MODULE 5
CRUCIAL CONCEPTS BOOTCAMP
Dosage
Calculations
Workbook
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MODULE 5
UNIT
ABBREVIATIONS
DOSAGE CALCULATIONS
LENGTH
Millimeter = mm
Centimeter = cm
VOLUME
Milliliter = ml
Teaspoon = tsp
Tablespoon = tbsp
Ounce = oz
WEIGHT
Nanogram = ng
Microgram = mcg
Milligram = mg
Gram = g
Kilogram = kg
Pound = lb
Pounds = lbs
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MODULE 5
UNIT
CONVERSIONS
DOSAGE CALCULATIONS
LENGTH
1 cm = 10 mm
1 meter = 100 cm
1 in = 2.54 cm
1 L = 1000 ml
1 tsp = 5 ml
1 tbsp = 15 ml
1 oz = 30 ml
1 dram = 0.125 oz
1 gallon = 3785 ml
2 tbsp = 1 oz
3 tsp = 1 tbsp
VOLUME
WEIGHT
1 mcg = 1000 ng
1 mg = 1000 mcg
1 kg = 1000 g
1 kg = 2.2 lbs
1 grain = 64.8 mg
MODULE 5: DOSAGE CALCULATIONS
1 g = 1000 mg
1 lb = 453.6 g
usually rounded to 454 g
1 oz = 30 g
common rounding
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MODULE 5
ROUTES OF
ADMINISTRATION
ABBREVIATIONS
PO
by mouth (pills, tablets, capsules, lozenges, elixirs)
PR
by rectum (suppositories)
SUBQ or SQ
subcutaneous (insulin)
IM
intramuscular injection (vaccines)
IV
intravenous (fluids, antibiotics, continuous infusions)
IVPB
IV piggy back (runs secondary to main infusion)
IVP
IV push (opioids)
INHL
inhalation (breathing treatments)
TOPICAL
applied to the skin (anti-fungal cream)
SL
sublingual (disintegrating tablets)
NGT/OGT/PEG
via nasogastric tube, orogastric tube, or PEG tube
AD/AS/AU
right ear, left ear, both ears (ear drops)
OD/OS/OU
right eye, left eye, both eyes (eye drops or ointments)
gtt
drip (as in a continuous IV infusion or “drip”)
gtts
drops (as in “20 drops per ml”, written as 20 gtts/ml)
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MODULE 5
TIMING OF
ADMINISTRATION
ABBREVIATIONS
You will see many abbreviations in the medical field. Not all are “approved” for use by
The Joint Commission. However, these abbreviations still exist so you should know
what they are. Abbreviations that are on The Joint Commission’s official “do not use”
list are indicated by an asterisk* with alternate language provided.
ATC
around the clock
Q
every (ex: q 4 hours)
Q DAY*
every day (write “daily” instead)
QOD*
every other day (write “every other day” instead)
BID
twice a day (usually 0900 and 2100)
TID
three times a day (usually morning, noon, evening)
QID
four times a day (usually morning, two mid-day, one in evening)
AC
before meals
PC
after meals
HS
at bedtime (“hour of sleep”)
PRN
as needed
ASAP
as soon as possible
STAT
immediately
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MODULE 5
ROUNDING
RULES
DOSAGE CALCULATIONS
Rounding Rules
Dependent upon a variety of factors
Always ask your professor before any med calc exam what their
rounding expectations are
Rounding Terminology
"Round to the nearest tenth" = round to one decimal place
"Round to the nearest hundredth" = round to two decimal places
Example: 3.684
3.7
tenths place
MODULE 5: DOSAGE CALCULATIONS
3.68
hundredths place
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MODULE 5
DECIMAL
USAGE
DOSAGE CALCULATIONS
Rule 1
Always place a leading zero BEFORE the decimal if the number is < 1.
CORRECT:
0.25 ml
INCORRECT:
.25 ml
CORRECT:
1.25 ml
INCORRECT:
01.25 ml
Rule 2
Never place a zero at the far right (this is a “trailing zero”).
CORRECT:
0.5 ml
INCORRECT:
0.50 ml
CORRECT:
1.25 ml
INCORRECT:
1.250 ml
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MODULE 5
THE FOUR
QUESTIONS
INTRO TO DOSAGE CALCULATIONS
What is the question asking?
1
2
Think of the concept behind the question and where you want to end up.
Where do I start?
This is usually with the ordered dose, but you will see exceptions based on
what the question is asking. This question determines what the first
element will be in your dimensional analysis setup.
What information do I need or not need?
3
Some questions will have information included that you do not need.
These distracting details can easily cause you to perform the wrong
calculation or get stuck entirely.
What are the conversions?
4
You want to be sure you don’t miss any unit conversions, so it’s good to
pause and quickly make note of what’s needed.
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MODULE 5
PRACTICE #1
LESSON 6 - SINGLE CONVERSIONS
Patient:
Kai
Order:
650 mg Tylenol PO ordered q 6 hours PRN for fever above 101.5
Scenario: The patient weighs 72 kg and his last dose was two days ago at
0308. Each tablet of Tylenol contains 325 mg and there are 83
tablets in the bottle. How many tablets will you administer to your
patient when his temperature reads 101.7 at 0710?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
Underline or highlight things you need, and cross out things you don’t need.
4. What are my conversions?
CONVERSION
START
X
MODULE 5: DOSAGE CALCULATIONS
RESULT
=
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MODULE 5
PRACTICE #2
LESSON 6 - SINGLE CONVERSIONS
Patient:
Howard
Order:
0.25 mg Klonopin PO BID
Scenario: Klonopin comes in 0.5 mg tablets. How many tablets of Klonopin
will you administer?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
Underline or highlight things you need, and cross out things you don’t need.
4. What are my conversions?
CONVERSION
START
X
MODULE 5: DOSAGE CALCULATIONS
RESULT
=
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MODULE 5
PRACTICE #1
LESSON 7 - MULTIPLE CONVERSIONS
Patient:
Travis
Order:
50 mcg PainAway q 4 hours IV prn severe pain
Scenario: Your patient rates his pain a 7 on a 0-10 scale. PainAway comes in
a 5 ml vial containing 1 mg of medication. How many ml will you
administer?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
Underline or highlight things you need, and cross out things you don’t need.
4. What are my conversions?
CONVERSION
START
X
MODULE 5: DOSAGE CALCULATIONS
CONVERSION
X
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RESULT
=
Pg. 11
MODULE 5
PRACTICE #2
LESSON 7 - MULTIPLE CONVERSIONS
Patient:
Sharon
Order:
500 mg Emenda q 4 hours IV prn nausea/vomiting
Scenario: Emenda comes in a 2 ml vial containing 2 g medication.
How many ml will you administer?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
Underline or highlight things you need, and cross out things you don’t need.
4. What are my conversions?
CONVERSION
START
X
MODULE 5: DOSAGE CALCULATIONS
CONVERSION
X
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RESULT
=
Pg. 12
MODULE 5
PRACTICE #3
LESSON 7 - MULTIPLE CONVERSIONS
Patient:
Louisa
Order:
NitroPaste 1.5 cm topical q 12 hours
Scenario: Each cm of NitroPaste contains 7.5 mg medication. When you
remove the previous patch, you see it has 2.25 inch NitroPaste on it.
How many mg of NitroPaste did the patient receive with the
previous dose?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
Underline or highlight things you need, and cross out things you don’t need.
4. What are my conversions?
CONVERSION
START
X
MODULE 5: DOSAGE CALCULATIONS
CONVERSION
X
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RESULT
=
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MODULE 5
PRACTICE #1
LESSON 8 - DOSED BY TIME
Patient:
Ezekial
Order:
Pressure-Up 0.04 units per min IV gtt
Scenario: Ezekial is hypotensive, so the MD orders a medication that causes
the blood pressure to increase. It comes in a 200 ml bag containing
100 units of medication. How many ml per hour will you set your IV
pump to deliver?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Answer:
X
MODULE 5: DOSAGE CALCULATIONS
X
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=
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MODULE 5
PRACTICE #2
LESSON 8 - DOSED BY TIME
Patient:
Brandy
Order:
1 L 0.9% NaCl over 8 hr
Scenario: Brandy just had her gallbladder removed and the MD has ordered
fluids. How many ml per hour will you set the infusion pump?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Answer:
X
MODULE 5: DOSAGE CALCULATIONS
=
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MODULE 5
PRACTICE #3
LESSON 8 - DOSED BY TIME
Patient:
Weiland (part 1)
Order:
100 mg phenytoin IV q day
Scenario: Weiland has a seizure disorder for which he takes phenytoin.
Phenytoin must be given via slow IVP at a rate of 25 mg per minute.
Phenytoin comes in a 2 ml vial containing 50 mg of medication. You
will draw up your dose in a 3 ml syringe. How many minutes will it
take to administer this medication? Round to one decimal place.
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Answer:
X
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=
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MODULE 5
PRACTICE #4
LESSON 8 - DOSED BY TIME
Patient:
Weiland (part 2)
Order:
100 mg phenytoin IV q day
Scenario: You’ve calculated the medication will be administered over 4
minutes. Phenytoin comes in a 2 ml vial containing 50 mg of
medication. How many ml will you administer each minute?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Answer:
X
MODULE 5: DOSAGE CALCULATIONS
=
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MODULE 5
PRACTICE #5
LESSON 8 - DOSED BY TIME
Patient:
Audrey
Order:
Thiamine 75 mg over 30 min
Scenario: Thiamine comes premixed from the pharmacy in a 50 ml bag. At
what rate will you set the infusion pump in ml/hr?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
OPTION 1
X
X
OPTION 2
Answer (hint: you can do this one two ways):
X
=
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=
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MODULE 5
PRACTICE #6
LESSON 8 - DOSED BY TIME
Patient:
Claudia
Order:
500 ml Lactated Ringers to infuse over 90 min
Scenario: At what rate will you set the infusion pump in ml/hr?
Round to the nearest whole number.
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
OPTION 1
X
OPTION 2
Answer:
=
MODULE 5: DOSAGE CALCULATIONS
=
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MODULE 5
PRACTICE #1
LESSON 9 - DOSED BY WEIGHT
Patient:
Allan
Order:
200 mg per kg antibiotic IM once
Scenario: Allan has been prescribed an antibiotic that comes in a vial
containing 4 g of powdered formula which you will reconstitute with
10 ml 0.9% NaCl. If Allan weighs 78 kg, how many ml will you
administer?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Answer:
X
MODULE 5: DOSAGE CALCULATIONS
X
X
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=
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MODULE 5
PRACTICE #2
LESSON 9 - DOSED BY WEIGHT
Patient:
Elizabeth
Order:
2 mg per kg antibiotic IV daily
Scenario: Elizabeth has a nasty infection for which the MD has prescribed a
powerful antibiotic. The medication comes in a 10 ml vial containing
50 mg of antibiotic. If Elizabeth weighs 42 lbs, how many ml will you
administer?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Answer:
X
MODULE 5: DOSAGE CALCULATIONS
X
X
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=
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MODULE 5
PRACTICE #3
LESSON 9 - DOSED BY WEIGHT
Patient:
Jason
Order:
8 mg per kg anxiolytic SL daily
Scenario: A flight attendant, who weighs 155 lbs, is at risk of losing his job
because he is afraid to fly. His anti-anxiety medication comes in a
10 ml vial containing 2 g of medication. How many ml of the
medication will he take each day?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Answer:
X
MODULE 5: DOSAGE CALCULATIONS
X
X
X
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=
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MODULE 5
PRACTICE #1
LESSON 10 - DOSED BY WEIGHT & TIME
Patient:
Jimmy
Order:
2 mcg/kg/min Sedata IV gtt
Scenario: Your ICU is trying out a new medication that keeps patients from
feeling restless. Sedata comes in a bag of 250 ml solution
containing 250 mg of medication. You will run this as a continuous
infusion, based on the patient’s weight of 60 kg. Your pump
administers medication based on ml/hr. At what rate will you infuse
your medication?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Answer:
X
MODULE 5: DOSAGE CALCULATIONS
X
X
X
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=
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MODULE 5
PRACTICE #2
LESSON 10 - DOSED BY WEIGHT & TIME
Patient:
Katy
Order:
4 to 10 mcg/kg/min Vasolift IV gtt to maintain SBP > 110
Scenario: Your patient’s blood pressure has been steadily dropping all night.
You finally get an order for Vasolift, which comes in a 100 ml bag
containing 500 mg medication. Your patient weighs 160 lbs. You
will start the infusion at 4 mcg/kg/min and titrate by
1 mcg/kg/min every 10 minutes to the desired effect. How many
ml/hr of medication will your patient receive to start?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #3
LESSON 10 - DOSED BY WEIGHT & TIME
Patient:
Brianna
Order:
5 mcg/kg/min dobutamine
Scenario: Brianna has heart failure with low cardiac output, so her blood
pressure is low. The MD orders dobutamine to increase her cardiac
output. The medication comes in a 250 ml bag containing 250 mg
medication. At what rate will you set the infusion pump in ml/hr if
Brianna weighs 135 lbs? Round to two decimal places.
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #4
LESSON 10 - DOSED BY WEIGHT & TIME
Patient:
Walter
Order:
2 mg/kg/min of sedative IV gtt nightly from 2100 to 0600
Scenario: Little Walter has horrifying nightmares, so the MD orders a sedative
to help him sleep, to be run as a continuous infusion from 21000600 each night. It comes in a 50 ml bag containing 10 g of
medication. If Walter weighs 40 lbs, how many ml per hour will you
infuse?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #5
LESSON 10 - DOSED BY WEIGHT & TIME
Patient:
Richard
Order:
0.2 to 0.9 mcg/kg/hr Precedex
Scenario: Precedex comes in a vial of 400 mcg in 100 ml. The order is to
infuse 0.2 to 0.9 mcg/kg/hr of medication starting at 0.2
mcg/kg/hr and titrating every five minutes by 0.1 mcg/kg/hr to
achieve a RASS score of -1 to 0. You started the infusion at 0813 at
0.2 mcg/kg/hr and you’ve titrated it up by the ordered amount
every five minutes...it is now 0823. If Richard weighs 78 kg, how
many ml/hr is the medication currently infusing?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #1
LESSON 11 - DOSED BY DROPS
IV tubing delivers a set number of drops per ml (gtts/ml)
• Microtubing delivers 60 gtts/ml
• Macrotubing delivers 10, 15 or 20 gtts/ml
Patient:
Lewis
Order:
0.9% NaCl 125 ml/hr
Scenario: You are using IV tubing with a drop factor of 15 gtts/ml.
How many drops per minute will you infuse?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #2
LESSON 11 - DOSED BY DROPS
Patient:
Jen
Order:
500 ml Banana Bag IV over 6 hours
Scenario: Your IV tubing has a drop factor of 20 gtts per ml. How many gtts
per minute will you count out to ensure your patient receives the
proper dose?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
MODULE 5: DOSAGE CALCULATIONS
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MODULE 5
PRACTICE #3
LESSON 11 - DOSED BY DROPS
Patient:
Stephanie
Order:
10 ml/kg Lactated Ringers given over 2 hours
Scenario: Stephanie weighs 127 lbs and your tubing has a drop factor of 15
gtts/ml. How many gtts per minute will you infuse? How many will
you count out for ten seconds?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #4
LESSON 11 - DOSED BY DROPS
Patient:
Rainbow
Order:
20 mg Sober-Up over 3 hours
Scenario: You are working in the medical tent at Burning Man and Rainbow,
who weighs 48 kg, is ready to drive home. Sober-Up comes
premixed 20 mg in a 200 ml bag. Your IV tubing has a drop factor
of 15. How many gtts per minute will your tipsy patient receive?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #1
LESSON 12 - RECONSTITUTING
MEDICATIONS
Order:
Cefazolin 300 mg IM
Available:
500 mg powder
Reconstitute:
Add 2 ml 0.9% NaCl
Concentration:
225 mg/ml
How many ml will you give per dose?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #2
LESSON 12 - RECONSTITUTING
MEDICATIONS
Order:
Loracarbef 400 mg PO
Available:
1 g powder
Reconstitute:
25 ml sterile water
How many ml will you give per dose?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
EXAMPLE #1
LESSON 13 - DILUTING FORMULAS
Total volume indicated
The MD has ordered 240 ml Jevity tube feeding to be administered at ⅓ strength.
How much water will you use to create the proper dilution?
With this type of question, MULTIPLY then SUBTRACT.
Step 1:
Convert the fraction or percentage to a decimal
Step 2:
Plug the numbers into the formula (then round to nearest ten):
ORDERED VOLUME x DESIRED STRENGTH = AMOUNT OF FORMULA
Step 3:
Determine how much diluent to use
ORDERED VOLUME - AMOUNT OF FORMULA = AMOUNT OF DILUENT TO USE
Your final solution will total
and
ml and consist of
ml Jevity
ml water.
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MODULE 5
EXAMPLE #2
LESSON 13 - DILUTING FORMULAS
Total volume not indicated
The MD has ordered Glucerna at ⅓ strength to run continuously at 45 ml/hr. You
have a 240 ml can of Glucerna available. How many ml of water will you add to
make the ordered strength?
With this type of question, DIVIDE then SUBTRACT.
Step 1:
Convert the fraction or percentage to a decimal
Step 2:
Plug the numbers into the formula (then round to nearest ten):
VOLUME AVAILABLE ÷ DESIRED STRENGTH = TOTAL VOLUME TO BE CREATED
Step 3:
Determine how much diluent to use
TOTAL VOLUME TO BE CREATED - VOLUME AVAILABLE =
Your final solution will total
Glucerna and
MODULE 5: DOSAGE CALCULATIONS
ml and consist of
AMOUNT OF
DILUENT TO USE
ml
ml water.
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MODULE 5
PRACTICE #1
LESSON 13 - DILUTING FORMULAS
The MD has ordered 60 ml PediaCare formula to be administered at ⅔ strength.
How much formula and water will you use to create the proper dilution?
Step 1:
Convert the fraction or percentage to a decimal
Step 2:
Plug the numbers into the formula (then round to nearest ten):
ORDERED VOLUME x DESIRED STRENGTH = AMOUNT OF FORMULA
Step 3:
Determine how much diluent to use
ORDERED VOLUME - AMOUNT OF FORMULA = AMOUNT OF DILUENT TO USE
Your final solution will total
PediaCare and
MODULE 5: DOSAGE CALCULATIONS
ml and consist of
ml
ml water.
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MODULE 5
PRACTICE #2
LESSON 13 - DILUTING FORMULAS
The MD has ordered PediaSure formula to be administered at ⅔ strength over a
period of 4 hours. You have a 60 ml container of PediaSure available. How much
water will you add to create the proper dilution?
Step 1:
Convert the fraction or percentage to a decimal
Step 2:
Plug the numbers into the formula (then round to nearest ten):
VOLUME AVAILABLE ÷ DESIRED STRENGTH = TOTAL VOLUME TO BE CREATED
Step 3:
Determine how much diluent to use
TOTAL VOLUME TO BE CREATED - VOLUME AVAILABLE =
Your final solution will total
PediaSure and
MODULE 5: DOSAGE CALCULATIONS
ml and consist of
AMOUNT OF
DILUENT TO USE
ml
ml water.
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MODULE 5
PRACTICE #3 & #4
LESSON 13 - DILUTING FORMULAS
You are to create a tube feeding solution for your patient at 25% strength. You have
an 84 ml can of PediaCal. How much water will you add to arrive at the proper
concentration of tube feeding?
Perform your calculation here:
Your final solution will total
PediaCal and
ml and consist of
ml
ml water.
The MD has ordered 84 ml NutriPedia tube feeding to be administered at 25%
strength. How much water will you add to create the proper dilution?
Perform your calculation here:
Your final solution will total
NutriPedia and
MODULE 5: DOSAGE CALCULATIONS
ml and consist of
ml
ml water.
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MODULE 5
PRACTICE #1
LESSON 14 - CALCULATING PERCENT
WEIGHT LOSS
Olivia's birth weight was 7 lbs 4 oz. At discharge three days later, she weighs
6 lbs 12 oz. What is her percent weight loss? If weight loss is greater than 10%,
the doctor needs to be notified.
Four Easy Steps:
1. Convert all weights into ounces
2. Subtract the lower weight from the higher one to get the difference
3. Divide the difference by your starting weight
4. Multiply this by 100 to get a percentage
Let's do this one together:
Step 1:
Convert all weights into ounces
Step 2:
Subtract the lower weight from the higher one to get the difference
Step 3:
Divide the difference by your starting weight
Step 4:
Multiply this by 100 to get a percentage
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MODULE 5
PRACTICE #2
LESSON 14 - CALCULATING PERCENT
WEIGHT LOSS
Charlotte's birth weight was 6 lbs 2 oz. At discharge five days later, she weighs 5 lbs
6 oz. What percentage of her birth weight did she lose? If more than 10%, the doctor
needs to be notified.
Let's do this one together:
Step 1:
Convert all weights into ounces
Step 2:
Subtract the lower weight from the higher one to get the difference
Step 3:
Divide the difference by your starting weight
Step 4:
Multiply this by 100 to get a percentage
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MODULE 5
PRACTICE #1
LESSON 15 - TRICK #1 - INFORMATION
YOU DON’T NEED
Drake has been ordered 4 mg of an antibiotic to be given IVP q 8 hrs. Each vial
of the antibiotic contains 10 mg of powdered solution. The reconstitution
instructions call for it to be mixed with 20 ml 0.9% NaCl and it must be given
slowly at a rate not to exceed 1 mg in 10 minutes.
How many ml of the antibiotic will your patient receive?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #2
LESSON 15 - TRICK #1 - INFORMATION
YOU DON’T NEED
Pam is vomiting uncontrollably, so the MD orders 1500 mg of an
antiemetic IV q 6 hours. The pharmacy has provided a vial containing 3 g
powdered medication with instructions to reconstitute with 9.6 ml 0.9% NaCl for
a final volume of 10 ml.
How many ml of the antiemetic will you give for each dose?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #3
LESSON 15 - TRICK #1 - INFORMATION
YOU DON’T NEED
You are studying for your CCRN exam while getting your MSN and working fulltime. The stress is causing insomnia, so your doctor prescribes a sleep aid. The
medication is provided as 2 g powder that is reconstituted with 5 ml sterile
water for a total volume of 2 g in 5 ml.
If you inject the dose of 150 mg daily, how many total mg will you administer in
one week?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #4
LESSON 15 - TRICK #1 - INFORMATION
YOU DON’T NEED
Monica weighs 18.62 kg. The doctor has ordered the patient to receive 14 mg/hr
of medication which comes in a concentration of 2.8 mg/ml.
How many mcg/kg/min will the patient receive?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #5
LESSON 15 - TRICK #1 - INFORMATION
YOU DON’T NEED
Ted has been prescribed 10 mg/min SnoreNoMore IV as a continuous infusion.
He weighs 185 lbs. SnoreNoMore comes in a 250 ml bag containing 8 g
medication. You hung a new bag at 0700 and it is currently 1100.
How many mg of SnoreNoMore has your patient received?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #1
LESSON 16 - TRICK #2 - CUMULATIVE
DOSE QUESTIONS
Lucille is taking acetaminophen every 4 hours. If she is taking 650 mg with each
dose, will she exceed the maximum 24-hr limit of 4 g acetaminophen?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #2
LESSON 16 - TRICK #2 - CUMULATIVE
DOSE QUESTIONS
Hugh is not waking up after surgery and you are curious what medications he
received. You check the anesthesia record and see the following:
Induction - 2 mg/kg ketamine at 0716
Continuous - 0.5 mg/min for 1 hour and 22 minutes
If Hugh weighs 62 kg, how many mg of ketamine did he receive?
PART 1-INDUCTION
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
PART 1
Write out your equation here:
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MODULE 5
PRACTICE #2
LESSON 16 - TRICK #2 - CUMULATIVE
DOSE QUESTIONS
Hugh is not waking up after surgery and you are curious what medications he
received. You check the anesthesia record and see the following:
Induction - 2 mg/kg ketamine at 0716
Continuous - 0.5 mg/min for 1 hour and 22 minutes
If Hugh weighs 62 kg, how many mg of ketamine did he receive?
PART 2- CONTINUOUS
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
PART 2
Write out your equation here:
TOTAL
What is the TOTAL cumulative dose from the induction dose and
the continuous dose?
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MODULE 5
PRACTICE #3
LESSON 16 - TRICK #2 - CUMULATIVE
DOSE QUESTIONS
Maggie takes lithium for bipolar disorder. She takes 400 mg TID in an oral
solution with a concentration of 300 mg in 5 ml. How many ml does she
take per day?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
MODULE 5: DOSAGE CALCULATIONS
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MODULE 5
PRACTICE #1
LESSON 17 - TRICK #3 - DISGUISING
THE ACTUAL QUESTION
Mrs. Reynolds has been admitted for severe epigastric pain. The physician orders
a proton pump inhibitor (PPI) to run at 8 mg/hr IV. The PPI is available in a 100 ml
vial containing a concentration of 40 mg/ml. The infusion requires 200 mg of the
PPI to be added to a 250 ml bag of normal saline.
What volume (in ml) of the PPI will you add to the bag of normal saline?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #2
LESSON 17 - TRICK #3 - DISGUISING
THE ACTUAL QUESTION
750 ml of IV fluid (IVF) was ordered to infuse over five hours for your patient Allie.
You used tubing with a drop factor of 15 gtts/ml. After three hours, 400 ml of IVF
remains. What will you reset the flow rate to in gtts/min in order to complete this
infusion on time?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
MODULE 5: DOSAGE CALCULATIONS
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MODULE 5
PRACTICE #1
LESSON 18 - TRICK #4 - CONVOLUTED
QUESTIONS
A 30 ml bag of solution contains 3.5 g of an antifungal and is to be infused over
25 minutes for Joeleen, who has fungal pneumonia. What should the rate of
flow per minute be if each ml contains 60 drops of solution?
When the intravenous solution has infused at the correct rate for 15 minutes,
how many grams of medication will the patient have received (rounded to one
decimal place)?
PART 1
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
PART 1
Write out your equation here:
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MODULE 5
PRACTICE #1
LESSON 18 - TRICK #4 - CONVOLUTED
QUESTIONS
A 30 ml bag of solution contains 3.5 grams of an antifungal and is to be infused
over 25 minutes for Joeleen, who has fungal pneumonia. What should the rate
of flow per minute be if each milliliter contains 60 drops of solution?
When the intravenous solution has infused at the correct rate for 15 minutes,
how many grams of medication will the patient have received (rounded to one
decimal place)?
PART 2
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
PART 2
Write out your equation here:
MODULE 5: DOSAGE CALCULATIONS
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MODULE 5
PRACTICE #1
LESSON 19 - CRITICAL THINKING WITH
DOSAGE CALCULATIONS
Patient:
Mackenzie
Order:
2 g vancomycin over 120 minutes
Scenario: The NP has ordered for the patient to receive 2 g vancomycin to be
given over 120 minutes. The medication comes pre-mixed in a 500
ml bag. At what rate will you set the infusion pump in ml/hr?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
MODULE 5: DOSAGE CALCULATIONS
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MODULE 5
PRACTICE #2
LESSON 19 - CRITICAL THINKING WITH
DOSAGE CALCULATIONS
Patient:
Marcus
Order:
1750 mg vancomycin over 120 minutes
Scenario: The NP has ordered for the patient to receive 1750 mg vancomycin
to be given over 120 minutes. The medication comes pre-mixed in a
500 ml bag. At what rate will you set the infusion pump in ml/hr?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #3
LESSON 19 - CRITICAL THINKING WITH
DOSAGE CALCULATIONS
Patient:
Mel
Order:
1000 mg levofloxacin over 120 minutes
Scenario: The NP has ordered for the patient to receive 1000 mg levofloxacin
to be given over 120 minutes. The medication comes pre-mixed in a
500 ml bag. At what rate will you set the infusion pump in ml/hr?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #4
LESSON 19 - CRITICAL THINKING WITH
DOSAGE CALCULATIONS
Patient:
Maddie
Order:
500 ml Lactated Ringers over 120 minutes
Scenario: The NP has ordered for the patient to receive 500 ml Lactated
Ringers to be given over 120 minutes. At what rate will you set the
infusion pump in ml/hr?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #5
LESSON 19 - CRITICAL THINKING WITH
DOSAGE CALCULATIONS
Patient:
Morgan
Order:
1.5 g vancomycin over 120 minutes
Scenario: The NP has ordered for the patient to receive 1.5 g vancomycin to
be given over 120 minutes. The medication comes pre-mixed in a
500 ml bag. At what rate will you set the infusion pump in ml/hr?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #6
LESSON 19 - CRITICAL THINKING WITH
DOSAGE CALCULATIONS
Patient:
Truman
Order:
500 mg metronidazole over 120 minutes
Scenario: The NP has ordered for the patient to receive 500 mg
metronidazole to be given over 120 minutes. The medication comes
pre-mixed and ready to use in a 500 ml bag. At what rate will you
set the infusion pump in ml/hr?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #7
LESSON 19 - CRITICAL THINKING WITH
DOSAGE CALCULATIONS
Patient:
Ollie
Order:
750 mg cefazolin over 30 minutes
Scenario: This medication comes in powdered form which you will mix with
100 ml 0.9% NaCl. How many ml/hr will you set the infusion pump?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #8
LESSON 19 - CRITICAL THINKING WITH
DOSAGE CALCULATIONS
Patient:
David
Order:
75 mcg levothyroxine IV q day
Scenario: Levothyroxine comes in a 5 ml vial with a concentration of 20 mcg
per ml. How many ml will you administer?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #9
LESSON 19 - CRITICAL THINKING WITH
DOSAGE CALCULATIONS
Patient:
Duke
Order:
75 mcg levothyroxine IV q day
Scenario: Levothyroxine comes in a 5 ml vial containing 100 mcg of
medication. How many ml will you administer?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
MODULE 5: DOSAGE CALCULATIONS
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MODULE 5
PRACTICE #10
LESSON 19 - CRITICAL THINKING WITH
DOSAGE CALCULATIONS
Patient:
Paula
Order:
0.5 mcg norepinephrine per minute
Scenario: Norepinephrine comes in a 250 ml bag containing 4 mg of
medication. At what rate will you set the infusion pump in ml/hr?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #1
LESSON 20 - REVIEW
Patient:
Zena
Scenario: You’re a new nurse working on a Zombie Apocalypse Recovery Unit.
A newly-infected zombie has just arrived. Based on signs that
indicate Zena has been infected for less than 24 hours, the MD
orders 20 mg of VirusKilz IV q 8 hours. This humanity-saving drug
comes in 5 ml vials that contain 30 mg of medication. How many ml
will you administer to Zena?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #2
LESSON 20 - REVIEW
Patient:
Tazz
Scenario: You are the personal RN for a rockstar and it’s your job to make
sure he doesn’t overdose on caffeine. After his 10th energy drink,
you step in with the antidote. CalmDown comes in 4 g tablets and
the dose is 500 mg per can of energy drink consumed. How many
tablets will you administer to your famous friend?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #3
LESSON 20 - REVIEW
Patient:
Chelsea
Scenario: You get home from a long shift to find your roommate on a Real
Housewives binge. The next morning, she is still on the sofa,
babbling incoherently. You call 9-1-1 and the paramedics arrive
with a cutting-edge medication called BrainRenew, which has a
rescue dose of 50 mg/kg IV and comes in a 10 ml vial containing
10 g medication. Your roommate weighs 132 lbs. How many mg of
BrainRenew will she require?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #4
LESSON 20 - REVIEW
Patient:
Jillian
Scenario: You receive report on a 16-year-old girl admitted to the hospital for
temporary blindness secondary to rolling her eyes so far back
they’ve become stuck. The ophthalmologist on call prescribes 25
mcg/kg/min Unroll via continuous IV infusion until vision is restored.
Unroll is available in a 500 ml bag containing 500 mg of
medication. Your patient weighs 112 lbs. For how many ml per hour
will you program your pump, rounded to the nearest tenth?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #5
LESSON 20 - REVIEW
Patient:
Barry
Scenario: Your patient is coming out of anesthesia, and begins telling you every
secret thought he’s ever had. By the time he gets to his 8th grade
confessions, you’ve had enough. You beg the MD for an order of
Make-It-Stop, which you know comes in a 250 ml IV bag containing
200 mg medication. If you need to infuse 200 mg over 90 minutes by
gravity using tubing with a drop factor of 20, how many drops per
minute will you administer to your talkative patient?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equation here:
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MODULE 5
PRACTICE #6
LESSON 20 - REVIEW
Patient:
Cecelia (part 1)
Scenario: Cecelia is a nursing student putting in long hours at her desk. In an
attempt to burn more calories she takes a new medication called
CalBurn. CalBurn comes in a 250 ml bottle containing 1750 mg of
calorie-burning magic. Her daily dose is 500 mcg/kg and she
weighs 135 lbs. Unfortunately, Cecelia’s roommate drank 120 ml.
How many mg did the roommate consume, is this above Cecelia’s
daily dose, and how many ml does Cecelia take daily?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equations here:
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MODULE 5
PRACTICE #6
LESSON 20 - REVIEW
Patient:
Cecelia (part 2)
Scenario: Cecelia is a nursing student putting in long hours at her desk. In an
attempt to burn more calories she takes a new medication called
CalBurn. CalBurn comes in a 250 ml bottle containing 1750 mg of
calorie-burning magic. Her daily dose is 500 mcg/kg and she
weighs 135 lbs. Unfortunately, Cecelia’s roommate drank 120 ml.
How many mg did the roommate consume, is this above Cecelia’s
daily dose, and how many ml does Cecelia take daily?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equations here:
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MODULE 5
PRACTICE #6
LESSON 20 - REVIEW
Patient:
Cecelia (part 3)
Scenario: Cecelia is a nursing student putting in long hours at her desk. In an
attempt to burn more calories she takes a new medication called
CalBurn. CalBurn comes in a 250 ml bottle containing 1750 mg of
calorie-burning magic. Her daily dose is 500 mcg/kg and she
weighs 135 lbs. Unfortunately, Cecelia’s roommate drank 120 ml.
How many mg did the roommate consume, is this above Cecelia’s
daily dose, and how many ml does Cecelia take daily?
Go through the four questions:
1. What is the question asking?
2. Where do I start?
3. What information do I need or not need?
4. What are my conversions?
Write out your equations here:
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