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Computation of
Dosage and Solutions
2 H r s $12.95
C O U R S E A B S T R A C T
This course teaches one simple method of calculating all dosages without the need to memorize
cumbersome and easy-to-forget rules. The method presented is called dimensional analysis.
Dimensional analysis simply, easily, and systematically converts one unit of measurement to another
by using a conversion factor.
The course provides an opportunity to see how dimensional analysis works for a wide variety of oral,
intramuscular, subcutaneous, and intravenous calculations. It provides practice calculations and a one-
step, no-rules method for calculating the number of drops per minute at which an intravenous solution
should be run. Alene M. Burke,
This course is highly useful to nurses with “math phobia,” student nurses, those studying for the NCLEX RN, MSN
exam, and others who are preparing to take a pre-employment medication or pharmacology exam.
Ms. Burke serves
as Nursing
Bert Rodgers Schools of Continuing Education is accredited as a provider of continuing education Consultant and
in nursing by the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation. Instructor for Bert
Bert Rodgers Schools is also approved by the Florida Board of Nursing, Provider FBN # 2783, by the Rodgers Schools
Florida Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health of Continuing
Counseling, Provider # BAP–570–Exp. 3/2005, and by the California Board of Registered Nursing, Education. Her
Provider # CEP 12763. See Provider Approval Summary page for other professions. degrees in nursing
were granted by
Queensborough
Learning Objectives Community
College of New
1. Use dimensional analysis to solve a 3. Compute intramuscular and subcutane- York (ASN), State
wide variety of dosage and solution ous dosages using dimensional analysis. University of New
problems. 4. Determine intravenous (IV) flow rates York, Regents Col-
2. Calculate oral dosages using using dimensional analysis and the one- lege (BSN), and
dimensional analysis. step, no-rules method of calculation. Adelphi Univer-
sity (MSN).
Alene has served
as an innovative
INTRODUCTION
that they are easily forgotten. Now, finally, and creative nurs-
In nursing school, most nurses learned how there is a method to easily and accurately ing staff develop-
to calculate, or compute, drug dosages and calculate all dosage and solution problems ment director for
IV flow rates. Not too many of us were great using one step and no rules for each type of more than 15
mathematicians, and few enjoyed or looked dosage and solution problem that you need years for major
forward to our medication or pharmacology to calculate. The method used for this metropolitan New
exam every semester. As we prepared for course is called dimensional analysis. York medical cen-
these tests, we spent many hours memoriz- Dimensional analysis is a method that ters. She has, for
ing rules, such as “desired over have times converts one unit of measurement to the last several
quantity,” and the correct method of calcu- another unit of measurement using a conver- years, presented
lating dosage and solution rates using ratio sion factor or factors. seminars and
and proportion. Once you have mastered this method workshops to
The primary reason we studied and you do not have to remember multiple cum- large groups of
restudied all of these cumbersome rules is bersome rules and steps. Instead, you will be healthcare
10
TABLE 1: CALCULATION EQUIVALENTS:
500 mg 1 mL = _____ mL
AN EASY REFERENCE 50 mg
1 gr 60 milligrams (mg) 1
15 gr 1 g or 1000 mg
1000 mcg 1 mg Multiply the numerators (10 1) and the denom-
inators (1), and finally divide the product of the
1 kg 2.2 pounds (lbs) numerators by the denominator to get the final
1 mL or 1 cc 15 minims (m) answer:
500 mL or 500 cc 1 pint (pt) or 16 ounces (oz) Medication label: Lanoxin 0.25 mg per tablet
1000 mL or 1000 cc 1 liter (L), 1 quart (qt), or How many tablets should you give?
32 ounces (oz) The starting factor is 0.5 mg, the conversion fac-
tor is 0.25 mg/1 tablet, and the answer unit is the
Source: Joanne M. Daniels and Loretta M. Smith. Clinical number of tablets you would give.
Calculations: A Unified Approach. 4th Edition. Delmar Publishers:
Albany et al. 1994 Starting conversion = answer
factor factor unit
0.5 mg 1 tablet = _____ tablets
CALCULATING ORAL DOSAGES USING 0.25 mg
DIMENSIONAL ANALYSIS
Cancel out and reduce the numerators and
The following examples show how to compute oral
denominators:
dosage calculations using dimensional analysis.
Example 1 0.5 mg 1 tablet = _____ tablets
Doctor’s order: tetracycline syrup 500 mg po 0.25 mg
conversion factors. One of the conversion factors is 3. Doctor’s order: trimethoprim 5 mg/kg po. The
the number of mg ordered for each kg, or 50 mg/kg, patient weighs 70 kg.
and the other conversion factor is the manufacturer’s Medication label: trimethoprim 160 mg/tab. The
equivalent, or 250 mg/cap. The answer unit is the tabs are scored in half.
number of caps. How many tabs would you administer?
(The starting factor is 70 kg. The conversion fac-
Starting conversion = answer tors are 5 mg for every kg of body weight and 1 tab
factor factor unit = 160 mg. The answer unit is the number of tabs.
Round off to the nearest half or whole tab.)
80 kg 50 mg 1 cap = _____ caps
1 kg 250 mg
4. Doctor’s order: nystatin 2.5 mg/kg po. The patient
weighs 115 lb.
Cancel out and reduce the numerators and
Medication label: nystatin 100 mg/tab
denominators:
How many tabs would you administer?
(The starting factor is 115 lb. There are three con-
1 version factors in this problem because you have to
80 kg 50 mg 1 cap = _____ caps convert lb to kg. The conversion factors are 1 kg =
1 kg 250 mg 2.2 lb, 2.5 mg for every kg of body weight, and 1
tab = 100 mg. The answer unit is the number of
5
tabs. These tabs are not scored, so round off to the
Multiply the numerators and the denominators nearest whole tab.)
and then divide their products:
5. Doctor’s order: nystatin 1,000,000 U po
80 1 1 cap = 80 = 16 caps/day Medication label: nystatin 500,000 U/tab
1 5 5 How many tabs would you administer?
(The starting factor is 1,000,000 U; the conversion
Because the doctor’s order read “flucytosine 50 factor is 1 tab = 500,000 U; and the answer unit is
mg/kg/day in four divided doses,” it is necessary to the number of tabs.)
divide the total of 16 caps by 4 to determine the num-
ber of capsules that would be given for each of the
Answers
doses:
1. 7.5 mL
16 = 4 caps for each dose 2. 1 tab
4 3. 2 tabs
4. 1 tab
5. 2 tabs
Practice Oral Dosages Here is how the problems were set up and solved:
Now try these oral dosage calculations. 1.
2
1. Doctor’s order: KCl 10 meq po 10 meq 11.25 mL = 22.5 = 7.5 mL
Medication label: KCl 15 meq/11.25 mL 15 meq 3
How many mL would you administer? 3
(The starting factor is 10 meq, the conversion fac-
tor is 15 meq/11.25 mL, and the answer unit is 2.
______ mL.) 1
500 mg 1g 1 tab = 1 = 1 tab
2. Doctor’s order: Gantrisin 500 mg po 1,000 mg 0.5 g 1
Medication label: Gantrisin 0.5 g/tab 2
How many tabs would you administer?
3.
(The starting factor is 500 mg. There are two con-
1
version factors: 1,000 mg = 1 g and 0.5 g/tab. In this
70 kg 5 mg 1 tab = 70 = 2.18 tabs,
calculation problem, you have an order for mg and
1 kg 160 mg 32
the available tabs are in g. It is therefore necessary
32
to convert mg into g so you can determine the num-
ber of tabs. The answer unit is the number of tabs.) which rounds off to 2 tabs.
Computation of Dosage and Solutions 5
How many mL would you administer for each of 4. Doctor’s order: neomycin 30 mg/kg/day IM in
the three doses? three divided doses. The patient weighs 120 lb.
Medication label: neomycin 250 mg/mL
The starting factor is 120 lb. The conversion fac-
tors are 30 mg/1 kg, 1 kg = 2.2 lb, and 250 mg/1 mL. How many mL would you administer for each of
The answer unit is the number of mL. the three doses?
(The starting factor is 120 lb; the conversion fac-
Starting conversion = answer
tors are 30 mg/1 kg, 1 kg = 2.2 lb, and 250 mg/1
factor factors unit
mL; and the answer unit is the number of mL.)
120 lb 1 kg 30 mg 1 mL = _____ mL
5. Doctor’s order: 400,000 U of ampicillin
2.2 lb 1 kg 250 mg Medication label: 250,000 U/mL
60 6 How many mL would you administer?
120 lb 1 kg 30 mg 1 mL = _____ mL (The starting factor is 400,000 U, the conversion
2.2 lb 1 kg 250 mg factor is 250,000 U/1 mL, and the answer unit is
1.1 50 the number of mL.)
Computation of Dosage and Solutions 7
Example 2
5.
Doctor’s order: 1,000 mL of 5% D 0.45 normal
8
saline solution to infuse over 5 hours
400,000 U 1 mL = 8 = 1.6 mL
250,000 Units 5 How many gtt per minute would you give if the
5 tubing delivered 10 gtt/mL?
8 Bert Rodgers Schools Continuing Education Course
number 60. The relationship between 60 and 10 is 6: tions that you will also have to know. These include
60/10 = 6. Finally, if you are using IV tubing that calculating the following:
delivers 15 gtt/min, the relationship of 60 to 15, or 4,
• total infusion time;
requires you to divide the number of mL an hour by 4.
Now that you know all the possible relationships, • the concentration of a medication in an IV solution
it is only necessary to divide the number of mL an that should be given; and
hour by 3 for a 20 gtt/mL drop factor tubing, by 6 for • IV flow rates based on body weight.
a 10 gtt/mL drop factor tubing, and by 4 for a 15
gtt/mL drop factor tubing. All you have to do is one Calculating Total Infusion Time
step. There are no rules to forget, no complicated for-
mulas, and no unnecessary steps! When you have adjusted an IV solution to run at a
Here are some examples: certain number of drops per minute, you will want to
know when the solution is due to finish infusing so
If you are using a 10 gtt/mL set, the number of that you can anticipate the need to hang another bag
drops per minute will always be the number of mL an of solution, if so ordered. You must, therefore, be able
hour divided by 6. to calculate the total infusion time for the presently
100 mL/h: 100/6 = 16.6 = 17 gtt/min rounded off infusing bag.
125 mL/h: 125/6 = 20.8 = 21 gtt/min rounded off Following is an example of how this type of calcu-
150 mL/h: 150/6 = 25 gtt/min lation is accomplished using dimensional analysis.
Total volume of IV fluid: 1,000 mL
If you are using 20 gtt/mL IV tubing, the number
of drops per minute will always be the number of mL Infusion rate: 23 gtt/min
an hour divided by 3. Drop factor: 10 gtt/mL
100 mL/h: 100/3 = 33.3 = 33 gtt/min rounded off When will the liter of fluid run out?
125 mL/h: 125/3 = 41.6 = 42 gtt/min rounded off The starting factor is 1,000 mL; the conversion
150 mL/h: 150/3 = 50 gtt/min factors are 10 gtt/1 mL and 23 gtt/1 min; and the
answer unit is time, that is, the number of hours
And, finally, if you are using 15 gtt/mL tubing, the and/or minutes.
number of drops per minute will be the number of mL
an hour divided by 4.
Starting conversion = answer
100 mL/h: 100/4 = 25 gtt/min factor factors unit
125 mL/h: 125/4 = 31.2 = 31 gtt/min rounded off
1,000 mL 10 gtt 1 min 1 h = ___ h
150 mL/h: 150/4 = 37.5 = 38 gtt/min
1 mL 23 gtt 60 min
This one-step, -no-rules- method of calculating
the number of IV drops per minute works all the time 1
because there are always 60 minutes in an hour. The 1,000 mL 10 gtt 1 min 1 h = 1,000 =
one step involved in calculating the number of drops 1 mL 23 gtt 60 min 138
per minute consists of dividing the relationship num- 6
ber for the specific IV tubing set into the number of
mL per hour ordered by the doctor. Pediatric (60 = 7.24 h (7 h 14 min)
gtt/mL) tubing has an identity relationship; therefore,
the number of drops per minute will always exactly
match the number of mL per hour. Calculating the Concentration of a
This one-step method is particularly useful Medication in an IV Solution
because nurses caring for patients with IV infusions
should count and verify the number of drops per On some occasions, a physician may order an hourly
minute at the bedside with each patient contact. dosage of a medication that has been diluted in an IV
Volumetric controllers and pumps are not always fluid. For example, the doctor may order an hourly
accurate and do not always function properly. dosage of 1,200 units of heparin that has 20,000 units
of heparin diluted in 1,000 mL of normal saline solu-
tion. The nurse must then be able to calculate the flow
rate of the fluid based not on the volume of the fluid
OTHER IV CALCULATIONS ordered but on the dosage of the medication.
Calculating the number of drops per minute, or the The starting factor is 1 h; the conversion factors
flow rate, is perhaps the most frequently encountered are 1,200 U/1 h and 20,000 U/1,000 mL; and the
IV calculation; however, there are other IV computa- answer unit is the number of mL.
10 Bert Rodgers Schools Continuing Education Course
= 0.9 mL
3.
Per minute:
The number of mL to be administered per hour = 100 lb 1kg 5 mcg 1 mg 500 mL = __ mL
0.9 60 = 54. 2.2 lb 1 kg 1,000 mcg 250 mg
Computation of Dosage and Solutions 11
1 SUMMARY
1 1 10
Dimensional analysis is a highly useful way to calcu-
100 lb 1kg 5 mcg 1 mg 500 mL = 1 = late dosage and solution problems of all types. It is an
2.2 lb 1 kg 1,000 mcg 250 mg 2.2 orderly and systematic mathematical process that
10 50 results in consistent accuracy, provided the equation is
1 1 set up correctly and careless mathematical errors are
avoided.
= 0.45 mL
Per hour:
0.45 60 = 27 mL
P O S T T E S T
1. How many mL would you 4. If the doctor has ordered 200 8. If the doctor orders
administer if the doctor mg of aminophylline po and gentamicin 3 mg/kg/day in
orders 300 mg of ferrous each tablet contains 0.1 g, four equal doses, the patient
sulfate elixir and the label on how many tablets would you weighs 77 kg, and the label
the elixir states that there are give to the patient? reads 40 mg/mL, how many
220 mg/5 mL? mg would you give for each
a. 1
⁄2 tablet
dose?
a. 1.4 mL b. 1 tablet
b. 5.5 mL c. 11⁄2 tablets a. 0.4 mL
c. 6.2 mL d. 2 tablets b. 1.4 mL
d. 6.8 mL c. 4 mL
5. If the doctor orders 1.8 mg of d. 14 mL
2. How many sulfamethoxazole betamethasone and you have
tablets per dose would you tablets that contain 0.6 mg, 9. How many drops per minute
administer to a patient weigh- how many tablets would you would you deliver if the
ing 154 lb if the doctor has administer? doctor has ordered 700 mL
ordered 100 mg/kg/day in q8h and the drop factor of the
a. 1
⁄3 tablet
three divided doses? The IV tubing is 20 gtt/mL?
b. 3 tablets
label on the sulfamethoxazole
c. 1
⁄4 tablet a. 29 gtt/min
bottle states that there are
d. 4 tablets b. 87 gtt/min
800 mg per tablet.
c. 158 gtt/min
a. 1 tablet 6. If the doctor has ordered 15 d. 233 gtt/min
b. 2 tablets mg/kg/day in four equal doses
c. 3 tablets and the patient weighs 155 lb, 10. How many mL/h would you
d. 4 tablets how many mL would you administer if the doctor
administer for each dose if orders 50 U/h of a medication
3. If the doctor has ordered there are 500 mg/2 mL? that has been diluted in a
phenobarbital gr 1⁄2 orally and solution with a total of 250 U
a. 0.5 mL
there are 15 mg per tablet, in 1,000 mL?
b. 1 mL
how many tablets would you
c. 1.5 mL a. 50 mL
administer?
d. 2.5 mL b. 100 mL
a. 2 tablets c. 150 mL
b. 1 tablet 7. If the doctor orders d. 200 mL
c. 1
⁄4 tablet streptomycin 1 g and you
d. 1
⁄2 tablet have added 12 mL to a
powdered streptomycin to
yield 400 mg/mL, how many
mL would you give?
a. 2.5 mL
b. 2 mL
c. 1.5 mL
d. 0.5 mL
ANSWER SHEET
5. ❍ a ❍ b ❍ c ❍ d 10. ❍ a ❍ b ❍ c ❍ d
Course Evaluation:
I achieved the following learning objectives: Agree Disagree
1. Use dimensional analysis to solve a wide variety of dosage and solution problems. ❍ ❍ ❍ ❍
2. Calculate oral dosages using dimensional analysis. ❍ ❍ ❍ ❍
3. Compute intramuscular and subcutaneous dosages using dimensional analysis. ❍ ❍ ❍ ❍
4. Determine intravenous (IV) flow rates using dimensional analysis and the one-step, ❍ ❍ ❍ ❍
no-rules method of calculation.
The objectives stated above related to the overall goals of the course. ❍ ❍ ❍ ❍
The teaching/learning method was effective. ❍ ❍ ❍ ❍
Notes:
Certificates of Completion are dated the day our School receives and processes your Answer Sheet, Registration Form, and
payment. Duplicate Certificates of Completion are available at no charge! There is no charge for processing a re-exam.