Math Calculation Information

Below are the Department of Prelicensure Nursing Universal Dosage Calculations

Directions:

Solve the following calculation problems. Only answers in the space provided for each

question will be graded. No partial credit will be given.

The answer must be labeled in correct units/terms. An incorrectly labeled or unlabeled

answer is considered incorrect.

You must show your formulas and calculations.

The Department of Prelicensure Nursing employs standard Systems International (SI)

Conversions and does not estimate.

Round all answers to the appropriate level of significance:

Pediatrics: round mg down to nearest hundredth; round milliliters down to nearest

tenth for oral dosing. Round IV pump rates down to nearest hundredth. Intake and

output and gtts/ml flow rates are expressed in whole numbers.

All other courses: round mg to nearest hundredth; round milliliters to nearest tenth

for oral dosing. Round IV pump rates to nearest hundredth. Intake and output and

gtts/ml flow rates are expressed in whole numbers.

Weight-based calculations:

Kilogram weights should be rounded immediately to the hundredths,

before proceeding with the problem.

One milliliter syringes are available (if needed) and all tablets are scored
1. The Joint Commission’s “Do Not Use” List prohibits writing a decimal with a value of less
than one without a leading zero preceding the decimal point.

Example: 0.25 instead of .25

2. The Joint Commission’s official “Do Not Use” List forbids the use of trailing zeros for
medication orders or other medication related documentation.

Example: 2 instead of 2.0

3. Rounding Decimals 1. To express an answer to the nearest tenth, carry the division to the
hundredths place. If the number in the hundredths place is 5 or greater, add one to the tenths
place. If less than 5, drop the number.

Example: 6.15 to the nearest tenth = 6.2 or 2.24 to the nearest tenth = 2.2

4. To express an answer to the nearest hundredth, carry the division to the thousandths place. If
the number in the thousandths place is 5 or greater, add one to the hundredths place. If less than
5, drop the number.

Example: 0.186 to the nearest hundredth = 0.19 or 0.654 to the nearest hundredth = 0.65

5. Units of measure: (Metric System)

Gram: measures weight. Gram may be written g

Liter: measures liquid. Liter may be written L

Meter: measures length. Meter may be written m

6. The metric system also uses prefixes to describe how much of the basic unit:

Kilo =1000 times the basic unit.

Centi =1/100 of the basic unit or 0.01.

Milli = 1/1000 of the basic unit or 0.001.

Conversion rules:
Conversion factors occur in multiples of 10.

To convert from one subunit to another, you must multiply or divide. a.

If you convert from a larger unit to a smaller unit, you multiply by the equivalency (1000)
or move the decimal point three places to the right.

Example: Convert 4 grams to ___ mg 4 x 1000 = 4000 mg or

move decimal point 3 spaces to right 4.(000) = 4,000 mg

If you must convert from a smaller unit to a larger one, then divide by 1000, or move the
decimal point 3 places to the left.

Example: Express 4000 milliliters in Liters. 4000/1000 = 4 L or

move decimal point three places to the left. 4000 = 4L

Metric Equivalents: Memorize these conversions to accurately calculate dosages:

Weight Volume Length

1 kg = 1,000 g 1 L = 1,000 mL 1 m = 100 cm

1 g = 1,000 mg 1 mL = 0.001 L 1 mm = 0.001 m

1 mg = 1,000 mcg

*mEq (milliequivalent) measures electrolytes and represents ionic activity of a

medication.

The Household System includes drops, teaspoons, tablespoons, and cups.

1. Teaspoon is written tsp or t.

2. Tablespoon is abbreviated to T, or tbsp.

3. Cup is represented by C.
 HOUSEHOLD EQUIVALENTS

UNIT ABBREVIATION EQUIVALENT

drop Gtt 15gtt = 1mL

teaspoon t (tsp) 1 tsp = 5ml

Tablespoon T (tbs) 1 T = 3t ; 15mL

Ounce (fluid) Oz 1 oz = 2 T; 30 mL

Cup C 1 cup = 8 oz; 240mL

Pint pt 1 pt = 2 cups; 160z

Quart qt 1 qt = 4 cups; 2pts

Gallon gal 1 gal = 4 qts

Pound lb 1 lb = 2.2kg
 IV Flow Rate Calculations
Intravenous fluids are most often ordered to be delivered at rates expressed in
milliliters per hour (mL/hr). The IV fluid is supplied in a bag, and delivered
through intravenous tubing connected to a catheter in the patient’s vein. The flow
of the intravenous fluids can be regulated by an infusion pump or by gravity using
a roller clamp on the tubing.

1. When an infusion device or pump is used to deliver the IV fluids, the rate is
calculated in mL/hr. Round IV pump rates to nearest hundredth.

2. When regulating intravenous fluids by gravity, the nurse must calculate the
appropriate flow in drops per minute (gtts/min) using a formula that incorporates
the size of the drops delivered by the tubing, or Drop Factor (DF). The nurse
counts the drops that fall for a minute in the drop chamber while adjusting the
clamp to regulate the flow of fluid into the patient.

Types of Tubing: Tubing is available in a variety drop factors.

1. Microdrip tubing delivers small drops, and ALWAYS has DF = 60 drops to a

mL or gtts/mL

2. Macrodrip tubing delivers larger drops, and can have a DF = 10, 12, 15, or 20
gtts/mL

(Remember, Microdrip is DF = 60, Macrodrip is everything else.)

Gravity rates (drops per minute), gtts/min must always be expressed in whole
numbers
 Formula For IV Pump (mL/hr)

Total # of mL ordered = mL/hr

Total # of hours ordered

Example: Order: 2000 mL LR to infuse in 10 hours

• Using formula for setting up calculation:

• Total number of milliliters ordered = mL/hour

Number of hours to run

Determine the amount of IV fluid ordered and divide this by the

number of hours

2000 mL = 200 mL/hr

10 hr

Answer: Set the IV Pump at 200 mL/hr

 Formula for Calculating IV drop factor; gtts

Example: Order is 1000 mL of D5/W to infuse 130 mL /hr.

Drop factor of tubing is 20 gtts = 1 mL. What is the gtt/min?

• Formula:
Total mL x drop factor (gtt/mL) = gtt/min
60 minutes

Example: Provider order 1000mL 0f LR to infuse over 8 hours. You have a

Macro drip tubing with a drop factor of 15 gtt/mL. Calculate how many
gtt/min to set the IV flow rate.

1000 mL x 15gtt/mL = 31.2 31 gtts/min

8(60)

Manually would have to count drops as you watch the clock for one minute
 Practice Problems

1. Doctor's order: tetracycline syrup 250 mg po Medication

label: tetracycline syrup 50 mg/mL How many mL should you
administer?
250 mg x mL = 5 mL
50 mg

2. Doctor's order: Gantrisin 250 mg po. Medication label:

Gantrisin 0.5 g/tab How many tabs would you administer?

Convert 250 mg to g: 250 mg = 0.25 g

Next set up formula:
0.25 g x 1 tab = 0.5 tab
0.5 g

Or

250 mg x 1g x 1 tab = 0.5 tab

1000 mg 0.5 g
3. Order: Coumadin 5 mg PO. Available: Coumadin 2.5 mg
tablets. What will the nurse administer?

4. Order: Theophylline 40 mg po qid. Available: Theophylline

elixir labeled 80 mg per 15 mL. How many mL will the nurse
administer?

5. Order: Atropine 0.1 mg SQ stat. Available: Atropine 400 mcg

per mL. How many mL will the nurse administer?

6. Order: Give 0.016 g of Medication X. Available: Medication

X 4 mg/mL. How many mL will the nurse administer?
Hint: you will need 2 conversion factors here:
4 mg/ mL and 1 g / 1000 mg.
7. The provider has ordered 200 mg of Ampicillin IV for your
patient. The Ampicillin is delivered in a 50 mL bag of normal
saline, with instructions to infuse in 20 minutes. Find the rate to
infuse the medication by gravity. The tubing has a drop factor of
10.
Total mL x DF = gtts/min
Total minutes

8. The provider orders 1000 mL Lactated Ringer’s Solution to

infuse over 24 hours. The nurse plans to use an infusion pump.
How many mL will the patient receive per hour?

9. If the nurse is unable to locate an infusion pump, and

administers the same fluids as ordered via gravity using tubing
with a DF of 15 gtts/mL, what are the gtts/min?
10. The provider orders 100 mL of Normal Saline to infuse over
20 minutes. The drop factor of the tubing is 15 gtts/mL.
a. If the IV is infused by gravity, what will the flow rate be in
gtts/min?

b. If the IV is infused via infusion pump, what will the mL/hr

rate be?

11. The Nurse Practitioner orders a bolus of 200 mL of Normal

Saline to be infused over 4 hours. The Nurse will use microdrip
tubing to infuse the fluid by gravity. To what rate should she
regulate the infusion?

12. The provider orders 1 unit (270 mL) of packed red blood
cells to infuse in 1.5 hours. How many mL will the patient
receive per hour?
Determining the Number of Hours an IV Will Run

Formula:

Number of milliliters ordered = Number of hours to run

Number of milliliters per hour

Example:
• How many hours will 500 mL of D5½NS run at 125
mL/hour?
Number of milliliters ordered = Number of hours to run
Number of milliliters per hour

500 mL = 4 hours
125 mL/hour
 Example

The provider has ordered 1,000 mL Lactated

Ringers to infuse over 8 hours. You have a
macrodrip tubing with a drop factor of 15 gtts/mL.
Calculate how many gtts/min to set as the IV flow
rate.
Formula:
Total mL x DF = gtts/min
Total minutes

1000 mL x 15 gtt/mL = 31.2 31gtts/min

8(60)

OR

Using the formula, 1,000 mL divided by 8 x 60 (since we have 8 hours times

60min/hr), then multiply by 15 gtts/min to equal 31.2, rounded to 31 gtts/min.

1000mL/8hr x 15 gtt/min = 1875 = 31.25 gtt/min

60 minutes = 1 hr

Answer = 31 gtts/min
13. 500 mL = _____L 0.12 kg = _________ g

600mg = _____g 0.736mg = _________mcg

15. 4 0z = ______mL

16. 110lbs = _____kg

17. 55cm = ____in

18. 2.4L = _____mL

19. 120mL = ____0z

20. 3 1/2pt = ____0z

21. Infants HC is 35.5 cm. How many inches is this?

22) 7 lbs 4 oz = ______kg

23) 24.7 kg = ______ lbs

24) convert 65lbs to kg

25) Ordered 40mg Lasix. Available is 20mg per mL. How many mL would you give?

26) Ordered 0.375mg p.o. of a medication. Available is 0.25mg per tab. How many
tabs would you give?
27) Ordered 0.1mg p.o. OD. Available 50mcg per tab

28) Ordered 0.05mg p.o. Available tablets labled 25mcg. How many tabs would
you give?

29) Ordered Demerol 50mg IM Q 4H PRN pain. Available Demerol 75mg per mL.
How many mL would you give?

30) Ordered Beneadry 30mg p.o. TID. Available is oral solution 12.5mg per 5mL.
How many mL’s would you give?

31) Ordered Cipro 0.5g p.o. Q 12H. Available is 250mg tablets.

32) Ordered Clindamycin 0.3g IV q 6H. Available is Clindamycin labeled 150mg per
mL. How many mL would you give?
33) Ordered Heparin 6,500 units subcutaneous Q 12H. Available Heparin 10,000
units per mL. ( express answer in hundredths)

34) Ordered Solu-Medrol 175mg IV OD. Available Solu-Medrol labeled 500mg per
8mL. How many mL do you draw up?

35) Ordered Strattera 0.1g p.o. OD. Available Strattera 100mg per tablet. How
many tablets would you give?

36) MD has a sliding Insulin order in place for your diabetic patient. Using the sliding
scale below, how many units of Insulin would be given to your patient with a
glucometer reading of 218mg/dl?

Insulin Coverage Glucose Reading

No coverage Glucose is < 160
2 units 161 - 180
4 units 181 - 200
6 units 201 - 220
8 units 221 - 240
Call MD >241

37)Instructions on a vial of Zyprexa states to reconstitute with 2mL of sterile water to

make a concentration of 10mg per 2 mL. After reconstituting the vial, How many mL
would you administer if the ordered dose was Zyprexa 5mg IM ?
28) Child has a BSA of 1.2m2 The drug comes 3mg per m2 How many mg would
you give?

29) Child weighs 12lbs 6oz. Recommended dose of IV fluconazole is 6mg/kg on the
first day followed by 3mg/kg once daily for the next 2 weeks. What is the first dose
the child would receive? What would the subsequent doses be?

30) Calculate in mL the I&0’s

Client had 8oz apple juice, 6oz gelatin, 1 cup of coffee, 1 ½ cups oatmeal, and IV
LR for 4 hours @ 125mL/hr.

Client had the following output: urine via Foley with 50mL each hour for 8hours,
diarrhea 400mL,and a JP drainage of 120mL for 4 hours.

31) Calculate patient’s Intake:

6oz orange juice ½ tuna sandwich

8oz milk with cereal 16oz soda
Gelatin 3x at 8oz each 4oz ice cream
Cup of soup 10 cookies
8oz Ensure
If the same patient was also on a tube feeding for 8 hours at 70mL/hr what would total
intake be?