Dosage calculation proficiency module review(1)

DOSAGE CALCULATION PROFICIENCY MODULE Table of contents

INTRODUCTION

………………………………………………………………………...

1

……………………………………………………... 2

NURSING DEPARTMENTAL GUIDE

PRACTICE PROBLEMS AND ANSWERS Non-conversion problems ……………………………………………………...

Conversion problems …………………………………………………………..

Diluent problems ………………………………………………………………..

Label Problems …………………………………………………..

IV Problems ……………………………………………………………………...

Pediatric Problems ……………………………………………………………...

Advanced IV Problems ………………………………………………………..

3 8 13 18 26 31 39

PRACTICE TESTS Practice I Test (Basic) Practice II Test (Basic) Practice III Test (Advanced) Practice IV Test (Advanced)

……………………………………………………………

44

…………………………………………………………..

49

…………………………………………………………. 54 …………………………………………………………. 58

ADDENDUM: remediation forms

………………………………………………………

65

ADDENDUM: Answers Using Dimensional Analysis Format……Located on Answer Pages

DOSAGE CALCULATION PROFICIENCY MODULE Introduction This Dosage Calculation Proficiency Module has been designed to help you to achieve proficiency at working nursing math problems. In your module you will find: a dosage calculation test plan; equivalents accepted by the Nursing Department; sample practice problems of each type; the answers to problems; and finally, practice test for each level.

The answer keys to the practice problems give not only the correct answer but also the way in which that the answer was derived, using ratio and proportion method and dimensional analysis. It is noted that the Nursing department accepts both ration and proportion and dimensional analysis method in computation of these problems. It is important that the student demonstrate the correct steps in whatever process they use, and that they get the correct answer.

Revised November 2011, August 2012

1

NURSING DOSAGE CALCULATION GUIDE Conversions: 1. Kilograms and Grams:

1 kg = 1000g

2.

Grams and milligrams:

1 g = 1000 mg

3.

Milligrams and micrograms:

1 mg = 1000 mcg

4.

Ounces and milliliters:

1 oz = 30 mL

5.

Teaspoon and milliliters:

1 tsp. = 5 mL

6.

Tablespoon and milliliters:

1 Tbsp. = 15 mL

7.

Liter and milliliters:

1 L = 1000 mL

8.

Kilogram and pounds:

1 kg = 2.2 lbs.

9.

Cups and ounces:

1 c = 8 oz

10 .

Milliliters and cubic centimeters

1 mL = 1 cc

Rounding Guidelines 1.

2.

3.

4.

5.

6.

General Rounding Rule: If the number following the rounding point is 5 or greater, the number at the rounding point will be raised. (Examples: 0.7284 rounds to 0.73; 1.567 rounds to 1.6.) If the numbers following the rounding point is less than 5, the number at the rounding point remains the same. (Examples: 3.9248 rounds to 3.9; 0.984 rounds to 0.98.)

Injectables/PO liquids (mL): (PO, IM, Subcutaneous, I.V., I.V.P.) If the final answer is < 1 mL, round to nearest hundredth. (EX: 0.01) If the final answer is > 1 mL, round to nearest tenth. (EX: 1.1) Do not round Tablespoons or teaspoons.

IV Fluid Rates: Unless Otherwise directed: Fractions of drops/min must be rounded to the whole number.

Fractions of mL/hr must be rounded to the nearest tenth. (EX: 0.1) Milligrams or micrograms: Final answers in mg or mcg are rounded to whole number, unless otherwise directed.

Leading Zeros/Trailing Zeros: If final answer is <1 a zero must be placed before the decimal.

No zero should be placed at the end of the numeric answer. (EX: 0.2 or 1.2) Weights: When converting pounds to kilograms (lbs to kg), round to the hundredths. (ex: 23.12 kg)

2

PRACTICE PROBLEMS NON-CONVERSIONS 1.

The physician orders 65 mg of Demerol IM you have a vial of 50 mg per mL. How many mL should be administered?

2.

Ordered is 0.75 g of a medication to be given IM you have a vial containing 2g/5mL of the medication. How many mL should be given?

3.

A patient is to receive 0.25 mg of Lanoxin. You have a scored tablet of 0.5 mg.

How many tablets should you give?

4.

Amikin is available in a vial labeled 500 mg in 2 mL. 150 mg Amikin has been prescribed IV. How many mLs should you withdraw from the vial in preparing to administer the drug?

5.

The physician orders 1.2 million units of Penicillin. You have a vial of Penicillin 500,000 units per mL. How many mL should be given?

3

6.

Ordered is 15 mEq KCL to be added to an IV. You have a vial of KCL 40 mEq per 20 mL. How many mL should be given?

7.

The physician orders 55 mg of a medication to be given P.O. You have available the medication labeled 60 mg per mL. How many mL will be administered?

8.

The physician has prescribed 3 mg of Coumadin P.O. The pharmacy sends Coumadin 2mg tablet. How many scored tablets should you administer?

9.

Ordered is 75 mg of Ceclor IM. In the medication refrigerator is a bottle of Ceclor labeled 250mg/5mL with the patientâ&#x20AC;&#x2122;s name and MR number. How many mLs should be given?

10.

The physician orders 6,000 units of Heparin. There is a unit dose vial in the patientâ&#x20AC;&#x2122;s drawer labeled: Heparin sodium 5,000 units/mL. How many mL should be administered?

4

ANSWERS TO THE NON-CONVERSION PROBLEMS IN RATIO AND PROPORTION 1.

65 mg: x mL = 50 mg: 1 mL 50 x = 65 x = 65 50 x = 1.3 mL

2.

0.75 Gram: x mL = 2 Grams: 5 mL 2 x = 3.75 x = 3.75 2 x = 1.875 = 1.9 mL

3.

0.25 mg: x tab = 0.5 mg: 1 tab 0.5 x = 0.25 x = 0.25 0.5 x = 0.5 or ½ tab

4.

150 mg: x mL = 500 mg: 2 mL 500 x = 300 x = 0.6 mL

5.

1,200,000 units: x mL = 500,000 units: 1 mL 500,000 x = 1,200,000 x = 12 = 2.4 mL 5

6.

15 mEq: x mL = 40 mEq: 20 mL 40 x = 300 x = 300 40 x = 7.5 mL

5

7.

55 mg: x mL = 60 mg: 1 mL 60 x = 55 x = 55 = 0.92 mL 60

8.

3 mg: x tabs = 2 mg: 1 tab 2x=3 x = 1 ½ tab or 1.5 tab

9.

75 mg: x mL = 250 mg: 5 mL 250 x = 375 x = 375 250 x = 1.5 mL

10.

6,000 units: x mL = 5,000 units: 1 mL 5,000 x = 6,000 x = 6,000 5,000 x = 1.2 mL

6

ANSWERS TO THE NON-CONVERSION PRACTICE PROBLEMS IN DIMENSIONAL ANALYSIS 1. 65 mg x 1 mL = 1.3 mL 1 50 mg 2. 0.75 g 1

x

5 mL = 3.75 mL = 1.875 = 1.9 mL 2g 2

3. 0.25 mg x 1 tab = 0.25 tab = 0.5 or ½ tab 1 0.5 mg 0.5 4. 150 mg x 2 mL = 6 mL = 0.6 mL 1 500 mg 10 5. 1,200,000 Units x 1 mL = 2.4 mL 1 500,000 Units 6. 15 mEq x 20 mL = 300 = 7.5 mL 1 40 mEq 40 7. 55 mg x 1 mL = 55 = 0.92 mL 1 60 mg 60 8. 3 mg x 1 tab = 3 = 1.5 tab or 1 ½ tab 1 2 mg 2 9. 375 mg x 5 mL = 375 = 1.5 mL 1 250 mg 250 10. 6000 Units x 1 mL = 6000 = 1.2 mL 1 5000 Units 5000

7

PRACTICE CONVERSION PROBLEMS 1.

The physician orders 225 mg of Ampicillin. You have available a vial of 1 gram Ampicillin per 5 mL. How many mLs should be administered?

2.

A patient is to receive 50 mg of medication. You have a bottle labeled 5 mg/mL. How many teaspoons should the patient take?

3.

To give 0.35 g of drug from a vial of 750-mg/ 5 mL, how mL should you give?

4.

A patient has ordered 30 mL of Maalox. How many tablespoons should he take?

5.

Crystodigin 300mcg is ordered P.O. You have Crystodigin 0.15-mg tablets. How many tablets should you administer?

6.

Ordered is 1.75 g of Keflex to be added to an IV. You have a vial of Keflex 500 mg per mL. How many mL of Keflex will be given?

8

7.

0.25 g of Diabinese has been prescribed P.O. Diabinese 100 mg is available in scored tablets. How many scored tablets should be administered?

8.

Solucortef 0.21 g is ordered. On hand is solucortef 200 mg per mL. How many mL will you give?

9.

Your patient is to take 0.065 mg Lanoxin daily. Lanoxin 125 mcg/mL is available.

How many mL should the patient receive?

10.

A newborn weighs 6.6 lb. How much does the newborn weigh in kilograms?

11.

Synthroid 0.15 mg is ordered. It is available as 125-mcg/5 mL. How many mL will you give?

12.

Hydrocortisone 12 mg IM is ordered. It is available as 0.1 g per 2 mL. How many mL will you administer?

9

ANSWERS TO PRACTICE CONVERSION PROBLEMS IN RATIO AND PROPORTION

1.

a) Convert grams to milligrams 1000 mg: 1 Gram = x mg: 1 Gram 1000(1) = 1 x x = 1000 mg

2.

x = 1.125 = 1.1 mL

a) 50 mg: x mL = 5 mg: 1 mL 5 x = 50 x = 50 5

b) Conversion of mLs to teaspoons 5 mL: 1 tsp. = 10 mL: x tsp.

5 x = 10 x = 10 5 x = 2 teaspoons

x = 10 mL 3.

b) 1000 mg: 5 mL = 225 mg: x mL 1000 x = 1125 1000 1000

a) Convert Grams to Milligrams 1 g: 1000 mg = 0.35 g: x mg

b) 350 mg: x mL = 730 mg: 750 mg: 5 mL 750 x = 1750

x = 350 mg x = 2.3333 = 2.3 mL 4.

a) Convert mL to Tablespoons 1 Tbsp.: 15 mL = x Tbsp.: 30 mL 15 x = 30 x = 30 15 x = 2 Tbsp.

5.

a) Convert mg to mcg: 1 mg: 1000 mcg = 0.15 mg: x mcg x = 150 mcg

b) 150 mcg: 1 tab = 300 mcg: x tab 150 x = 300 x = 2 tabs

6.

a) Convert Grams to milligrams 1 g: 1000 mg = 1.75 g: x mg

b) 1750 mg: x mL = 500 mg: 1 mL 500 x = 1750 x = 1750 500 x = 3.5 mL

x = 1750 mg

7.

a) Convert Grams to milligrams 1 g: 1000 mg = 0.25 g: x mg (1) x = (1000) 0.25

b) 100 mg: 1 tab = 250 mg: x tab (100) x = (1) 250 x = 250 100 x =2 ½ tabs or 2.5 tabs

x = 250 mg

10

8.

a) Convert grams to milligrams 1 g: 1000 mg = 0.21 g: x mg

b) 210 mg: x tabs = 200 mg: 1 mL 200 x = 210

x = 210 mg 9.

x = 1.05 = 1.1 mL

a) Convert mg to mcg: 1 mg: 1000 mcg = 0.065 mg: x mcg x = 65 mcg

10.

b) 65 mcg: 1 tab = 125 mcg: 1 mL 65 = 125 x x = 0.52 mL

a) Convert lbs. to kg 1 kg: 2.2 lb. = x kg: 6.6 lb.

2.2 x = 3 kg

11.

12.

a) Convert mg to mcg: 1 mg: 1000 mcg = 0.15 mg: x mcg x = 150 mcg a) Convert g to mg: 1 g: 1000 mg = 0.1 m: x mg

b) 125 mcg: 5 mL = 150 mcg: x mL 125 x = 750 x = 6 mL b) 100 mg: 2 mL = 12 mg: x mL 100 x = 24

x = 100 mg

x = 0.24 mL

11

ANSWERS TO CONVERSION PROBLEMS IN DIMENSIONAL ANALYSIS 1.

225 mg x 1 g x 1 1000 mg

5 mL = 1125 = 1.125 mL = 1.1 mL 1g 1000

2.

50 mg x 1 mL x 1 tsp = 50 = 2 tsp 1 5 mg 5 mg 25

3.

0.35 g x 1000 mg x 5 mL = 1750 = 2.333 mL = 2.3 mL 1 1g 750 mg 750

4.

30 mL x 1 Tbsp = 30 = 2 Tbsp 1 15 mL 15

5.

300 mcg x 1 mg x 1 tab = 300 = 2 tabs 1 1000 mcg 0.15 mg 150

6.

1.75 g x 1000 mg x 1 mL = 1750 = 3.5 mL 1 1g 500 mg 500

7.

0.25 g x 1000 mg x 1 tab = 250 = 2.5 or 2 ½ tabs 1 1g 100 mg 100

8.

0.21 g x 1000 mg x 1 mL = 1 1g 200 mg

9.

0.065 mg x 1000 mcg x 1 mL = 65 = 0.52 mL 1 1 mg 125 mcg 125

10.

6.6 lbs x 1 kg 1 2.2 lbs

11.

0.15 mg x 1000 mcg x 5 mL = 750 = 6 mL 1 1 mg 125 mcg 125

12.

12 mg x 1 g x 2 mL = 24 = 0.24 mL 1 1000 mg 0.1 g 100

210 = 1.05 mL = 1.1 mL 200

= 3 kg

12

PRACTICE DILUENT PROBLEMS 1. The physician orders 175 mg IM of Keflin. On hand is a 10-mL vial of Kelfin, which contains 1 g of the drug. Instructions are to add 4 mL of sterile water to obtain a solution of 500 mg in 2.2 mL. How many mL will the nurse administer?

2. The physician orders Ampicillin 75 mg IM. The drug is contained in a 3-mL vial, which has directions to add 1.8 mL of diluent to obtain 250 mg in 1 mL. How many mL will the nurse administer?

3. The physician orders Amoxil 125 mg P.O this drug us supplied in a 10-mL bottle. Reconstitution with sterile water yields a solution of 250 mg per 5 mL. The nurse should give how many mLs?

4. The physician orders Polycillin 650 mg IM. The drug is supplied in a vial to which the nurse adds 6.8-mL diluent to the 2 g powdered drug. The resulting solution contains 250 mg/mL. How many mL will the nurse administer?

5. An infant is ordered to receive Staphcillin 125mg IM qid. On hand is a 5-mL vial containing 1 g Staphcillin in powder form. Adding 1.5-mL diluent yields a concentration of 1 g/2 mL reconstituted solution. How many mL will the nurse give the infant?

13

6. The physician ordered Pyopen 1725-mg I.V. q 6h. Available is a 5-g vial of Pyopen to which sterile water should be added to dissolve the drug. Adding 9.5-mL diluent yields 5-g/10 mL of reconstituted solution. How many mL will the nurse administer?

7. The physician ordered Staphcillin 300-mg q 4h. Available are 10-mL vials of Staphcillin containing the drug in dry form. Adding 5.7-mL diluent yields a concentration of 175 mg/mL. How many mL should the nurse administer?

8. The doctorâ&#x20AC;&#x2122;s order reads Prostaphlin 450-mg IM q 6h. On hand are 10-mL vials of Prostaphlin 1 g in dry form. If the nurse adds 5.7-mL diluent, every 1.5-mL then contains 250 mg. How many mL will the nurse give?

9. A one-month-old is ordered to have Keflin 75-mg IM q 6h. Available are 10 mL vials containing Keflin 1 g in dry form. Adding sterile water yields a solution of 1000 mg in each 4.4 mL. How many mL will the nurse administer?

10. Vibramycin 125 mg is ordered by the physician to be given by I.V, The drug is supplied in a 100-mg vial container. After reconstituting the dry powder form with sterile water, the resulting solution is 10 mg/mL. How many mL will the nurse add to the IV solution?

14

ANSWERS TO DILUENT PROBLEMS IN RATIO AND PROPORTION 1.

500 mg: 2.2 mL = 175 mg: x mL 500 x = 385 x = 385 500 x = 0.77 mL

2.

250 mg: 1 mL = 75 mg: x mL 250 x = 75 x = 75 250 x = 0.3 mL

3.

250 mg: 5 mL = 125 mg: x mL 250 x = 625 x = 625 250 x = 2.5 mL

4.

250 mg: 1 mL = 650 mg: x mL 230 x = 650 x = 650 230 x = 2.6 mL

5.

Convert g to mg we know that 1g = 1000 mg, so: 1000 mg: 2 mL = 125 mg: x mL (1000 )x = (2) 125 x = 250 1000 x = 0.25 mL

15

6.

Convert 5 g to 5000 mg, then 5000 mg: 10 mL = 1725 mg: x mL 5000 x = 17250 x = 17250 5000 x = 3.45 = 3.5 mL

7.

175 mg: 1 mL = 300 mg: x mL 175 x = 300 x = 300 175 x = 1.714 = 1.7 mL

8.

250 mg: 1.5 mL = 450 mg: x mL 250 x = 675 x = 675 250 x = 2.7 mL

9.

1000 mg: 4.4 mL = 75 mg: x mL 1000 x = 330 x = 330 1000 x = 0.33 mL

10. 10 mg: 1 mL = 125 mg: x mL 10 x = 125 x = 125 10 x = 12.5 mL

16

ANSWERS TO DILUENT PROBLEMS IN DIMENSIONAL ANALYSIS 1.

175 mg x 2.2 mL = 385 mL = 0.77 mL 1 500 mg 500

2.

75 mg x 1 mL = 75 mL = 0.3 mL 1 250 mg 250

3

125 mg x 5 mL = 625 mL = 2.5 mL 1 250 mg 250

4.

650 mg x 1 mL = 650 mL = 2.6 mL 6 250 mg 250

5.

125 mg x 1 g x 2 mL = 250 mL = 0.25 mL 1 1000 mg 1g 1000

6.

1725 mg x 1 g x 10 mL = 17250 mL = 3.45 mL = 3.5 mL 1 1000 mg 5 g 5000

7.

300 mg x 1 mL = 300 mL = 1.714 mL = 1.7 mL 1 175 mg 175

8.

450 mg x 1.5 mL = 675 mL = 2.7 mL 1 250 mg 250

9.

75 mg x 4.4 mL = 330 mL = 0.33 mL 1 1000 mg 1000

10.

125 mg x 1 mL = 125 = 12.5 mL 1 10 mg 10

17

LABEL PRACTICE Instructions: Calculate drug dosage of each of the drug orders given. The labels are provided on the following pages.

1.

Vistaril 35 mg IM stat.

Give: ____________

2.

Tobramycin 65 mg IM q 8h.

Give: ____________

3.

Vitamin B12 0.5 mg IM stat.

Give: ____________

4.

Atropine 300 mcg SC stat.

Give: ____________

5.

Humulin R regular U-100 22 units SC stat.

Give _____________

6.

Heparin 8000 units SC q 12h, Give _____________

18

7.

Meperidine (Demerol) 75 mg IM q 6h.

Give _____________

8.

Dexamethasone (Decadron) 4mg IM q8h.

Give _____________

9.

Methylprednisolone(Solu-Medrol) 200 mg IM stat.

Give _____________

10.

Nafcillin 500 mg IM q 6h.

Give _____________

11.

Furosemide (Lasix) 40 mg IV q day.

Give _____________

12.

Terbutaline 0.25 mg SC q 30 minutes x 2 doses.

Give _____________

19

Medication Labels:

20

21

22

ANSWERS TO LABEL PRACTICE 1.

Vistaril 35 mg IM stat.

Give: ___0.7 mL_______

35 mg x 1 mL x = 35 mL = 0.7 mL 1 50 mg 50

2.

Tobramycin 65 mg IM q 8h.

Give: ____1.6 mL_____

65 mg x 2 mL = 130 mL = 1.625 mL = 1.6 mL 1 80mg 80

3.

Vitamin B12 0.5 mg IM stat.

Give: ____0.5 mL_____

0.5 mg x 1 mL = 0.5 mL 1 1 mg

4.

Atropine 300 mcg SC stat.

Give: __0.75 mL______

300 mcg x 1 mg x 1 mL = 300 mL = 0.75 mL 1 1000 mcg 0.4 mg 400

5.

Humulin R regular U-100 22 units SC stat.

Give _preferred ->_22 units__or O.22 mL <-not optimum, should always use insulin syringe_

6.

Heparin 8000 units SC q 12h, Give __0.8 mL________

8000 units 1

x

1 mL = 8000 mL = 0.8 mL 10000 units 10000

23

7.

Demerol 75 mg IM q 6h.

Give ___0.75 mL_______ 75 mg x 1 mL = 75 = 0.75 mL 1 100 mg 100

8.

Decadron 4mg IM q8h.

Give ___1 mL_______ 4mg x x 1 mL = 4 mL = 1 mL 1 4 mg 4

9.

Methylprednisolone 200 mg IM stat.

Give ___3.2 mL_____ 200 mg x 1 mL = 200 = 3.2 mL 1 62.5 mg 62.5

10.

Nafcillin 500 IM q 6h.

Give _2 mL_________ 500 mg x 1 mL = 500 = 2 mL 1 250 mg 250

11.

Lasix 40 mg IM q day.

Give ___4 mL_____ 40 mg x 2 mL = 60 mL = 4 mL 1 20 mg 20

12.

Terbutaline 0.25 mg SC q 30 minutes x 2 doses.

Give ____0.25 mL___ 0.25 mg x 1 mL = 0.25 mL 1 1 mg

24

PRACTICE IV PROBLEMS

1.

If 0.5 L of blood is to be administered over a 3-hr period, what should the flowrate be in mL/hr?

2.

If 1.5 L of fluid is to be absorbed over a 10-hr period, what should be the flowrate in mL/hr?

3.

A two-year-old is to receive 1000 mL of fluid over a 24-hr period. If you have a microdrop tubing, what is the flow-rate in mcgtts/min?

4.

If 2 L of fluid is to be administered over a 16-hr period, how many mL per hour will the patient receive?

5.

A person is to receive 1000 mL over a 4-hr period, what should the flow-rate be if the drop factor is 15 gtts/mL?

6.

Ampicillin 500 mg in 100 mL of fluid is to be administered in 1 hr. How fast should the nurse run the IV considering the drop factor is 15 gtts/mL?

25

7.

A burned patient is to receive 3 L of fluid in a 4-hr period. What should be the flow-rate in mL per hour?

8.

The specified solution is 250 mL to be run in 2 hours. How many gtts/min will the nurse run the IV considering the drop factor to be 10 gtts per mL?

9.

A patient is to receive a gram of a medication, which is mixed in 50 mL D5W. To run the IV over an hour with a 15 gtts/mL set, how many gtts/min should the IV run?

10.

Ordered is 1000 mL D5W @ 100 mL/hr. Using an administration set 20 drop/mL, how many gtts/min should the IV run?

11.

50 mL D5W with Reglan is to infuse over 20 min. At how many mL/hr should the IV run?

12.

If 115 mL of a solution is to run in over 30 min, At how many mL/hr should you run the IV?

26

ANSWERS TO IV PROBLEMS IN RATIO AND PROPORTION AND DIMENSIONAL ANALYSIS 1.

500 mL = 166.66 = 166.7 mL/hr 3 hr

2.

1500 mL = 150 mL/hr 10 hr OR 1.5 L x 1000 mL = 1500 = 150 mL/hr 10 hr 1L 10

3.

1000 mL x 60 micro gtts/mL = 41. 666 = 42 gtts/min (microdrop) 42 microgtts/min 24 hr x 60 OR 1000 mL x 1 hr x 60 gtts = 60000 = 41.666 = 42 gtts/min 24 hr 60 min 1 mL 1440

4.

2000 mL = 125 mL/hr 16 hr OR 2 L x 1000 mL = 2000 = 125 mL/hr 16 hr 1L 16

5.

1000 mL x 15 gtts/mL = 15000 = 62. 5 = 63 gtts/min 240min 240 OR 1000 mL x 1 hr x 15 gtts = 1500 = 62.5 = 63 gtts/min 4 hrs 60 min 1 mL 240

27

6.

100 mL x 15 gtts/mL = 1500 = 25 gtts/min 60 min 60 OR 100 mL x 15 gtts = 1500 = 25 gtts/min 60 min 1 mL 60

7.

3000 mL = 750 mL/hr 4 hr OR 3 L x 1000 mL = 3000 = 750 mL/hr 4 hr 1L 4

8.

250 mL x 10 gtts/mL = 2500 = 20.83 = 21 gtts/min 2hrs x 60 120 OR 250 mL x 10 gtts = 2500 = 20.83 = 21 gtts/min 120 min 1 mL 120

9.

50 mL x 15 gtts/mL = 750 = 12.5 = 13 gtts/min 60 min 60 OR 50 mL x 15 gtts = 750 = 12.5 = 13 gtts/min 60 min 1 mL 60

10.

100 mL x 20 gtts/mL = 2000 = 33.33 = 33 gtts/min 60 min 60 OR 1000 mL x 1 hr x 20 gtts = 20000 = 100 = 33.3 = 33 gtts/min 10 hr 60 min 1 mL 600 3

28

11.

50 mL: 20 min = x mL: 60 min 20 x = 3000 x = 150 mL/hr OR 50 mL x 60 min = 3000 = 150 mL/hr 20 min 1 hr 20

12.

115 mL: 30 min = x mL: 60 min 30 x = 6900 x = 230 mL/hr OR 115 mL x 60 min = 6900 = 230 mL/hr 30 min 1 hr 30

29

PRACTICE PEDIATRIC PROBLEMS 1.

Erythromycin 125 mg PO QID is ordered for a child who weighs 22 lbs. The recommended safe dose is 7.5 to 12.5 mg/kg q 6 hr. What is the safe dose range for this child? _________________ Is the ordered dose safe? _________

2.

Ordered is Zithromax 180-mg PO daily for a child weighing 35 lb. You have Zithromax 200 mg/5 mL. The recommended daily PO dosage for a child is 12 mg/kg/day for 5 days. What is the childâ&#x20AC;&#x2122;s weight in kg? ______________ What is the safe recommended dosage or range for this child? ___________________ Is the order safe? _____________ If yes, how many mL will you administer?

3.

Biaxin 300-mg PO BID for a child weighing 92 lb. is ordered. You have Biaxin 125 mg/5 mL. The recommended daily PO maximum dosage for a child is 15 mg/kg/day. What is the safe recommended dosage for this child? ________________ Is the order safe? __________ If yes, how many mL will you administer? __________________________

4.

A physician has prescribed Garamycin 36-mg q 8 h IV for a child weighing 32 lb.

The literature recommends a max of 7.5 mg/kg/day. Is the child receiving a safe dose?

30

5.

The physician orders cephradine 320 mg IV q 6 hr for a child who weighs 16 kg.

The recommended dose is 12-25 mg/kg q 6 h. Is the ordered dosage therapeutic and safe?

6.

The drug is ordered 2 mg/kg of body weight. The child weighs 22 lbs. What is the childâ&#x20AC;&#x2122;s dosage?

7.

The order is for digoxin 43 mcg PO BID. The infantâ&#x20AC;&#x2122;s weight is 8 kilograms. The recommended dose is: less than 2 years, 10-12 mcg/kg/day q 12 hours. Is the dose therapeutic and safe? (Please final answer in single dose format.)

8.

You need to verify that a prescribed dose of Vancomycin IV for a child weighing 35 kg is safe? The drug literature recommends a maximum of 40 mg/kg/day. A maximum dose for this child would be ________________ per single dose?

9.

You need to verify that a prescribed dose of Claforan IM for a child weighing 9 lbs. Is safe. The drug literature recommends a maximum dose of 100 mg/kg/day.

The maximum safe dose for this child would be ____________ per single dose?

31

10.

You need to verify that a prescribed dose of Ancef 700 mg TID IV for a child weighing 27 kg is safe. The drug literature recommends a maximum of 80 mg/kg/day. A maximum dose for this child would be __________________ per single dose? Is the prescribed dose safe?

11.

Phenobarbital 100 mg PO q 12 hr is ordered for a child weighing 55 lbs. The recommended daily dose is 4-6 mg/kg/day. What is the safe dose range for this child? __________________ Is the ordered dose safe? __________________

12.

Amoxil 275-mg PO q 8 hr is ordered for a child weighing 58 lb. You have Amoxil 125 mg/5 mL. Recommended safe dose range is 20-40 mg/kg/day. What is the safe dose range for this child? ______________________ Is the ordered dose safe? _______________ If safe, how many mL will you give? _____________

13.

Acetaminophen 15 mg/kg is ordered for a 22 lb. febrile infant. How many mL will you give of acetaminophen 500-mg/5 mL?

14.

The physician orders Demerol 25-mg q 6 hr PRN for a 38-lb. child. The max dose is 1 mg/kg/dose q 4-6 h. What is the safe dose for this child? _______________ Is the ordered dose safe?

15.

The physician orders sodium bicarb 5 mEq for a 1900-gram infant. The recommended dose is 1-3 mEq/kg/dose. What is the recommended dosage range for this child? Is the ordered dose safe?

32

ANSWERS TO PEDIATRIC PROBLEMS IN RATIO AND PROPORTION 1.

22 lb. = 10 kg 7.5 mg/kg x 10 kg = 75 mg AND 12.5 mg/kg x 10 kg = 125 mg Safe range is 75-125 mg per dose YES, the ordered dose is safe, administer 2.5 mL

2.

35 lb. = 15.909 kg 15.909 kg x 12 mg/kg =109.909 = 191 mg (safe dose) Ordered dose is SAFE, administer: 4.5 mL.

3.

92 lb. = 41.818 kg 41.818 kg x 15 mg/kg = 627.2727 = 313.6363 = 314 mg/dose is safe 2 doses YES, ordered dose is safe, administer 12 mL.

4.

a) 32 lb. = 14.545 kg x 7.5 mg/kg = 109.0909 mg/day = 36.36 = 36 mg/dose 2.2 kg 3 doses b) ordered dose is 36 mg â&#x20AC;¦ YES, SAFE

5.

a) The therapeutic or minimum dose: 16 kg x 12 mg/kg = 192 mg q 6 hr b) The safe or maximum dose: 16 kg x 25 mg/kg = 400 mg q 6hr Yes, the ordered dose of 320-mg q 6 hr is both therapeutic and safe

6.

a) 1 kg: 2.2 lb. = x kg: 22 lb.

2.2 x = 22 x = 22 2.2 x = 10 kg b) 10 kg x 2 mg/kg = 20 mg

7.

a) Minimum or therapeutic dose: 8kg x 10 mcg/kg = 80 mcg/day = 40 mcg/dose 2 doses b) Max safe dose: 8 kg x 12 mcg/kg = 96 mcg/day = 48 mcg/dose 2 doses The order is 45 mcg BID. Yes, this is both safe and therapeutic.

8.

40 mg: 1 kg = x mg: 35 kg x = 1400 mg/day

33

9.

9 lbs. = 4.09 kg x 100 mg/kg/day = 409 mg/day 2.2 kg

10.

a) 80 mg: 1 kg = x mg: 27 kg x = 2160 mg/day b) 700 mg x 3 doses = 2100 mg/day Yes, this dose is safe

11.

a) 55lb = 25 kg x 4 = 100 mg per day = 50 mg/dose 2.2 kg 2 doses 25 kg x 6 = 150 mg per day = 75 mg/dose 2 doses b) ordered dose is 100 mg NO, this dose is above the safe range of 50-75 mg/dose

12.

a) 58lb = 26.3636 kg x 20 mg = 527.27 mg per day = 175.75 = 176 mg/dose 2.2 kg 3 doses 26.3636 kg x 40 = 1054.54 mg per day = 351.5 = 352 mg/dose 3 doses b) YES, 275 mg is within the safe range of 176 to 352 mg per dose c) 125 mg: 5 mL = 275 mg: x mL 125 x = 1375 x = 1375 125 x = 11 mL

13.

a) 22 lb. = 10 kg x 15 mg/kg = 150 mg 2.2 kg b) 500 mg: 5 mL = 150 mg: x mL 500 x = 750 x = 750 500 x = 1.5 mL

14.

a) 38 lb. x 1kg = 17.2727 kg x 1 mg/kg = 17 mg 2.2 lb NO, the ordered dose of 25 mg is TOO HIGH

15.

1900 g = 1.9 kg Minimum: 1.9 kg x 1mg/kg/dose = 1.9 mEq Maximum: 1.9 kg x 3 mg/kg/dose = 5.7 mEq YES, ordered dose of 5 mEq is safe 34

ANSWERS TO PEDIATRIC PROBLEMS IN DIMENSIONAL ANALYSIS 1. Low dose: 22 lbs x 1kg x 7.5 mg = 75 mg 1 2.2 lbs 1 kg High dose: 22 lbs x 1kg x 12.5 mg = 125 mg 1 2.2 lbs 1 kg Safe dosage range: 75 mg to 125 mg Yes, the ordered dose is safe.

125 mg x 5 mL = 2.5 mL 1 250 mg Administer 2.5 mL 2. 35 lbs x 1 kg = 15.9 kg 1 2.2 lbs 15.9 kg x 12 mg x 1 day = 190.909 = 191 mg (maximum safe dosage) 1 kg/day 1 dose Yes the order is safe.

180 x 5 mL = 900 = 4.5 mL 1 200 mg 200 Administer 4.5 mL 3. 92 lbs x 1 kg x 15 mg x 1 day = 1380 = 313.6 = 314 mg 1 2.2 lbs kg/day 2 doses 4.4 Maximum safe dosage is 314 mg. Yes the order is safe.

300 mg x 5 mL = 1500 = 12 mL 1 125 mg 125 Administer 12 mL 4. 32 lbs x 1 kg x 7.5 mg x 1 day = 240 = 36.36 = 36 mg 1 2.2 lbs kg/day 3 doses 6.6 Maximum safe dose is 36 mg. Yes the order is safe.

5. Low dose: 16 kg x 12 mg = 192 mg q 6 hrs 1 kg/6 hr High dose: 16 kg x 25 mg = 400 mg q 6 hrs 1 kg/6 hr Yes the ordered dose of 320 mg q 6 hrs is safe and therapeutic.

35

6. 22 lbs x 1 kg x 2 mg = 44 = 20 mg 1 2.2 lbs kg 2.2 7. Low dose: 8 kg x 10 mcg x 1 day = 80 = 40 mcg/dose 1 kg/day 2 doses 2 High dose: 8 kg x 12 mcg x 1 day = 96 = 48 mcg/dose 1 kg/day 2 doses 2 Yes the dose of 45 mcg BID is safe and therapeutic.

8. 35 kg x 40 mg = 1400 mg/day (maximum dose) 1 kg/day 9. 9 lbs x 1 kg x 100 mg = 900 = 409 mg/day 1 2.2 lbs kg/day 2.2 10. 27 kg x 80 mg = 2160 mg/day (maximum safe dose) 1 kg/day 700 mg x 3 doses/day = 2100 mg/day Yes the dose of 700 mg TID is safe.

11. Low dose: 55 lbs x 1 kg x 4 mg x 1 day = 220 = 50 mg/dose 1 2.2 lbs kg/day 2 doses 4.4 High dose: 55 lbs x 1 kg x 6 mg x 1 day = 330 = 75 mg/dose 1 2.2 lbs kg/day 2 doses 4.4 The safe dose range is 50 to 75 mg/dose.

Order dose of 100 mg is not safe.

12. Low dose: 58 lbs x 1 kg x 20 mg x 1 day = 1160 = 175.75 = 176 mg/dose 1 2.2 lbs kg/day 3 doses 6.6 High dose: 58 lbs x 1 kg x 40 mg x 1 day = 2320 = 351.5 = 352 mg/dose 1 2.2 lbs kg/day 3 doses 6.6 Safe dose range is 176 to 352 mg. Yes the order is safe.

275 mg x 5 mL = 1375 = 11 mL 1 125 mg 125

36

13. 22 lbs x 1 kg x 15 mg x 5 mL = 1650 = 1.5 mL 1 2.2 lbs kg 500 mg 1100 14. 38 lbs x 1 mg x 1 kg = 38 = 17.27 = 17 mg/ dose 1 kg/dose 2.2 lbs 2.2 No the ordered dose of 25 mg is too high!

15. Low dose: 1.9 kg x 1 mEq = 1.9 mEq/dose 1 kg/dose High dose: 1.9 kg x 3 mEq = 5.7 mEq/dose 1 kg/dose The safe dosage range is 1.9 to 5.7 mEq/dose.

Yes the ordered dose of 5 mEq is safe.

37

ADVANCED IV PRACTICE PROBLEMS 1.

The physician orders Heparin 1250 units/hr. The pharmacy sends 1000-mL bag with 20, 000 units Heparin. How many mL per hour should the nurse set the infusion pump?

2.

The physician orders Dobutamine 5 mcg/kg/min for a patient weighing 106 lb.

The pharmacy sends D5W 250 mL with 250 mg of dobutamine. How many microdrops per minute (mcgtt/min) should the IV infuse?

3.

The physician orders Aminophylline 350 mcg/min. You have a 1000-mL bag of D5W with 500 mg of Aminophylline. How many mL/hr should the patient receive?

4.

The order reads: “Dopamine 5 mcg/kg/min” and you have a bag of D5W 250 mL with 400 mg of dopamine. The patient weighs 90 kg. How many microdrops per minute (mcgtt/min) should the IV infuse?

5.

Ordered is heparin 1800 units/hr. You have a solution of 25,000-units/500 mL D5W. At how many mL/hr should the heparin be infused?

6.

A patient requires an IV infusion of 1-g Pronestyl in 500 mL D5W. An infusion rate of 1 mg/min has been prescribed. At how many microdrops per minute (mcgtt/min) should the IV run?

38

7.

You have a solution of 250-mL D5W with 1-g lidocaine. Ordered is lidocaine 0.05 mg/kg/min. The patient weighs 163 lb. What rate should the IV infuse at in mL/hr?

8.

Ordered is Aminophylline 18 mg per hour. You have available aminophylline 800mg/500 mL D5W. How many mL/hr will the patient receive?

9.

A child is to receive 5 mg/kg of a medication that is to be added to a 30-mL Iv fluids per volutrol. If the child weighs 33 lb., what is the total dose to be received? How mL should the IV run to administer the medication in one hour? (place answer in mL/hr)

10.

The physician orders IV morphine sulfate 3 mg for pain management. The pharmacy sends an IV of 250 mg of morphine sulfate 500 mL D5W. What rate will the nurse set on the IV pump (mL/hr) to administer 3 mg/hr?

11.

0.9% NS 500 mL with 250 units regular insulin is to infuse at 8 units/hour. How many microdrops per minute do you infuse the IV?

12.

1000 mL D5W with 100 mEq KCL is to infuse at 7 mEq KCL/hr for a hypokalemic patient. The drop factor is 12 gtts/mL. How many gtts/min will you run the IV?

13.

A patient, who weighs 170 lbs., requires an IV infusion of 50 mg of Nipride in 250-mL D5W. An infusion rate of 1.5 mcg/kg/min has been prescribed. At how many microdrops per minute should you infuse the IV? 39

ANSWERS TO ADVANCED IV PROBLEMS IN RATIO AND PROPORTION 1.

20,000 U: 1000 mL = 1250 U: x mL 20,000 x = 1,250,000 x = 62.5 mL/hr

2.

106 lb. = 48.182 kg x 5 mcg/kg = 240.909 mcg/min 2.2 kg 240.909 x 60 = 14454.545 mcg/hr (divided by 1000 to convert mcg to mg) = 14.545 mg/hr (dose per hour) 250 mg: 250 mL = 14.454 mg: x mL 250 x = 3613.636 x = 14.45 mL/hr = 14 mcgtts/min

3.

350 mcg/min x 60 = 21,000 mcg/hr = 21 mg/hr (dose per hour) 500 mg: 1000 mL = 21 mg: x mL 500 x = 21000 x = 42 mL/hr

4.

90 kg x 5 mcg/kg = 450 mcg/min 450 x 60 = 27,000 mcg/hr =27 mg/hr (dose per hour) 400 mg: 250 mL = 27 mg: x mL 400 x = 6750 x = 16.875 = 16.8 mL/hr =17 mcgtts/min

5.

25,000 U: 500 mL = 1800 U: x mL 25,000 x = 900,000 x = 36 mL/hr

6.

1 mg/min = 60 mg/hr (dose per hour) 1000 mg: 500 mL = 60 mg: x mL 1000 x = 30,000 x = 30 mL/hr = 30 mcgtts/min

7.

163 lb. = 74.091 kg x 0.05 mg/kg =3.705 mg/min 2.2 kg 3.705 mg x 60 = 222.273 mg/hr (dose per hour) 1000 mg: 250 mL = 222.273 mg: x mL x = 55.568 = 55.6 mL/hr

40

8.

800 mg: 500 mL = 18 mg: x mL 800 x = 9000 x = 11.25 = 11.3 mL/hr

9.

33 lb. X 5 mg/kg = 75 mg (total dose) 2.2 kg IV rate 30 mL/hr

10.

250 mg: 500 mL = 3 mg: x mL x = 6 mL/hr

11.

250 U: 500 mL = 8 U: x mL 250 x = 4000 x = 16 mL/hr = 16 mcgtts/min

12.

100 mEq: 1000 mL = 7 mEq: x mL 100 x = 7000 x = 70 mL/hr 70 x 12 = 14 gtts/min 60

13.

170 lb. = 77.273 kg x 1.5 mcg/kg = 115.909 mcg/min 115.909 x 60 = 6954.545 mcg/hr (divided by 1000 to convert from mcg to mg) 1000 = 6.954 mg/hr (dose per hour) 50 mg: 250 mL = 6.954 mg: x mL x = 34.77 = 34.8 mL/hr = 35 mcgtts/min

41

ANSWERS TO ADVANCED IV PROBLEMS IN DIMENSIONAL ANALYSIS 1.

1250 Units x 1000 mL = 1250000 = 62.5 mL/hr 1 hr 20,000 units 20000

2.

106 lbs x 1 kg x 5 mcg x 60 mgtts x 250 mL x 1 mg = 7950000 1 2.2 lbs kg/min 1 mL 250 mg 1000 mcg 550000 = 14.45 = 14 microgtts/min

3.

350 mcg x 1 mg x 1000 mL x 60 min = 21000000 = 42 mL/hr 1min 1000 mcg 500 mg 1 hr 500000

4.

90 kg x 5 mcg x 1 mg x 250 mL x 60 mgtts = 6750000 1 kg/min 1000 mcg 400 mg 1 hr 400000 = 16.875 = 17 microgtts/min

5.

1800 units x 500 mL = 900000 = 36 mL/hr 1 25000 units 25000

6.

1 mg x 1 gm x 500 mL x 60 mgtts = 30000 = 30 microgtts/min 1 min 1000 mg 1 gm 1 mL 1000

7.

163 lbs x 1 kg x 0.05 mg x 1 gm x 250 mL x 60 min = 122250 1 2.2 lbs kg/min 1000 mg 1 gm 1 hr 2200 = 55.568 = 55.6 mL/hr

8.

18 mg x 500 mL = 9000 = 11.25 or 11.3 mL/hr 1 800 mg 800

9.

33 lbs x 1kg x 5 mg = 165 = 75 mg 1 2.2 lbs 1 kg 2.2 30 mL = 30 mL/hr 1 hr

10.

3 mg x 500 mL = 1500 = 6 mL/hr 1 hr 250 mg 250

11.

8 units x 500 mL x 60 gtts x 1 hr = 16 microgtts/min 1 hr 250 units 1 mL 60 min

12.

7 mEq x 1000 mL x 12 gtts x 1 hr = 84000 = 14 gtts/min 1 hr 100 mEq mL 60 min 6000

13.

170 lbs x 1 kg x 1.5 mcg x 1 mg x 250 mL x 60 mgtts = 3825000 1 2.2 lbs kg/min 1000 mcg 50 mg 1 mL 110000 = 34.77 = 35 microgtts/min

42

PRACTICE LEVEL I TEST (BASIC DOSAGE CALCULATIONS) 1. The patient has ordered 75 mg of Demerol. You have a 2-mL vial of 100 mg.

How many mL will the patient receive?

2. Ordered are 750,000 units of Penicillin. You have a 20-mL vial, which contains 600,000 units/mL. How many mL should be administered?

3. You have scored tablets of Ziac 2.5mg/1 tab. To administer 3.75 mg, how many tablets should the patient receive?

4.

Your patient has Lanoxin 80 mcg ordered IM. Lanoxin 0.5 mg per 2 mL is available. How many mL will you give?

43

5.

How many kg does a 132-lb. person weigh?

6.

A patient is to receive Codeine 60-mg PO. You have Codeine 30 mg/5 mL. How many teaspoons will the patient get?

7.

The physician orders 135 mg of a drug. You have a vial of powdered drug and the label reads: Add 1.8-mL sterile water to yield 100 mg/mL. How many mL should you give?

8.

2 g of powdered Mefoxin is available. Directions for reconstitution state: Add 20 mL of diluent to yield 1000 mg in 10.5 mL. To administer a prescribed dosage of 1.5 g for IV administration, how many mL of drug should you withdraw from the vial after reconstituting the drug as directed?

9.

You are to infuse 0.5 L D5LR over 4 hours. At how many mL/hr will you run the IV?

10.

The physician orders an IV infusion of 1000-mL NS to run in over 12 hours. At how many mL/hr will you run the IV?

44

ANSWERS TO PRACTICE LEVEL I TEST IN RATIO AND PROPORTION 1.

75 mg: x mL = 100 mg: 2 mL 100 x = 150 x = 150 100 x = 1.5 mL

2.

750,000 U: x mL = 600, 000 U: 1 mL 600, 000 x = 750,000 x = 750,000 600,000 x = 1.3 mL

3.

3.75 mg: x tab = 2.5 mg: 1 tab x = 1 ½ tab

4.

a) Convert mg to mcg 1 mg: 1000 mcg = 0.5 mg: x mcg x = 500 mcg

b) 500 mcg: 2 mL = 80 mcg: x mL 500 x =160 x = 0.32 mL

5.

6.

Convert lb. To kg: 2.2 lb.:1 kg = 132 lb.: x kg 2.2 x = 132 x = 60 kg a) 60 mg: x mL = 30 mg: 5 mL 30 x = 300 x = 300 30 x = 10 mL b) Convert mL to teaspoons 1 tsp.: 5 mL = x tsp.: 10 mL 5 x = 10 x = 10 5 x = 2 tsp.

45

7.

135 mg: x mL = 100 mg: 1 mL 100 x = 135 x = 1.35 = 1.4 mL

8.

a) Convert grams to mg: 1 g: 1000 mg = 1.5 g: x mg x = 1500 mg

b) 1500 mg: x mL = 1000 mg: 10.5 mL 1000 x = 15750 x = 15.75 = 15.8 mL

9.

0.5 L = 500 mL 500 mL = 125 mL/hr 4 hr

10.

1000 mL =83.3 mL/hr 12 hr

46

ANSWERS TO PRACTICE LEVEL I TEST IN DIMENSIONAL ANALYSIS 1.

75 mg x 2 mL = 150 = 1.5 mL 1 100 mg 100

2.

750,000 units x 1 mL = 1.25 = 1.3 mL 1 600,000 units

3.

3.75 mg x 1 tab = 1.5 or 1 ½ tab 1 2.5 mg

4.

80 mcg x 2 mL x 1 mg = 4 1 0.5 mg 1000 mcg 12.5

5.

132 lbs x 1 kg = 60 kg 1 2.2 lbs

6.

60 mg x 5 mL = 10 mL 1 30 mg

7.

135 mg x 1 mL = 1.35 = 1.4 mL 1 100 mg

8.

1.5 gm x 10.5 mL x 1000 mg = 15.75 = 15.8 mL 1 1000 mg 1 gm

9.

0.5 L x 1000 mL = 500 = 125 mL/hr 4 hr 1L 4

10.

1000 mL = 83.3 mL/hr 12 hr

= 0.32 mL

10mL x 1 tsp = 10 = 2 tsp 1 5 mL

47

PRACTICE LEVEL II TEST (Basic Dosage Calculations) 1. 2 mg of decadron has been prescribed PO. 0.5 mg of decadron is available in unscored tablets. How many unscored tablets should be administered?

2. The physician orders 4500 units Heparin. You have a 10-cc vial of Heparin 10,000 units/mL. How many mL should be given?

3. Ordered is Lanoxin 0.25-mg PO. Available are scored tablets 125 mcg per tab.

How many tabs will your patient receive?

4. The physician orders 30 mEq of KCL. You have available 60 mEq of KCL per 30 mL. How many tablespoons should the patient receive?

5. Your patient drinks 8 ounces of coffee and 4 ounces of juice. How many mL did this person consume?

6. The physician orders 175 mg of Keflin. You have a 10 mL vial which contains 1 g of Keflin. Directions indicate to add 4 mL of sterile water to yield 500 mg in 2.2 mL. How many mL should be given?

48

7. You have a bottle of powdered Ampicillin for oral administration with instructions to add 20-mL water to give a suspension containing 100 mg per mL. To administer 125 mg, how many mL should be given?

8. Your patient is to receive IV fluid 1000 mL over 6 hours. At how many mL/hr will your set the IV infusion pump?

9. The physician orders 500 mg of a drug to be mixed in 100 mL D5W. To run the fluid in 30 minutes using an administration set of 15 gtts/mL. How fast should the IV run in mL/hr?

10. You administer 375 Augmentin PO. The label on the bottle contains, Augmentin: 250 mg / 5 mL. How many mL will you give of the following labeled drug?

49

ANSWERS TO PRACTICE LEVEL II TEST IN RATIO AND PROPORTION 1.

2 mg: x tab = 0.5 mg: 1 tab 0.5 x = 2 x = 4 tabs

2.

4500 U: x mL = 10,000 U: 1 mL 10,000 x = 4500 x = 4500 10,000 x = 0.45 mL

3.

a) Convert mg to mcg: 1 mg: 1000 mcg = 0.25 mg: x mcg x = 250 mcg b) 250 mcg: x tab = 125 mcg: 1 tab 125 x = 250 x = 2 tabs

4.

a) 60 mEq: 30 mL = 30 mEq: x mL 60 x = 900 x = 15 mL b) Convert mL to tablespoons: 1 tbs.: 15 mL = x tbs.: 15 mL 15 x = 15 x = 1 Tbsp.

5.

1 ounce: 30 mL = 12 ounces: x mL x = 360 mL

6.

175 mg = x mL = 500 mg: 2.2 mL 500 x = 385 x = 385 500 x = 0.77 mL 50

7.

125 mg: x mL = 100 mg: 1 mL 100 x = 125 x = 1.25 = 1.3 mL

8.

1000 = 166.66 = 166.7 mL/hr 6

9.

100 mL: 30min = x mL: 60 min 30 x = 6000 x =200 mL/hr

10.

250 mg: 5 mL = 375 mg: x mL 250 x = 1875 x = 7.5 mL

51

ANSWERS TO PRACTICE LEVEL II TEST IN DIMENSIONAL ANALYSIS 1. 2 mg x 1 tab = 4 tabs 1 0.5 mg 2. 4500 units x 1 mL = 0.45 mL 1 10,000 units 3. 0.25 mg x 1 tab x 1000 mcg = 2 tabs 1 125 mcg 1 mg 4. 30 mEq x 30 mL x 1 tbsp = 1 tbsp 1 60 mEq 15 mL 5. 12 oz x 30 mL = 360 mL 1 1 oz 6. 175 mg x 2.2 mL = 385 = 0.77 mL 1 500 mg 500 7. 125 mg x 1 mL = 125 = 1.3 mL 1 100 mg 100 8. 1000 mL = 166.7 mL/hr 6 hr 9. 100 mL x 60 min = 200 mL/hr 30 min 1 hr 10. 375 mg x 5 mL = 7.5 mL 1 250 mg

52

PRACTICE LEVEL III TEST (Advanced Dosage Calculations) 1.

A patient has an IV medication ordered which has been diluted in 50-mL D5W. To run the fluid in 30 minutes, at what mL/hr rate should the pump be set?

2.

Ordered is 1000 mL to run in 10 hours. Using a set which deliver 20 drops per mL, what would be the drops/min flow rate?

3.

You have available a vial of Solu-Medrol labeled 2 g in 30.6 mL. The physician IV has prescribed Solu-Medrol 500 mg. What volume (mL) of the drug will you prepare?

4.

A patient has Digoxin 80 mcg ordered. Available is Digoxin 0.5 mg in 2 mL. How many mL will you give?

5.

A physician has prescribed Vancomycin IV for a child weighing 85 lb. The drug literature recommends a maximum of 40 mg/kg/day. In checking the appropriateness of the physicianâ&#x20AC;&#x2122;s order, you determine that ________________ of Vancomycin would be a maximum safe dosage per day. (Please express answer in single dose format).

6.

You need to verify that a prescribed dose of Keflex for a child weighing 33 lb. is safe. The drug literature recommends a range of 25-50 mg/kg/day in divided dose q 6h. What is the recommended dosage range for this child? __________ The physician has ordered Keflex 150-mg PO q6h. Is this a safe dose? _______

53

7.

You have an order for an IV of 0.9% NS 250 mL with 100 unitâ&#x20AC;&#x2122;s Regular insulin to infuse at 8 units/hr. At how many mL/hr will you run the IV?

8.

Aminophylline 350 mcg/min is ordered. Your solution contains 2 grams Aminophylline in 1 liter of D5W. At how many mL/hr should you run the IV?

9.

The physician orders Dobutamine 250 mg in 250-mL D5W to infuse 5 mcg/kg/min for a 80-kg patient. At how many mL/hr should you run the dobutamine?

10.

A child is to receive 10 mg Vibramycin per kg of body weight. If the child weighs 24 lb. How many mg should the child receive?

54

ANSWERS TO PRACTICE LEVEL III TEST IN RATIO AND PROPORTION 1.

50 mL: 30 min = x mL: 60 min 30 x = 3000 x = 100 mL/hr

2.

1000 x 20 = 33.3 = 33 gtts/min 600

3.

a) Convert g to mg: 1 g: 1000 mcg = 2 g: x mg x = 500 mg

b) 500 mg: x mL = 2000 mg: 30.6 mL 2000 x =15,300 x = 7.65 = 7.7 mL

4.

a) Convert mg to mcg: 1 mg: 1000 mcg = 0.5 mg: x mcg x = 500 mcg

b) 500 mcg: 2 mL = 80 mcg: x mL 500 x = 160 x = 0.32 mL

5.

a) Convert pounds to kilograms: 2.2 lb.: 1 kg = 85 lb.: x kg 2.2 x = 85 x = 38.636 kg

b) 40 mg: 1 kg: x mg: 38.636 kg x = 1545 mg per day

6.

33 lb. = 15 kg x 25 mg/kg = 375 mg/day = 93.75 = 94 mg 2.2 kg 4 doses 33 lb. = 15 kg x 50 mg/kg = 375 mg/day = 187.5 = 188 mg 2.2 kg 4 doses Recommended safe dose range is 94 to 188 mg per single dose, YES, the ordered dose of 150 mg is SAFE.

7.

100 units: 250 mL = 8 units: x mL 100 x = 2000 x = 20 mL/hr

8.

Dose per hour is 350 mcg/min x 60 min = 21000 mcg/hr = 21 mg/hr 2000 mg: 1000 mL = 21 mg: x mL 2000 x = 21000 x = 10.5 mL/hr

9.

80 kg x 5 mcg/kg = 400 mcg/min x 60 min = 24,000 mcg/hr = 24 mg/hr 250 mg: 250 mL = 24 mg: x mL 250 x = 6000 x = 24 mL/hr

10. 1 kg: 2.2 lb. = x kg: 24 lb. x = 10.909 kg 10.909 kg x 10 mg/kg = 109.09 = 109 mg 55

ANSWERS TO LEVEL III PRACTICE TEST IN DIMENSIONAL ANALYSIS 1. 50 mL x 60 min = 3000 = 100 mL/hr 30 min 1 hr 30 2. 1000 mL x 1 hr x 20 gtts = 20000 = 33.33 = 33 gtts/min 10 hrs 60 min 1 mL 600 3. 500 mg x 1 gm x 30.6 mL = 15300 = 7.65 = 7.7 mL 1 1000 mg 2 gm 2000 4. 80 mcg x 1 mg x 2 mL = 160 = 0.32 mL 1 1000 mcg 0.5 mg 500 5. 85 lbs x 1 kg x 40 mg = 3400 = 1545 mg/day 1 2.2 lbs kg/day 2.2 6. Low dose: 33 lbs x 1 kg x 25 mg 1 day = 825 = 93.75 = 94 mg/dose 1 2.2 lbs kg/day 4 doses 8.8 High dose: 33 lbs x 1 kg x 50 mg 1 day = 1650 = 187.5 = 188 mg/dose 1 2.2 lbs kg/day 4 doses 8.8 Recommended dosage range: 94 to 188 mg per dose Yes the dose of 150 mg is safe.

7. 8 units x 250 mL = 2000 = 20 mL/hr 1 hr 100 units 100 8. 350 mcg x 60 min x 1 mg x 1 gm x 1000 mL = 21000000 1 min 1 hr 1000 mcg 1000 mg 2 gm 2000000 = 10.5 mL/hr 9. 80 kg x 5 mcg x 60 min x 1 mg x 250 mL = 6000000 1 kg/min 1 hr 1000 mcg 250 mg 250000 = 24 mL/hr 10. 24 lbs x 1 kg x 10 mg = 240 = 109. 09 = 109 mg 1 2.2 lbs 1 kg 2.2

56

PRACTIVE LEVEL IV TEST (Advanced Dosage Calculations) 1. Codeine 45 mg PO q 12 h is ordered for a child weighing 55 lb. The recommended PO dosage for a child is 2.5 to 5 mg/kg/day. What is the safe recommended dosage range for this child? Is the Prescribed dose appropriate? YES or NO (circle one)

2. You are to infuse Pepcid 20 mg in 50-mL d5w over 20 minutes. At how many mL per hour will you set the IV pump?

3. Furadantin 10-mg PO q day for a child weighing 15 lb. is ordered. The recommended daily dosage is 2 mg/kg/day. What is the maximum safe dose for this child? Is the prescribed dosage appropriate? YES or NO (circle one) (please express answers in single dose format).

4. The physician has ordered 0.5 L lactated ringersâ&#x20AC;&#x2122; solution to infuse over 5 hours.

Drop factor of the tubing is 15 gtts/mL. At how many drops per minute will you infuse the IV?

57

5. Acetaminophen 15 mg/kg is ordered for a febrile child who weighs 38 lb. You have on hand acetaminophen 120-mg/5 mL. How many mL will you administer?

6. You have available a vial of Lanoxin labeled 0.25 mg in 1 cc. The physician has prescribed IV Lanoxin 150 mcg. What volume (mL) of the drug will you prepare?

7. A patient who weigh 110 lb. requires an IV infusion of 250 mg of dobutamine in 250mL d5w. An infusion rate of 5 mcg/kg/min has been prescribed. At how many microdrops per minute will you infuse the IV?

8. A patient requires an IV infusion of 25-mg Nitrostat in 250 mL of d5w. An infusion rate of 50 mcg/min has been prescribed. At how many mL per hour will you infuse the IV?

58

9. You have an order for your diabetic patient to receive 0.9% NS 250 mL with 100 unitsâ&#x20AC;&#x2122; regular insulin to infuse at 8 unit/hr. At how many microdrops per minute do you run the IV?

10. For breakfast your patient has 6 ounces of broth, 4 ounces of juice, and 8 ounces of coffee. How many mL of fluids did your patient consume?

59

ANSWERS TO PRACTICE LEVEL IV TEST IN RATIO AND PROPORTION 1.

31 mg â&#x20AC;&#x201C; 63 mg and Yes, it is safe.

55 lb. = 25 kg x 2.5 mg/kg = 62.5 mg/day = 31.25 = 31 mg per dose 2.2 kg 2 doses 55 lb. = 25 kg x 5 mg/kg = 125 mg/day = 62.5 = 63 mg per dose 2.2 kg 2 doses

2.

50 mL: 20 min = x mL: 60 min 20 x = 3000 x = 150 mL/hr

3.

15 lb. = 6.818 kg x 2 mg/kg = 13.636 = 14 mg/day 2.2 kg YES 10 mg is a SAFE DOSE

4.

500 mL x 15 = 7500 = 25 gtts/min 5 x 60 300

5.

38 lb. = 17.273 kg x 15 mg = 259. 091 = 259 mg 2.2 kg 120 mg: 5 mL = 259 mg: x mL 120 x = 1295 x = 10.79 = 10.8 mL

6.

Convert 0.25 mg to 250 mcg, then 250 mcg: 1 mL = 150 mcg: x mL 250 x = 150 x = 0.6 mL

7.

110 lb. = 50 kg x 5 mcg/kg/min = 250 mcg/min 2.2 kg 250 x 60 = 15,000 mcg/hr = 15 mg/hr 250mg: 250 mL = 15 mg: x mL 250 x = 3750 x = 15 mL/hr = 15 mcgtts/min 60

8.

50 mcg/min x 60 = 3000 mcg/hr = 3 mg/hr 25 mg: 250 mL = 3 mg: x mL 25 x = 750 x = 30 mL/hr

9.

100 U: 259 mL = 8 U: x mL 100 x = 2000 x = 20 mL/hr = 20 mcgtts/min

10.

6 + 4 + 8 = 18 ounces Convert: 1 oz.: 30 mL = 18 oz: x mL x = 540 mL

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ANSWERS TO PRACTICE LEVEL IV TEST IN DIMENSIONAL ANALYSIS 1. Low dose: 55 lbs x 1 kg x 2.5 mg x 1 day = 137.5 = 31.25 = 31 mg/dose 1 2.2 lbs kg/day 2 doses 4.4 High dose: 55 lbs x 1 kg x 5 mg x 1 day = 275 = 62.5 = 63 mg/dose 1 2.2 lbs kg/day 2 doses 4.4 Yes, Safe recommended dosage range is 31 to 63 mg per dose.

2. 50 mL x 60 min = 3000 = 150 mL/hr 20 min 1 hr 20 3. 15 lbs x 1 kg x 2 mg = 30 = 13.636 = 14 mg/day 1 2.2 lbs kg/day 2.2 Yes the ordered dose of 10 mg a day is safe.

4. 500 mL x 1 hr x 15 gtts = 7500 = 25 gtts/min 5 hrs 60 min 1 mL 300 5. 38 lbs x 1 kg x 15 mg x 5 mL = 2850 = 10.795 = 10.8 mL 1 2.2 lbs kg 120 mg 264 6. 150 mcg x 1 mg x 1 mL = 150 = 0.6 mL 1 1000 mcg 0.25 mg 250 7. 110 lbs x 1 kg x 5 mcg x 1 mg x 250 mL x 60 mcgtts = 8250000 1 2.2 lbs kg/min 1000 mcg 250 mg 1 mL 550000 = 15 mcgtts/min 8. 50 mcg x 1 mg x 250 mL x 60 min = 750000 = 30 mL/hr 1 min 1000 mcg 25 mg 1 hr 25000 9. 8 Units x 250 mL x 60 mcgtts x 1 hr = 120000 = 20 mcgtts/min 1 hr 100 units 1 mL 60 min 6000 10. 6 + 4 + 8 oz = 18 oz

18 oz x 30 mL = 540 mL 1 1 oz

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Remediation: ď&#x201A;ˇ

If the student fails to complete the required remediation prior to the next scheduled unit exam, he/she will not be allowed to take the unit exam. The student must complete the remediation as required and will have to take the exam that was missed on the designated make-up test day, which is usually the day before the final exam.

SEE REMEDIATION FORM ON NEXT PAGE

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DOSAGE CALCULATION REMEDIATION CONTRACT

As a MGCCC Nursing student, I understand that I must complete my assigned dosage calculation remediation by the specified date prior to attempting the next dosage calculation retest. I also understand that it is my responsibility to make an appointment with the remediation counselor and complete all requirements prior to the clinical/lab experience as outlined in the handbook.

1. Remediation Content: Basic and/or Advanced Calculations

2. Remediation completion date: ______________________

YES NO (Circle one): I waive my one week remediation period to retake the dosage calculation test for Pass/Fail grading (no score). I understand I am still responsible to complete and submit remediation work prior to test as outlined in the handbook. I understand that I will not be allowed to retest on the same day.

_________________________________________ Print Student Name

________________________________________ Date

_______________________________

______________________________

Student Signature

Nursing Instructor Signature

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