 Is used when medication needs to enter the

bloodstream directly.
The rate of absorption and the onset of action are
increased because it bypassed the enzymatic
process of the digestive system and the first-pass
effect of the liver.
The Three (3) basic types of IV administration

 Long volume infusion. For fluid maintenance, replacement

or supplementation. Compatible drugs maybe mixed into
a large-volume IV container with fluids such as normal
saline or Ringer’s lactate.

 Intermittent infusion. Small amount of IV solution that is

arranged tandem or piggy-backed to the primary large-
volume infusion. Used to instill adjunct medications, such
as antibiotics or analgesics over a short period of time.
 IV bolus (push) administration. Concentrated dose
delivered directly to the circulation via syringe to
administer single dose medications. Bolus
injections maybe given through an intermittent
injection port or by direct IV push.
 Principle in choosing venipuncture site:
Avoid the use of vessels over bony prominences or
joints unless absolutely necessary.
In the elderly, the use of veins on the hands is
discourage because of fragility of the skin and veins
in this area.
In the infants and children, the site of choice are back
of the hand, dorsum of the foot, or the temporal region
of the scalp.
 Technique:
1. Wash hand thoroughly.
2. Position the patient appropriately.
3. Apply the torniquet using a slip knot 2-6 inches
above the site chosen.
4. Explain the procedure and position the patient
appropriately.
5. Cleanse the skin surface with antiseptic pledget
starting from injection site and working outward in
circular motion.
6. Let the area air dry.
7. Put on disposable gloves.
8. Provide tension on the skin surface to stretch the skin
and stabilize the vein.
9. Hold the needle bevel up, 45˚ angle and penetrate the
skin into the vein, then decrease the angle to 15˚ and
slowly advance the needle along the course of the vein.
When blood is established, connect the tubing to the
needle, release the tourniquet, cleanse the area, remove
gloves and anchor the needle and tubing to the arm or
hand with tape.
 Metric system
is the most widely used system of
measurement.
It is based on the decimal system, so all units
are determined as multiples of 10.
 Apothecary system
Uses the minim as the basic unit of liquid
measure and the grain as the basic unit for solid
measure
 Household system
It is the measuring system found in recipe book.
Uses teaspoon as basic unit for liquid measure
and pound for solid measure

 Avoirdupois system
 this system uses ounces and grain
METRIC AND ENGLISH UNIT OF MEASUREMENTS
UNIT EQUIVALENT UNITS OF MEASUREMENT

WEIGHT 1Kilogram (Kg) = 1000 g = 2.2 lb

1 gram (g, gm, G, Gm) = 1000 mg
1 milligram (mg) = 1000 mcg
1 microgram = 1000 ng
(nanograms)
VOLUME 1 Liter = 1000 ml
LENGTH 1 kilometer (km) = 1000 m
1 meter (m, M) = 100 cm
1 centimeter (cm) = 10 mm
2.54 cm = 1 inch
25.4 millimeters (mm) = 1 inch
1 measuring cup =8 oz 0r 240ml (1 oz = 30 ml)
1 medium-size glass =8 oz or 240 ml
1 ounce (oz) =2 tablespoons or 30 ml
1 tablespoon (T) = 3 teaspoons or 15 ml
1 teaspoon (t) =60 drops (60 gtt)
WEIGHT APPROXIMATE VOLUME APPROXIMATE
EQUIVALENT (S) EQUIVALENT (S)

1 grain Weight of a grain 1 minim Quantity of water

(gr) of wheat in a drop
60 mg or
1 grain
1 scruple 20 grains 1 fluid dram 60 minims

1 dram 3 scruples 1 fluid ounce 8 fluid drams

1 ounce 8 drams 1 pint 16 fluid

ounces

1 pound 12 ounces 1 quart 2 pints

1 gallon 4 quarts
METRIC APOTHECARY HOUSEHOLD

1 milliliter 15-16 minims 15-16 drops

4-5 milliliters 1 fluid dram 1 teaspoon or 60

drops

15-16 milliliters 4 fluid drams 1 tablespoon or 3-4

teaspoons
30 milliliters 8 fluid drams or 1 2 tablespoons
fluid ounce

240-250 milliliters 8 fluid ounces or 1 glass or cup

1/2 pint

500 milliliters 1 pint 2 glasses or 2

cups

1 liter 32 fluid ounces or 4 glasses, 4 cups

1 quart or 1 quart
1 milligram 1/60 grain

60 milligrams 1 grain

300-325 5 grains
milligrams

1 gram 15-16 grains

1 kilogram 2.2 pounds

 Fahrenheit to Celsius
 To convert Fahrenheit to Celsius, just subtract 32
and divide result by 1.8.

Formula:C= (F-32) / 1.8

 Celsius to Fahrenheit
 To convert Celsius to Fahrenheit, just multiply
by 1.8 and add 32.

Formula:F= 1.8 X C + 32
 BRAND NAME
- also known as Trade Name, written in large
letters

Generic Name
- The chemical name of a drug.
What is written on the drug label?
The formulation or the drug amount per tablet,
capsule or unit of liquid
Lot number
Expiration date
Proper storage of the drug
Whether it is a controlled substance
 D
__________ x V =A
H
Where: D is the desired dose (as ordered)
H is the drug on Hand (available)
V is the vehicle or volume of a drug form
(tablet, capsule, liquid [ml}])
A is the amount calculated to be given to
patient
 Example
Order: ampicillin (Polycillin) 0.5 g, P.O., bid
Available (drug label): Polycillin 250 mg/capsule
0.5 g = 0.500 mg or 500mg
500mg x 1 capsule = 500 = 2 capsules
250mg 250
 Ratio and Proportion Method
 The Ratio and Proportion Method has been around for years and is
one of the oldest methods utilized in drug calculations (as cited in
Boyer, 2002)[Lindow, 2004].
 Addition principals is a problem-solving technique that has no
bearing on this relationship, only multiplication, and division are
used to navigate through a ratio and proportion problem, not adding.
 Have on hand / Quantity you have = Desired Amount / x
 H:V::D:X and multiply means DV and Extremes HX.
 Where H – is the drug on hand
V – Vehicle or drug form
D – Desired dose
X – Unknown amount to give

KNOWN DESIRED
H :V :: D :X
means
extremes

X=
Multiply the means and the extremes
Solve for X; X is the divisor
Example: Order: Ampicillin 100mg, p.o. Q.I.D (4 times per day)
Available : Ampicillin 250 mg/5ml

a. Conversion is not needed

b. H : V :: D : X
250mg 5ml :: 100mg : x ml

means
extremes
250 X = 500
X = 500
250

X = 2 ml
Is a calculation method known as units and conversions
Steps for DA
1. Identify the unit/form (tablet, capsule, mL) of the drug
to be calculated. Place the unit/form to one side of the
equal sign (=). This is your desired unit/form.
2. Determine the known dose and unit/form from the
drug label that matches the unit/form of the desired
dosage. Place this on the other side of the equal sign
3. Continue with additional fraction using a
multiplication operation between each fraction until
all but that one unit you want is eliminated
4. Multiply the numerators and multiply the
denominators
5. Solve for x (unknown)
Example:
Order: Amoxicillin 500 mg PO q8h
Available: 250 mg capsule
How many capsules will the nurse administer per dose?
cap = 1 cap x 500 mg
250mg x cap
500 ; then x = 2 caps
250
Answer: 2 capsules
Steps
1. Convert pounds to kilograms; 2.2 lb = 1 kg
2. Determine the drug dose for the body weight by
multiplying as follows:
drug dose x body weight = patient’s
dose
3. Follow the basic formula, ratio and proportion, or
dimensional analysis method to calculate the drug
dosage.
Example:
Order: Fluorouracil 12 mg per kg per day IV for
patient who weighs 176 lb
Available: 2 vials of fluorouracil 50 mg per ml (500
mg/10 mL)
How many mL should the nurse administer per day?
 Basic Formula
176 lb / 2.2 lb = 80 kg
12 mg x 80 kg = 960 mg per day
= 960 mg x 1 mL
50 mg
= 19. 2 mL
 Dimensional analysis
mL = 1 mL x 12mg x 1kg x 176 lb
50mg 1 kg 2.2 lb x mL
= 2112 mL
110 mL
= 19.2 mL
1. Continuous IV infusion
- replaces fluid loss, maintains fluid
balance, and is a vehicle for drug administration.
2. Intermittent IV administration
- is primarily used for giving drugs
1. Knowledge of intravenous sets and their drop factors
2. Calculating IV flow rates
3. Mixing and diluting drugs in IV fluids
4. Gathering equipment
5. Knowledge of the drugs and the expected and
untoward reactions
 Drop factor – the number of drops per milliliter,
usually printed on the packaging cover of the IV set

1. MACRODRIP SETS - sets that deliver large drops

per milliliter (10-20 gtt/ml)
2. MICRODRIP/MINIDRIP SETS – sets that deliver
small drops per milliliter (60 gtt/ml)
 Keep Vein Open (KVO) or To Keep Open (TKO)
- intravenous fluids that are given at slow rate
- usually regulated to deliver 10 ml/hr
Indication: suspected or potential emergency situation
for rapid administration of fluids and drugs and the
need for an open line to give IV drugs at specified
hours.
METHOD 1: Three Step
1. Amount of Solution = ml/hr
Hours to administer

2. Milliliters per hour = ml/min

60 minutes
3. mL/min x drops per mL of IV set = drops/min
(gtt/min)
METHOD 2: Two-Step
1. Amount of fluid = ml/hr
Hours to administer

2. ml/hr x drops per milliliter (IV set) = gtt/min

60 minutes
METHOD 3: One-Step
Amount of Fluid x drops per ml (IV set) = gtt/min
hours to administer x mins per hour (60)
Example:
Order: 1000 ml of D5 ½ NSS to infuse over 12 hours
Available: macroset with 10 gtt/ml and a microset
with 60 gtt/ml
a. would you use a macroset or microset?
b. calculate the flow rate in drops per minute
according to the IV set that you selected.
a. Microdrip set since the client is to receive 83
ml/hr
b. 1000 = 83 ml/hr
12
83 ml/hr x 60 drops = 83 gtt/min
60 minutes
Order : 3L of IV solutions to infuse over 24 hours
1L of D5 W and 2L of D5 ½ NSS
a. One liter is equal to how many milliliters?
b. Each liter should run for how many hours?
c. The institution uses a set with a drop factor of 15
gtt/ml. how many drops per minute should the
client receive?
a. 1000 ml
b. 8 hours
c. 1000 = 125 ml/hr
8
125 ml/hr x 15 gtt = 125 = 31 gtt/min
60 minutes 4
Exercise:
Order : 250 ml of D5W to keep vein open, 10 gtt/ml
a. What type of IV set would you use?
b. Determine how many drops per minute the client
should receive
a. Microdrip set
b. 250 = 10 ml/h
24
10 ml/h x 60 gtt = 10 gtt/min
60 minutes
Computation for Total infusion time and minutes
Order: 1000 ml of 0.9% NaCl to infuse at 75 ml/hr
What is the total infusion time in hours and minute?
time (h and min) = 1h x 1000 ml
75 ml x time
= 1000
75
= 13.33 h 0.33 h x 60 min = 19.8 min = 20 min
Answer: Total infusion time is 13 hours and 20
minutes
 DRUG COMPUTATIONS
1. A patient is scheduled to receive 0.8g P.O. of
the analgesic Ibuprofen TID. Each tablet is
labeled 400mg. How many tablets should the
nurse administer with each dose?

0.8g x 1000mg x 1tab = 800tab = 2tablets

1g 400mg 400

2. A patient is to receive 0.25mg P.O. of Lanoxin.

The bottle is labeled 1ml=50mcg. How many
ml of this antiarrhythmic should be
administered ?
0.25mg x 1000mcg x 1ml = 250ml = 5ml
1mg 50mcg 50
 INTRAVENOUS CALCULATIONS
Formulas:
A. Flow Rates

Total volume x gtt factor (DF)

-------------------------------- = gtts per min
Time (in minute)

B. Infusion Time
Total Volume to infuse
----------------------------------- = Infusion Time
mL per hour being infused
Infusions Ordered by Unit Dosage per Hour

Calculation of these problems requires a two- step process:

1. Determine the amount of medication per 1 mL.
2. Determine the infusion rate or mL per hour.

Step 1
Known amount of medication in solution
------------------------------------------------------- = Amount of medication per mL
Total volume of diluent
Step 2
Dose per hour desired
------------------------------- = Infusion rate or ml per hour
Concentration per mL
 Example Problem:
 Order: Continuous Regular Insulin by IV at 10 units per hour
 Available: IV bag of 100 mL NS with 50 units Regular Insulin
 How many Ml per hour are required to administer the correct dose?
 Step 1: Known amount of medication in
Amount of medication per
solution =
mL
Total volume of diluent

50 units
= 0.5 units per 1mL
100 ml
1 mL = 0.5 units

Step 2: Dose per hour desired

= Infusion rate or ml per hour
Concentration per mL

10 units

0.5 units per mL = 20 mL per hour

ESTIMATING PEDIATRIC DOSAGES

CLARK’S RULE: Uses child’s weight in LB

WEIGHT IN LB
--------------------------- x ADULT DOSE = CHILD’S
150 lb DOSE
FRIED’S RULE: uses age in months
AGE IN MONTHS
------------------------------- x ADULT DOSE = CHILD’S
150 DOSE

YOUNG’S RULE: uses age in years (1-12 years)

AGE IN YEARS
------------------------------- x ADULT DOSE = CHILD’S
AGE IN YEARS + 12 DOSE
A. TABLET
D/S = No. of Tablets
B. MIXTURES AND SOLUTIONS
D/S X STOCK VOLUME = Amt. of solution to be given
C. IV RATE
1. ml/hr or min = Total IV Volume
Time (hour or min)
2. gtts/min = Total IV Volume x DF (drop factor)
Time
3. Remaining time of Infusion = Vol. remaining (in ml) X DF
drops per minute