mg)
gram (g)
kilogram (Kg)
pounds (lbs, #)

Volume: milliliter (mL) = (cc) do not use cc
liter (L)
teaspoon (tsp) ounce (oz)
tablespoon (tbs) cup (C)
9
Other Abbreviations -continued
Time: hour (h, hr) minute (min)
Count: tablet (tab)
drop = gtt [Latin: gutta or guttae]
(singular plural)
Unit [quantity of certain medications]
mEq [milliequivalents for electrolytes]
tablet
10
Rate definition
Rate = flow (These two words mean the same thing)
How much medication AND how quickly?
Volume & Time (gtt/min, mL/hr)
Mass & Time (mg/min)
Counting & Time (tablets/dose, Units/hr)
mL/hr is the default flow for IV
pumps
11
Graphic representation of grams,
milligrams and micrograms
12
Introduction to problem solving
Answer exactly what you are being asked to find.
Not what you think the question means.
Not what you think the question should ask.

Determine the label for the answer.
NOTE: The answer label should be, but may not
always be explicitly stated in the problem.
Example: IV flow through a pump implies mL/hr.
13
Problem solving strategy
(1) Based upon the question, determine what the answers
label will be and place it to the right of the previous
lines. Then place an equal sign (=) to the right of the
label.
(2) The numerator of term immediately to the right of the
answers numerator label must match the answers
numerator label. You may require a conversion factor
such as (1,000 mcg/1 mg) to force the correct label in
the 1
st
numerator.
14
Problem solving strategy
(3) If the question asks you to find (for example) mL/hr,
set up the following generic statement. The intention
is to cascade as many labels as you need so that the
labels that do not appear in the answer are
arithmetically canceled. (x to x, y to y and z to z;
leaving mL per hr, as required in the answer)

mL = mL * x * y * z
hr x y z hr
15
Problem solving strategy
Include medication order, medication source and other
factors to cancel labels that are not used in the answer.
(examples that may be relevant: patient weight, drip set
ratio, time factors and conversions)

Notice that all parts of the formula contain PAIRS of
data. Examples: gtt/mL, mg/hr, mg/mL, g/L,
something/dose, mg/Kg/day
By definition: a microdrip set = 60 ggt/mL
By definition: a macrodrip set = 10, 15 or 20 gtt/mL
16
Rounding Rules. Always follow
special directions in the question.

Verify the rounding rules with your instructor. Typical rules follow:

Infant & Pediatric: calculate final answer to 3 places to right of decimal; then
round back to 2 places. Follow the 5/4 rule: Value on dashed line affects solid
lines.
_______ . ___ ___
----

Adult: calculate final answer to 2 places to right of decimal; then round back
to 1 place. Follow the 5/4 rule: Value on dashed line affects solid lines.
_______ . ___
----


Drops (gtt) and Units [medication] are always rounded to the nearest whole
number. Follow the 5/4 rule: Value on dashed line affects solid lines.
_______ .
----

17
Problem with an explicit answer
Order: 400 mg of med. Supply: 125 mg per 5 mL.
How many mL will you give?

5 mL * 400 mg
? mL = ------ ---------
125 mg 1 an number over 1 makes the
numerator obvious & does not
= 16 mL change the numerators value.
18
Problem with an implied answer
Order: 400 mg of med. Supply: 125 mg per 5 mL.

5 mL * 400 mg
? mL = -------- ---------
125 mg 1
= 16 mL

All further examples are typed on these slides as follows:
mL = (5 mL/125 mg) * (400 mg/1)
= 16 mL
19
Class Problem mg/min
Determine the mg/min required to administer
when the flow and solution concentration are
given. The medication is infusing at 32 mL/hr.
The IV volume is 250 mL. The amount of
dissolved medication is 700 mg. If necessary,
round answer to 1 decimal place.

See next slide for important considerations.
20
Class Problem mg/min
Identify the pairs of data: 250 mL & 700 mg
1 hour and 32 mL
Orient the pairs as required to satisfy the answers
label and cancel all other labels.

Which conversion tool will you use to change the
hours to minutes?


21
Answer - mg/min
Determine the mg/min required to administer when the flow and
solution concentration are given. The medication is infusing at
32 mL/hr. The IV volume is 250 mL. The amount of dissolved
medication is 700 mg.

mg/min=(700mg/250mL) * (32mL/hr) * (1 hr/60min)
= 1.49 Round up to 1.5 mg/min
___1____ . _4__
--9--
mg/min rounds to:
___1____ . _5__
-
mg/min




22
Class Problem mcg/min
Determine how many mcg/min are infusing if the IV
contains 240 mg of medication per 500 mL and is
infusing at 16 mL/hr. If necessary, round answer to 1
decimal place.

This problem does not have mcg in any of the data;
therefore, put a conversion tool for mcg and mg
immediately to the right of the equal sign (=). Then
cascade and orient the rest of the data so that labels not
appearing in the answers label are canceled.
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Answer mcg/min
Determine how many mcg/min are infusing if
the IV contains 240 mg of medication per 500
mL and is infusing at 16 mL/hr

mcg/min = (1000mcg/mg) *(240mg/500mL) * (16mL/hr) * (hr/60min)
= 218 mcg/min
24
Class Problem mL/hr

The provider has ordered 2 mcg/min. The nurse
has 5 mg per 250 mL. The flow rate is
_________________ mL/hr. If necessary,
round answer to 1 decimal place.


25
Answer mL/hr
The provider has ordered 2 mcg/min. The nurse
has 5 mg per 250 mL. The flow rate is
_________________ mL/hr


mL/hr = (250mL/5mg) * (1 mg/1000mcg) * (2 mcg/min)* (60min/1 hr)
= 6 mL/hr
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Class Problem mL/hr
The provider ordered a medication at the rate of 46
mcg/Kg/min. The client weighs 72.7 Kg. The
medication is supplied as 300 mg in 75 mL of solution.
The client should receive ______________mL/hr. If
necessary, round answer to 1 decimal place.

When using a 3-part component (e.g., mcg/Kg/min),
always use the 1
st
component in the numerator (mg)
and everything else in the denominator. For example:
mg
Kg/min

27
Answer mL/hr
The provider ordered a medication at the rate of
46 mcg/Kg/min. The client weighs 72.7 Kg.
The medication is supplied as 300 mg in 75 mL
of solution. The client should receive
______________mL/hr

mL/hr =
(75mL/300mg) * (1 mg/1000mcg) * (46mcg/Kg/1 min) * (72.7 Kg/1) * (60min/1 hr)
= 50.163 rounds up to 50.2 mL/hr
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Class Problem - tablets
A medication comes out of the bottle as
2.5mg/tablet. Give 2.5mg tid. If necessary,
round answer to 1 decimal place.

(1) How many tablets/dose?

(2) How many tablets daily?
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Answer - tablets
A medication comes out of the bottle as 2.5mg/tablets.
Give 2.5mg tid.

(1) How many tablets/dose? (Each 1 dose = 2.5 mg.)

tabs/dose = (1 tab/2.5mg) * (2.5mg/1 dose)
= 1 tablet/dose

(2) How many tablets daily? (tid = 3 doses/day)

tabs/day = (1 tab/2.5mg) * (2.5mg/dose) * (3doses/day)
= 3 tablet/day
30
Class Problem mg/day
The provider ordered 2 mg/Kg/day IV for a 16
pound infant. The infant should receive
_____________mg per day. If necessary,
round answer to 2 decimal places.


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Answer mg/day
The provider ordered 2 mg/Kg/day IV for a 16
pound infant. The infant should receive
_____________mg per day.

mg/day = (2mg/Kg/day) * (1 Kg/2.2 lbs) * (16 lbs/1)
=14.545 round up to 14.55 mg/day
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Class Problem determine the label
and solve the problem

A medication is ordered for your patient at 80
mg/Kg/24 hours every 8 hours. The child
weighs 18 lbs. How many mg of medication will
you administer at each dose? If necessary, round
answer to 1 decimal place.

33
Answer determine the label and
solve the problem

A medication is ordered for your patient at 80
mg/Kg/24 hours every 8 hours. The child
weighs 18 lbs. How many mg of medication will
you administer at each dose?

mg/dose= (80mg/Kg/24hrs) * (8hrs/dose) * (1 Kg/2.2 lbs) * (18 lbs/1)
= 218.182 rounds down to 218.2 mg/dose
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Class Problem gtt/min

Calculate the drip rate of 1,000 mL of
medication to infuse over 10 hours using an
infusion set that delivers 15gtt/mL. How many
drops/min? If necessary, round answer to 1
decimal place.

35
Answer gtt/min
Calculate the drip rate of 1,000 mL of
medication to infuse over 10 hours using an
infusion set that delivers 15gtt/mL.

gtt/min= (15gtt/mL) * (1,000 mL/10 hrs) * (1 hr/60 min)
= 25gtt/min
36

4 AM
5 AM
6 AM
7 AM
8 AM
9 AM
10 AM
To the patient
1,000 mL
900 mL
800 mL
700 mL
600 mL
500 mL
400 mL



0 mL
Expectation What is observed
1,000 mL
? mL
? mL
? mL
? mL
? mL
600 mL
1 Liter bag of
medication
Drip chamber
7 tubing
37
Class Problem Is the IV setup
working as expected?

The IV above was started at 4 AM.
At 10 AM 600 mL remain in the bottle.
Is the IV running on time?
(Refer to previous slide for mL/hr)
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Answer Is the IV setup working as
expected?
The IV above was started at 4 AM.
At 10 AM 600 mL remain in the bottle.
Is the IV running on time?

(4 AM to 10 AM) = 6 hrs running time.
(1,000 mL/10 hrs) = 100 mL/hr.
(100 mL/hr * 6 hrs/1) = 600 mL should be used in 6 hours.
(1,000 mL 600 mL) = 400 mL should still be in the bottle.
Therefore: bottle is emptying too slowly NO: not on time.
Patient may have laid on the tubing and caused it to crimp.
There are other possible reasons for the delayed emptying.
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Conversion factors to memorize

1 oz = 30 mL
8 oz = 1 cup = 240 mL
======================
16 oz = 1 pint = 500 mL
32 oz = 1 quart = 1,000 mL = 1 liter
128 oz = 1 gallon = 4,000 mL
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Class Problem Intake & Output
12 hour I/O for patient Smith on 4/7/2008:
4 oz cranberry juice 175 mL urine 1/2 cup oatmeal
2 slices of toast 120 mL yellow vomit 8 oz black coffee
a tuna fish sandwich 1/2 cup flavored gelatin 100 mL diarrhea
3 oz cream of mushroom soup 6 oz 1% milk 230 mL urine
16 oz water 1 pint ice cream
2 tsp liquid medication 1 tbs liquid medication
IV @ 150mL for 3 hrs 1 cup applesauce
What is the intake? ______________
What is the output? ______________
Net gain or net loss of fluid? _______

41
Answer - Intake
4 oz cranberry juice 4 oz * 30 mL/oz = 120 mL
8 oz black coffee 8 oz * 30 mL/oz = 240 mL
1/2 cup flavored gelatin 4 oz * 30 mL/oz = 120 mL
3 oz cream of mushroom soup 3 oz * 30 mL/oz = 90 mL
6 oz 1% milk 6 oz * 30 mL/oz = 180 mL
16 oz water 1 pint = 500 mL
1 pint ice cream 1 pint = 500 mL
2 tsp liquid medication 2 tsp * 5 mL/tsp = 10 mL
1 tbs liquid medication 1 tbs * 15 mL/tbs = 15 mL
IV @ 150 mL for 3 hrs 150 mL/hr * 3 hr = 450 mL
1 cup applesauce 1 cup * 16 oz/cup = 240 mL
Answer: - ---------------------------------------- 2,465 mL
42
Answer - Output & Net gain or loss
175 mL urine
120 mL yellow vomit
230 mL urine
100 mL diarrhea Input = 2,465 mL
625 mL Output Output = 625 mL
Net gain = 1,840 mL
More fluid was retained
than was excreted; therefore,
patient has a net gain.
43
Class Problem mL/hr
with distracters
This problem contains distracters. Determine what the
answer label is. Then look to see which components of
the question will satisfy the requirements for the
answers label. Ignore everything else. If necessary,
round answer to 1 decimal place.
An IV of 1,000 mL medication contains 60 mEq of an
electrolyte and is set to infuse at 27 drops per minute.
The tubing delivers 10gtts/cc. How many mL/hr are
you administering?

44
Answer - mL/hr
with distracters

An IV of 1,000mL medication contains 60 mEq of an electrolyte and is set to
infuse at 27 drops per minute. The tubing delivers 10gtts/cc. How many
mL/hr are you administering?

Be in the habit of rewriting drops to gtt and cc to mL.
Remember to find pairs of data that may work for you.
27 gtt/min 10 gtt/mL mL/hr 1,000 mL/mEq

Correct answer: mL/hr = (1 ml/10 gtt) * (27 gtt/1 min) * (60 min/1 hr)
= 162mL/hr

Why is this wrong? mL/hr = (1,000 ml/60 mEq) *
(27 gtt/1 min) * (60 min/1 hr)
45
Class Problem Time-based
Unless otherwise specified, and if necessary, round
answer to 1 decimal place.
900 mL of medication is ordered to infuse at 80 mL
per hour.

(1) Assuming that there are no interruptions, how
long will it take to empty the bag?

(2) If the IV line is started at 2:47 PM, what time will
the bag run dry?

46
Answer - Calculate the hours

1) Assuming that there are no interruptions, how
long will it take to empty the bag?

Hours = (1 hr/80 mL) * ( 900 mL/1)
= 11.25 hours
This answer is expressed in hours and it means
11 and hours.
It is NOT 11 hours and 25 minutes!
47
Answer - Calculate the minutes

minutes = (60 min/1 hr) * (0.25 hr/1)
= 15 minutes
48
Answer total run time
expressed in hours & minutes

(1) Assuming that there are no interruptions, how
long will it take to empty the bag?

The bag will empty in 11 hours and 15 min.
49
Answer - Time bag will
theoretically empty

(2) If the IV line is started at 2:47 PM, what time
will the bag run dry?

(from previous page)
2 PM + 11 hours -------> 1 AM
47 minutes + 15 minutes = 62 minutes
1 AM + 62 minutes ------> 2:02 AM

50
Class Problem Reconstitution
Reconstitution problems ask the nurse to dissolve
a drug (typically a powder) whose quantity is
usually expressed in grams or milligrams in:
a specific quantity of a liquid (usually measured in
milliliters). Frequently, the liquid is normal
saline (0.9% NS) or D5W.
Conceptually, this is identical to dissolving 1
teaspoon of table salt in 1 cup of hot water.
51
Class Problem Reconstitution
Order: 350 mg of the drug to be given q8h IV.
How many mL will you give per dose?

Supply: The drug is available in 500 mg containers.
The label tells the nurse to dissolve the powder
in 25 mL of normal saline (NS).




52
Class Problem Reconstitution
Which pairs of data do you find in the problem?
350 mg every 8 hours. (every 8 hours means: 1 dose.)
500 mg of the powder is dissolved in 25 mL of NS.

What is the answers label for your calculation?
How many mL/dose?

Can you isolate all of the components that are required to
solve this problem? (YES, of course you can do this!)

53
Answer Reconstitution


mL/dose = (25 mL/500 mg) * (350 mg/dose)
= 17.5 mL/dose

54
Class Problem Reconstitution
Order: 250 mg of the drug to be given q8h IV.
How many mL will you give per dose?

Supply: The drug is available in 1g containers.
The label tells the nurse to dissolve the powder
in 50 mL of normal saline (NS).
The disconnect is between the grams and the
milligrams, so use the appropriate conversion
tool.
55
Answer Reconstitution

mL/dose = (50 mL/1 g) * (1 g/1000 mg) *
(250 mg/dose)
= 12.5 mL/dose
56
Class Problem Reconstitution
Order: 20 mg/Kg of the drug to be given q8h
IV. Patient weighs 50 pounds. How many mL
will you give per dose?

Supply: The drug is available in 500 mg
containers. The label tells the nurse to dissolve
the powder in 5 mL of normal saline (NS).
With which data pair is the dose a factor?
Why?

57
Answer Reconstitution

mL/dose = (5 mL/500 mg) * (20 mg/1 Kg/1 dose) *
(1 Kg/2.2 lbs) * (50 lbs/1)
= 4.545 rounds up to 4.55 mL/dose

Dose is only related mg/Kg. Any other pair does
not make any sense.
58
Class Problem Reconstitution
Order: 700,000 Units given IM. How many mL will you
give?
Supply: The drug is available in 5,000,000 Unit containers.
The label tells the nurse to reconstitute (dissolve) the
powder in 3.2 mL of normal saline (NS) to yield 1,000,000
Units/mL.

This problem contains a distracting pair. To determine what
the distracting pair is, you must understand the sequence of
the problems operation. See picture on next slide.
59
Reconstitution Graphic

5 million
Units in
3.2 mL
1 million
Units/1 mL The patient
Which medication source DIRECTLY affects the patient?
60
Answer Reconstitution
The distracters are the 5 million Units and 3.2 mL.

Your reconstituted supply is now 1 million Units/mL.
The 5 million units dissolved in the 3.2mL is how you
arrived at the 1 million Units/mL. Now they are
irrelevant = distractors.

mL = (1 mL/1,00,000 Units) *
(7.000,000 Units/1)
= 0.7 mL

61
Class Problem Reconstitution
Order: 500 mg IV every 4 hours.

Supply: The drug is available in 1 gram
containers. The label tells the nurse to
reconstitute (dissolve) the powder in 10 mL of
0.9% NS. THEN further dilute this mixture in
50 mL of NS. Infuse it over 30 minutes. The
drip set is 10gtt/mL.

62
Class Problem Reconstitution
Refer to the previous graphic and make a similar picture for
this problem.

Step-A: How many mL will you use of the 10 mL
in which you dissolve the 500 mg of powder?

Step-B: How many mL/hr will you give the patient?

Step-C: How many drops/min?

63
Answer Reconstitution
This is a multi-step (3) problem.

(A) Determine how many mL after mixing the
powder (Step-1).

mL = (10 mL/1 gram) * (1 gram/1,000 mg) *
500 mg/1)
= 5 mL
64
Answer Reconstitution
(B) Determine how many mL/hr after diluting the
mixture (Step-2).

mL/hr = (55 mL/30 min) * (60 min/1 hr)
= 110 mL/hr

Your picture should tell you why we use 55 mL,
not 50 mL.
65
Answer Reconstitution
(C) Determine how many gtt/min:

gtt/min = (10 gtt/1 mL) * (110 mL/1 hr) *
(1 hr/60 min)
= 18.3 rounds down to 18 gtt/min

66
Easily solved problems
with answers [in brackets]

Supply: 5 mg/mL. Order: 50 mg. Tsp____? [2 tsp]

Supply: 10 mg tablets. Order: 30 mg. Tablets__? [3 tablets]

Supply: 250 mg/5 mL. Order: 1.5 g. mL____? [30 mL]

Supply: 50 mg tablets. Order: 0.2 g. Tablets__? [4 tablets]

Supply: 100 mg/5mL. Order: 0.25 g. mL____? [12.5 mL]

Supply: 5 mL/tsp, tsp contains 250 mg.
Order: 0.5 g . mL____? [10 mL]


67
Easily solved problems
with answers
Supply: 10 mL/1 million Units.
Order: 200,000 Units. mL____? [2 mL]

Supply: each tablet contains 0.25 g.
Order: 500 mg. Tabs___? [2 tablets]

Supply: 2 mL per 600,000 Units.
Order: 300,000 Units. mL____? [1 mL]

Supply: 0.1 g per tablet.
Order: 200 mg. Tabs____? [2 tablets]

Supply: 500 mcg in 1.5 mL.
Order: 0.8 mg. mL____? [2.4 mL]

68
More Solved Problems Unless otherwise
instructed, as necessary, round all final answers to 1
decimal place.
How many milliliters you will give for each
medication? Answers begin on slide 92.

1. Give your patient 0.1 mcg. Your stock has 1.5
mL vials with 0.3 mcg.

2. Order is for 3,500 Units. Supply is 8,500 Units
per 1.5 mL.
69
More Solved Problems
3. Prepare a 25 mEq dose. You have 20 mEq
dissolved in 10 mL.

4. Supply is 1 mg/mL. You are ordered to give 750
mcg.

5. Your inventory contains a bottle with 0.4 g in 2
mL. Order is for 300 mg.
70
More Solved Problems

6. Supply is an elixor labeled 3 mg/mL. Order is
for 3 teaspoons. How many milliliters will you
give? This dose is equal to how many
milligrams?

7. The order is for an oral suspension of 50 mg.
your inventory contains 25 mg/5 mL. How
many teaspoons will you give?

71
More Solved Problems
8. Drug comes in 10 mg tablets. APRN orders 30
mg daily. How many tablets will you give over
the course of the whole day? How many tabs
per dose if the drug is to be given every 8 hours
(tid)?

9. Prescribed are 1.5 mg. Liquid is labeled 250 mg
per 5 mL. How many mL will you give?

72
More Solved Problems

10. Give your patient 200,000 Units. Available is a
multiple dose vial labeled 1,000,000 Units in 10
mL (cc). How many mL will you give?

11. You have scored (can be split) tablets labeled
0.1 g. Your order is for 200 mg every morning.
How many tablets, or part of a tablet, will you
give?


73
More Solved Problems
12. Prescribed is a 0.75 mg dose for an infant
weighing 8.7 pounds. The drug is available as
500 mcg dissolved in 1.5 mL. How many mL
will you give?

13. 360 mg to be given orally every 4 to 6 hours.
Available drug is 180 mg/5 mL. How many mL
should be given at each dose?
74
More Solved Problems

14. Your patient weighs 60 Kg. Order is for 500
mg of medication daily. Drug package
instructions say there are 125 mg/tsp. How
many milliliters will you give?

15. Patient weighs 41 pounds. APRN orders 75
mg/Kg/day in 4 divided doses. Drug is available
in 175 mg/3 mL. How many mL should be give
for each dose?

75
More Solved Problems
16. Give 15 mg/Kg/day. Drug is prescribed in 3
evenly spaced doses over 24 hours. Patient
weighs 231 pounds.

(A) How many hours apart will you give each
dose?

(B) If the drug is available in units of 75mg/mL,
how many milliliters will you give per dose?

76
More Solved Problems
17. How many micrograms are in 1 gram?

18. How many mL in 4 tablespoons?

19. Give 500 mL of an IV liquid over 8 hours. The
drip set is 10 drops/mL. How many gtt/min will
you adjust the manual control on the drip set?
77
More Solved Problems
20. A piggyback IV liquid contains 50 mL of
medication. It is attached to a microdrip set.
Deliver the medication over 2 hours. How many
drops per minute is this?

21. Referring to the previous problem, what
happens to the flow of medication from the
main medication bag when the piggyback is
running thru the IV line?
78
More Solved Problems
22. An IV drug is administered via a pump. The
medication is packaged as 50 mg per 100 mL of liquid
to be given over 2 hours. The drip set package is
marked 15 gtt. How many mL/hour will you set the
pump?

23. Using a pump, an IV medication is to be given over 90
minutes. The medication is dispensed from a 250
milliliter bag. How many mL/hour will you set the
pump?
79
More Solved Problems
24. Order is for 16 mcg/Kg. Infuse in 90 minutes.
Drug volume is 75 mL. The patient is a child
who weighs 46 pounds. The child should receive
223.03 mcg at a rate of ____ mL/hour?

80
More Solved Problems
25. 150 mL of liquid contains 8 mEq of a
continuous infusion at 25 ml/hour. The patient
will receive how many mEq/day?

26. How many mcg/min are being infused if an IV
contains 150 mg of medication per 250 mL and
is infusing at 10 mL/hr?

81
More Solved Problems
27. Calculate the intake expressed in mL and in liters. Ignore the output.

6 oz orange juice
150 mL urine
2/3 cup cereal with an additional 4 oz whole milk
3 pancakes covered with 1 oz maple syrup
120 mL of brownish-yellow vomit
6 oz black coffee with an additional 2 oz 2% milk
1/4 cup orange gelatin
100 mL diarrhea
3 tbs apple sauce
An IV infusing at 150 mL/hr for 8 hours
2 tsp liquid medicine
2 pills taken with a total of 4 oz water
1 pint sherbet
82
More Solved Problems
28. 450 mL of medication is ordered to infuse at
52 mL per hour.

(A) Assuming that there are no interruptions,
how long will it take to empty the bag?

(B) If the IV line is started at 7:47 PM, what
time will the bag run dry?
83
More Solved Problems
29. A dehydrated patient is placed on a continuous
drip at 15mL/hr. The drip set is 15 gtt/mL. The
nurse enters the patients bathroom where she
observes a toilet mounted hat containing 200 ml
of urine. An unlicensed assistant tells the nurse
that within the past few minutes he cleaned up 2
times after the patient soiled himself and the
bed. Each time about 75 mL of diarrhea came
out. Then the patient vomited about 250 mL.
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More Solved Problems
(A) How much fluid was lost?

(B) The physician orders the existing drip to
continue as ordered PLUS an order to replace
the lost fluid over the next hour. How much
fluid will the nurse infuse over the next hour?

(C) How many drops/minute?
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More Solved Problems
(D) In a separate IV, the patient is receiving 1350
Units/hr of a medication that is dispensed from
a 500 mL bag containing 25,000 Units of the
drug through a micro drip set. How many
mL/hr are being infused?

(E) How many drops/minute are being infused?

86
More Solved Problems
The physician decides to increase the dosage by 3
Units/Kg/hr. The patient weighs 185 pounds.
(F) How many Units/hr will the nurse administer?


(G) How many mL/hour will the pump be set?
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More Solved Problems
(H) How many gtt/min will be infused?

(I) How many hours will this IV run? Express as a
decimal quantity 3 decimal places?

88
More Solved Problems
(J) How many whole hours will the IV run?

(K) How many remaining minutes will there be?

(L) This IV started at 8:57 PM. What time will the
bag empty?

89
More Solved Problems
(M) An additional IV is ordered to run at 60
mL/hr. The bag contains 2 grams of
medication dissolved in 500 mL of D
5
W. The
label specifies that the normal dosage is from 1
to 4 mg/min. What does the manufacturer
consider the safe dosage range?

(N) At 60 mL/hr, what will be the ordered dosage
range in mg/hr?
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More Solved Problems
(O) Is the order in part (N) a safe dose?

(P) If the physician were to order 1800 mg of the
same medication at 70 mL/hr, will the nurse
accept or reject the order? Why?

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More Solved Problems
30. Determine how many of combined drug you
will give the patient per minute. Order: 22
mL/hr. If required, round to 3 decimal places.
Formulation:
Drug A dissolve 70 mg/10 mL of D5W
Drug B dissolve 30 mg/15 mL of D5W

More Solved Problems
31. Infuse an IV at 1,000 mL for the 1st 10 Kg of
body weight, plus 50 mL/Kg per day for each
Kg between 10 and 20. How many mL/hr
should the pump be set for a patient who weighs
19.5 Kg? Round to the nearest whole number.

92
93
Answers to Solved Problems
1. mL = (1.5 mL/0.3 mcg) * (0.1 mcg/1)
= 0.5 mL

2. mL = (1.5 mL/8500 Units) * (3500 Units/1)
= 0.63 rounds down to: 0.6 mL

3. mL = (10 mL/20 mEq) * (25 mEq/1)
= 12.5 mL

4. mL = (1 mL/1 mg) * (1 mg/1,000 mcg) * (750 mcg/1)
= 0.75 rounds up to: 0.8 mL

5. mL = (2 mL/0.4 g) * (1 g/1,000 mg) * (300 mg/1)
= 1.5 mL
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Answers to Solved Problems
6. mL = (5 mL/1 tsp) * (3 tsp/1)
= 15 mL

mg = (3 mg/1 mL) * (15 mL/1)
= 45 mg

7. tsp = (1 tsp/5 mL) * (5 mL/25 mg) * (50 mg/1)
= 2 tsp

8. mL = (5 mL/250 mg) * (1,000 mg/1 g) * (1.5 g/1)
= 30 mL
95
Answers to Solved Problems
9. tablets = (1 tablet/50 mg) * (1,000 mg/1 g) * (0.2 g/1)
= 4 tablets

10. mL = (10 mL/1,000,000 Units) * (200,000 Units/1)
= 2 mL

11. tablets = (1 tablet/0.1 g) * (1 g/1,000 mg)*(200 mg/1)
= 2 tablets

12. mL = (1.5 mL/500 mcg) * (1,000 mcg/1 mg) * (0.75 mg/1)
= 2.250 rounds down to: 2.25 mL

96
Answers to Solved Problems
13. mL = (5 mL/180 mg) * (360 mg/1)
= 10 mL
14. mL = (5 mL/1 tsp) * (1 tsp/125 mg) * (500 mg/1)
= 20 mL
15. mL/dose = (3 mL/175 mg) * (75 mg/Kg/day) *
(day/4 doses) * (1 Kg/2.2 lbs) *
(41 lbs/1)
= 5.993 rounds down to 5.99 mL/dose
97
Answers to Solved Problems
16A. hr = (24 hr/3)
= 8 hours
16B. mL/dose = (1 mL/75 mg) * (15 mg/Kg/day) *
(1 Kg/2.2 lbs) * (231 lbs/1) *
(1 day/3 doses)
= 7 mL/dose
17. mcg/g = (1,000 mcg/1 mg) * (1,000 mg/1 g)
= 1,000,000 mcg/g
18. mL = (15 mL/tbs) * (4 tbs/1)
= 60 mL

98
Answers to Solved Problems
19. gtt/min = (10 gtt/1 mL) * (500 mL/8 hr) *
(1 hr/60 min)
= 10.4 rounds down to 10 gtt/min
20. gtt/min = (60 gtt/1 mL) * (50 mL/2 hr) *
(1 hr/60 min)
= 25 gtt/min
21. Main bag stops flowing into the IV line until
piggyback bag is empty.
22. mL/hr = (100 mL/2 hr)
= 50 mL/hr
99
Answers to Solved Problems
23. mL/hr = (250 mL/90 min) * (60 min/1 hr)
= 166.66 rounds up to 166.7 mL/hr
24. mL/hr = (75 mL/90 min) * (60 min/1 hr)
= 50 mL/hr
25. mEq/day = (8 mEq/150 mL) * (25 mL/1 hr) *
(24 hr/ day)
= 32 mEq/day
26. mcg/min = (1,000 mcg/1mg) * (150 mg/250 mL) *
(10 mL/1 hr) * (1 hr/60 min)
= 100 mcg/min

100
Answers to Solved Problems
27.
orange juice (6 oz * 30 mL/oz) = 180 mL
milk (4 oz * 30 mL/oz) = 120 mL
syrup (1 oz * 30 mL/oz) = 30 mL
coffee + milk (8 oz * 30 mL/oz) = 240 mL
gelatin (1/4 cup * 240 mL/cup) = 60 mL
apple sauce (3 tbs * 15 mL/tbs) = 45 mL
infusion (150 mL/hr * 8 hr) =1,200 mL
medication (2 tsp * 5 mL/tsp) = 10 mL
water (4 oz * 30 mL/oz) = 120 mL
sherbet (1 pt * 500 mL/pint) = 500 mL
---------------
2,505 mL
(2,505 mL * 1,000 mL/liter) = 2.5 liters
101
Answers to Solved Problems
28.
(A) hours = (1 hr/52 mL) * (450 mL/1)
= 8.65 hours Not 8 hours and 65 minutes!
minutes = (60 min/hr) * (0.65 hr/1)
= 39 minutes
The bag will empty in 8 hours and 39 minutes

(B) 7 PM + 8 hours = 3 AM
47 minutes + 39 minutes = 86 minutes
3 AM + 86 minutes = 4:26 AM
The clock will show 4:26 AM.
102
Answers to Solved Problems
29.
(A) How much fluid was lost?
200 urine + 2 * 75 diarrhea + 250 vomit = 600 mL
(B) The physician orders the existing drip to continue as
ordered PLUS an order to replace the lost fluid over
the next hour. How much fluid will the nurse infuse
over the next hour?
600 replacement + 15 existing order = 615 mL
(C) How many drops/minute?
gtt/min = (15 gtt/mL) * (615 mL/60 min) = 154 mL
103
Answers to Solved Problems
(D) In a separate IV, the patient is receiving 1350
Units/hr of a medication that is dispensed
from a 500 mL bag containing 25,000 Units of
the drug through a micro drip set. How many
mL/hr are being infused?
mL/hr = (500 mL/25,000 Units) * (1350 Units/hr) = 27 mL/hr
(E) How many drops/minute are being infused?
gtt/min = (60 gtt/mL) * (27 mL/hr) * (hr/60 min) = 27 gtt/min

104
Answers to Solved Problems
The physician decides to increase the dosage by 3
Units/Kg/hr. The patient weighs 185 pounds.

(F) How many Units/hr will the nurse administer?
Units/hr = (3 Units/Kg/hr) * (Kg/2.2 pounds) * (185 pounds/1)
= 252 Units/hr + 1,350 Units/hr 1,602 Units/hr
(G) How many mL/hour will the pump be set?
mL/hr = (500 ml/25,000 Units) * (1,602 Units/hr) = 32 mL/hr

105
Answers to Solved Problems
(H) How many gtt/min will be infused?
gtt/min = (60 gtt/mL) * (32 mL/hr) * (hr/60 min) = 32 gtt/mmin

(I) How many hours will this IV run? Express as a
decimal quantity 3 decimal places.
hr = (hr/32 mL) * (500 mL/1) = 15.625 gtt/min
106
Answers to Solved Problems
(J) How many whole hours will the IV run?
15 hours

(K) How many remaining minutes will there be?
min = (60 min/hr) * (0.625 hr/1) = 38 min

(L) This IV started at 8:57 PM. What time will the
bag empty?
8:57 PM + 15 hrs = 11:57 AM
11:57 AM + 38 minutes = 11:95 AM = 12:35 PM
107
Answers to Solved Problems
(M) An additional IV is ordered to run at 60 mL/hr. The
bag contains 2 grams of medication dissolved in 500
mL of D5W. The label specifies that the normal
dosage is from 1 to 4 mg/min. What does the
manufacturer consider the safe dosage range?
1 to 4 milligrams per minute

(N) At 60 mL/hr, what will be the ordered dosage range
in mg/hr?
(1 mg/min) (60 min/hr) = 60 mg/hr
(4 mg/min) (60 min/hr) = 240 mg/hr

108
Answers to Solved Problems
(O) Referring back to slide #104, is the order in
part N a safe dose?
mg/hr = (1,000 mg/g) * (2 g/500 mL) * (60 mL/hr) = 240 mg/hr
Yes it is a safe dose
(P) If the physician were to order 1800 mg of the
same medication at 70 mL/hr, will the nurse
accept or reject the order? Why?
mg/hr = (1,800 mg/500 mL) * (70 mL/hr) = 252 mg/hr
Reject & question the order. It is (252 mg 240 mg) =12 mg/hr
too large.
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Answers to Solved Problems
30. Determine how much of the combined drug you will give the
patient per minute. Order: 22 mL/hr. If required, round to 3
decimal places.
Formulation:
Drug A dissolve 70 mg/10 mL of D5W
Drug B dissolve 30 mg/15 mL of D5W
You will dissolve and mix the 2 drugs as above. This will yield 25
mL of combined drugs. Of the 25 mL, you will give the patient
22 mL spread over 60 minutes. The 70 & 30 mg are distracters.
mL/hr = (22 mL/hr) * (hr/60 min) = 0.367 mL/hr

Answers to Solved Problems
31.
(a) Parse the total weight into 2 pieces: (19.5 Kg - 10 Kg) = 9.5 Kg

(b) Calculate the infusion rate for the 1st 10 Kilograms:
mL/hour = (1000 mL/24 hr) = 41.66 mL/hour

(c) Calculate the infusion rate for the remaining 9.5 Kilograms:
mL/hour = (50 mL/Kg/day) * (9.5 Kg/1) * (1 day/24 hr) = 19.79 mL/hour

(d) Combine the result of both calculations:
mL/hour = (41.66 + 19.79) = 61.45
rounds to 61 mL/hour

110
Med-Math Calculations for SJC
Nursing Students
A Dimensional Analysis Approach


THE END
03/23/2008 @ 23:00

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