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Example s

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Converting factors

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Common Abbreviations

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Dosage Forms

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Solution Measurements

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Miscellaneous Usage in the Hospital

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Abbreviations to Avoid

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µg __ ss or ss

Micrograms should be written out, insist on it! Write out one-half or 1/2 clearly.

OD

Ordered daily? Write out daily. QD, if legible, should be acceptable.

n or N

Nightly? QN? Write out nightly or use hs.

d or D

Daily? Write out how many days.

BT

Ordered at bedtime? Write out bedtime or use the standard hs.

Fishing for answers?

Examples

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Example

Doctor's order: 0.25 mg of digoxin p.o. On hand: 0.5 mg tablets

1 نصف ملغ 52.0 ملغ 1 X 0.25 0.5

تعادل تعادل

حبة كم حبة

=كم حبة

Answer

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Example

Doctor's order: 0.25 mg of digoxin p.o. On hand: 0.5 mg tablets

1 نصف ملغ 52.0 ملغ 1 X 0.25 0.5

تعادل تعادل

حبة كم حبة

=كم حبة

0.5 tablet

Example

Doctor's order: Give deltasone 7.5 mg PO now. Available : deltasone 2.5 mg tablet.

AVAILABLE المتوفر حاليا

Answer

Example

Doctor's order: Give deltasone 7.5 mg PO now. Available : deltasone 2.5 mg tablet.

AVAILABLE المتوفر حاليا

3 tablet

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Example

Doctor's order: Give ranitidine 40 mg PO ABT. Available is ranitidine 20 mg tablet How many tablet you should give? Answer

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Solution

ABT عند النوم

40

X

20

1

40

20 2 tablets

Example

Doctor's order: Give 7500 i.u of heparin injection S/C . Available:( heparin injection 5000 i.u/ml) How many ml you should give? Answer

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Solution

7500

5000

X

1

7500

5000 1.5 ml

Example

Doctor's order: Give 500 cc D5RL to be infused in 6 hrs. You should regulate the I.V at: Answer

Solution

500 cc 15hrs 6

المعادلة (عامل التنقيط xالكمية بالمل ( مقسومة على (دقيقة 06 Xعدد الساعات (

X

X 60 m 0057

دائما يعتبر عامل التنقيط 51 ال اذا ذكر في السؤال غير ذلك

063 21 drop/m

Example

Doctor's order: Give 1500 cc normal saline over 4 hrs. You should regulate the I.V at: Answer

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Solution

1500 cc X 4 hrs X 51

60 m 00522

المعادلة (عامل التنقيط xالكمية بالمل ( مقسومة على (دقيقة 06 Xعدد الساعات (

دائما يعتبر عامل التنقيط 51 ال اذا ذكر في السؤال غير ذلك

042 94 drop/m

Example

Doctor's order: Give 1000 cc dextrose 5% I.V Q 8 hrs. You should regulate the I.V at: Answer

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Solution

1000 cc X 51 8 hrs X

60 m

دائما يعتبر عامل التنقيط 51 ال اذا ذكر في السؤال غير ذلك

**00051 084 31 drop/m
**

exit

Example

Doctor's order: Give 3 L of I.V fluid 5% D/0.45% normal saline over 24 hrs.(the drop factor is 60 gtt/ml). You should regulate the I.V at: Answer

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Solution

3000 cc 24 hrs 06

دائما يعتبر عامل التنقيط 51 ال اذا ذكر في السؤال غير ذلك

X

X

60 m 000081

0441 521 drop/m

Example

Doctor's order: Give 3000 cc dextrose 5% I.V Q 6 hrs, drop factor is 20 gtt/m) How many drops should you give per minute? Answer

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Solution

3000 cc X 6 hrs X 02

60 m 00006

دائما يعتبر عامل التنقيط 51 ال اذا ذكر في السؤال غير ذلك

063 66.661 )761(

Example

Doctor's order: Give penicillin 600.000 u I.M stat Available: (penicillin 800.000 u/2 cc) How many ml should you give? Answer

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Example

Doctor's order: Give penicillin 600.000 u I.M stat Available: (penicillin 800.000 u/2 cc) How many ml should you give? 1.5 ml

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Example

Doctor's order: Give G/S 2000 cc I.V Q 24 hrs, The rate will be how many drop per minute? Answer

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Example

Doctor's order: Give G/S 2000 cc I.V Q 24 hrs, The rate will be how many drop per minute? 21 drop/m

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Example

• The physician orders IV fluids to hydrate a client. The order is written as "D5NS 4 Liters over 24 hours." Looking at the package indicates the drip factor of the tubing is 15 gtt/ml. What is the drip rate?

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Answer

Example

• The physician orders IV fluids to hydrate a client. The order is written as "D5NS 4 Liters over 24 hours." Looking at the package indicates the drip factor of the tubing is 15 gtt/ml. What is the drip rate?

42 gtt/m

:Shortcut method when you know the ordered ml/hr

gtt/ml: divide the ml/hr by 4 15

gtt/ml (typically blood products): divide ml/hr by 6 10

gtt/ml: divide ml/hr by 3 20

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4 / 175 6 / 175 3 / 175

= = =

43.75 gtt/min 29.16 gtt/min 58.33 gtt/min

Example

The client's K+ is 2.0 mEq/dl and the • physician orders a potassium bolus of 40 mEq of KCl in 200 ml of NS to be delivered at a rate of 10 mEq/hr. What is the drip rate inmicrodrops? (.(Ideal, deliver on a pump

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Answer

•This is a two-part problem. •Calculate the concentration of the KCl in the NS using ratio and proportion

mEq 40 ml 200 40x

=

mEq 10 x ml

= =

2000 50

x

**• Now you can use the IV formula.
**

ml 50 60 min

x = =

gtt 60 1 cc

x 60 50

3000 50

60 / 3000

Answer: 50 (microgtts/min)

**Calculating flow rate
**

• Flow rate refers to number of ml of fluid to be infused over one hour (ml/hr).

)total # of milliliters )volume total # of hours

=

X ml/hr

Example

Order: 500 ml NS bolus over 3 hours

Answer

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Example

Order: 500 ml NS bolus over 3 hours

167 ml/h

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Example

• The nurse makes rounds and notes that the current IV bag contains approximately 450 ml. The IV flow rate is 150 ml/hr. How long will it be before the nurse must hang a new bag?

Answer

exit

Example

• The nurse makes rounds and notes that the current IV bag contains approximately 450 ml. The IV flow rate is 150 ml/hr. How long will it be before the nurse must hang a new bag?

3 hrs

exit

Example

• Order: Administer 1000 cc at 50 gtt/min.

Answer

exit

Example

• Order: Administer 1000 cc at 50 gtt/min.

5 hrs

exit

Example

• John is to receive Cleocin 150 mg IV q 8 hours. The nurse dilutes the medication to a total volume of 30 ml and plans to deliver it via an infusion pump over thirty minutes. What would be the flow rate?

Answer

exit

Example

• John is to receive Cleocin 150 mg IV q 8 hours. The nurse dilutes the medication to a total volume of 30 ml and plans to deliver it via an infusion pump over thirty minutes. What would be the flow rate?

60

exit

Example

• For the client whose weight is 130 lbs and has dopamine ordered at 8 mcg/kg/min, what rate should the infusion pump be set for a solution of 400 mg dopamine in 250 ml D5W?

Answer

exit

• Client's weight: 130 lbs • Dosage: 8 mcg/kg/min • Solution: 400 (mg) in 250 (ml) Tip • Convert wt to kg. 130 / 2.2 = 59.09 kg • Find concentration of dopamine in 1 cc.

mg 400 250 ml = x mg 1 ml 250x x = = 400 1.6

• 3) Concentration is 1.6 mg /cc. Convert the mg to micrograms. • 1.6 (mg) x 1000 (mcg per 1 mg) = 1600 mcg/cc.you have gathered all Now that

the information, plug it into the formula

unit"/kg/min) ") 8 X 59.09 )wt in kg)X 60 )min/hr) )1600 )"unit" / ml

= =

28363.32 1600

x

17.727

17.727 or 18 ( ml/hr) will dialed on the pump

Example

• A client is receiving dopamine at 12 ml/hr. The solution hanging indicates "D5W 250 ml/200 mg dopamine". The client weighs 133 lbs. What is the dosage (mcg/kg/min) the client is receiving?

Answer

exit

• Flow rate: 12 ml/hr • Solution: 200 mg dopa / 250 cc D5W • Client's weight: 133 lbs Tip 1) Convert wt to kg. 133 / 2.2 = 60.45 kg 2) Find 200 mg concentration of dopamine x mg = 250 ml 1 ml in 1 cc. 250x 200 =

x

=

0.8

3) Concentration is 0.8 mg/ml. Convert mg to mcg. 0.8 (mg) X 1000 (mcg per 1 mg) = 800 mcg /ml. you have gathered all Now that

the information, plug it into the formula.

ml/hr) ) 12X 800 ("unit"/ml) (Time) 60 min/hr X( 60.45 (weight in kgs

= =

9600 3627

X

2.65

The dosage the client is receiving is 2.65 mcg/kg/min.

Example

• A client is receiving a heparin drip at 22 ml/hr via an infusion pump. The label on the liter bag of D5W indicates 40,000 U of heparin. How many units of heparin does the client receive per hour?

Answer nadersmadi@hotmail.com

U 40,000 1000 ml

= = =

xU 22 ml

1000x

880,000 880

x

.The client is receiving 880 U of heparin per hour

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3) Concentration is 0.8 mg/ml. Convert mg to mcg. 0.8 (mg) X 1000 (mcg per 1 mg) = 800 that you have gathered all the information, mcg /ml. Now

plug it into the formula.

ml/hr) ) 12X 800 ("unit"/ml) (Time) 60 min/hr X( 60.45 (weight in kgs

= =

9600 3627

X

2.65

The dosage the client is receiving is 2.65 mcg/kg/min.

Example

• The physician becomes concerned about John’s renal function and orders the Vancomycin dose (60 mg) to be infused over 90 minutes instead of the usual 60 minutes. If the Vancomycin dosage is diluted into 60 ml of IV fluid, what will be the flow rate? (Given on an IV pump for control.)

ml 60 90 min x 90 x

=

X ml 60 min

= =

3600 (ml/hr) 40

exit

Example

• John's primary IV is running at 34 ml/hr while NPO. When the nurse runs the Vancomycin (250 mg IV q 8 hr) in over 90 minutes [volume is 100 ml--(2 50 ml syringes)], the primary IV is stopped. The ampicillin (395 mg IV q 6 hr) is given concurrently in 10 ml of fluid over 30 minutes. He received 2 boluses of aminophylline (20 ml each over 20 minutes). The IV fluids were stopped while the aminophylline infused. Since microtubing was used for the medications, total flush is negligible (approximately 3 ml). What is John’s total intake for 24 hours? Answer exit

Vancomycin runs for 1.5 hrs Primary or maintenance IV :fluids Primary fluid is stopped while :aminophylline is infusing hr 30 minutes minus 19 40 minutes

x 3 doses hr) minus 4.5) 24 min x 2 20 hr 50 minutes )18.84 hrs) 18 = x 34 ml

.hrs IV is stopped 4.5 = .hrs 19.5 = minutes 40 =

ml 640.5 =

:Vancomycin :Ampicillin :Aminophylline Normal saline :flush

**cc x 3 100 cc x 4 10 cc x 2 20 )approximate)
**

=

.ml 300 = .ml 40 = .ml 40 = 3ml =

.ml / 24 hrs 1023.5

3 + 40 + 40 + 300 + 640.5

.John's daily intake, based on all therapeutic modalities, is 1023.5 ml

Example

• Crystal has an IV infusing at KVO (10 ml/hr). She receives an antibiotic in 22.5 ml q 8° concurrently. One ml flush is given after each antibiotic. She is given 30 ml of formula q 3°. • She had diaper weights of 17 ml, 33 ml, 55 ml, 45 ml, 52 ml, 50 ml, 15 ml, and 36 ml. • Calculate her I & O for the past 24 hours. Answer

Intake: IV @ 10 ml/hr Med of 22.5 ml Flush of 1 ml Formula of 30 ml x 24 hr x 3 )q8°) x3 x 8 )q 3°) = 240 ml = 67.5 ml = 3 ml = 240 ml

.Crystal's intake is 550.5 ml for the past 24 hours

Output:

36 + 15 + 50 + 52 + 45 + 55 + 33 + 17 ml 303 =

.Crystal's output is 303 ml for the past 24 hours

Example

• John also has an order for ampicillin sodium 395 mg IV q 6 hr. The safe range for his type of infection in the literature is 100-200 mg /kg /day. Is this a safe dose?

Answer

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**Calculate the recommended range:
**

•Minimal: 100 mg x 20 kg = 2000 mg •Maximal: 200 mg x 20 kg = 4000 mg Recommended range is 2000 - 4000 mg. Actual dose is: 395 x 4 )q 6 hr) = 1580 mg / day Compare the two values. The actual dose is less than the recommended dose. Dose is “safe”, but not necessarily therapeutic.

Example

• The physician stopped John’s gentamicin and cleocin when the culture report came back. His new orders include Vancomycin 250 mg IV q 8°. The literature indicates that the minimal dilution concentration for infusion should be 2.5 mg / ml if given through a peripheral intravenous line (PIV). How many ml of diluent will the nurse need to mix the Vancomycin to meet this safety requirement? Answer

Example

• The physician stopped John’s gentamicin and cleocin when the culture report came back. His new orders include Vancomycin 250 mg IV q 8°. The literature indicates that the minimal dilution concentration for infusion should be 2.5 mg / ml if given through a peripheral intravenous line (PIV). How many ml of diluent will the nurse need to mix the Vancomycin to meet this safety requirement? 100 ml

Example

• A newborn has an order for 0.15 micrograms of Prostin VR (alprostadil) per hour to maintain patency of the ductus arteriosus. The pharmacy prepared a Prostin drip with 25 mcg alprostadil in 50 ml of D5W. What hourly rate is needed to deliver the dosage of medication as ordered? Answer

Example

• A newborn has an order for 0.15 micrograms of Prostin VR (alprostadil) per hour to maintain patency of the ductus arteriosus. The pharmacy prepared a Prostin drip with 25 mcg alprostadil in 50 ml of D5W. What hourly rate is needed to deliver the dosage of medication as ordered? 0.3exit ml/h

Example

• John is to be given an Aminophylline bolus of 30 mg in 20 ml of fluid over 20 minutes. The primary IV is running at 40 ml/hr. The drip factor of the tubing (buretrol) is 60 gtts/cc or minidrip. What is the flow rate needed to deliver the Aminophylline bolus as ordered? Answer exit

Example

• John is to be given an Aminophylline bolus of 30 mg in 20 ml of fluid over 20 minutes. The primary IV is running at 40 ml/hr. The drip factor of the tubing (buretrol) is 60 gtts/cc or minidrip. What is the flow rate needed to deliver the Aminophylline bolus as ordered? 60 exit ml/h

Example

• John is a pediatric client in a hospital in which the policy is to place all children on IV therapy on a buretrol and to only fill the buretrol no more than two-three hours worth of fluid. The nurse fills the buretrol to 90 ml at 10 a.m. If John’s IV is running at 34 ml per hour, how long will it be before the nurse will need to fill it again?

exit Answer

**90 ml ÷ 34 (ml/hr) = 2.65 hrs However, 0.65 hrs = ? minutes
**

hr 1 60 min 1x X = = = hr 0.65 X min 39.00 39

Answer = 39 minutes Add this to the 2 hours. 10 a.m. + 2 hr 39 minutes = 12:39 p.m. At 12:39 p.m. the buretrol will need more fluid added so that air does not get into the tubing.

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drug calculations for nurses

drug calculations for nurses

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