Dosage Calculation Review

RNSG 1341

Some Basic Rules

Zeros lead, they dont follow.
Ex. 0.01 or 0.1 not 1.00 (could be mistaken for 100)

ac means before meals pc means after meals hs means hour of sleep = bedtime If a med was to be given pc and hs, that would be 4 times

Rounding Rules
1. Be as precise as possible/practical in the calculation process. If calculating using multiple formulas (i.e., ratio::proportional), round to the nearest hundredth (2 decimal places) with each step. For example, if converting pounds to kilograms, keep at least 2 decimals until you reach your solution. If calculating using dimensional analysis, do not clear your calculator when multiplying or dividing until you reach your solution.

 2. Round at the end of the calculation process. If the final answer is:
a. Greater than 1mL, round to the tenth decimal place. Ex: 2.44 = 2.4 2.45 = 2.5 2.49 = 2.5

b. Less than 1mL, round to the hundredths place. Ex: 0.082 = 0.08 0.084 = 0.08 0.085 = 0.09
c. Zeroes always Lead, never Trail. (Ex: 0.5, is correct, NOT .5 and 1 is correct, NOT1.0 for medication purposes.)

 3. Calculating Intravenous infusion rates:

a. For an infusion pump, (calculated to milliliters per hour, mL/hr), round to the nearest tenth if necessary.
Ex: preliminary answer = 32.8 mL/hr, then show answer as 33 mL/hr.

b. For gravity drip (calculated in drops per minute, gtt/min), use the above rounding rules, and then round to the whole number. The human eye cannot calculate a fraction of a whole drop.
Ex: If your preliminary answer is 20.2, show 20 gtt/min. If your preliminary answer is 20.45, show 20 gtt/min If your preliminary answer is 20.5, show 21 gtt/min.
A.D.N./Faculty/Forms and Resources/Dosage Calc/Rounding Rules Rev. 11-27-06, 7/11

 Questions?

Dimensional Analysis
What does that mean?
Using equivalents to change your unit of measurement Multiplying anything by one doesnt change the value 1000 mg = 1 g *1 cup = 240 mL 1000 mL = 1 L * 2.2 lb = 1 kg 1000 mcg = 1 mg *1 kg = 1000 g 1 gr = 60 mg *1 tsp = 5 mL

 The physician orders 10 mL of Milk of Magnesia. How many teaspoons is this equal to?

 The physician orders 10 mL of Milk of Magnesia. How many teaspoons is this equal to? Hint: use 1 tsp = 5 mL 10mL x 1 tsp = X 1 5 mL
X = 2 tsp

 The physician orders Digoxin 0.5 mg po qd. The medication available is Digoxin 0.125 mg/5mL. How many mL per dose will you administer to the patient?

 The physician orders Septra 0.25g po tid. Available is Septra 200 mg/5mL. How many mL will you administer to the patient per dose?

 Order: morphine gr 1/4 po q6h prn for pain. Available: morphine 15 mg per scored tablet. How many tablet(s) per dose will the nurse administer?

 Order: Keflex 425 mg po bid. Available: Keflex 125 mg/5mL. How many mL will the nurse administer per dose?

 The physician orders Biaxin (clarithromycin) 7.5 mg / kg PO q12h. If the drug strength is 250 mg / 5 mL, how many mL will you administer to a client who weighs 70 kg per dose?

 A drug is ordered 6 mg/kg po b.i.d. How many tablets will a client receive if he weighs 148 lbs and the strength of the tablet is 200 mg/tab?

 Keftab (cephalexin) 50 mg/kg PO in two equally divided doses is prescribed for a client who weighs 88 lb. If each tablet contains 500 mg, how many tablets of this medication will the client receive per dose?

 A patient is scheduled to receive 0.015 g of a drug by mouth every morning. The drug is available as 7.5 mg tablets. How many tablets would you administer?

 Sustacal 240 mL infuse over 2 hours via a feeding tube stat. Calculate the flow rate.

 850 mL IV fluid in 8 hours. Drop factor of IV tubing is 10 drops / mL. Calculate drip rate for gravity flow. Calculate rate with IV pump. What if the tubing where microdrip?

 The physician orders 500 mL of 0.45%NaCl (type of IV solution) to be infused in 4 hours. You will be using an infusion pump. Calculate the flow rate (to the nearest tenth) for this IV remembering you will be using an infusion pump.

 A patient has an order for aminophylline IVPB 250 mg in 250 mL D5W to infuse at 0.5 mg/kg/h. The patient weighs 80 kg. What is the flow rate in mL/h?

 A patient has an IV infusing at 25 gtt/min. How many mL/h is the patient receiving if the drop factor is 15 gtt/mL?

 Order: Ticar (ticarcillin disodium) 1 g IM q6h The package insert states to reconstitute each 1 g vial with 2 mL of sterile water for injection. Each 2.5 mL = 1 g. How many milliliters will you administer?

 The recommended dose of Cleocin (clindamycin) pediatric oral solution is 8 to 25 mg/kg/day in three to four equally divided doses. A child weighs 60 pounds.
A. Calculate the minimum safe daily dose in mg/d. B. Calculate the maximum safe daily dose in mg/d.