Dosage & Solutions Types of questions IM - Intramuscular Medication Labels PO - Oral Tsp and tbsp conversions SQ - Subcutaneous Dosage by weight IV - Intravernous Marking a syringe I&O - Intake and Output Marking a medication cup Is the dosage safe? Differentiating daily dose vs. single dose Differentiating Intake and Output while adding them and subtracting, etc. ABbreviations BID “Bi” - Two times per Day - “2x a day" q12hrs mg/kg/day Milligrams per Kilogram per DAY TID “Tri” - Three times per Day - “3x a day” q8hrs mcg/kg/day Micrograms per Kilogram per DAY QID “Quad” - Four times per Day - “4x a day” q6hrs ALWAYS THE DAILY AMOUNT NEVER THE DOSAGE AMOUNT What is Dimensional Analysis Dimensional analysis, also known as factor-label method or unit-factor method, is a method used to convert one unit to a diļ¬erent unit. To do this, we make use of a conversion factor, which is a numerical quantity that we multiply or divide to the quantity or number that we want to convert. Most Common Mistakes • • • • • They did not read the questions fully or correctly They did not convert the weight or units correctly or at all They did not take note of whether or not the question asked for per dose or per day They overthought and confused the values that were per day and that were per dose They did not READ THE RULES ON THE FRONT PAGE OF YOUR EXAM BOOK Conversions you must know 1 kg 1 mL 2.2 pounds 15 drops 5 mL 15 mL 1 teaspoon 1 tablespoon 30 mL 2 tablespoons 8 oz 2 cups 1 cup 1 pint 2 pints 4 quarts 1 quart 1 gallon 1 oz 1 kg 1,000 g 1 gram (g or gm) 1,000 mg 1 mg 1,000 mcg Oral (PO) Questions The Doctor puts in an order for Decadron (dexamethasone) 1.5 mg po bid. The tablets you have in stock are labeled 0.75 mg. How many tablets would you give the patient per day? The Doctor puts in an order for Lanoxin (digoxin) 0.25 mg po every day. The tablets you have in stock are scored and labeled 0.5 mg. How many tablets would you give the patient per dose? The Doctor puts in an order for Catapres (clonidine) 400 mcg po q4hr. The tablets you have in stock are labeled 0.2 mg. How many tablets would you give the patient per day? The Doctor puts in an order for Micronase (glyburide) 0.625 mg TID. The nurse notices that when she goes to pull the medication from the Pixis they have scored tablets labeled 1.25 mg in stock. How tablets would the nurse give the patient per dose? The Doctor puts in an order for Catapres (clonidine) 400 mcg po q4hr. The tablets you have in stock are labeled 0.2 mg. How many tablets would you give the patient per day? Oral (PO) Questions Your patient begins having an allergic reaction and you know they have ordered Diphenhydramine 35mg in prn. You go to pull the medication and you notice you only have liquid labeled 12.5 mg/5 mL on stock. How many mL will you administer to the Patient? The doctor orders Digoxin 0.125 mg po q4h prn. The nurse has in stock an elixir labeled 500 mcg/10 mL. What is the maximum amount of mL that this patient should be given per day? Pediatric Safe Dosage Steps Pediatric Safe Dosage Questions The doctor orders Tylenol 115mg PO for a 25lb child.The hospital policy states Tylenol is to be given to children within the following range; 10-15mg/kg/day . The hospital only has in stock acetaminophen 160mg/5mL. How mLs will the nurse give the patient? What is the maximum dosage in mg can the child be given? Is what the doctor ordered safe? Yes or No The doctor orders amoxicillin 326mg TID for a child weighing 55lbs. The amoxicillin suspension label reads 0.125g/5 ml. The recommended dosage for children: 19-39 mg/Kg/ day in three equally divided doses. How mLs will the nurse give the patient? What is the maximum dosage in mg can the child be given? Is what the doctor ordered safe? Yes or No The doctor orders a Acyclovir 12g BID for a child weighing 25lbs. The safe does range (SDR) of Acyclovir is 25-50 mg/kg/day into two equal doses. The hospital has .012 g tablets in stock. How tablets will the nurse give the patient per dose? What is the maximum dosage in mg can the child be given? Is what the doctor ordered safe? Yes or No Subcutaneous Questions The doctors orders read NPH insulin 15 units A.C. Breakfast, NPH insulin 10 units P.C. Breakfast, Humulin insulin 5 units P.C. Breakfast. Breakfast is at 7:30 am, how much insulin will the nurse draw up at 8:00pm. The doctors orders read regular insulin 5 units A.C. breakfast, Regular insulin 10 units P.C. lunch, and Humulin insulin 5 units P.C. dinner. How much insulin will the nurse be drawing up in total this afternoon. The doctors orders read regular insulin 5 units A.C. breakfast, Regular insulin 10 units P.C. lunch, and Humulin insulin 5 units P.C. dinner. How much insulin will the nurse be drawing up in total this afternoon. The doctors orders read NPH insulin 20 units A.C. breakfast, Regular insulin 10 units P.C. dinner. How much insulin will the nurse be drawing up in total this afternoon. Intravascular questions The doctor orders Heparin 25,000 Units mixed in 500 ml D5W and running at 7mL / hour. How many Units are being administered per hour? The doctor orders Heparin 25,000 Units / 500ml D5W to run at 1200 units/hr. What is the flow rate mL/hr the nurse should set the pump at? The doctor orders a Heparin bolus of 10,000 Units, followed by IV drip of 18 units/kg/hr for a patient weighing 167lbs. You have a Heparin vial labeled 5,000 Units/ml. What will you give your patient for the initial bolus? What will you set your IV pump at for a continuous drip if your 1 L IV bag has a total of 50,000 Units of Heparin? Intravascular questions The nurse needs to infuse Ampicillin that has been reconstituted to 500mg/ 300 mL over the next 40 minutes with a drip factor of 20 gtt/mL. How many gtt/min will the nurse need to set the pump to? The nurse needs to infuse 0.4L of D5W in normal saline over the next 4 hours. The drip factor is 60gtt/mL. How many mL of normal saline will the patient receive each hour? The nurse needs to infuse 1500mL of Normal Saline q12hrs with a drip factor of 55 gtt/mL. How many gtt/min will the nurse need to set the pump to? The doctor orders 2mg of morphine q4h IVP for a patient that weighs 110lbs. The nurse notices that the hospital only has have 4mg/2mL in stock. How many mg will you administer per day? How many mL will you administer per dose? Intake & Output Questions A nurse is reviewing the 24 hour intake and output for a patient. In the past 24 hours, the patient has consumed 2 liters of water, 24 ounces of juice, 1 pint of clear liquid soup, and 20 ounces of chocolate pudding. The patient has been on IV Fluids: Normal Saline at 250 mL/hr for 4 hours. Furthermore, the nurse noted 350mL of emesis, drained 1200mL of urine from the foley catheter, and the patient voided three times: 150 mL, 200 mL, and 50 mL. What is the patient’s fluid balance? A nurse is reviewing the 24 hour intake and output for a patient. In the past 24 hours, the patient has consumed 250mL of apple juice, 0.5L of water, 50 ounces of broth, and 8 ounces of crackers. The patient has been on IV Fluids: NS at 150 mL/hr for 2 hours. Furthermore, the patient had 200mL of emesis, nasal gastric suction of 500 mL, and voided three times; 350mL, 400mL, and 375mL. What is the patient’s fluid balance?