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Medication Module

This document provides information on medication dosage calculations for nurses. It begins with basic rules and terminology for calculations involving metrics, conversions, rounding, and dosage units. It then discusses the principles of dosage calculations and provides examples of calculations for medication orders. Several practice exercises are included involving dosage calculations for various medications and intravenous infusions and fluids. The goal is to help nurses accurately calculate and administer medication dosages.

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100% found this document useful (1 vote)
841 views53 pages

Medication Module

This document provides information on medication dosage calculations for nurses. It begins with basic rules and terminology for calculations involving metrics, conversions, rounding, and dosage units. It then discusses the principles of dosage calculations and provides examples of calculations for medication orders. Several practice exercises are included involving dosage calculations for various medications and intravenous infusions and fluids. The goal is to help nurses accurately calculate and administer medication dosages.

Uploaded by

farhana
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Nursing Services

Medication Module
Introduction
Basic rules / terminologies
 Metric problems
 Conversions
 Rounding off
 Drug dosage units

Dosage calculation
Metric exercises
Drug dosage calculassions practice exercices
Medication Module

 Nurses have many responsibilities related to care of


patients; out of which one of the prime function ‟is
the safe calculation and accurate administration of
medications”.
This package consists of:
1. Basic rules for different calculations.
2. Dosage calculations of drugs / solutions.
3. Rate of IV administration.
4. IV infusion with specific concentration.
BASIC RULES / TERMINOLOGIES:

1. Whole number: A number without fractions,


example: 5, 17, 438, 10592

2. Decimals:
a) Decimal  Generally used to mean a number which
includes a decimal point example: 6.35, 0.748, 0.002, 236.5
b) Decimal places  Numbers to the right of decimal point.
example: 236.5 has 1 decimal place
6.35 has 2 decimal places 0.748 has 3 decimal places 0.0025
has 4 decimal places
BASIC RULES / TERMINOLOGIES
3. Multiplication by 10, 100 & 1000
To multiply by Move the decimal point

10 1 place right

100 2 places right

1000 3 places right


BASIC RULES / TERMINOLOGIES
BASIC RULES / TERMINOLOGIES

2.5% means 2.5 parts per 100 parts


BASIC RULES / TERMINOLOGIES
6. Converting metric units and mls of Blood
products in a bag:
1 gram (g) = 1000 milligrams (mg)
1 milligram (mg) = 1000 micrograms (μg)
1 liter (L) = 1000 Milliliters (ml)
1 kilogram (kg) = 1000 grams (g)
1 milligram (mg) = 1 cubic centimeter (cc)
1 Pack Cell = 300 ml
1 Whole Blood = 500 ml
1 FFP = 150 ml
1 PLT = 50 ml
BASIC RULES / TERMINOLOGIES
7. Rounding-off decimal numbers:
* Method: If the second decimal place is 5 or
more, then add 1 to the first decimal place as it is.
(i) Rounding-off to one decimal place:
Example:
 0.62 = 0.6
 1.75 = 1.8
 3.49 = 3.5
 9.6 = 10
BASIC RULES / TERMINOLOGIES
(ii) Rounding-off to two decimal places:
If the third decimal place is five or more then add one
to the second decimal place. If the third decimal place
is less than 5 then leave the second decimal place as it
is.
Example:
 0.827 = 0.83
 2.145 = 2.15
 0.694 = 0.69
 2.398 = 2.4
BASIC RULES / TERMINOLOGIES
(iii) Round off to three decimal places:
If the fourth decimal place is 5 or more then add one
to the third decimal place. If the fourth decimal place
is less than 5 then leave the third decimal place as it
is:
 0.7854 = 0.785
 0.9705 = 0.971
 1.5968 = 1.597
 1.9999 = 2
BASIC RULES / TERMINOLOGIES
8. Dosage calculations should be done in same units.
9. The Units for drug dosage calculation are:
a. For ml/hr calculation= ml/hr
b. For flow rate calculation= drops/min or gtt/min

c. For concentration calculation= mcg/ml or mg/ml


BASIC RULES / TERMINOLOGIES
II. DOSAGE CALCULATION:
The drug may be available in the form of a tablet, powder,
granules, capsules, liquid or solution to be administered.
Principles applied in calculating the ordered dosage is
same, regardless of the route of administration and the
form it is applied.

PRACTICE EXERCISE # 1
Medication order states: “Diclofenac Sodium 50mg q8hrly
I/M.” Available is 75mg/ 3 ml. How many ml/s will you
administer?
PRACTICE EXERCISE # 2 A

Medication order read: “Give syrup largactil 1.5mg/


kg/ day/ po every 6 hrly”. Available is 50mg/ 2 ml.
Child’s weight is 9.5kg Calculate the ml/s patient
will receive ?
PRACTICE EXERCISE # 2 B:
Medication order states “Give syrup Digoxin 5mcg/ kg
Po, stat.” Available is 50 mcg/ ml/s, patient’s weight is
9 kg. How many ml/s will you give?
III. RATE OF ADMINISTRATION OF
I.V FLUIDS
D.F stands for Drop factor or Set Calibration, that
is, drops in one ml of desired set.
 Regular set/ macro chamber = 15 gtt/ml
 Paediatric/ Burretol/ micro chamber = 60 gtt/ml
 Blood = 10 gtt/ml
PRACTICE EXERCISE # 3A:
Give Aminophyline250mg in 500cc of DW in 10 hrs.
Calculate cc/ hr and flow rate.
PRACTICE EXERCISE # 3 B:

Give Heparin 1500 units in 500 N/S over 5hours.


Calculate cc/hr, units/hr and flow rate using
micro chamber.
PRACTICE EXERCISE :

Medication order states: “Give GTN infusion at the


rate of 10mcg/ min. The dilution is to be made by
adding 10ml of GTN (10mg) in 90ml of normal saline.
(a) What will be the concentration of GTN in 1cc
solution?
(b) How many drops/ minute will the patient receive?
(Use paediatric set)
PRACTICE EXERCISE
PART 1:
a) Multiply
i. 0.68 X 10
ii. 0.975 X 100
iii. 3.7 X 1000
iv. 5.62 X 10
v. 77 X 100
vi. 825 X 1000
vii. 0.2 X 100
viii. 0.046 X 100
ix. 0.0147 X 1000
x. 0.006 X 10
PRACTICE EXERCISE
b) Divide (Write answers in decimal form)
i. 68/10
ii. 2.29/100
iii. 51.4/1000
iv. 916/10
v. 67.2/100
vi. 387/1000
vii. 8.94/10
viii. 0.707/100
ix. 307/1000
x. 7.5/10
PRACTICE EXERCISE
 c) Change to milligrams
 i. 4 g
 ii. 8.7 g
 iii. 0.69 g
 iv. 0.035 g
 v. 4.28 g

 d) Change to grams
 i. 6000 mg
 ii. 865 mg
 iii. 12.5 mg
 iv. 70 mg
 v. 5 mg
PRACTICE EXERCISE
 e) Change into microgram
 i. 0.195 mg
 ii. 0.6 mg
 iii. 75 mg
 iv. 0.08 mg
 v. 0.001 mg

 f) Change into milligrams


 i. 825 micrograms
 ii. 65 micrograms
 iii. 9.5 micrograms
 iv. 5 micrograms
 v. 20.8 micrograms
PRACTICE EXERCISE
 g) Change into milliliters
 i. 30 L
 ii. 1.5 L
 iii. 1.67
 iv. 0.8 L
 v. 0.75 L

 h) Change into Liters


 i. 4000 ml
 ii. 10000 ml
 iii. 625 ml
 iv. 95 ml
 v. 5 ml
PRACTICE EXERCISE
 i) Write each number correct to one decimal place
 i. 0.93
 ii. 1.22
 iii. 0.16
 iv. 2.65
 v. 8.02

 j) Write each number correct to two decimal places


 i. 0.333
 ii. 1.667
 iii. 0.875
 iv. 0.833
 v. 0.142
PRACTICE EXERCISE
k) Write each number correct to three decimal
places
i. 9.4863
ii. 1.5288
iii. 0.3113
iv. 2.8585
v. 0.1699
PRACTICE EXERCISE
 PART 1:
 1. Medication order states: dose of Flagyl is 2000mg q8h. Available is 2000mg/5ml. how
many ml will you give?
 2. Dose ordered is 160 mg PO. Available is 0.08gm/tab. How many tab/s will you give?
 3. Give gentamycin 4 mg/kg q8hrly. Available is 80 mg/2 ml. child’s weight is 5 kg. How
many ml will you give each time?
 4. IV fluid order states: give 1000 ml of Inj. D/S at 125 ml/hr. calculate the flow rate
using the pediatric set?
 5. Give digoxin 0.05 gm/kg IV OD. Available is 250 mg/2ml. patients weight is 3 kg. How
many mls will you give?
 6. Give 400,000 units of penicillin IV every 6 hourly. The available dose is a multiple
dose via labeled 1,000,000 units in 5 ml. how many ml/s will you give?
 7. Order states: 1500 ml of Inj 5% D/W is to infused in 10 hours with regular set.
Calculate
 a. How many ml/hr
 b. Flow rate
PRACTICE EXERCISE
 8. Give 1000 units of heparin in 500 ml of N/S to run over 06 hours.
 a. Calculate ml/hr?
 b. How many drops/min would you gve using the regular IV set?
 c. How many units of heparin patien will get each hour?
 9. Give lignocaine 2 mg/min. dilution strength is to be made by
adding 30 ml of lignocaine 600 mg in 70 ml of 5% D/W.
 a. Calculate concentration
 b. Calculate flow rate of pediatric set
 10. Give dopamine 20mcg/kg/min. patient weight is 80 kg. the
dilution is to be made by adding 10 cc of dopamine 250mg in 90 cc of
5% D/W.
 a. Calculate Concentration.
 b. Calculate flow rate using pediatric set.
PART 2:
 1. The recommended dose of Lasix is 2 mg/kg/day divided q8h. What
is the recommended single q8h dose for a 20 Kg child, when the
available is 20mg/ml?
 2. Order is to give Calcium Gluconate 400mg IV. Available is
1000mg/10ml. What will be the dosage?
 3. Give syrup Negram 450mg. Available is 250mcg/5ml. How many
ml/s will you give?
 4. Order is to give Salbutamol nebulizer 2.5 mg q4hrly. Available is
100mg/20ml. How much dose will you give to patient?
 5. Give Largectil 0.5gm/kg/day IV q 6 hrly. Patient weighs 39.5 Kg and
available is 500mg/2ml. What dose will you give to patient?
 6. Administer erythropoietin 75U/kg. Patient weighs 28 Kg. on hand
you have 2000U/0.5ml. How much dose should the patient
receive?
PART 2:
7. Administer Temgesic 100 mcg IM stat. If the available
drug comes in strength of 0.3 mg/ml, what dose will the
patient receive?
8. Order states: Give atropine 600mcg. You have Atropine
1mg/ml. How many ml/s will you administer to
patient?

9. Order states: Give morphine 0.5 mg/kg IV. Available is


15mg/ml and patient’s weight is 20kg. What will be the
dosage?
10. Medication order states: Give injection Flagyl 800 mg
IV q 8 hrly. Available is 500 mg/ 100 ml. How many ml
will you give in one dose?
PART 3
 1. The order is to give Mandol 1g q6h IVPB. Recommended dilution is 100cc of
compatible IV fluid. Recommended time of administration is 30 minutes.
Using micro chamber, determine the drops/min needed to give a 100 cc
piggyback in 30 minutes.
 2. The order is to give Aldomet 250 mg q6h IVPB. The medication is
diluted in 100 cc of 5% dextrose. Using 60 drops/cc, Find the rate in
drops/min needed to give the Aldomet over 1 hour.
 3. The physician has ordered Garamycin 80 mg q8h. The medication is
dissolved in 150 ml of normal saline. Using 15 drops/cc, find the rate in
drops/min needed to give the medication in 45 minutes.
 4. The patient is to receive 100 mg of Vibramycin q12h IVPB dissolved in 500
cc of IV fluid. The medication is to be infused over 3 hours. Determine the
rate of IV in cc/h.
 5. A patient is receiving heparin at a rate of 1500 units in 500 cc Normal Saline
over 5
 hours. Find the rate in cc/h, drops/minute (DF60gtts/ml) and units of
 heparin/hour.
PART 3
6. Give 2 pints packed cells (300 each) over 6 hours. Calculate
ml/hr and flow rate (DF 
10 gtts/ml)
7. Dilution contains injection KCl 20meq in 500ml of N/S.
Patients has to get 100ml/hr. How
much KCl and mls patient will receive in each hour?
8. Give ampicillin 1400mg q12 hrly. Available is 500mg/5 ml that
is further diluted in 250cc
N/S to be given over 1.5 hours. Calculate ml/hr and drops/
min using regular chamber.
9. Order states: Transfuse 20 FFPs (150 each) over 1.5 hrs.
Calculate cc/hrs and drops/min.
10. 10. Give injection Heparin 25000U in 1000ml N/S in 10 hours.
Calculate cc/hrs and drops/min using macro chamber.
PART 4:
 1. The order is to give Dobutrex (dobutamine) 250 mg in 250 cc of 5% dextrose
at a rate of 6
 μg/kg/min. The patient weighs 50 kg. Take out the concentration, and find
the rate of IV in drops/min using 60 gtts/cc.
 2. The order is to give Dopamine at a rate of 7 μg/kg/min. The available drug
is 200 mg dissolved in 500 ml. The patient weighs 130 lb. What will be the
concentration and drops/ minute, using the burretol?
 3. The order is for Intropin (dopamine) 13 ug/kg/min using 400 mg in 100 cc of
normal saline. The patient weighs 90 kg. Using 60 gtts/cc, find the
concentration and gtts/min.
 4. The patient is receiving Dopamine at a rate of 20 mcg/kg/min. The weight
of the patient is 65 kg. What will be the concentration of Dopamine (200)
mg in 100 ml. Find the drops/ minute, the patient is receiving by using
burretol set.
 5. A 56 Kg patient is receiving Dobutrex (dobutramine) 4 μg/kg/min through a
micro chamber. The drug is diluted as 350mg in 100cc Normal Saline. Find
the concentration and gtts/min that the patient is receiving.
ANSWER KEYS:
PART 1:
l) Multiply
i. 6.8
ii. 97.5
iii. 3700
iv. 56.2
v. 7700
vi. 825000
vii. 20
viii. 4.6
ix. 14.7
x. 0.06
ANSWER KEYS:

 m) Divide (Write answers in decimal form)


 i. 6.8
 ii. 0.0229/100
 iii. 0.0514
 iv. 91.6
 v. 0.672
 vi. 0.387
 vii. 0.894
 viii. 0.00707
 ix. 0.307
 x. 0.75

 n) Change to milligrams
 i. 4000 mg
 ii. 8700 mg
 iii. 690 mg
 iv. 35 mg
 v. 4280 mg
ANSWER KEYS:

 o) Change to grams
 i. 6 g
 ii. 0.865 g
 iii. 0.0125 g
 iv. 0.070 g
 v. 0.005 g

 p) Change into microgram


 i. 195 mcg
 ii. 600 mcg
 iii. 75000 mcg
 iv. 80 mcg
 v. 1 mcg
ANSWER KEYS:

 q) Change into milligrams


 i. 0.825 mg
 ii. 0.065 mg
 iii. 0.0095 mg
 iv. 0.005 mg
 v. 0.0208 mg

 r) Change into milliliters


 i. 30000 ml
 ii. 1500 ml
 iii. 1670 ml
 iv. 800 ml
 v. 750 ml

 s) Change into Liters


 i. 4 L
 ii. 10 L
 iii. 0.625 L
 iv. 0.095 L
 v. 0.005 L
ANSWER KEYS:

 t) Write each number correct to one decimal place


 i. 9.3
 ii. 12.2
 iii. 1.6
 iv. 26.5
 v. 80.2

 u) Write each number correct to two decimal places


 i. 03.33
 ii. 16.67
 iii. 08.75
 iv. 08.33
 v. 01.42

 v) Write each number correct to three decimal places


 i. 94.863
 ii. 15.288
 iii. 3.113
 iv. 28.585
 v. 1.699
ANSWER KEYS:
 PART 1:
 1. 50 ml
 2. 2 tabs
 3. 0.5 ml
 4. 125cc/hr
 5. 1.2 ml
 6. 2 ml
 7.
 a. 150 ml/hr
 b. 37.5-> 38 gtt/min
 8.
 a. 83.3 ml/hr
 b. 20.7-> 21gtt/min
 c. 166.6-> 167units/hr
 9.
 a. 6 mg/ml
 b. 20 gtt/min
 10.
 a. 2.5 mg/ml or 2500mcg/ml
 b. 38.4-> 38gtt/min
ANSWER KEYS:
 PART 2:
 1. 2ml
 2. 4 ml
 3. 9 ml
 4. 0.5 ml
 5. 79 ml
 6. 0.525 units
 7. 0.33 ml
 8. 0.6 ml
 9. 0.66 ml
 10. 160 ml

 PART 3:
 1. 200 gtt/min
 2. 100 gtt/min
 3. 50 gtt/min
 4. 166.6-> 167gtt/min
 5.
 a. 100cc/hr
 b. 100 gtt/min
 c. 300 u/hr
 6.
 a. 100 ml/hr
 b. 16.6-> 17 gtt/min
 7. 4 meq/hr
ANSWER KEYS:

 8.
 a. 41.6-> 42 gtt/min
 b. 166.6 ml/hr
 9.
 a. 2000 ml/hr
 b. 333 gtt/min
 10.
 a. 100 ml/hr
 b. 25 gtt/min
 PART 4:
 1.
 a. 1 mg/ml or 1000 mcg/ml
 b. 18 gtt/min
 2.
 a. 0.4 mg/ml or 400 mcg/ml
 b. 61.95-> 62 gtt/min
 3.
 a. 4 mg/ml or 4000 mcg/ml
 b. 17.5 -> 18 gtt/min
 4.
 a. 2 mg/ml or 2000 mcg/ml
 b. 39 gtt/min
 5.
 a. 3.5 mg/ml or 3500 mcg/ml
 b. 3.84-> 4 gtt/min
THANK YOU

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