Nursing V Self Study Dosage & Calc. Packet Medication Math For the Nursing Student Stating amount Fey amounts End Amount 2dineties | 1 foot |= 2 feet 12 inchesValencia Dosage Calculation & Conversion Dosage Conversion Metric Volume 1 iter (Ly (mL) 1 milliliter (mL) (eo) Weight 1 gram (G) (mg) 1 milligeam (mg) (meg) Household Volume 1 eup (C) Length 1 foot (ft) = 1000 milliliters = Leubie centimeter = 1000 milligrams 1000 micrograms. = Sounces (02.) = 12inches (in,) Honsehold Apothecary Metric Volume — 1eup (C.) 8 fluid ounces (07.) 240 milliliters (mL) 2 tablespoons 1 fluid ounce (07.) 30 milliliters (mb) 1 tablespoon (Ths.) 15 milliliters (mb) 1 teaspoon (tsp.) 5 milliliters (mL) Weight 2.2 pounds (Ihs.) 1 kilogram (kg) 1 grain (gr) 60 milligrams (mg) Length 1 ineh (in.) 2.8 centimeters Mierodrip LV tubing is always 60 gtts/mt agtts/min is always rounded to a whole number Approved 11/17/08Nursing V Nursing V Dosage and Calculation Review Systems of Measurement Problems 1. 0.3mg=_ mg 2 60mg=__g 3 100mg=_ a 4, 00089=___mg [760mg = meg & 200mog = __mg fare aeMNcNccceesieicceceeccccealseeceeeeeeeeeeeaieaaae 70.90mL = ___ounce(s)Nursing V Dosage and Calculation Review Systems of Measurement Solutions 10,90mL = S15URES(@) Nursing VROUNDING Alll dosage calculations should consider the method of delivery 4. DONOT round unti the end of the calculation (final answer) 2. Round to the tenth or hundredth place when directed to do so. ‘a. Decimal numbers ending in 5 or greater should be rounded upward, Example: Round to the tenth: 4.68 = 4.7 Example: Round to the hundredth: 4.238 b. Decimal numbers ending in 4 or less should be rounded downward Example: Round to the nearest tenth: 462 = 46 Example: Found to the nearest hundredth: 4.624 = 4.62 3. Azero (0) should 2¢ placed to the left of the decimal point as an indication that a decimal point exists. Example: 0.4 NOT .4 “Always lead, never follow.” 4. A zero to the far right of a decimal point should be dropped as it holds no numerical value. Example: 4 NOT 4.0 “Always lead, never follow.” 5. Capsules and IV crops (gttiminute) should be rounded to the whole number. Example: 20 8gtt becomes 21 gtt 6. Round kilograms to the hundredth Example: 24.8589 = 24.86 kg *Remember if not indicated to round as specified above, do not round. Nursing VRounding Decimal Numbers Round each number to the nearest tenth. a) 2) 3) 4) 2) 4.63 6.78 1.96 5.95 7.24 6) 7) 8) 9) 10) Round each number to the nearest tenth. 1) 2) 3) 4) ) 4.346 6.341 5.614 9.594 8.889 6) 7) 8) 10) ‘Nursing V rounding worksheet 7.96 att 4.33 8.317 4.844 5.583 5.772 6.766 Hn Math-Aids.com RRRounding Decimal Numbers Round each number to the nearest tenth. 1) 2) 3) 4) 5) 463 6.78 5.95 7.24 46 6.8 7.2 6) 8) 9) 10) Round each number to the nearest tenth. 1) 2) 3) 4) =) 4.346 6.341 5.614 9.594 8.889 43 6.3 5.6 9.6 8.9 6) 7) 9) 10) Nursing V rounding worksheet 8.58 7.96 4.33 9.31 8.317 4.844 5.583 5.772 6.766 8.6 78 4.3 9.3 4.8 5.6 5.8 6.8 ‘ $5) Math-aids.com HRRounding Decimal Numbers Round each number to the nearest hundredth. 1) 1.286 2) 7.759 3) 6.184 4) 8.313 5) 8.647 6) 7) 8) 9) 10) Round each number to the nearest hundredth. 1) 3.7261 2) 8.3336 3) 1.3679 4) 2.3985 5) 8.3949 Nursing V rounding worksheet 6) 7) 8) 9) 10) 3.413, 9.214 5.432 2.328 7.287 5.6162 1.3789 9.8452 7.3166 6.9182 : @ $5 matr-aids.com HEHRounding Decimal Numbers Round each number to the nearest hundredth. 1) 2) 3) 4) 5) 1.286 7.759 6.184 8.313 8.647 1.29 7.76 6.18 8.31 8.65 6) 7) 8) 9) 10) Round each number to the nearest hundredth. 1) 2) 3) 4) oS) Nursing V rounding worksheet 3.7261 8.3336 1.3679 2.3985 8.3949 3.73 8.33 1.37 24 8.39 6) 7) 8) 9) 10) 3.413 9.214 5.432 2.328 7.287 5.6162 1.3789 9.8452 7.3166 6.9182 3.41 5.43 2.33 7.29 1.38 9.85 7.32 6.92 i " $5 math.ids.com REERounding Decimal Numbers Round each number to the nearest thousandth. 1) 1.7375 6) 4.9766 2) 1.9321 7) 2.6186 3) 6.2595 8) 5.4149 4) 9.1632 9) 2.9134 5) 7.8974 10) 9.9257 Round each number to the nearest thousandth. 1) 4.62693 6) 6.26693 2) 4.68485 7) 7.36851 3) 7.81823 8) 2.22578 4) 5.86868 9) 5.73552 -) 3.52545 10) 8.14763 - Nursing V rounding worksheet 5 math-aids.com aERounding Decimal Numbers Round each number to the nearest thousandth. 1) 1.7375 2) 1.9321 3) 6.2595 4) 9.1632 5) 7.8974 1.738, 14.932 6.26 9.163, 7.897 6) 4.9766 7) 2.6186 8) 5.4149 9) 2.9134 10) 9.9257 Round each number to the nearest thousandth. 1) 4.62693 2) 4.68485 3) 7.81823 4) 5.86868 “) 3.52545 4.627 4.685 7.818 5.869 3.525 Nursing V rounding worksheet 6) 6.26693 7) 7.36851 8) 2.22578 9) 5.73552 10) 8.14763 4.977 2.619 5.415, 2.913 9.926 6.267. 7.369 2.226 5.736 8.148 . £5) Math-aids.com ReConverting Fahrenheit and Celsius Convert Fahrenheit to Celsius C= 5/9 (F - 32) (Round to the tenth) 1) 53°F 2) 35°F 3) 87°F 4) 106°F 5) 116°F 6) 33°F 7) 118°F 8) 73°F Convert Celsius to Fahrenheit F = (9/5 x C) + 32 (Round to the tenth) 9) 32°C 10) 47°C 11)8°C 12) 13°C 13) 26°C 14) 24°C 15) 17°C 16 ) 19°C Nursing VConverting Fahrenheit and Celsius Answer Key Convert Fahrenheit to Celsius C = 5/9 (F - 32) 1)63°F 9 14,7°C carr oe 3)87°F 306°C 4)106°F 41.1°C 5)116°F 46.7°C 6) 33°F 6° 7)118°F = 47.8°C 8) 73°F 22.8°C Convert Celsius to Fahrenheit F = (9/5 x C) + 32 9) 32°C 89.6°F 10)47°C 116.6°F 11) 8°C 46.4°F 12)13°C —-§5.4°F 13)26°C 78.8°F 14)24°C —-75.2°F 15)17°C 62.6°F 16)19°C —-66.2°F Nursing VNursing V Guide to Dimensional Analysis For examples and more see: http:ipersonal riverusers.com/~busybee/dimensional/fun.htm Determine what you want to know. Read the problem and identity what you're being asked to figure out, €g, "how many miligrams are in a liter of solution.” a. Rephrase if necessary using "per." Example: You want to know “milligrams per Iter.” to "math terms" using appropriate abbreviations to end up with ‘mg/L” as your answer unit (AU). Write this down, e.g. “AU= mg/L” Determine what you already know. ‘a. What are you given by the problem, ifanything? Example: "in one minute, you counted 45 drops + Rephrase if necessary. Think: "Drip rate is 45 drops per minute. + Translate into math terms using abbreviations, e.g. "45 atin” ‘+ Ifa given is in the form mglkgiday, rewrite as mg/kg x day (see example 4) ‘+ Ifa percentage is given, e.g. 25%, rewrite as 25/100 with appropriate labels (see example 5) b. Determine conversion factors that may be needed and write them in a form you can use, such as 60 min/t hour." You will need enough to form a "bridge" to your answer unit). See exemple 1 ‘+ Factors known from memory: You may know that 1 kg = 2.2 Ib, so write down "1 kg/2.2 Ib" ardor "2.2 Ib/1 kg" as conversion factors you may need. Factors from a conversion table: Ifthe table says "to convert from Ib to kg ‘multiply by 2.2" then write down "2.2 Ib/t kg" ‘Setup the problem using only what you need to know. a. Pick a starting factor. * Ifpossible, pick from what you know a factor having one of the units that's also in your answer unit and that's in the right place. See example 1 Or pick a factor thats given, such as what the physician ordered, + Note that the starting factor will always have at least one unit notin the desired answer units) that will need to be changed by canceling it out.. ick from what you know a conversion factor that cancels out a unit in the starting factor thal you don't want. See example 1 ‘c. Keep picking from what you know factors that cancel out units you don't want Lunt! you end up with only the units answer units) you do want 4d. Ifyou can't get to what you want, ty picking a different starting factor, or ‘checking for a needed conversion factor, fan intermediate result must be rounded to a whole number, such as dropsidose which can only be administered in whole drops, setup as a separate sub- problem, solve, then use the rounded off answer as a new stating factor. See example 9 4, Solve: Make sure all the units other than the answer units cancel out, then do the math a. Simplify the numbers by cancellation. Ifthe same number is on the top and bottom, cancel ther out . Muttiply all the top numbers together, and then divide into that number all the bottom numbers ©. Double check to make sure you didn't press a wrong calculator key by dividing the first top number by the first bottom number, alternating unti finished, then ‘comparing the answer to the first one. Miskeying is a significant source of error, 0 always double sheck, 4d. Round off the calculated answer. * Be realistic. Ifyou round off 74.733333 to 74.73 mL that implies that all ‘measurements were of an extreme accuracy and that the answer is known to fall between 74.725 and 74.736, of 74.73 + 0.005 mL. Amore realistic, answer would probably be 74.7 mL or 75 mL. See example 6, + Ifyou round toa whole number that implies a greater accuracy than is appropriate, wite your answer to indicate a range, such as 75 +5 mL. See example 9 8. Add labels (the answer unit) tothe appropriately rounded number to get your answer. Compare units in answer to answer units recorded from fist step. 5. Take a few seconds end ask vourself if the answer you came up with makes sense. Ifit doesn't, slart over. Nursing VDosage Calculation Practice Questions 41: Mr. Cooper is inthe tical care unit and requires sedation for an emergency procedure. The prescrition reads midazolam (Versed) 10 mogikg intravenous now. The Patient weighs 220 pounds. How many micrograms of Versed do you give Mr. Cooper? A: 22 meg, B: 1,000 mog, 2 100-me. D: 2.200 meg, 2: You are preparing to give Me. Hamptou his Lopressor (metoprolol tartrate) 100 mg PO daly as prescribed. The pharmacy sends up Lipitor 50-mg tablets. How many tablets do you give to Nr. Hamptou? As 2 tablets, B: 1 tablet, ‘C: None; the phamacy sent up the wrong medication D: None; the prescription is for capsules and the pharmacy sent up tablets, ‘3: Prescription: Synthroid, generic name levothyroxine, 100 meg PO daily, 50 meg (0.05 mg. The pharmacy sends up a 0.1-mg tablet of Synthroid. Is this the correct dose? A: No, it should be 0.5 mg, es, this isthe corect dose, es, but you should give one-half of the tablet daly 3: No, you cannol convert micrograms to miligrams ‘4: Prescription: Lamivudine 30 mg by mouth. Have: Lamivuaine ora solution = 10, mami. How much wil ou give? R300 mL, B:30 mL.6: Prescription: Indomthacin 20 mg by mouth every morning. Have: Indomethacin oral suspension = 25 mg/5 nL. How much indomethacin wil you give each morning? A: Sm. B:4m. 5m. D: 100 mL, 6: Prescription: Valproc acid 400 mg by mouth now. Have: Valproic acid oral syrup 250mg/5 mL. How much valproic acid wil you give? A BmL. B: 3.125 mL, 6:20 mL, D: Sm. 7: Prescription: Albuterol 1.6 mg by mouth, Have: Albuterol oral syrup = 2 mg/S mi How much will you give? wom. BS mb. cram. D:Smt. 8: Prescription: Ampre ivi 450 mg by mouth, Have: Amprenivr 150-mg capsules. How ‘many capsules of Amprenivir will you give? ‘A: 2 capsules. B: 3 capsules. C4 capsules, capsules,:_Nine-year-old Peteris clagnosed with otis media and receives the following prescription: Cefproai eral suspension 360 mg by mouth, Have: Cefprozil oral suspension = 250 mglé mL. How much Cefprozil will you give? ATM B: Sl. 6: 357 mL D: 120ml. 410: Mrs. Jennings has herpes zoster due to immunosuppression as a result of ‘chemotherapy given fo treat her breast cancer. She receives the following prescription ‘Acyclovir 200 mg IV, Have: Acyclovir solution for IV infusion = 500 mg/10 mL. How ‘much wil you give? 25 mL, B:4ml, Gem. D: 70 mt. ‘14: Mr Markwood is dagnosed with severe adrenocortical insuificiency and is prescribed nydrocortisane sodium succnate (Solu-Contel) 250 mg IV now. The Pharmacy sends up mutipe vals of Solu-Corte intravenous solution 125 mg/2 ml. How ‘much Solu-Cortef wil you give? 75 ml. B: 187.5 mL, mL. D: 2mL, 412; Erica is seven years old and needs to be premedicated fo prevent nausea from the chemotherapy that she is set to receive in 1 hour. The standing order reads as folows: Metaclopramide syrup 8 mg by mouth 1 hour prior to chemotherapy. Tne pharmacy sends up multiple containers of metaclopramide syrup 5 mg/S ml. How much metaclopramide wal you give 1 hour prir to chemotherapy? 40 mL. B:emL. ©: 3.4125 mL. - D:SmiL,413: Mr. Walberg has abistory of seizures, and hs laboratory work indicates that he has 2 therapeutic blood level of phenytoin. Therefore, te nurse practioner prescribes the Usual dose of phenytoin Mi. Walberg takes at home: phenytoin 75 mg orally by suspension every evering. The pharmacy sends up phenytoin 125 mg/mL. How much phenytoin will you give Mr. Walberg this evening? ATM. © B:asomt 2.5 mu, D: 3m. 414: Mrs. Corliss was ir Mexico for vacation 3 months ago and has stomach complaints. ‘She has just been diagnosed with intestinal amebiasis. The physician prescribes the following’ erythromycin (Estolate suspension) 400 mg by mouth now. The pharmacy sends up Estolate suspension 250 mgiS mL. How much Estolate suspension do you sive now? womL B:3:125mL. c: 16m. 200 mt. 418: Me. Johanson just atved on the unit and is prescribed loracarbef (Lorabid) 400 mg ‘orally now. The pharmacy dispenses Lorabid 200 mg/5 ml. suspension, How much Lorabid do you give Mr. Johanson? © 25m. B: SL. ©: 10 mL, D:20 mL, 16: Mrs. Bailey says ste cannot sleep without her sleeping pil. The nurse practioner prescribes what Mrs. Bale has been teking at home, whichis lorazepam (Ativan) 1 mg orally every evening at beatime. The pharmacy sends up scored 2-mg tablets of lorazepam. How much brazepam do you give Mis. Baily tonight? S tablet B: 1 tablet, : 2 tablets 4tablels17: Mr. Doe comes into your cic with an extreme case of poison ivy. He says the last time he had this problem, you gave him a @shot@ that worked miracles, His meical records show that he received dexamethasone (Decadron) 10 mg IM, so you prescribe the same medication axd dose. The pharmacy dispenses dexamethasone 4 mg/mL per vial. How many mites of Decadron do you draw up? 04 mL B: 15 mL ce: 2m. D:25 mL. 18: Ms. Tumer in prescribed fluoxetine hycrochlorde (Prozac) ral solution 10 mg orally daly in the moming by her psychiatric Clinical Nurse Specialist, The pharmacy sends up Prozac liquid 20 mg/5 mi. How much Prozac do you draw upto give Ms, Tumer? amt. B: 2m. ©: 2.5m. D: 10 mL, 48: The physician prescribes phenobarbital elixir 60 mg PO now forthe patient. The ‘pharmacy dispenses a 120-mL bottle of phenobarbital elixir labeled 20 may mL. How ‘mush ofthe elixir should you administer to this patient? A: SL. B: 15 mL, 6: 30 mL, © petam. 20: Randy has an infection in his foot from a cut he received at the beach. His nurse practioner prescribes 2ephalothin (Kein) 0.5 g orally every 8 hours x 10 days. The ‘pharmacist has dispencea Kefln in 250-mg capsules. How many capsules should you educate Randy to take avery 8 hours? A: 1 capsule capsules capsules CD: S capsules,21: Me. Klingon is prescribed Demerol 150 mg inramusculary as a preoperative medication. The pharmacy dispenses meperidine hydrochloride (Demerol) 100 mg/mL for IM use, How much Demerol do you draw up to administer? © tS. B:2mL. ©:25 mL, D: 0.68 mt. 22: Your patient in the intensive care unit has an infection thatthe culture and Sensitity indicate is sensitive to fluconazole (Diflucan). The physician prescribes 4 mg of fluconazole intravenously now. The pharmacy sends up multiple vals of fluconazole 2 ‘maim for IV infusion. How much Diflucan do you draw up in preparation for ming the ‘medication withthe proper intravenous fluids per policy? © osm. © prem © eam. D: 4m 23: Ten-year-old Seraphima ate some peanuts about § minutes ago; she is allergic to Nuts. She comes to the Emergency Department wth hives, The nurse practioner prescribes diphenhydramine hydrochloride (Benadry) 25 mg intravenously now. The pharmacy dispenses a vial of Benadryl at 50 mgiml. or IM or IV use. How much Benadtyl do you draw up to administer to Seraphima? © 05m © arm. ©: 0.75 mL. D:2mL. ‘24: Daniel isa &-year-old patient who broken his ankle while playing football. He is prescribed atropine sufate 0.2 mg IV as a preoperative medication. The pharmacy dispenses a via of atropine suifate 0.4 maim. How much atropine do you draw up to ‘give Daniel preoperatively? © 0.25 mL. . Sm. ce: 2m, © D:08mt.25: Mr. Cooper s prescribed midazolam HCI (Versed) 3 mg intramuscularly 30 minutes Prior to colonoscopy. The pharmacy dispenses a multidose val of Versed 1 mg/mL, How ‘any milters do you sraw up to give Mr. Cooper? Act ml. B: 2m. ce: 3m. D:4 mL. 26: Mrs. Skiba has developed heart failure and is prescribed Lanoxin (digoxin) 250 meg IV push now. The phamacy dispenses digoxin 500 meg/2 mL, How much digoxin do you administer? © 90.25 mL. B05 mL, tm. D:4mt. 227: Ms. Calugar has severe nausea related to a stomach vis. The physician in the Emergency Department prescribes cimetisine (Tagamet) 200 mg IM now The pharmacy Sends up vias of Tagamet 300 mg/2 mi fr IM use. How mich Tagamet do you draw up to give Ms Calugar? 0.75 mL. B05 ml, tml. D:2mL. 228: Me. Holden is prescribed Fragmin (dalteparin sodium) 7.500 units subcutaneous dail for 5 days. The pharmacy d'spenses Fragmin §,000 units/0.2 mL. How much Fragmin do you draw up per day? © wo2m. B: 03 mL. 75m. © D:4S mb.28: Mrs. Fowlers prescribed Kenalog (triamcinolone) 60 mg IM x 1, The pharmacy tlispenses Kenalog 40 mg/ml for intramuscular use. How much Kenalog do you draw up to administer? © sm B:0.75 mL. 2m. D:36 mL 30: Mr. Havens comesto the Emergency Department wit intractable hiccups lasting {or 2 days. The physician prescribes chlorpromazine (Thorazine) 50 mg IM now. The pharmacy dispenses vials of Thorazine 25 mgimL for IM use. How much medication do you draw up? Ato. B: 2m. er 3m D:4mb, 31: Your patient needs anticoagulation therapy, and the physician prescribes heparin ‘sodium injection of 12,£00 units SC now. The pharmacy sends up vals of heparin ‘sodium 5,000 unitsml for subcutaneous injection. How much heparin sodium do you raw up? A: 0.4 mL B:2mL. © e:26m. D: 5m. 32: Your patient is 10 days post-chemotherapy and is prescribed epoetin alfa (Proc) 42000 units subcutaneous three times per week. The pharmacy dispenses a vial of Procrit 20,000 units/ml. How much epoetin alfa do you draw up for each dose? 665 mL, B: 06 mi. c: 2m. mL.33: To keep Ms. Grimmit’s cardiac output within normal range, she must receive Lanoxin (cigoxin) 750 reg intravenously daly. The medication strength received from pharmacy is Lanoxin 500 mog/2mL. How much Lanoxin do you draw up dally to give Ms, ‘Gamma? A 5ml, B:0.33 mL :1.330mL, D:SmL, Answer Key‘Dosage Calculation Practice Questions #2 2: Allowing an 1 solution ts run dry may resuit in oss of V access due to catheter occlusion, ‘Therefore, you need to determine when an intravenous infusion should be totaly complete. Based on the information below, whet time should the infusion be completed? Prescription: Infuse D5 NS 2000 mV a 125 mL until taking PO fluids. Youhave a1,000-m. bag ofD5 NS and you hang the bag at 0800 hours (8 A.M.) (© A: 2400 hours (12:00 midnight © B: 2600 hours (4:00 PI), © © 1400 hours (2:00 8.1m, 9: 1200 hours (12:00 son), 2 Prior toher hospital dscrage, your patient brings youthe prescription the nurse practitioner has ‘written out, which reads, Telterodine tartrate (Detrol) extended release 4 mg PO.QD in AM. The patient asks you how many pil per day she should take and how often should she take them, You call ‘the pharmacy, and the phamacist states that the Detral vl be dispensed in 4-mg tablets. What s our response to the patient? (© AcTake 1 tablet every morning, © B Take 2 tablets every morning (© CTake tablet in themomning and 1 tablet inthe evening every day FD: Take 1 tablet everyather day. 23: Your patient, Mr. Lawrerce, has een prescribed Milclnex (guaifenesin) 300 me orally daly as part ‘fis treatment for bronchts. The pharmacy sends up Mucinex 600-mg extended-release tablets, How many tablets do you give M. Lawrence? © ReNone. © BOS tablet Grtabiet CD: 2tablets 4: Based on safety 25a rationale 1 nit of packed red blood cells should run in completely between 2 ‘and 4 hours according to your hospital policy. The nurse from whom you are reelvng report states that she st the 1 unit of packed cells (250 mL} to run at 80 ml/h and hung it at 1400 hours (2.00 P.M), Based on your calculations, 1 long shoud it take the compete unit to be administered ands ths time fame according to hasta policy time frame? 'A: Complete infusion ime shouldbe 3.1 hours, which s within the 2-to4-hour time rane. © 8: Complete infusion me should be 6 hours, which isnot within the 2- to 4shour time range © Complete inusion ime shouldbe 2.4 hours, which is within the 2to4-hour time rane. © Complete infusion ime should be 4.1 hours, whichis within the 2-to hour time range'5: A prescription of 12 units regular and 20 units NPH insulin SC every AM. canbe mined so that both insula are contained in one insulin syringe © aTRUE Br FALSE 6: For Mrs. Kolanowskl to keep her serum potassium within normal mis, she needs to take KCI (potassium chloride) 40 morally daly. Her pharmacist has Gispensed KC tablets, each of which Contains 10 mq of KC mecieation, How many tablets pr day should Mrs, Kolanowsk take? © A2tables tablets C Geatablets F DeStablets 7: Mr. Whitney takes Captpril 12. mg orally dally to maintain his blood pressure around 320/80 mm Ng. He tells you that he hasa new pharmacist and te pilslok diffrent. The pill botle states that it contains Captopri 25 mg taslts. How many tablets should Mr. Whitney take per day? © ROS tablet (© Brttabiet F earablets © DrAtables, 8: Your patient, Mrs, Sullivan, needs a bolus of heparin at 80 units intravenously You ask your colleague to determine the dose base on the patient's weight of 4 kg, 35 you want to compare your Calculation result to that mede by you colleague. How many units of heparin should you administer? ALTS2units 8:7,520unit, 220units © 3,482 units. 9: Five-year old Johnay hasan order for Tylenol (acetaminophen) liquid 128 me for fever of more than 100F. His temperature is curenty 1004F. The pharmacy sends up Tylenol oral solution ata dose strength of 160 mg/S mL Hew much Tylenol de you gle Johnny? 6.25mi 824096 mL Game 0:31.25m.10: Mrs. Flancesl is prescbed digoxin 0.25 me orally dal. The pharmacy dispenses her prescription ‘using digoxin 0.125-mg tabets How many tablets should Mrs, Flancest take per day? mao tablet. © Gruber co tablets, CO Dsatablets 4: Karen is 29-year-old ptient with a dagnoss of fever who has been prescribed Cleocin (clindamycin patmitratehyerochorie) 150 mg orally daly. The pharmacy sends up Clocin oral Solution ata dose strength af 75 mg/S ml How much medication do you gve Karen? - A2mL © 8:150mL co Gasm 10 mL 12; Mrs, Hopi keeps her type 2 diabetes under contro by taking metformin (Glucophage) 1 g orally dally. Her pharmacist dispenses metformin in 250-mg tablets because they ae easier to swallow, How ‘many tablets should Mrs. Hap take per day? © Art tablet. 2ablets 3 tablets. © Des tablets 413: Ms. Oglethorpe is post cholecystectomy and has gas and bloating. You contact the nurse practitioner oneal and receive a prescription for simethicone 100 mg now. The pharmacy sends up a simethicone suspension thas abeled 40 mg/2 mL How much suspension do you pour to administer to IMs. Oglethorpe? m125mL © BSmL © €2,000 me © p02mt 4 Your patient has a discharge prescription for methotrexate 2.5 mg erally twice a day Qty 20 tablets. Your patent asks you how many days in total she should take her medication, What do you teller? © As0days © 8: 20davs, Gebdays © :50days.5: Medication labels often indcate that two medications are med inte one tablet. Ifthe medication label reads amoxcilin and davulanate potassium tablets 500 m/125 me, how many miligrams of amosciin would be in 2 tanets? AsAmg, © 61,000. © 0:250mg 46: Mr. Smiths blood sugar has not stabilized, so the physician decides to add glyburide ta his medication regimen to conta the blood sugar. The new medication comes asa combination of slyburide and metformin (25 mg/S00 mg). The physician states that you should give Mr. Smith the amountaf glyburide that matches his 1g of metformin per day. How many miligams per day of lyburde will be receive inthis new combination medication? 7 m25me. © B:5me. © e756 © B:1,000 mg, 17: Mrs. Raphaellsscheduk to beginher maintenance dose ofan antidepressant, specifically, 3 Selective serotonin reuptake inhibitor, She prefers quid toa pil, Paroxetine 30 mg oraly every ‘morning is prescribed. The paroxetine suspension is packaged as 10 mg/S ml How many milters wil vou aaminister every morning? kam 18: Twelve-year-old Jonathon has an infection He prescribed 75 me of Vibramycin(doxycycine ‘monohydrate orally daly. The Bottle from the loca pharmacy reas raspberry flavored Vibramycin 25. ‘mg/S mL Jonathon’s mothe, whois a nurse, left to go to work erly and forgot to give Jonathon his ‘medication When she called home, her husband sai, Dont worry. gave Jonathon 10 mL of his ‘medicine. What should the mother instruct the husband todo? (~ _eTank hm for giving Jonathon his medicine, (© BrTelLhim to give Jonathon another 10 mi of the medline, (© GTellhim to give Jonathon another S mb ofthe medicine. CD: Telthim to call 9-1-1 ashe has overdosed Jonathon.49: Ms. Thompson has Graves’ sease ands prescribed methimazole 7.5 mg orally every morning. Her pharmacist fils the presrgton with methimazol Sm tablets. How many tablets do you tell Ms, ‘Thompson to take every morning? FAL tablets © Br atables © C075 tablet 66 table. 20: Mr Rollins sa known zleohoic whois brought tothe Emergency Department bythe police. He has Severe ascites from his chen alcoholism, andthe physician prescribes spironolactone 50 morally ow. The pharmacy aispenses spironolactone 25-m tablets. How many tablets do you give Mr. Ralins? Ao tablet tablet © G2tables bratablets 1: Sixyearold Helen comes ito the pediatric nurs clinic complaining of ear pain. According to her ‘mather, she keeps puling an her ea. The nurse practitioner diagnoses otitis media and prescribes an antibiotic for Helen's ear ilection. Which ofthe folowing words would you find written on this prescription? a optic ©: Topica. 6 Got. orto administering a vaginal suppository toa femal patent, you should have the patient CAV - eDetecate, © e003 situps © Di Lie on her stomach, To relieve Mrs. Bally ‘silateal leg edema du to heart fllure, the physician preseribes furosemide (Lasix) 80 mg inavencusiy now. The pharmacy sends up multile vals of furosemide 40 ma/mL for intravenous use. How many mllitrs of furosemide do you draw upnow? am © B2mt © 05m © 20m,2A: To maintain adequate tidney function, your renal failure patient, Mr. Borck, ion fluid restriction Specifically, his oral fad iniake i resiicted to 1,200 m/day. You note that Mr. Borick has ingested 300, ml over the 11:00 t0 7:00 sift. How much ra intake can he have over the next 16 hours? 600m © BeES00mL © e900mt. 400 mt 25: Mr. Rolliou needs to hae his heparin adjusted dally based on the results of his PTT lab testo ‘maintain proper coagulation. The physician writes the fllowing prescription: Adjust IV heparin daly based on PTT results and use the sliding scale below: PTT <35: Give 20 units bolus. IT 35 t045: Give 0 untekg bolus PTT6 to 70:No change PTT> 70: Call the physicianimmediatay. "Mr. Rollou’s PTT result came back as 44. What is your intervention? nothing: give hi no heparin (© Br Call the physician inmediately. © €:GWve an 60 units/ke bolus now. Ds Give 240 units/4g bolus now. 26: Mr. Boyle is postoperative day 2from repair ofa compound leg facture. On nurse-to-ause report, you are told he s 56 years cd, has a low pain tolerance, is demanding, and is allergicto Tylenol (acetaminophen). Wis patiext-contoled analgesia (PCA) medication has just been discontinued, and he has been presribed oxycodone with acetaminaphen (Percocet 5/225) 1 to 2 tablets orally every 4106 hours as needed for pan. We. Boyle calls the nurses’ desk and ask, Can my new nurse give me whatever can have the mos of for pan? Lam realy hurting. What is your © A:GWve Mr. Boyle 2 oxcadone tablets (7B: Give Me. Boye 1 oxycodone tablet and reevaluate his pan in 30 minutes, (/£Callthe physician fer new prescription for pain control © _D:Share with Mr. Boye that he should try watching television as distraction and to callback in 25 minutes if he i still having pai,gePnoraye 16. 27: To maintain adequatehydration ntially in your patient who is burned, you ned to use formula ike the following: Parkland form l/l X 565A burn fr liters of fuid over 28 hours ‘Yur patient weighs 77 kg and the % BSA (percent body surface area burned i 35. How many milters ‘offluld should you give the patient over the next 24 hours? © ALE © B:108mt © ©:10780m ° :23,726mL 2; Mr Yeh is manic depressive and ie being treated with ithium carbonate (Ekaith) for ths ‘condition. Hes also anuous and has been prescribed diazepam (Valu, These two medications can Interact and cause hypothermia a side effet To asses or this potential side eect, wht would you skthe patient? © AeHave you been fetingdiany? © B:Doyouhavea sis ashanyuhere on your body? (© GHlave oubeen gong the bathroom aot? co D: Have you been fsting cold?Nursing V_ More. -Nursing V Dosage and Calculation Using Dimensional Analysis ‘The health care provider orders 600 mg ofan ant-hypertensve for your patient whose BP is elevated, Thepharmacy supplies 750mg/2.SmL. How many ml. would you administer to your patient? _ i (ourdt the nearest whole number) Answer ‘mL= (2.5mL/750mg}(600mg/1) = 2 ‘The health care provider orders 1.25 mg ofa cardiac medication for your eient, The pharmacy supplies 0.5 mg (scored tablets). How many tablet (s) would you administer to ‘your patient? fables) (round tothe tenth) ab Sg. 25mg/1)= 288 ‘The health care provider orders 275 mg ofa PPL for your client. The pharmacy supplies 0.5g/2mL, How many mL would you administer to your patient? sn (rou to the tenth) Answer 2mL/0.5e)(1/1000mg)275me/1) = I‘Nursing V 4 The health care previder orders 0.Smg of an aniartnythmic medication for your client. ‘The pharmacy supplies 200megimL. How many ml. would you administer to your patient? nL (round to the tenth) ‘Answer: ‘mL (Iml/200megX1000meg/Img)(0.5mg/1) = 2 ‘The health eare provider orders for a client with a DVT to begin a heparin drip at S00 ‘unitshour. The plsrmacy supplies 20,000 units of heparin in $00 ml. DSW. What ‘would you set the IV pump rate in mil hour? ‘mL hour (round tothe whole number) Answer: mL/hour= (500units/hour)(500mL/20,000units) = 1SmmiMHOE ‘The health care provider asks “how many unis/hour of heparin your patient is receiving ‘The IV pump is stat 20 mL/hour. The solution hanging is heparin 20,000 unit/SO0ml. DSW. How many wnits an hour is your patient receiving? unis/hou: (round to the whole number) ‘Answer: units/hour = (20mLhowr}(20,000units/S00mL) = SOOiRitSIONENursing V 7. The health care provider orders dobutamine hydrochloride IV infusion 0.Smegykg/min for 24 hours. The pharmacy supplies dobutamine 250mg/2S0ml. DSW. The patient ‘weighs 100kg. What isthe IV pump setting in ml! hour to admi this medication? _nLJhour (found tothe whole number) Answer: sm Jhour~ (0Smeg/ks(100kg/ min Omi Ihourk Imay/1000meg250mL 250m) 8, The health cae provider orders Nivoglyerine (NTG) IV 1Omeg/nin. The pharmacy supplies NT S0m/S0OmL. DSW. The patient weighs 100k. What is the IV pump setting in mL hour f administer the correct dose ofthis mediation? mL houe (oid tothe whole number) Answer: ml hour=(10meg)min(Img/1000nca)60min/ hour) SOOmL/SOng)= GLEEred Practice DA Problems Show all vour work, put vour answer inthe blank, ‘Besure to include the appropriate unit of measure, 4. The physician orders Zofran (Ondansetron) 8 mg po TID for a patient with nausea & ‘vomiting frorn a SBO. Zofran in 9 100 ml bottle laboled 4 mgltop. ia sent from Pharmacy. How many mL wil the nurse administer for each dose? (round to a whole number) Answer: mL 2, ‘The Healthcare Provider orders for a post-op patient, Morphine 4 mg IV q 4 hrs PRN for pain. Morphine 10 mg/m! is stocked in the pyxsis. How many mL will the nurse administer for a pain ‘ate of 8/10? (round to the tenths) Answer: me 3. Fortaz (Ceftazidime) 50 mg/kg po TID to a child who weighs 25.5kq was ordered by the primary physician on the Pediatric Unit. Fortaz is available in an oral suspension labeled 100mg/mL. How many ml would the nurse administer per dose? (round to the tenths) Answer: mt 4. The ARNP ordered Rocephin (Ceftriaxone) 2 G in 100 mL DSW IVPB over 30 mins. For a pre-op Pacemaker patient. The IV tubing is 15 gttml. Calculate the flow rate. (‘ound to a whole number) Answer: cttimin‘The physician writes an order for heparin 900 unitsfhr for a patient with a pulmonary embolism (PE), The label on the IV bag reads: Heparin 10,000 units in 500 mL DSW. What hourly dose of Heparin isthe patient receiving? (round to a whole number) Answer: Uhr ‘The patient's Heparin dip is infusing at 11 mifhr on an infusion pump. The bag of fluid is mixed with 25,000 units of Heparin in 250 mL DSW. How many units of Heparin wil the patient receive over 6 hrs? (round to a whole number) Answer: units In the ICU, a patient is started on regular insulin by continuous IV infusion at 20 units/hr for uncontrolled Diabetes. The solution is 250 mL NS with 100 units of Regular insulin. What s the correct infusion rate per hr.? (round to a whole number) Answer. mUhr At change of shift, the nurse noticed 200 ml eft to count in the IV bag. The IV is infusing at 80 ml/he. How much longer wil the IV run before a new bag is hhung?{round to the tenths) Answer: brs The patient weighs 197 lbs, convert to kilograms? (round to the hundredths) Answer: ka10.Give 10 units of Lantus Insulin bid at am and hs. At 0730, the patient's blood sugar was 235. According fo the ordered AC and HS sliding scale below, what isthe total amount of insulin the nurse will administer at 0730? Blood Sugar (mg/dL) Regular Insulin (0-150 No insulin 161 ~200 2 units 201 ~ 240 4 units 241- 280 6 units 281 - 330 8 units over 330 Call MD Answer units 1 ‘The order isto restrict IV fluid intake to 1200 mL/24 hour starting at 0700 - 0700, ‘You are caring for this client on the 11 pm-7 am shift, The intake and output record indicates the client hes received 900 mL IV during the last 16 hour. For the remaining & hrs, how many mifhr will have to infuse to complete the 1200 mi restriction? (round tothe tenths) Answer: mUbr 12. The pediatric dosage of a medication is 8 mg/kg every 4 hours. Calculate the individual dosage fora child weighing 40 Ibs. (round to the tenths) Answer: mg 18.The normal pediatric dosage of a medication is 4 mg/kg every 6 hours, Calculate the dally dosage for achild weighing 40 Ib. (round to the hundredths) Answer: mglday414, The order reads to give 6000 units of Heparin. You have a 10 mL mult-dose vial of heparin labeled 10,000 units per 2 mL. How many mL will you administer? (round to the tenths) Answer: mL 15. AnV of 1000 mL DEW2 NS is to infuse ata rate of 125 mL. ow long wl take to complete the in sion? (ound f-@ whole numb) Answer hr 16.The Healthcare Provider writes an order for oxycodone 15mg po bid. Oxycodone comes in a 80mg tab. How many tabs will the nurse administer at 0800? (round to the tenths) Answer: tab 17.An IV of 600 mL. containing 600 mg of medication is ordered to infuse at the rate of 20 mL. What dosage is infusing per hour? (round to a whole number) Answer: mgihr 18.A child weighs 22 tb. The physician prescribes ampicilin (Omnipen) 100 to 200 ‘mg/kg/24hrs. The medication is administered q 6 hrs. What is the safe dose range per day? What is the safe dose range per dose? (round to a whole number) Safe range, to. mg/day Safe range. to mgidose19.A child has been admitted to the hospital with a fever of unknown origin. The body temperature is 104 ° =, The pediatrician orders Cefaclor (Ceclor) 20 mgkkg qh dally po. The child weighs 32 pounds. The label reads 300 mg/2mL. How many mL wil the nurse administer? (round to the tenths) Answer: mL, 20. Cyanocobalamin (vitzmin B12) is available in vials labeled 1 miligram per milter. How many micrograms would you give a child ifthe order is 2 micrograms per kilogram and the child's weight is 25 klograms? How many milliters would you administer to this child IM? (round to the hundredths) Answer, mL Teper REA xanuuaeres) saree (ehes eran ra eee)ANSWER KEY 4) 10 mL ML ttsp/ 4mg xSmL/ttsp x 8mg = 40/4 = 10 mL ML = tmL/10mg ».4mg = 4/10 = 0.4 mL. ML = tmL/100mg x 50 mg/ kg x 25.5 kg = 1275mg/100 = 12.75 = 12.8 mL Gittimin = 15 gttimi. x 100mL/30mi 1600/20 = 60 gtt/min Mine = 500mL/10000u x 900 ur = 450,000/10,000 = 45 mLihr U-= 25,000 w250mL x 11mLir x Bhs: ,650,000/250 = 6,600 u ‘MUphr = 250mL/100u x 20u/hr = §,000/100 = 60 mLIhr Hr the/@0mL x 200mL = 2.6 hrs 197ibsi2.2 = 89.545 = 89.55 4.u reg. insulin +19 u Lantus = 14 units 300mL/Bhr = 37.5 mL/hr ‘8 mghkg x 1 kg/2.2 Ibs x 40 Ibs = 320/2.2 = 145.454 = 145.5 mg 13) 290.91 mg/day Magiday = 4 mg/kg x 1 kg/2.2 lbs x 40 Ibs/ 6 hrs x 24 hrs! 1 day= 3840/13.2 = 290.909 = 280. 91 mgidayML = 2mL/10,000 u x 6000u = 12,000/10,000 = 1.2 mL 15) ihr Hr = 1he/125mL x 1,000mL = 8 hrs 16) 0.5 tab Tab = 1 tab/S0mgx 15mg = 0.5 tab 17) 24 mgihe ‘Mglhr = 60Omg/ScOmL x 20mLir = 12,000/500 = 24 mg/hr 18) 1000 - 2000 malay | ,260 ~ 600 mgldose Magiday = 100 mg kg/24 hrs x 1 kg/ 2.2 lbs x 22 Ibs x 24 hrs/ 1 day = 52,800/52.8 ida Magiday = 200 may kg/24 hrs x 1 kg! 2.2 lbs x 22 tbs x 24 hrs/ 4 day = 4105,600/82.8 = 2,000 ma/day Magidose = 1,000 mg/ day x 1 day/ 24 hrs x 6 hrs! dose = 6,000/24 = 250 maldose Magidose = 2,000 mg/ day x 1 day/ 24 hrs x6 hrs! dose = 12,000/24 = 500 maldose 19) 4.9 mL, ML = 2/300 mg » 20 mal kg x 1 kg/ 2.2 Ibs x 82 Ibs = 1,280(680 = 1.939 = 1.9 mL 20) 0.05 mL ML = tmL/1mg x2 mog/ 1 kg x 1 mg/ 1000 meg x 25 kg = 50/1000 = 0.05 mL.Intake and Output Practice Problems all vour work, put vour answer i the blank, ‘Be sure (o include the appropriate unit of measure, 41) Anurse is reviewing ‘he daly intake and output ofa patient consuming a clear det “The foley drainage bag indicates a total of 1175 ml forthe past 24 hours, The total intake is: (2) Boz cups of coffe, (1) 16 oz serving of clear soup, and (1) quart of water consumed throughout the day How much is the deftef in mers? Answer: mt 2) For breakfast, the patient drank a 12 oz cup of juice, 240 ml. of ginger ale, ‘consumed 4 0z of jello, and had a 2 oz popcicle. What isthe pts total intake in mL? Answer: mL 3) After undergoing a transurethral prostatectomy a client returns to his room with a triple-lumen indwelling catheter for continuous bladder inigation. The irigation fluid is normal saline delivered at a rate of 150 mLihr. After 8 hours the nurse empties the drainage bag which contains a total of 2520 mL. Of the total, __mL.is urine output Answer: urine output4) Whatis the patient's iota fuid output? Urine- 300 mL. Urine- 250 mL. Urine- 410 mL Emesis- 50 mL. Jackson Pratt drain- 70 mL NGT suction. 235 mL Answer: me 5) The patient is a client who had a gastrectomy. A nasogastric tube is in place to drain al fluids. Itis connected to suction and irigated at times. Intake is limited to sips of Ginger ale and ice cubes. What is the total 12 hr shift intake in mL? Water] Ginger | tee |W Emesie- | Une [Brows | NG] NG intake | “ale” | cubes Tigud_| suction | iigation (Note stool oat mi) AN] TaN] 9a] 7a |e Ta] 0m | 2a 2Tesp | ttsp | tee | soomt | room. | 450m. | 750mL | 7oomL | 30mL ‘sear trom igus fue Pit ian | 2A ap | 2 Toa 1Tosp sevse_| 450 mL s0omL_| 200mL Som PM 31 oP 2M a Top 2eutes | 600m. _ Som ‘oP a5 Answer: iL total 12-hr intake What is the total 12 hr shift output in mL? Answer: mL total 12-hr outputANSWER KEY Using fl oz (coffee) 16 + (soup) 16 + (water) 32 = 64 oz mL = 30 mL 1 02x84 02 = 1920 1920 {otal intake ~ 1175 foley oulpul ~ 745 deficit Using f oz (Juice) 12 + (ello) 4 + (popcicie) 2 =18 oz mL= 30 mL/1 02x 18 o2 = 540 mL 540 mL. +240 mL (ginger ale) = 780 mL 40 mL x8 hrs = 1200 mL 2520 ml (total output) ~ 1200 mL. = 1320 ml. mL urine output: 4320mL 300 mL. + 250 mL +410 mL. + 50 mL +70.mL +235 mL = 1315 mL 5) 1775 mL total intake & 2500 mL total output ‘You add up all of the intzke values using the same units Water) 2+ 1+3=6 Tbsp mL = 15 mL/ 1 Tbsp x6 Thsp = 90 mL. (Ginger ale) 15 mL + 30 nL = 45 mL. mL=5 mL/1 tsp x 1 tsp= S mb, mL= 30 mL/ 1 02x 10z= 30 mL (Ice cubes) 1+ 1+2=4 cubes mL=5 mL/1 cube x 4 cubes = 20 mL, (1) 500 ml. + 450 mL + 500 ml. = 1450 mL. (NG irrigation) 30 mL + 30 mL + 30 mL +45 mL = 435 mL. Total intake = 4775 mL (Emesis) 100 mL + (urine) 450 + 300 mL. + (stoo!) 750 + 200 mL + (NG suction) 700 mL 2500 mL. Total output* Insulin syringes «Different sized syringes and when to use them (TB, insulin, 3 mL, etc.) ferent needle gauges and lengths and when to use them (infants, newboms, 6 year old, adult) * Ounces = how many’ teaspoons, tablespoons ‘* How to calculate a range of medication and determine if the dosage is safe. (get out your pecs notes) ‘© Practice using large numbers Review problems in DA book you struggle with, ask a friend or instructor to help if you are not “getting it” Round correctly Read the directions Watch your zeros Make sure you copy the numbers correctly If you have any questions please contact: Mrs. Lapinski plapinski@valenciacollege.edu Mrs. Sobratti ksobratti@valenciacollege.edu Mrs. White-Sparks kwhitesparks@valenciacollege.edu Nursing V rrans