Safe Dosage Calculations

SAFE DOSAGE CALCULATIONS 3 mL Syringe
- Calibrations read from top to the

Drug Calculation black ring of the suction plunger
- Calibrated in milliliters for each tenth
Principles of Algebra are integrated and
united in solving dosage and solution for Prefilled Single Dose Syringe
nurses. Principles applied in nursing are in
the following: - Used only once and is discarded
- Discard any extra medication prior to
- Dosage determination injection
- Administration of drugs
- Preparation of solutions 1 mL Syringe
- Intravenous infusion - Also known as Tuberculin or TB
syringe
EQUIPMENT USED IN DOSAGE - Used to administer small doses
MEASUREMENT - Calibrated in hundredths of a
milliliter
Medicine Cup
- Used to give dosages of less than
Includes milliliters and ounces 0.5 mL
30 milliliters = 1 ounce Units -100 Insulin Syringe
5 milliliters = 1 teaspoon
- Measurement and administration
15 milliliters = 1 tablespoon of units-100 insulin only
Calibrated Dropper - Do not use with any other
medications
- Used to administer small quantities - Syringe may be a standard units-
- Useful in medication of children and 100 or a Lo-dose units-100 for
adults and adding small quantities to smaller doses
liquid
- Dispense eye and ear medications Safety Syringes
Pediatric Oral Devices - The needle is protected by a shield
- Used with oral medications for - Safety syringes are used to protect
children from injury
- Teach caregivers to use correctly
- Oral syringes do not have a Intravenous Syringe
Luerlock hub and have a cap on the - Used to prepare medication for IV
Tip - administration
-
- Examine calibrations and select the
Parenteral Medication - best syringe based upon volume
Administration
- Used to identify route of Needleless Syringe System
administration by injection - Used to prevent needle sticks during
- Includes syringes and IV catheters IV medication administration
- Must use principles of rounding to
ensure safety
INTERPRETING DRUG ORDERS • Right time
• Right documentation
Nursing Responsibilities
- Interpret order MEDICATION ADMINISTRATION RECORD

- Prepare exact dosage of prescribed
drug • May be a paper form or electronic
- Identify the patient • Used to record drug orders
- Administer dosage by prescribed • Health care professional must verify
route and initial each order
at prescribed time intervals
- Record the administration of the
prescribed drug Three checks to ensure safe medication
- Monitor the patient’s response for administration
desired and adverse effects • Drug order
• Correct dosage
Seven Parts of a Drug Order • Record drug administration
- Patient name
- Name of drug PREVENTING MEDICATION ERRORS
- Dosage
- Route of administration • Read entire MAR at beginning of
- Frequency, time, and special each
instructions • shift
- Date and time of order • Verify times scheduled with
- Signature and licensure of person ordered frequency
writing the order • Review all medications to identify
any potential drug interactions or
inconsistencies
Caution: If any parts of the order are
missing or unclear, the order is
incomplete UNDERSTANDING DRUG LABELS
Drug order must be clearly written If any Brand name is usually most prominent
parts are missing, it is incomplete If ever
in doubt ask the writer to clarify
- Generic name must be on all drug
Labels
- Nurses must cross check
medications to prevent errors
SIX RIGHTS OF MEDICATION

ADMINISTRATION
• Right patient Dosage Strength - Dosage weight or

• Right drug amount of drug provided in a specific unit of
measurement
• Right amount
• Right route
• Total fluid volume for liquids
Administration Route
Site of body or method of drug delivery
• Oral
• Enteral
(20 mg/mL) • Sublingual
• Injection
Form
Structure and composition of
drug • Otic
• Optic
• Solid forms for oral use • Topical
• Injectable • Rectal
• Suppositories
• Creams Expiration Date
• Patches - Check prior to administration
- Discard or return to pharmacy if
expired
Controlled
Substance Schedule
Classifies drugs according to potential
for use and abuse
Supply Dosage Schedule I – highest potential for abuse
• Both dosage and form
• Dosage per tablet Schedule V – lowest potential for abuse
• Dosage per milliliter
Total Volume
PREVENTING MEDICATION ERRORS
• Full quantity contained in Effects of medication errors
bottle or vial
• Total number of tablets or - Increase length of stay
other solids - Increased cost
- Patient disability
- Death • Intramuscular (IM)
- Nurse’s personal and professional • Subcutaneous (SC)
status, • Intradermal (ID)
- confidence, and practice • Intravenous (IV)
Safe Medication Administration Parenteral
Prescription Most parenteral medications are
- Licensed providers must have prepared in liquid form and packaged in
authority within their state to write
prescriptions dose vials
- Includes verbal orders
- Ampules or prefilled syringes
- Repeat and verify all verbal orders for
accuracy
Injectable Solutions
- Nurses play an important role in
- preventing errors at prescription step
- Intramuscular maximum dosage
- Practitioner who administers a drug
- Average 150 lb adult = 3 mL
shares liability
- Maximum for deltoid site is 2 mL
- for injury, even if medical order was
- Children age 6-12 years = 2 mL
incorrect
- Children birth to age 5 years = 1 mL
- Verify safety of drug order by
checking a reliable
RULE
- drug reference
Parenteral dosages
Verbal Orders
- Round amount to be administered to
- Seven parts of drug orders
tenths is amount greater than 1 mL
- Patient’s name
and measure it in a 3 mL syringe
- Date and time of order
- Measure amounts less than 1 mL
- Name of drug
rounded to hundredths and all
- Amount of drug
amounts less than 0.5 mL in a 1 mL
- Route
syringe
- Frequency or administration
- Amounts of 0.5 mL to 1 mL calculated
schedule
in tenths can be accurately measured
- Prescriber’s name and licensure
in either a 1 mL or a 3 mL syringe
Parenteral Dosage of Drugs

Reconstitution of Solutions
- Reconstitution: process of mixing
Route of administration other than and diluting solutions
gastrointestinal
TERMS
Solute: Substance to be dissolved or diluted.
It can be either a solid or a liquid.
Solvent: Substance (liquid) that dissolves
another substance to prepare a solution.
Solution: Resulting mixture of a solute plus
a solvent
Caution
Before reconstituting injectable drugs, read
and follow the label or package insert
directions carefully
- Check the drug
- Check drug and diluent dates
Rules
When reconstituting injectable medications
You must:
- determine both the type and amount
of diluent to be used
- determine the volume in mL of diluent
to be used for the route as ordered
- Then reconstitute the drug and not
the resulting supply dosage on the
vial
Remember
When reconstituting a multiple-dose,
label with:
- Date and time of preparation
- Supply dosage prepared
- Length of potency
- Storage directions
- Your initials
SAFE DOSAGE CALCULATIONS

Drug Calculation
united in solving dosage and solution for
the following: 5. Pediatric Doses:
- Dosage determination
- Preparation of solutions
- Intravenous infusion
FORMULAS FOR COMPUTATION OF

DRUG DOSAGES
1. ORAL MEDS (SOLIDS):
6. Body surface area in m2 base on

2. ORAL OR PARENTERAL MEDS metric measurement of height and
(LIQUIDS) weight:
3. IV FLUID FLOW RATES:

household measure of height and
weight:
Total Daily IV Fluid for Children

Use this formula to calculate the daily
4. Conversion of Temperatures:
rate of pediatric maintenance IV fluids:
• 100 mL per kg per day for the first

10 kg of body weight
• 50 mL per kg per day for the next
• 20 mL per kg per day for each kg
above 20 kg of body weight
Example:
Drug Calculation
the following:
EQUIPMENT USED IN DOSAGE

MEASUREMENT
Medicine Cup
Includes milliliters and ounces
30 milliliters = 1 ounce
5 milliliters = 1 teaspoon
15 milliliters = 1 tablespoon
Calibrated Dropper
- Used to administer small quantities
- Useful in medication of children and
adults and adding small quantities to
liquid
- Dispense eye and ear medications
Pediatric Oral Devices
- Used with oral medications for - Safety syringes are used to protect
children from injury
- Teach caregivers to use correctly
- Oral syringes do not have a Intravenous Syringe
Luerlock hub and have a cap on the - Used to prepare medication for IV
Tip - administration
-
- Examine calibrations and select the
Parenteral Medication - best syringe based upon volume
Administration
- Used to identify route of Needleless Syringe System
administration by injection - Used to prevent needle sticks during
- Includes syringes and IV catheters IV medication administration
- Must use principles of rounding to
ensure safety
4 mL Syringe INTERPRETING DRUG ORDERS

- Calibrations read from top to the
black ring of the suction plunger Nursing Responsibilities
- Calibrated in milliliters for each tenth
- Interpret order
Prefilled Single Dose Syringe
- Prepare exact dosage of prescribed
- Used only once and is discarded drug
- Discard any extra medication prior to - Identify the patient
injection - Administer dosage by prescribed
route
1 mL Syringe at prescribed time intervals
- Also known as Tuberculin or TB - Record the administration of the
syringe prescribed drug
- Used to administer small doses - Monitor the patient’s response for
- Calibrated in hundredths of a desired and adverse effects
milliliter
- Used to give dosages of less than Seven Parts of a Drug Order
0.5 mL - Patient name
- Name of drug
Units -100 Insulin Syringe - Dosage
- Route of administration
- Measurement and administration - Frequency, time, and special
of units-100 insulin only instructions
- Do not use with any other - Date and time of order
medications - Signature and licensure of person
- Syringe may be a standard units- writing the order
100 or a Lo-dose units-100 for
smaller doses
Caution: If any parts of the order are
Safety Syringes missing or unclear, the order is
- The needle is protected by a shield incomplete
Drug order must be clearly written If any Brand name is usually most prominent
parts are missing, it is incomplete If ever
in doubt ask the writer to clarify
- Generic name must be on all drug
Labels
- Nurses must cross check
medications to prevent errors
SIX RIGHTS OF MEDICATION

ADMINISTRATION
• Right patient Dosage Strength - Dosage weight or

• Right drug amount of drug provided in a specific unit of
• Right amount measurement
• Right route
• Right time
• Right documentation
MEDICATION ADMINISTRATION RECORD
• May be a paper form or electronic

• Used to record drug orders
• Health care professional must verify
and initial each order
(20 mg/mL)
Three checks to ensure safe medication
administration
Form
• Drug order Structure and composition of

• Correct dosage drug
• Record drug administration
• Solid forms for oral use
PREVENTING MEDICATION ERRORS • Injectable
• Suppositories
• Read entire MAR at beginning of
• Creams
each
• shift
• Verify times scheduled with
ordered frequency
• Review all medications to identify
any potential drug interactions or
inconsistencies
UNDERSTANDING DRUG LABELS

• Patches Expiration Date
- Check prior to administration
- Discard or return to pharmacy if
expired
Controlled
Substance Schedule
Classifies drugs according to potential
for use and abuse
Supply Dosage Schedule I – highest potential for abuse
• Both dosage and form
• Dosage per tablet Schedule V – lowest potential for abuse
• Dosage per milliliter
Total Volume
PREVENTING MEDICATION ERRORS
• Full quantity contained in Effects of medication errors
bottle or vial
• Total number of tablets or - Increase length of stay
other solids - Increased cost
• Total fluid volume for liquids - Patient disability
- Death
- Nurse’s personal and professional
status,
Administration Route
- confidence, and practice
Safe Medication Administration
• Oral
Prescription
• Enteral
• Sublingual - Licensed providers must have
• Injection authority within their state to write
prescriptions
- Includes verbal orders
Site of body or method of drug delivery - Repeat and verify all verbal orders for
• Otic accuracy
• Optic - Nurses play an important role in
- preventing errors at prescription step
• Topical
- Practitioner who administers a drug
• Rectal
shares liability
- for injury, even if medical order was - Maximum for deltoid site is 2 mL
incorrect - Children age 6-12 years = 2 mL
- Verify safety of drug order by - Children birth to age 5 years = 1 mL
checking a reliable
- drug reference RULE
Verbal Orders Parenteral dosages
- Seven parts of drug orders - Round amount to be administered to
- Patient’s name tenths is amount greater than 1 mL
- Date and time of order and measure it in a 3 mL syringe
- Name of drug - Measure amounts less than 1 mL
- Amount of drug rounded to hundredths and all
- Route amounts less than 0.5 mL in a 1 mL
- Frequency or administration syringe
schedule - Amounts of 0.5 mL to 1 mL calculated
- Prescriber’s name and licensure in tenths can be accurately measured
in either a 1 mL or a 3 mL syringe
Parenteral Dosage of Drugs

Reconstitution of Solutions
- Reconstitution: process of mixing
Route of administration other than
and diluting solutions
gastrointestinal
• Intramuscular (IM) TERMS

• Subcutaneous (SC)
• Intradermal (ID) Solute: Substance to be dissolved or diluted.
• Intravenous (IV) It can be either a solid or a liquid.
Parenteral Solvent: Substance (liquid) that dissolves

another substance to prepare a solution.
Most parenteral medications are
Solution: Resulting mixture of a solute plus
prepared in liquid form and packaged in a solvent
dose vials Caution
- Ampules or prefilled syringes Before reconstituting injectable drugs, read
and follow the label or package insert
Injectable Solutions directions carefully
- Intramuscular maximum dosage - Check the drug

- Average 150 lb adult = 3 mL - Check drug and diluent dates
Rules
When reconstituting injectable medications
You must:
- determine both the type and amount
of diluent to be used
- determine the volume in mL of diluent
to be used for the route as ordered
- Then reconstitute the drug and not
the resulting supply dosage on the
vial
Remember
When reconstituting a multiple-dose,
label with:
- Date and time of preparation
- Supply dosage prepared
- Length of potency
- Storage directions
- Your initials

Drug Calculation
the following:
FORMULAS FOR COMPUTATION OF

DRUG DOSAGES
7. ORAL MEDS (SOLIDS):

metric measurement of height and
weight:
8. ORAL OR PARENTERAL MEDS

(LIQUIDS)
9. IV FLUID FLOW RATES:

household measure of height and
weight:
10. Conversion of Temperatures:
Total Daily IV Fluid for Children

Use this formula to calculate the daily
11. Pediatric Doses: rate of pediatric maintenance IV fluids:
• 100 mL per kg per day for the first

• 50 mL per kg per day for the next
• 20 mL per kg per day for each kg
above 20 kg of body weight
Example:

Safe Dosage Calculations

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SAFE DOSAGE CALCULATIONS 3 mL Syringe

- Calibrations read from top to the

- Interpret order MEDICATION ADMINISTRATION RECORD

SIX RIGHTS OF MEDICATION

• Right patient Dosage Strength - Dosage weight or

Parenteral Dosage of Drugs