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Medication calculation – semester exam January

21.1.2015
As a nursing student you need to calculate and pass 5 exams of medication calculation (or 25
calculations in total) before you can graduate. An accomplished grade requires that all problems
are solved correctly, the calculations are made visible and the answer is clearly marked. You can
use a calculator, but NOT your mobile phone.

Remember that you have to pass your medication calculation test at least the previous semester
to be able to go out on practical training. You can check this with your teacher if you are not sure if
you need to calculate before the practical training you are going out on.

Please observe that some of the examples require that you get information about the medication
from the picture attached to be able to solve the calculation.

You can calculate in different ways,

I present one solution to the calculation!


1. Background: Peter has fallen on the icy road and has broken his leg. He is brought to the
emergency department and the surgeon reponates (pulls it in the right position) the leg.
Patient needs pain medication. The surgeons order is not right since you never give an order in
millilitre, but this surgeon gives it in millilitres anyway. You will take the order from the
surgeon, but ensure the amount in milligrams each time. You calculate this despite the poor
order.

Prescription: Alfentanil (Rapifen®) 0,5 ml until the patient’s pain is not so bad.

Drug available: Alfentanil (Rapifen®) 0,5 mg/ml injectable solution.

Dosage calculation: The surgeon asks you to give 0,5 ml to the patient. This is not enough so
he asks you to give 0,5 ml more. This is still not enough so you give the third dose of 0,5 ml of
alfentanil.

How many mg alfentanil does Peter get in total?

0,5ml + 0,5ml + 0,5ml = 1,5ml

0,5ml = 1ml

x = 1,5ml

0,5mg x 1,5ml

1ml =x

Answer: 0,75 mg
2. Background: Natalie is ill and goes to the physician. The doctor gives Natalie the of diagnose
respiratory infection. He prescribes amoxillin and asks you to give tablets to Natalie over the
weekend since the pharmacy is closed.

Prescription: Amoxillin (Amoxin®) 750 mg 1 x 2 for a week.

Drug available: Amoxillin (Amoxin®) 500 mg tablets.

Dosage calculation: You will give the tablets for the


dose Friday evening, the doses for Saturday and
Sunday, and also for Monday morning. How many
tablets do you give Natalie? Observe that the
medication on hand is amoxillin 500 mg tablets.

Doses:

Friday 1 x 750mg

Saturday 2 x 750mg

Sunday 2 x 750mg

Monday 1 x 750mg

TOTALT OF: 6 x 750mg

750mg tbl = 1½ x 500mg tbl

6 x 1½ = 9 tbl

Answer: 9 tablets
3. Background: Erica is 9 years old and has an ear infection. The physician orders naproxen oral
suspension for the fever and pain. Erica weighs 30 kg.

Prescription: Naproxen (Pronaxen®) 10 mg/kg divided in two doses per day.

Drug available: Naproxen (Pronaxen®) 25 mg/ml

Dosage calculation: How many millilitres of naproxen does Erica receive each time?

10mg/kg -> 30kg x 10mg/kg = 300mg (kg takes out itself)

25mg = 1ml
300mg = x

x = 1ml x 300mg = 12ml (mg takes out itself)


25mg

OBSERVE! 12ml is the total dose per day, you still have to
divide it into two doses.
 12ml /2 = 6ml

Answer: 6ml each time


4. Background: Angelina has very low blood pressure and will get a noradrenalin-infusion.
Angelina weighs 60 kg.

Prescription: You will prepare the noradrenalin-infusion by mixing 20 ml noradrenalin with 480
ml 5% glucose (G5) infusion.

Drug available: Noradrenalin 1 mg/ml + G5 ad 500 ml.

Dosage calculation a: What is the strength of the infusion in µg/ml (mcg/ml)?

Dosage calculation b: The infusion is started at the dose of 0,05 µg/kg/min. What is the
infusion rate in ml/h?

a)
noradr. 20ml + G5 480ml = 500ml

20ml x noradr. 1mg/ml = 20mg (ml takes out itself)

20mg = 0,04mg/ml = 40 mcg/ml


500ml

Answer a) 40mcg/ml

b)

0,05mcg/kg/min
60kg -> 60kg x 0,05mcg/kg/min = 3mcg/min (kg takes out itself)
We now have the infusion rate in mcg/min, but we want it in ml/h. We calculate or convert
one unit at a time. I will start by converting mcg to ml.

40mcg = 1ml

3mcg = x

x = 1ml x 3mcg = 0,075ml (mcg takes out itself)


40mcg
After that I will convert minutes to one hour by multiplying everything with 60min.

60 x 0,075ml = 4,5ml /60min = 4,5 ml/h


1min

Answer b) 4,5 ml/h

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