Nursing Dosage Calculations
Nursing Dosage Calculations
MOLLY CRAKER, ED.S., M.ED. AND CHANDA JANKE, M.ED.
WISTECH OPEN
EAU CLAIRE , WISCONSIN
Nursing Dosage Calculations Copyright © 2024 by WisTech Open is licensed under a Creative Commons Attribution 4.0 International
License, except where otherwise noted.
Contents
Introduction
1
Preface
2
Understanding Nursing Dosage Calculations
v
Part I. BASIC CONVERSIONS
Basic Conversions
9
Basic Conversions Practice
12
Part II. ORAL MEDICATIONS
Introduction to Oral Medications
17
Oral Medication Practice
19
Part III. INJECTION MEDICATION
Introduction to Injection Medications
25
Injection Medication Practice
27
Part IV. IV FLOW RATES & INFUSION TIME
Introduction to IV Flow Rates and Infusion Time
33
IV Flow Rates and Infusion Time Practice
35
Part V. RECONSTITUTION
Introduction to Reconstitution
43
Reconstitution Practice
45
Part VI. SAFE RANGE / WEIGHT-BASED
Introduction to Safe Range / Weight-Based
51
Safe Range / Weight-Based Practice
53
Part VII. IV BOLUS RATE
Introduction to IV Bolus Rate
59
IV Bolus Rate Practice
61
Part VIII. MCG/KG/MIN
Introduction to mcg/kg/min
69
Mcg/Kg/Min Practice
70
Appendix - Extended Practice Answer Keys
71
Answer Keys
78
Introduction
This Nursing Dosage Calculations book is an open educational resource with CC BY 4.0 licensing developed
for nursing and health students. This book is available for free online and can also be downloaded in multiple
formats for offline use. The online version is required for interaction with adaptive learning activities included in
the book.
This comprehensive guide to nursing dosage calculations provides a clear, step-by-step approach to
mastering the essential skills needed for accurate medication administration. The book begins with
foundational concepts in mathematics and measurement, ensuring readers understand basic principles before
progressing to more complex calculations. The book emphasizes critical thinking and problem-solving skills,
encouraging readers to apply their knowledge to real-world scenarios. With a focus on accuracy and patient
safety, this resource is an invaluable tool for nursing students and professionals alike.
This book was developed through the WisTech Open project and supported by funds from the Wisconsin
Technical College System (WTCS). However, this content does not necessarily represent the policy of WTCS, and
you should not assume endorsement by the state or federal government. More information about the WisTech
Open project can be found at cvtc.edu/WisTech.
The following video provides a quick overview of how to navigate the online version:
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Introduction | 1
Preface
About this Book
Authors
• Molly Craker, M.Ed., Ed.S., Academic Support Instructor, Chippewa Valley Technical College
• Chanda Janke, M.Ed., Academic Support Instructor, Chippewa Valley Technical College
About the Authors
Hello, nursing students—we’re Molly Craker and Chanda Janke, both instructors in Academic Support
at Chippewa Valley Technical College (CVTC). We’ve designed this workbook to help you learn how to
solve dosage calculations accurately and efficiently, and we’re here to guide you through the process
using practical methods and real-world scenarios. You can use this workbook alongside our self-paced
Canvas course or as a standalone resource.
Molly Craker
2 | Preface
Chanda Janke
Get ready to build confidence in your dosage calculation skills. Please contact us at
mcraker6@cvtc.edu or cjanke7@cvtc.edu if you have any questions.
WisTech Open Team
• Nic Ashman, MLIS, Graphics Editor/Librarian
• Jane Flesher, MST, Copy Editor
• Vince Mussehl, MLIS, Project Director
• Samantha Rubenzer, MA – Teaching & Education, Instructional Designer/Technologist
Licensing/Terms of Use
This textbook is licensed under a Creative Commons Attribution 4.0 International (CC-BY) license unless
otherwise indicated, which means that you are free to:
• SHARE – copy and redistribute the material in any medium or format
• ADAPT – remix, transform, and build upon the material for any purpose, even commercially
The licensor cannot revoke these freedoms as long as you follow the license terms.
• Attribution: You must give appropriate credit, provide a link to the license, and indicate if any changes
were made. You may do so in any reasonable manner, but not in any way that suggests the licensor
endorses you or your use.
• No Additional Restrictions: You may not apply legal terms or technological measures that legally restrict
others from doing anything the license permits.
• Notice: You do not have to comply with the license for elements of the material in the public domain or
where your use is permitted by an applicable exception or limitation.
• No Warranties are Given: The license may not give you all of the permissions necessary for your intended
use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
Preface | 3
Suggested Citation
Content that is not taken from the public domain should include the following attribution statement:
Craker, M., & Janke, C. (2024). Nursing Dosage Calculations by WisTech Open is licensed under CC BY 4.0
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4 | Preface
Understanding Nursing Dosage
Calculations
What’s Inside?
• Step-by-Step Instructions: We break down dosage problems using the method of dimensional analysis.
From oral medications to IV infusions, this method will help you solve any problem.
• Error-Proof Techniques: This systematic approach minimizes mistakes and boosts accuracy.
• Opportunity to Practice: Use our practice materials—repetition is the key to calculating dosage problems
both accurately and efficiently.
What is Dimensional Analysis (DA)?
Dimensional analysis, also known as the factor-label or unit matching method, is a problem-solving technique
that uses conversion factors to move between different units of measurement. Unlike memorizing specific
formulas, DA allows nurses to approach dosage calculations systematically and efficiently.
Why Use Dimensional Analysis?
Here are some reasons why using DA when solving dosage calculation problems is helpful for nursing students:
• Universal Applicability: DA can be used for all dosage calculations, whether it’s weight-based dosing, IV
infusions, or other scenarios. It provides a consistent approach across different medication types.
• Error Reduction: By relying on conversion factors rather than memorized formulas, DA minimizes the risk
of errors. Nurses can confidently calculate doses without second-guessing themselves.
• Flexibility: DA adapts to various situations. Whether you’re converting milligrams to milliliters or adjusting
infusion rates, the same method applies.
• No Rounding Until the End: Unlike some other methods, DA encourages nurses to avoid rounding
numbers prematurely. This precision ensures accurate results.
Layout of Content
The organization of this book can be found by viewing the Table of Contents.
Understanding Nursing Dosage Calculations | 5
6 | Understanding Nursing Dosage Calculations
PART I
BASIC CONVERSIONS
BASIC CONVERSIONS | 7
8 | BASIC CONVERSIONS
Basic Conversions
Introduction to Basic Metric Conversions
Vocabulary:
Liter (L) – Base unit for volume in the metric system
Gram (g) – Base unit for mass in the metric system
Meter (m) – Base unit for length in the metric system
Metric System Conversions:
Understanding how to convert within the metric system and between metric and standard (Imperial) systems
is crucial for nurses. The metric system is widely used in health care. It’s based on powers of 10, making
conversions straightforward, simple, and precise.
1. Learn the Metric Prefixes
Familiarize yourself with these common metric prefixes:
• Kilo (k) = 1,000 times larger than base
• Hecto (h) = 100 times larger than base
• Deka (da) = 10 times larger than base
• Base unit (e.g., meter, liter, gram)
• Deci (d) = 10 times smaller than base
• Centi (c)= 100 times smaller than base
• Milli (m) = 1,000 times smaller than base
◦ Use the mnemonic “King Henry Died Until Drinking Chocolate Milk” to remember these prefixes.
2. Dimensional Analysis Review
Rule 1. Set up the problem. What units will your answer have?
Rule 2. Work the problem until the unit(s) on one side match the units on the other.
Rule 3. Do your units MATCH?
Basic Conversions | 9
Rule 4. Solve by multiplying all the top numbers and write the answer in the numerator, and then multiply all
the bottom numbers and write the answer in the denominator.
= Dive the top by the bottom
Rule 5. Write the number to four (4) decimals and then round and write your units appropriately.
3. Conversion Steps
Nurses often convert between milliliters (mL) and liters (L) when administering medications or fluids.
Converting large units to small units
When going from larger to smaller units, multiply by 10 successively.
Converting small units to large units
When going from smaller to larger units, divide by 10 successively.
Converting between metric and standard (Imperial) systems
Examples of some conversions include:
◦ 1 fluid ounce (oz) = 30 mL (approximately)
◦ 1 pound (lb) = 16 ounces (oz)
◦ 1 cup = 8 fluid ounces (oz)
◦ 1 pint (pt) = 2 cups
◦ 1 quart (qt) = 4 cups
◦ 1 gallon (gal) = 4 quarts
Conversion Examples
(Large units to small units)
Convert 2 liters (L) to milliliters (mL) using dimensional analysis:
mL → 1000 mL / 1 L x 2 L = 2000 mL
(Small units to large units)
Convert 800 milliliters (mL) to liters (L) using dimensional analysis:
L → 1 L / 1000 mL x 800 mL = 0.8 L
(Metric system to standard/Imperial system)
Nurses often need to convert between metric and standard (Imperial) units. For example, if a patient
10 | Basic Conversions
consumed 20 ounces of fluid, and a nurse needed to record the total intake in milliliters (mL), they
would perform the following conversion using dimensional analysis:
mL → 30 mL / 1 oz x 20 oz = 600 mL
Basic Metric Conversions to Memorize
1 cup (c) = 8 oz
1 kg = 2.2 lbs
1 mL = 1 cc
1 teaspoon (t) = 5 mL
1 Tablespoon (T) = 15 mL
1 ounce (oz) = 30 mL
Microdrip tubing = 60 gtt/mL
Basic Metric Conversion Tutorial
1
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online here: https://wtcs.pressbooks.pub/nursingdosagecalculations/?p=5#oembed-1
1. WisTech Open. (2024, August 9). Nursing dosage calculations – Basic conversions [Video]. YouTube. CC BY 4.0.
https://www.youtube.com/watch?v=K0z5xHowr5Y
Basic Conversions | 11
Basic Conversions Practice
Basic Conversions Flashcards
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Basic Conversions Knowledge Check
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Basic Conversions Extended Practice 1
1. 60 lb = ______ kg
2. 20 mL = ______ tsp
3. 5 oz = ______ mL
4. 2.4 L = ______ mL
5. 7 oz = ______ mL
6. A client had the following:
8 oz. milk
6 oz. orange juice
4 oz. water with medication
Total mL = ______
12 | Basic Conversions Practice
7. Calculate the following individual items and give the total number of mL:
10 oz. coffee
8 oz. water
6 oz. broth
Total mL = _____
8. 36 mg = ______ g
9. 67.5 mL = ______ t
10. 2 T = ______ mL
Answer key is located in the Appendix
Basic Conversions Extended Practice 2
1. 4 oz = ______ mL
2. 110 lb = ______ kg
3. 55 cm = ______ in
4. Calculate the client’s fluid intake for breakfast in milliliters. (Assume that the glass holds 6 oz and
the cup holds 8 oz.)
The client had the following for breakfast at 8 AM:
⅓ glass of apple juice
½ cup of coffee
½ pint of milk
Total = _______ mL
5. 7 oz = ______ mL
6. 45 mL = _____ tbs
7. 178.2 lb = ______ kg
Basic Conversions Practice | 13
Answer key is located in the Appendix
14 | Basic Conversions Practice
PART II
ORAL MEDICATIONS
ORAL MEDICATIONS | 15
16 | ORAL MEDICATIONS
Introduction to Oral Medications
Vocabulary
t.i.d – Three times a day
b.i.d – Twice a day
PO – By mouth
IM – Inject the medicine into the muscle
stat – Immediately
prn – Latin for “pro re nata” and means depending on the pain
Oral Medication Conversions
Understanding how to calculate oral medications is essential for nurses. To accomplish this task, dimensional
analysis (unit matching) is the preferred method.
Oral medications come as solid tablets; capsules; chewable tablets or orally disintegrating tablets to be
swallowed whole or sucked; or as a liquid in the form of drops, syrups, or solutions. In most cases, the ingredients
in oral medication don’t enter the bloodstream until they reach the stomach or bowel.
1. Dimensional Analysis Review
Rule 1. Set up the problem. What units will your answer have?
Rule 2. Work the problem until the unit(s) on one side match the units on the other.
Rule 3. Do your units MATCH?
Rule 4. Solve by multiplying all the top numbers and write the answer in the numerator and then multiply all
the bottom numbers and write the answer in the denominator.
= Dive the top by the bottom
Rule 5. Write the number to four (4) decimals and then round and write your units appropriately.
2. Conversion Steps
Read the question carefully. Determine the desired units for the final answer. Begin with the end in mind.
Then, review the question. Remember that to cancel unwanted units, one must be on top and the other on the
bottom of a fraction.
Introduction to Oral Medications | 17
Oral Medication Conversion Example
Order: Cefaclor 250 mg PO t.i.d
Available: Cefaclor oral suspension labeled 125 mg per 5 mL
Solve: How many mL per dose?
mL →
x
Notes: Per means to “divide,” and always check your answer for reasonableness.
Oral Medication Conversion Video Tutorial
1
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watch?v=lVUi4NPbDFI
18 | Introduction to Oral Medications
Oral Medication Practice
Vocabulary Practice
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Oral Medication Knowledge Check
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Oral Medication Extended Practice 1
1. Order: Lasix 40 mg PO daily.
Available: Tablets labeled 20 mg.
How many tablets per dose?
2. Order: Propranolol 15 mg PO t.i.d.
Available: 10 mg tablets.
How many tablets per dose? How many tablets per day?
3. Order: Phenobarbital 90 mg PO at bedtime.
Available: Phenobarbital 30 mg tablets.
How many tablets will be administered per dose?
4. Order: Ampicillin 1 g PO stat.
Available: Ampicillin capsules labeled 500 mg.
How many capsules per dose?
Oral Medication Practice | 19
5. Order: Robaxin 1.5 g PO stat.
Available: Robaxin tablets labeled 500 mg tablets.
How many tablets per dose?
6. Order: Cefaclor 250 mg PO t.i.d.
Available: Cefaclor oral suspension labeled 125 mg per 5 mL.
How many mL per dose?
7. Order: 50 mg PO once daily for a patient.
Available: 25 mg tablets.
How many tablets will the patient take each day?
8. Oder: 12.5 mg PO of a drug.
Available: 5 mg scored tablets.
How many tablets should be administered?
9. Order: 100 mcg/day PO divided into two doses.
Available: 0.025 mg tablets.
How many tablets should be administered per dose?
10. Order: Tylenol 160 mg by mouth as needed every six hours for pain for a child.
Available: 80 mg per mL.
How many mL will be administered per dose?
11. Oder: 100 mg PO t.i.d of a drug.
Available: 20 mL vials containing 50 mg/mL.
How many mL will be administered each day?
12. Order: 0.25 mg of a medication.
Available: 50 mcg/mL.
How many mL will the nurse administer?
13. Order: A patient weighing 165 pounds has an order for a drug 100 mg/day divided into two
doses.
Available: 10 mL vials containing 50 mg/mL.
How many mL should be administered per dose?
14. Order: A 45-pound-child has an order for Furosemide 2 mg/kg PO once daily.
Available: Furosemide oral solution in 60 mL bottles containing 10 mg/mL.
How many mL should be administered per dose?
15. Order: An 81-kg-patient is to receive an initial bolus dose of a drug 0.086 mg/kg over at least
two minutes.
Available: 4 mL vials containing 2.5 mg/mL.
20 | Oral Medication Practice
How many mL should be administered?
Answer key is located in the Appendix
Oral Medication Extended Practice 2
1. The doctor writes an order for Diabinese 0.1 grams PO Q.d.
The drug container label reads Diabinese 100 mg tablets.
How many tablets should be given?
2. A patient is prescribed 250 mg Clozapine PO daily.
How many tablets would the patient take if each tablet contains 100 mg?
3. A patient is receiving 500 mg of Ceclor oral suspension.
The label says Ceclor 250 mg/5mL, and the bottle contains 100 mL.
How many mL of Ceclor should be given?
4. The order is for acetaminophen 10 mg/kg PRN every eight hours for an infant weighing 33 lbs.
How many mg of acetaminophen could the infant receive in a 24-hour period?
5. The order is for an antibiotic to be given every eight hours.
The recommended dose is 15 mg/kg of body weight every 24 hours. The infant weighs 22
lbs.
How many mg of the antibiotic should the infant receive per dose?
6. The patient is a 12-month-old female. Her weight is 44 lbs. The physician has ordered the
following: Amoxicillin 25 mg/kg PO every eght hours.
The supply sent from the pharmacy is Amoxicillin 300 mg/3 mL.
How many mL should the nurse administer for each dose?
7. Give Fortaz 50 mg/kg PO t.i.d. to a child who weighs 25 kg.
Fortaz is available in an oral suspension labeled 100 mg/mL.
How many mL should be administered per dose?
8. Give Ceclor 45 mg/kg/day PO in three divided doses for a patient who weighs 66 pounds.
A 75 mL stock medication is labeled Ceclor 125 mg/mL.
How many mL would the nurse administer per dose?
Answer key is located in the Appendix
Oral Medication Practice | 21
22 | Oral Medication Practice
PART III
INJECTION MEDICATION
INJECTION MEDICATION | 23
24 | INJECTION MEDICATION
Introduction to Injection Medications
Vocabulary
Intravenous (IV) – Administered into a vein using a syringe or IV infusion
Intramuscular (IM) – Injected deep into a muscle
Subcutaneous (SC or subcut) – Injected into the innermost layer of skin (subcutis or hypodermis)
Intradermal (ID) – Given directly into middle layer of skin (dermis)
An injection is a method of administering a sterile liquid form of medication into tissues of the body beneath the
skin, usually using a needle. Unlike oral medications that are absorbed through the digestive tract, injections
allow the medication to be absorbed more rapidly.
There are different types of injections based on the route of administration:
1. Intravenous (IV)
2. Intramuscular (IM)
3. Subcutaneous (SC)
4. Intradermal (ID)
Understanding how to solve dosage calculations for injection medications is critical for nurses. Accuracy is
essential to ensure patient safety.
Injection Conversion Example
Order: Administer digoxin 05. mg IV daily.
Available: concentrations: Digoxin 0.25 mg/mL.
Solve: How many mL of digoxin should be administered?
mL →
x
Introduction to Injection Medications | 25
1
Injection Medication Video Example
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4.0. https://www.youtube.com/watch?v=ZKBjhqhz7n8
26 | Introduction to Injection Medications
Injection Medication Practice
Vocabulary Practice
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Injection Medication Knowledge Check
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Injection Medication Practice 1
1. Order: Gentamicin 75 mg IM q8h.
Available: Gentamicin labeled 40 mg per mL.
How many mL will be given (Round to the nearest tenth)?
2. Order: Ceftriaxone 0.25 g IM state q12h.
Available: Ceftriaxone labeled 350 mg per 1 mL.
How many mL will be given (Round to the nearest tenth)?
3. Order: Atropine sulfate 0.6 mg IM stat.
Available: Atropine sulfate in 20-mL vial labeled 0.4 mg per mL.
How many mL will be given?
4. Order: Penicillin G procaine, 500,000 units IM b.i.d.
Injection Medication Practice | 27
Available: Penicillin G procaine labeled 300,000 units per mL.
How many mL will be given (Round to the nearest tenth)?
5. Order: Heparin 5,000 units subcut b.i.d.
Available: Heparin 20,000 units per mL.
How many mL will be given (Round to the nearest hundredth)?
6. Order: Morphine sulfate 15 mg IM q4h PRN for pain.
Available: Morphine sulfate labeled 15 mg per mL.
How many mL will be given?
7. Order: Methergine 0.4 mg IM q4h for three doses.
Available: Methergine labeled 0.2 mg per mL.
How many mL will be given?
8. Order: Tobramycin 50 mg IM q8h.
Available: Tobramycin Sulfate labeled 80 mg/2mL.
How many mL will be given (Round to the nearest tenth)?
9. Order: Robinul 100 mcg IM stat.
Available: Robinul 0.2 mg per 1 mL.
How many mL will be given?
10. Order: Gentamicin 55 mg/IM q8h.
Available: Gentamicin 80 mg per 2 mL.
How many mL per dose (Round to the nearest tenth)?
11. Order: Ampicillin 0.5 g IM q6h.
Available: Ampicillin labeled 250 mg per mL.
How many mL per dose?
12. A dose strength of 0.3 g has been ordered.
Available: 0.4 g per 1.5 mL.
How many mL per dose (Round to the nearest tenth)?
13. A dose strength of 15 mg is ordered.
Available: 15 mg per mL.
How many mL per dose?
14. Order: Heparin 6,500 units subcut q12 h.
Available: Heparin 10,000 units per mL.
How many mL (Express answer in hundredths)?
15. Order: Quinidine gluconate 200 mg IM q8h.
Available: Quinidine gluconate labeled 80 mg per mL.
28 | Injection Medication Practice
How many mL?
Answer key is located in the Appendix
Injection Medication Practice 2
1. Order: Lorazepam 0.05 mg/kg IM now. The patient weighs 135 pounds.
The lorazepam label reads 2 mg/2 mL.
How many milliliters will the nurse give? Round to the nearest tenth.
2. Order: Bicillin 2,400,000 units IM stat.
Available: 10 mL vial of Bivillin containing 600,000 units per mL.
How many milliliters should be given?
3. Order: Dexamethasone 4 mg IM.
The label reads 10 mg/2 mL.
How many milliliters of the medication will the nurse prepare?
4. Order: Gentamicin 9.1 mg IM q8h.
Available: 35 mg per 3 mL.
How many mL of the medication will be given to the patient? Round to the nearest
hundredth.
5. Order: Humulin R 0.2 units/kg subcutaneously twice a day before breakfast and dinner.
The child weighs 45 kg.
How many units will this child receive of this insulin in 24 hours?
6. A patient is to receive 0.75 units/kg of insulin in three divided doses.
The patient weighs 113 pounds.
What is the insulin amount the patient will receive with each dose? Round to the nearest
tenth.
7. Order: Lorazepam 0.05 mg/kg IM now. The patient weighs 135 pounds.
The lorazepam label reads 2 mg per 2 mL.
How many mL will the nurse give?
8. The nurse is to give 60 mg of methylprednisolone IM now.
The pharmacy provides a vial with 80 mg/mL.
How many mL will the nurse draw up for administration? Round to the nearest tenth.
Injection Medication Practice | 29
Answer key is located in the Appendix
30 | Injection Medication Practice
PART IV
IV FLOW RATES & INFUSION TIME
IV FLOW RATES & INFUSION TIME | 31
32 | IV FLOW RATES & INFUSION TIME
Introduction to IV Flow Rates and
Infusion Time
Vocabulary
gtt – drop
microdrip – 60 gtt/mL
1. Dimensional Analysis Review
Understanding how to calculate IV flow rates and infusion time is an essential skill for nurses. To accomplish this
task, dimensional analysis (unit matching) is the preferred method. The rate and quantity of intravenous fluid
given depend on the client’s medical condition, body size, and age. Regulation ensures the correct amount of
fluid drips from a bag down the IV into the vein at the correct rate. Complications can result from receiving
too much too quickly, or not enough too slowly. Infusion time is the length of time it takes for the infusion to
complete.
Rule 1. Set up the problem. What units will your answer have?
Rule 2. Work the problem until the unit(s) on one side match the units on the other.
Rule 3. Do your units MATCH?
Rule 4. Solve by multiplying all the top numbers and write the answer in the numerator and then
multiply all the bottom numbers and write the answer in the denominator.
= Dive the top by the bottom
Rule 5. Write the number to four (4) decimals and then round and write your units appropriately.
2. Conversions Steps
As always, read the question carefully and identify relevant information. Start with the end in mind when setting
up your dimensional analysis and round your final answers for gtt/min and mL/hr to the nearest whole number.
Introduction to IV Flow Rates and Infusion Time | 33
IV Flow Rate & Infusion Time Conversion Examples
1. A physician orders Ofirmev 1,000 mg in 500 mL of normal saline IV
over 45 minutes as a one-time dose. How many milliliters per hour would
the nurse program the IV infusion device?
Solve:
mL →
=
2. A patient has Acyclovir 480 mg in 150 mL of NS ordered to infuse over 120 minutes. The IV tubing
has a 20 drop per milliliter factor. How many drops per minute would the Acyclovir be infused?
Solve:
gtt/min →
=
3. An IV of 1500 mL NS to infuse at 60 mL/hr. Determine the infusion time. If the IV was started at
1400, when would the IV infusion be completed?
Solve:
hr →
x
=
1400 + 25 hours = 1500
2:00 PM + 25 hours = 3:00 PM the following day
IV Flow Rates and Infusion Time Video Tutorial
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34 | Introduction to IV Flow Rates and Infusion Time
IV Flow Rates and Infusion Time Practice
Adding Time Intervals Practice
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IV Flow Rates and Infusion Time Knowledge Check
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IV Flow Rates Extended Practice 1
1. A nurse practitioner orders 500 mL of 0.9% normal saline to infuse over two hours.
How many milliliters per hour will the nurse program the IV infusion device?
2. A physician orders 1,000 mL of D5W ½ NS to infuse over six hours. The IV tubing has a 20
drop per milliliter factor.
How many drops per minute will the nurse infuse the IV fluids (Round final answer to the
nearest whole number)?
3. A nurse practitioner orders 500 mL of 0.9% normal saline to infuse over two hours.
The IV tubing has a 60 drop per milliliter factor. How many drops per minute will the nurse
infuse the IV fluids?
4. A patient has 500 mL of 0.9% normal saline ordered to infuse over three hours. The IV tubing
has a 15 drop per milliliter factor.
How many drops per minute will the nurse infuse the IV fluids? (Round final answer to the
nearest whole number)?
5. A total of 1,800 mL of TPN is ordered to infuse during 8 PM and 6 AM.
IV Flow Rates and Infusion Time Practice | 35
How many milliliters per hour will the nurse program the IV infusion device?
6. Vancomycin 1 g/100 mL is ordered to be infused IV twice daily over one hour.
How many milliliters per hour will the nurse program the IV infusion device?
7. A total of 60 mEq of potassium chloride/200 mL is ordered to infuse at a rate of 10 mEq
potassium chloride per hour.
How many milliliters per hour will the nurse program the IV infusion device?
8. A patient with terminal cancer has morphine sulfate ordered at a rate of 4 milligrams per
hour. The morphine sulfate has a concentration of 50 mg/100 mL.
How many milliliters per hour will the nurse program the IV infusion device?
9. A physician orders Kefzol 1 gram/25 mL IV over 15 minutes every eight hours.
How many milliliters per hour would the nurse program the IV infusion device?
10. Cefepime 500 mg in 50 mL of NS is ordered IV every 12 hours. The pharmacy suggests
infusing the Cefepime over 30 minutes. The IV tubing has a 60 drop per milliliter drop factor.
How many drops per minute would the nurse infuse the medication?
11. A physician orders Ofirmev 1,000 mg in 100 mL of normal saline IV over 30 minutes as a onetime dose.
How many milliliters per hour would the nurse program the IV infusion device?
12. A patient has Acyclovir 480 mg in 150 mL of NS ordered to infuse over 120 minutes. The IV
tubing has a 20 drop per milliliter factor.
How many drops per minute would the Acyclovir be infused (Round final answer to the
nearest whole number)?
13. A patient on a ventilator has an order for a Lorazepam infusion at a rate of 1 milligram per
hour for sedation. The Lorazepam arrives from the pharmacy and has a 10 mg/50 mL
concentration.
How many milliliters per hour will the nurse program the IV infusion device?
14. Kefzol 1 gram/50 mL IV over 30 minutes is ordered every eight hours. The IV tubing has a 60
drop per milliliter factor.
How many drops per minute would the Kefzol be infused?
15. Piperacillin 2 grams in 100 mL of NS is ordered to infuse over 30 minutes four times per day.
How many milliliters per hour would the nurse program the IV infusion device?
16. A patient has Piperacillin 3 grams in 100 mL of NS ordered to infuse over 30 minutes twice
daily. The IV tubing has a 10 drop per milliliter factor.
How many drops per minute would the Piperacillin be infused (Round final answer to the
nearest whole number)?
17. One unit of packed red blood cells containing 300 milliliters arrives from the blood bank. The
blood tubing has a 20 drop per milliliter factor.
36 | IV Flow Rates and Infusion Time Practice
How many drops per minute would the nurse transfuse the blood over two hours (Round
final answer to the nearest whole number)?
18. Esomeprazole 40 mg in 50 mL NS IV to be infused over 30 minutes daily is ordered. The IV
tubing has a 60 drop per milliliter factor.
How many drops per minute would the esomeprazole be infused (Round final answer to
the nearest whole number)?
Answer key is located in the Appendix
IV Flow Rates Extended Practice 2
1. Order: D5W to infuse at 100 mL/hr.
Drop factor: 10 gtt/mL.
At what rate in gtt/min should the IV be regulated (Round to the nearest whole number)?
2. Order: IV medication in 50 mL NS in 20 minutes.
Drop factor: Microdrop (60 gtt/mL).
At what rate in gtt/min should the IV be regulated (Round to the nearest whole number)?
3. Order: 1000 mL D5W to infuse in eight hours.
Drop factor: 20 gtt/mL.
At what rate gtt/min should IV be regulated (Round to the nearest whole number)?
4. Order: 1500 mL 0.9% NS in ten hours.
Drop factor: 15 gtt/mL.
At what rate in gtt/min should the IV infuse (Round to the nearest whole number)?
5. Order: 1500 mL 0.9% NS in 10 hr.
Drop factor: 15 gtt/mL.
At what rate in gtt/min should the IV infuse (Round to the nearest whole number)?
6. Order: Keflin 2 g IVPB (piggyback) over 30 minutes. The Keflin is placed in 100 mL of fluid
after it is dissolved.
Drop factor: 15 gtt/mL.
What drip rate should be used (Round to the nearest whole number)?
7. Order: Mezlocillin 3 g IV piggyback in 130 mL NS over one hour.
Drop factor: 15 gtt/mL.
IV Flow Rates and Infusion Time Practice | 37
At what rate in gtt/min should the IV be regulated (Round to the nearest whole number)?
8. Order: Mezlocillin 3 g IV piggyback in 130 mL NS over one hour.
Drop factor: 15 gtt/mL.
At what rate in gtt/min should the IV be regulated (Round to the nearest whole number)?
9. Calculate the infusion time for an IV of 1000 mL D5W infusing at a rate of 125 mL/hr.
10. An IV of 500 mL NS is to infuse at 60 mL/hr.
What is the infusion time in hours?
The IV was started at 10:00 PM. When would the IV infusion be completed in military time?
11. An IV of 250 mL D5W is to infuse at 80 mL/hr.
What is the infusion time in hours? The IV started at 2:00 AM.
When would the IV infusion be completed in military time?
12. At 0600 you started an IV with 1000 mL D5 RL to infuse at 60 mL/hr.
What time will the infusion be complete? Answer in military time.
13. At 1400 you started an IV with 500 mL D5W to infuse at 75 ml/hr.
What time will the infusion be complete? Answer in military time.
14. If an IV is to be running at 75 mL/hr,
How many gtt/min should it be running at if the nurse is using microdrip tubing (60 gtt/
mL) (Round to the nearest whole number)?
15. If a nurse is using IV tubing with a drop factor of 10 gtt/mL and the IV is supposed to be
running at 21 mL/hr,
How many gtt/min should the IV be set at (Round to the nearest whole number)?
Answer key is located in the Appendix
Infusion Time – Extended Practice
1. An IV of 500 mL NS to infuse at 60 mL/hr.
Determine the infusion time.
If the IV was started at 2200, when would the IV infusion be completed?
2. An IV of 250 mL D5W is to infuse at 80 mL/hr.
Determine the infusion time.
If the IV was started at 0200, when would the IV infusion be completed?
38 | IV Flow Rates and Infusion Time Practice
3. 1000 mL of D5W is to infuse at 40 mL/hr.
Determine the infusion time.
If the IV was started at 1410 on August 26, when would the IV infusion be completed?
4. An IV of 1000 mL D5 RL is to infuse at 60 mL/hr.
Determine the infusion time.
If the IV was started at 0600, when would the infusion be completed?
5. An IV of 500 mL D5W is to infuse at 75 mL/hr.
Determine the infusion time.
If the IV was started at 1400, when would the infusion be completed?
6. A patient is receiving 250 mL of NS at 17 gtt/min. The drop factor is 15 gtt/mL.
Determine the infusion time.
If the IV was started at 1200, when would the infusion be completed?
7. A patient is receiving 1000 mL D5W. The IV is infusing at 30 gtt/min. The drop factor is 20 gtt/
mL.
Determine the infusion time.
If the IV was started at 0610, when would the infusion be completed?
8. A patient is receiving 1000 mL D5W at 20 gtt/min. The drop factor is 10 gtt/mL.
Determine the infusion time.
If the IV was started at 1800 hours, when would the infusion be completed?
9. A patient is receiving 100 mL at 10 gtt/min. The drop factor is 15 gtt/mL.
Determine the infusion time.
If the IV was started at 2200, when would the infusion be completed?
10. A patient is receiving 1000 mL of RL. The IV is infusing at 21 gtt/min. The drop factor is 10 gtt/
mL.
Calculate the infusion time.
If the IV was started at 0800, when would the infusion be completed?
Answer key is located in the Appendix
IV Flow Rates and Infusion Time Practice | 39
40 | IV Flow Rates and Infusion Time Practice
PART V
RECONSTITUTION
RECONSTITUTION | 41
42 | RECONSTITUTION
Introduction to Reconstitution
Vocabulary
Normal Saline (NS) – A sterile solution containing 0.9% sodium chloride (salt) in water
Sterile Water (SW) – A purified liquid used for reconstitution
Vial – The container holding the powdered medication
Concentration or Final Concentration – The strength of the reconstituted solution, often expressed in
milligrams per milliliter (mg/mL)
Dilution – Adding additional liquid (usually normal saline) to achieve the desired concentration
Intramuscular (IM) – The route of medication administration where the drug is injected directly into a muscle
Reconstitution Conversions
Reconstituting medication is a common task for nurses when dealing with powdered or concentrated forms
of drugs. Reconstitution is necessary when a medication is in a powdered form and needs to be mixed with a
specific amount of liquid (usually sterile water or saline) to create a usable solution.
1. Determine What Information is Needed From Problem.
You need to know:
◦ Order
◦ Final concentration
2. Dimensional Analysis Review
Using dimensional analysis, you will be able to solve the following problem, where you will be
determining how many mL you will give the patient.
Rule 1. Set up the problem. What units will your answer have?
Rule 2. Work the problem until the unit(s) on one side match the units on the other.
Rule 3. Do your units MATCH?
Rule 4. Solve by multiplying all the top numbers and write the answer in the numerator, and then
multiply all the bottom numbers and write the answer in the denominator.
= Dive the top by the bottom
Rule 5. Write the number to four (4) decimals and then round and write your units appropriately.
Introduction to Reconstitution | 43
3. Conversion Steps
Reconstitution Example
Order: 300 mg IM of a drug
Available: 1000 mg vial with directions to add 4.6 mL SW for injection for a final concentration of 200
mg/mL
How many mL will you administer? (Round to the nearest tenth)
mL →
Reconstitution Conversions Video Tutorial
1
One or more interactive elements has been excluded from this version of the text. You can view them
online here: https://wtcs.pressbooks.pub/nursingdosagecalculations/?p=99#oembed-1
1. WisTech Open. (2024, August 12). Nursing Dosage Calculations – Reconstitution. [Video]. YouTube. CC BY 4.0.
https://www.youtube.com/watch?v=85j5dHyOsMU
44 | Introduction to Reconstitution
Reconstitution Practice
Steps to Reconstitution
An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://wtcs.pressbooks.pub/nursingdosagecalculations/?p=200#h5p-13
Reconstitution Knowledge Check
An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://wtcs.pressbooks.pub/nursingdosagecalculations/?p=200#h5p-12
Reconstitution Extended Practice 1
1. Order: 300 mg IM of a drug.
Available: 1000 mg vial with directions to add 4.6 mL SW for injection for a final
concentration of 200 mg/mL.
How many mL should be administered (Round to the nearest tenth)?
2. Order: 200,000 units IM of a drug.
Available: 1,000,000 unit vial of a drug has instructions to reconstitute to a concentration of
100,000 units per mL, add 10 mL SW for injection.
How many mL should be administered?
3. Order: 400 mg IM of a drug.
Available: 1 g vials with directions to reconstitute with 8.5 mL of SW for injection for a final
concentration of 100 mg/mL.
How many mL should be administered?
4. Order: 500 mg IM.
Reconstitution Practice | 45
Available: 1 g vials with instructions to add 3.2 mL of water for injection USP for a final
concentration of 250 mg/mL.
How many mL should be administered?
5. Order: 300 mg IM q6h. Label states: This vial contains Oxacillin sodium monohydrate
equivalent to 2 grams Oxacillin and 40 mg Dibasic sodium phosphate.
For IM use, add 11.5 mL sterile water for injection, USP. Each 1.5 mL of solution contains 250
mg oxacillin.
How many mL should be administered (Round to the nearest hundredth)?
6. Order: Bicillin C-R (900/300) 1,200,000 units IM stat.
Label states: 900,000 units of Penicillin G benzathine and 300,000 units Penicillin G
procaine injectable suspension to yield 1,200,000 units per 2 mL.
How many mL should be administered (Round to the nearest hundredth)?
7. Order: Biaxin 15 mg/kg for a child who weighs 45 lb.
Label states: Measure 55 mL of water using a graduated cylinder. Add half the volume of
water to the bottle and shake vigorously. Add the remainder of water to the bottle; shake to
yield 125 mg per 5 mL.
How many mL should be administered (Round to the nearest hundredth)?
8. Order: 250 mg IM of a drug.
Available: 500 mg vial with instructions to add 4.3 mL of SW for injection for a final
concentration of 100 mg/mL.
How many mL should be administered?
9. Order: 200 mg IM of a drug.
Available: 1 g vials with instructions to add 3.5 mL SW for injection for a final concentration
of 250 mg/mL.
How many mL should be administered?
10. Order: Mezlocillin 1500 mg IV q6h.
Label states: For IV use, reconstitute with 30 mL sterile water for injection. Each 30 mL of
reconstituted solution will contain 3 g Mezlocillin.
How many mL should be administered?
Answer key is located in the Appendix
46 | Reconstitution Practice
Reconstitution Extended Practice 2
1. Order: Fortaz 250 mg IM.
The vial contains 500 mg powder with directions to add 1.5 mL of sterile water for a total
volume of 1.8 mL.
How many mL should be administered?
2. Order: Kefzol 0.5 g IM q6h.
Kefzol after reconstitution labeled 225 mg per mL.
How many mL should be administered (Round to the nearest tenth)?
3. Order: Bicillin C-R (900/300) 1,200,000 units IM stat.
Label states: 900,000 units of penicillin G benzathine and 300,000 units penicillin G
procaine injectable suspension to yield 1,200,000 units per 2 mL.
How many mL should be administered (Round to the nearest tenth)?
4. Order: Ticarcillin disodium 2 g IM q6h.
The package insert states to reconstitute each 2 g vial with 4 mL of sterile water for
injection. Each 5 mL = 1 g.
How many mL will the nurse administer?
5. Order: Ceftriaxone 300 mg IM stat.
Label states: Reconstitute the 750 mg vial with 1.8 mL of sterile water for injection, which
results in a total volume of 3.1 mL.
How many mL should be administered (Round to the nearest tenth)?
6. Order: Protamine sulfate 22 mg IVP over ten minutes.
Label states: Reconstitute with 20 mL of sterile water or saline which results in 50 mg/5 mL.
How many mL should be administered (Round to the nearest tenth)?
7. Order: 25 mg of Gentamicin IM.
Label states: Add 1.3 mL sterile diluent to yield 50 mg/1.5 mL.
How many mL of reconstituted solution should be given to the patient?
Answer key is located in the Appendix
Reconstitution Practice | 47
48 | Reconstitution Practice
PART VI
SAFE RANGE / WEIGHT-BASED
SAFE RANGE / WEIGHT-BASED | 49
50 | SAFE RANGE / WEIGHT-BASED
Introduction to Safe Range /
Weight-Based
Safe Range / Weight-Based Conversions
Nurses are often required to calculate weight-based doses that utilize a patient’s body weight to determine
a personal and appropriate medication dose. This will prevent the patient from receiving too much or too
little medication. Safe ranges of dosages are provided in drug reference materials. Nurses are most likely to
encounter weight-based dosing when calculating doses for a child. Medication errors often occur in children,
who have smaller ranges of safe dosage than adults due to their smaller weight.
When verifying that a dosage is within a safe range based on a patient’s weight, begin by completing the
dosage calculation. Then, calculate the low and high ends of the safe dosage range. Finally, verify that the
calculated dose is within this range.
Safe Range / Weight-Based Example 1
Declan is an 8-month-old infant who weighs 7 kg. He has been prescribed acetaminophen 100 mg
every 4-6 hours PO for a fever. The recommended dosage range for infants is 10-15 mg/kg/dose.
Calculate the acceptable dosage range for Declan and determine if the prescribed dose is safe.
1. Calculate the minimum and maximum of the recommended safe dose.
mg →
mg →
(min)
(max)
2. Compare to the prescribed dosage.
Minimum → Prescribed → Maximum
70mg → 100mg → 105mg
3. Solve.
This prescribed dosage fits between the minimum and maximum range and, therefore, is safe
to administer.
Introduction to Safe Range / Weight-Based | 51
Safe Range / Weight-Based Example 2
Order: Phenytoin 75 mg by mouth every 12 hours for a child weighing 50 lb.
On Hand: Dilantin chewable 50 mg tablets.
The recommended oral dose for a child is 5 to 7 mg/kg/day in divided doses every 12 hours. Is this
dose within the safe range?
If yes, how many tabs would the nurse give?
1. Calculate the minimum and maximum of the recommended safe dose.
mg →
(min)
mg →
(max)
2. Compare to the prescribed dosage.
Minimum → Prescribed → Maximum
56.8mg → 75mg → 79.5mg
This prescribed dosage fits between the minimum and maximum range and, therefore, is safe to
administer.
3. Calculate to the appropriate number of tablets.
Tabs →
1
Safe Range/ Weight-Based Video Tutorial
One or more interactive elements has been excluded from this version of the text. You can view them
online here: https://wtcs.pressbooks.pub/nursingdosagecalculations/?p=101#oembed-1
1. WisTech Open. (2024, August 12). Nursing dosage calculations – Safe range/Weight-based dosages [Video].
YouTube. CC BY 4.0. https://www.youtube.com/watch?v=BbBMtn4SR8c
52 | Introduction to Safe Range / Weight-Based
Safe Range / Weight-Based Practice
Safe Range / Weight-Based Practice Knowledge Check
An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://wtcs.pressbooks.pub/nursingdosagecalculations/?p=216#h5p-16
Safe Range / Weight-Based Practice 1
1. The recommended dosage of Cephalexin to treat impetigo in infants, children, and
adolescents is 25 to 50 mg/kg/day divided every 6 to 8 hours (with a maximum dose of 250 mg/
dose) for at least seven days. A 23-pound child has been prescribed 100 mg PO q8h for seven
days. The drug is available as 250 mg/5mL.
a. What is the recommended safe range in mg/dose for this child when dosed q8h?
b. Is the prescribed dosage within the recommended range for impetigo?
c. What is the range in mL/dose for this child?
d. How many mL/dose would the child receive for the prescribed dosage?
2. The recommended oral dosage of Amoxicillin to treat an ear infection is 80 to mg/kg/day in
divided doses every 12 hours. An infant weighing 18 pounds has been prescribed 350 mg q12h.
The drug is available as 250 mg/5 mL.
a. What is the recommended range in mg/dose for this child?
b. Is the prescribed dosage within the recommended range?
c. What is the recommended range in mL/dose for this child?
d. How many mL/dose would the child receive for the prescribed dosage?
3. The recommended oral dosage for a medication is 5mg/kg/day divided into 3-4 doses when
treating allergies in infants, children, and adolescents. A 46-pound-male child has been
prescribed 25 mg PO q6h. The medication is available as an oral solution containing 12.5 mg/5mL.
a. Is this a safe dosage for this child?
Safe Range / Weight-Based Practice | 53
b. How many mL/dose will this child receive?
4. A three-day regimen for Azithromycin is 10 mg/kg once daily for three days (Maximum: 500
mg/day). Azithromycin is available as 200 mg/5mL. How many mL will a child weighing 31 pounds
receive each day?
5. The dosing guidelines for a medication for children who are <50 kg is 0.2 to 0.5 mg/kg/dose
every 3 to 4 hours as needed, and for children 50 kg and over it is 15 to 20 mg every 3 to 4 hours
as needed. The medication is available in 2mg/mL and 4 mg/mL.
a. What is the safe mg/dose range for a child weighing 23 kilograms?
b. What is the normal mL/dose range using the 2 mg/mL solution for a child weighing 23
pounds?
c. The physician ordered 2 mL/dose of the 4 mg/mL solution for a patient who weighs 17
kilograms. Is this dose within the safe guidelines?
d. The physician has ordered 3.9 mL of the 4 mg/mL solution for a child who weighs 14
kilograms. Is this dose within the safe guidelines?
6. The dosing guidelines for 1V Ampicillin is 100 to 150 mg/kg/day divided every six hours with a
maximum daily dose of 4000 mg.
a. What is the safe mg/dose range for a 63-pound child?
b. What is the safe mg/day range for a 20-kilogram child?
c. The health care provider ordered 700 mg IV q6j for a 50-pound child. Is this dosage
within the safe general dosing guidelines?
d. How many mg/kg/day will this child be receiving?
e. A 32-kilogram child has been prescribed a dosage of 140 mg/kg/day divided every six
hours. Does this dosage fall within the safe dosing guidelines?
Answer key is located in the Appendix
54 | Safe Range / Weight-Based Practice
Safe Range / Weight-Based Practice 2
1. Order: Prednisolone oral suspension 10 mg every eight hours. The child weighs 40 pounds.
The safe dose range is 0.14-2 mg/kg/day divided t.i.d. (3x/day) or q.i.d. (4x/day).
Is this a safe dose?
If yes, and the medication is available in 5 mg/5 mL, how much will the nurse administer
per dose in mL?
2. Order: Phenytoin 75 mg by mouth every 12 hours for a child weighing 66 pounds. On hand
are Dilantin chewable 50 mg tablets. The recommended oral dose for a child is 5 to 7 mg/kg/day
in divided doses every 12 hours.
Is this dose safe?
If yes, how many tabs would the nurse give?
3. Order: Phenytoin 50 mg every 12 hours for a child weighing 70 pounds. Available are Dilantin
30 mg/5 mL. The recommended daily oral dose for a child is 5-7 mg/kg/day in divided dosages
every 12 hours.
Is this order safe?
If yes, how many mL would the nurse give?
4. Order: Nafcillin 600 mg in 50 mL D5W IVPB q6h. The pediatric patient with an infection
weighs 30 pounds. The recommended dose of this medication is 50-200 mg/kg per day.
Is the dose safe for this child?
5. Order: Amoxicillin 75 mg PO every eight hours for a child weighing 33 pounds. The
medication insert states that safe dosage is 6.7 mg to 13.3 mg/kg every eight hours.
Is this dose safe?
Answer key is located in the Appendix
Safe Range / Weight-Based Practice | 55
56 | Safe Range / Weight-Based Practice
PART VII
IV BOLUS RATE
IV BOLUS RATE | 57
58 | IV BOLUS RATE
Introduction to IV Bolus Rate
Vocabulary
Bolus – Refers to the administration of a single dose of a substance
IV Bolus – A medical technique that delivers necessary fluid or medication directly into the bloodstream
IV Push – An even quicker method than IV Bolus. The syringe’s content is delivered within seconds directly
into the bloodstream.
IV Bolus Rate Conversions
An IV bolus is a method of intravenous therapy that delivers a concentrated dose of medication or fluid directly
into a vein.
• It refers to a single dose of medication given over a short period.
• It is quicker than an IV drip but slower than an IV push.
An IV bolus can be used in critical situations where rapid treatment is necessary for non-emergency purposes,
such as pain management or rehydration.
IV Bolus Rate Example
Order: The physician prescribes Morphine 0.5mg IV every four hours as needed for pain. The vial is
labeled 2 mg/mL. How many mL should you give per dose?
mL →
x
=
Introduction to IV Bolus Rate | 59
1
IV Bolus Video Tutorial
One or more interactive elements has been excluded from this version of the text. You can view them
online here: https://wtcs.pressbooks.pub/nursingdosagecalculations/?p=103#oembed-1
1. WisTech Open. (2024, August 12). Nursing dosage calculations – IV bollus rate [Video]. YouTube. CC BY 4.0.
https://www.youtube.com/watch?v=nJ5urQJpZgM
60 | Introduction to IV Bolus Rate
IV Bolus Rate Practice
IV Bolus Rate Knowledge Check
IV Bolus Rate Conversion Practice
1. Order: Drug “x” 15 mg IV bolus
Available: 5 mg/ mL
How many mL should be drawn?
A drug reference book states to administer over two minutes.
1
How fast will the nurse push the medication per line? Use the syringe image .
1.
“5ml vector syringe 3ml” by Timothy W Ford is licensed under CC BY-SA 3.0
IV Bolus Rate Practice | 61
2. Order: Drug “x” 30mg IV push
Available: 15 mg/mL
How many mL should be drawn?
A drug reference book states to administer at a rate of 10 mg/minute.
How fast will the nurse push this medication per line? Use the syringe
2
image .
2.
“2point5ml_vector_syringe_2ml” by Timothy W Ford is licensed under CC BY-SA 3.0
62 | IV Bolus Rate Practice
3. Order: Drug “x” 20 mg IV push
Available: 5 mg/mL
How many mL should be drawn?
A drug reference book states to administer at a rate of 10 mg/minute.
How fast will the nurse push this medication per line? Use the syringe
3
image .
3.
“5ml_vector_syringe_4ml” by Timothy W Ford is licensed under CC BY-SA 3.0
IV Bolus Rate Practice | 63
How fast will the nurse push the post saline flush per line? Use the
4
syringe image .
4.
“10ml_vector_syringe_10ml” by Timothy W Ford is licensed under CC BY-SA 3.0
64 | IV Bolus Rate Practice
Answer key is located in the Appendix
IV Bolus Rate Practice | 65
66 | IV Bolus Rate Practice
PART VIII
MCG/KG/MIN
MCG/KG/MIN | 67
68 | MCG/KG/MIN
Introduction to mcg/kg/min
Vocabulary
Inotropic – Modifying the force or speed of contraction of muscles
mcg/kg/min Conversions
Mcg/kg/min IV infusions are often used for critically ill patients, particularly those needing inotropic support. We
will take the dimensional analysis method one step further to calculate weight-based continuous IV drips.
mcg/kg/min Example
A patient weighs 205 pounds. Patient is currently receiving Dobutamine at 15 mL/hr on the pump.
Dobutamine is mixed as 400 mg in 250 mL of D5W.
How many mcg/kg/min is the patient receiving?
mcg/kg/min →
x
x
x
x
=
1
mcg/kg/min Video Tutorial
One or more interactive elements has been excluded from this version of the text. You can view them
online here: https://wtcs.pressbooks.pub/nursingdosagecalculations/?p=105#oembed-1
1. WisTech Open. (2024, August 12). Nursing dosage calculations – mcg/kg/min [Video]. YouTube. CC BY 4.0.
https://www.youtube.com/watch?v=gnIsRm5UnqA
Introduction to mcg/kg/min | 69
Mcg/Kg/Min Practice
mcg/kg/min Knowledge Check
An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://wtcs.pressbooks.pub/nursingdosagecalculations/?p=251#h5p-15
mcg/kg/min Practice 1
1. A patient weighs 255 pounds. The patient is currently receiving Dobutamine at 15 mL/hr on the
pump. Dobutamine is mixed as 400 mg in 250 mL of D5W. How many mcg/kg/min is the patient
receiving?
2. A hyptensive client is receiving IV Dopamine (400 mg / 250 mL). The client weighs 72 kg and is
receiving 15 mL/hr. How many mcg/kg/min is the client receiving?
3. The client weighs 132 pounds and is receiving a Dopamine (400 mg / 500 mL) infusion at 22.5
mL/hr per volumetric pump. How many mcg/kg/min is being given?
4. A patient weighs 122 pounds. She is receiving Dopamine at 15 mL/hr on the pump. The solution
that is hanging is Dopamine 300 mg in 250 mL of D5W. How many mcg/kg/min is the patient
receiving?
5. An Esmolol drip is running at 15 mL/hr. The patient weighs 65 kg. The IV contains 2500 mg
Esmolol in 250 mL fluid. The IV is running at how many mcg/kg/min?
Answer key is located in the Appendix
70 | Mcg/Kg/Min Practice
Appendix - Extended Practice Answer
Keys
Answer Keys
Basic Metric Conversion Extended Practice 1
1. 60 lb = ______ kg
kg = 1 kg/2.2 lb x 60 lb/1 = 27.27 kg
2. 20 mL = ______ tsp
T = 1 t/5 mL = 20 mL/1 = 4 t.
3. 5 oz = ______ mL
mL = 30 mL/1 oz. x 5 oz/1 = 150 mL
4. 2.4 L = ______ mL
mL = 1000 mL/1 L x 2.4 L/1 = 2400 mL
5. 7 oz = ______ mL
mL = 30 mL/1 oz. x 7 oz/1 = 210 mL
6. Client had the following:
8 oz. milk
6 oz. orange juice
4 oz. water with medication
mL = 30 mL/1 oz. x 18 oz/1 = 540 mL
7. Calculate the following individual items and give the total number of mL:
10 oz. coffee
8 oz. water
6 oz. broth
mL = 30 mL/1 oz. x 24 oz. /1 = 720 mL
8. 36 mg = ______ g
g = 1 g/1000 mg x 36 mg/1 = .036 g
9. 67.5 mL = ______ t
t = 1 t/5 mL X 67.5 mL/1 = 13.5 t
10. 2 T = ______ mL
mL = 15 mL/1 T x 2 T/1 = 30 mL
Extended Practice Answer Keys | 71
Basic Metric Conversion Extended Practice 2
1. 4 oz. = ______ mL
mL = 30 mL/1 oz. x 4 oz/1 = 120 mL
2. 110 lb. = ______ kg
kg = 1 kg/2.2 lb x 110 lb/1 = 50 kg
3. 55 cm = ______ in.
in = 1 in/2.54 cm x 55 cm/1 = 21.65 in
4. Calculate the client’s fluid intake for breakfast in milliliters. Assume that the glass holds 6 oz. and the cup
holds 8 oz. The client had the following for breakfast at 8 AM:
** Convert all to mL
⅓ glass of apple juice 6 oz x ⅓ = 6/3 = 2 oz. so mL = 30 mL/1 oz. x 2 oz/1 = 60 mL
½ cup of coffee 8 oz x ½ = 8/2 = 4 oz. so mL = 30 mL/1 oz x 4 oz/1 = 120 mL
½ pint of milk 500 mL x ½ = 250 mL
430 mL
5. 7 oz. = ______ ml
mL = 30 mL/1 oz x 7 oz/1 = 210 mL
6. 45 mL = _____ tbs
T = 1 T/15 mL x 45 mL/1 = 3 T
7. 178.2 lb. = ______ kg
kg= 1 kg/2.2 lb x 178.2 lb/1 = 81 kg
Oral Medications Extended Practice 1
1. 2 tabs
2. 1.5tabs/dose
4.5 tabs/day
3. 3 tabs
4. 2 caps
5. 3 tabs
6. 10 mL
7. 2 tabs
8. 2.5 tabs
9. 2 tabs
10. 2 mL
11. 6 mL
12. 5 mL
13. 1 mL
14. 4.1 mL
72 | Extended Practice Answer Keys
15. 2.8 mL
Injection Medications Practice 1
1. 1.9 mL
2. 0.7 mL
3. 1.5 mL
4. 1.7 mL
5. 0.25 mL
6. 1 mL
7. 2 mL
8. 1.3 mL
9. 0.5 mL
10. 1.4 mL
11. 2 mL
12. 1.1 mL
13. 1 mL
14. 0.65 mL
15. 2.5 mL
Injection Medications Practice 2
1. 3.1 mL
2. 4 mL
3. 0.8 mL
4. 0.78 mL
5. 18 units
6. 12.8 units
7. 3.1 mL
8. 0.8 mL
IV Flow Rate Practice
1. 250 mL/hr
2. 56 gtt/min
3. 250 gtt/min
4. 42 gtt/min
Extended Practice Answer Keys | 73
5. 180 mL/hr
6. 100 mL/hr
7. 33 mL/hr
8. 8 mL/hr
9. 100 mL/hr
10. 100 gtt/min
11. 200 mL/hr
12. 25 gtt/min
13. 5 mL/hr
14. 100 gtt/min
15. 200 mL/hr
16. 33 gtt/min
17. 50 gtt/min
18. 100 gtt/min
IV Flow Rate + Infusion Time Practice
1. 17 gtt/min
2. 150 gtt/min
3. 42 gtt/min
4. 38 gtt/min
5. 21 gtt/min
6. 50 gtt/min
7. 33 gtt/min
8. 42 gtt/min
9. 8 hours
10. 8 hours 20 minutes
0620
11. 3 hours 8 minutes
0508
12. 2240
13. 2040
14. 75 gtt/min
15. 4 gtt/min
Infusion Time Practice
1. 0620
2. 0508
3. 1510 on August 27
4. 2240
5. 2040
6. 1541
74 | Extended Practice Answer Keys
7. 1717
8. 0220
9. 0030
10. 1556
Reconstitution Rate Practice 1
1. mL = 1 mL/200 mg x 300 mg/1 = 1.5 mL
2. mL = 1 mL/100,000 units x 200,000 units/1 = 2 mL
3. mL = 1 mL/100 mg X 400 mg/1 = 4 mL
4. mL = 1 mL/250 mg x 500 mg/1 = 2 mL
5. mL = 1.5 mL/250 mg x 300 mg/1 = 1.8 mL
6. mL = 2 mL/1,200,000 units x 1,200,000 units/1 = 2 mL
7. mL = 5 mL/125 mg x 15 mg/1 kg x 20.4545 kg/1 = 12.27 mL
8. mL = 5 mL/125 mg x 15 mg/1 kg x 20.4545 kg/1 = 12.27 mL
9. mL = 1 mL/250 mg x 200 mg/1 = 0.8 mL
10. mL = 30 mL/3 g x 1 g/1000 mg x 1500 mg/1 = 15 mL
Reconstitution Rate Practice 2
1. 0.9 mL
2. 2.2 mL
3. 2 mL
4. 10 mL
5. 1.2 mL
6. 2.2 mL
7. 0.75 mL
Safe Range / Weight-Based Practice 1
1a. Low mg = 25 mg/1kg x 10.4545 kg/1 = 261.3636/3 = 87 mg/dose; High mg = 50 mg/1kg x 10.4545 kg/1 = 522.725/3
= 174 mg/dose
1b. Yes–100 mg/dose falls between 87 and 174 mg/dose
1c. Low mL = 5 mL/250 mg x 87 mg/dose = 1.7 mL; High mL = 5 mL/250 mg x 174 mg/dose = 3.5 mL
1d. mL = 5 mL/250 mg x 100 mg = 2 mL
Extended Practice Answer Keys | 75
2a. Low mg = 80 mg/1 kg x 8.1818 kg/1 = 654.54/2 = 327 mg; High mg = 90 mg/1 kg x 8.1818 kg/1 = 736.362/2 =
368 mg
2b. Yes, 350 mg/dose is between 327 and 238 mg/dose
2c. Low mL = 5 mL/250 mg x 327 mg = 6.5 mL; High mL = 5 mL/250 mg x 269 mg = 7.4 mL
2d. mL = 5 mL/250 mg x 350 mg/dose = 7 mL
3a. Yes, 25 mg/dose is just below the recommended dose of 26 mg/dose
3b. mL = 5 mL/12.5 mg x 25 mg = 10 mL
4. Mg = 10 mg/1 kg x 14.0909 kg/1 = 141 mg; mL = 5 mL/200 mg x 141 mg/1 = 3.5 mL
5a. Low mg = 0.2 mg/1 kg x 23 kg/1 = 4.6 mg; High mg = 0.5 mg/1 kg x 23 kg/1 = 11. 5 mg
5b. Low mL = 1 mL/2 mg x 0.2 mg/1 kg x 10.4545 kg/1 = 1 mL; High mL = 1 mL/2 mg x 0.5 mg/1 kg x 10.4545 kg/1
= 2.6 mL
5c. Low mL = 1 mL/4 mg x 0.2 mg/1 kg x 17 kg/1 = 0.85 mL ; High mL = 1 mL/4 mg x 0.5 mg/1 kg x 17 kg/1 = 2.1
mL; Yes, 2 mL /dose falls between 0.85 mL and 2.1 mL/dose
5d. mL = 1 mL/4 mg x 0.5 mg/1 kg x 14 kg/1 = 1.8 mL dose is the safe dose; No, 3.9 mL is above the maximum
dose of 1.8 mL
6a. Low mg = 100 mg/1 kg x 28.6363 kg/1 = 2863.63/4 = 716 mg; High mg = 150 mg/1 kg x 28.6363 kg/1 =
4295.445/4 = 1074 mg
6b. Low mg = 100 mg/1 kg x 20 kg/1 = 2000 mg/day; High mg = 150 mg/1 kg x 20 kg/1 = 3000 mg/day
6c. Low mg = 100 mg/1 kg x 22.7272 kg/1 = 2272.72/4 = 568 mg/dose; High mg = 150 mg/1 kg x 22.7272 kg/1 =
3409.09/4 = 852 mg/dose; Yes, 700 mg/dose falls between 568 mg and 852 mg/dose
6d.
= 700 mg/1 dose x 4 doses /1 day x 1/22.7272 kg = 123 mg/kg/day
6e. Yes, 140 mg/day falls between 100 and 150 mg/kg/day
Safe Range / Weight-Based Practice 2
1. Yes, the order of 30 mg/day falls within the safe range of 2.54 mg —- 36.36 mg; 10 mL
2. Yes, the order of 150 mg/day falls within the safe range of 150 mg — 210 mg; 1.5 tabs
3. No, the order of 100 mg/day would not be therapeutic, as it falls below the range of 159.09 mg — 222.73
mg/day
4. Yes, the order of 2400 mg/day falls within the safe range of 681.81 mg/day — 2727.26 mg/day
5. No, the order of 75 mg/dose would not be therapeutic, as it falls below the range of 100.5 mg/dose —- 199.5
mg/dose
76 | Extended Practice Answer Keys
IV Bolus Rate Practice
1. mL = 1 mL/5g x 15 mg/1 = 3 mL
= 120sec/15 lines = 8 sec/line
2. mL = 1 mL/15 mg x 30 mg/1 = 2 mL
= 180 sec/20 lines = 9 sec/line
3. mL = 1 mL/5 mg x 20 mg = 4 mL
= 120 sec/20 lines = 6 sec/line
Post flush = 4 mL
Post flush rate = 120 sec/8 lines = 15 sec/line
**Remember: flush is the same rate and volume as medication administered
mcg/kg/min Practice
1
= 1000 mcg/1 mg x 400 mg/250 mL x 15 mL/hr x 1 hr/60 min x 1/115.9090 kg = 3.5 mcg/kg/min
2
= 1000 mcg/1 mg x 400 mg/250 mL x 15 mL/hr x 1 hr/60 min x 1/72 kg = 5.6 mcg/kg/min
3
= 1000 mcg/1 mg x 400 mg/500 mL x 22.5 mL/hr x 1 hr/60 min x 1/60 kg = 5 mcg/kg/min
4
= 1000 mcg/1 mg x 300 mg/250 mL x 15 mL/hr x 1 hr/60 min x 1/55.4545 kg = 5.4 mcg/kg/min
5
= 1000 mcg/1 mg x 2500 mg/250 mL x 15 mL/1 hr x 1 hr/60 min x 1/65 kg = 38.5 mcg/kg/min
Extended Practice Answer Keys | 77
b.i.d
Two times per day.
bioavailability
The proportion of the drug that enters the circulation when introduced into the body and so is able to have
an active effect.
Bolus
Refers to the administration of a single dose of a substance.
Concentration or Final Concentration
The strength of the reconstituted solution, often expressed in milligrams per milliliter (mg/mL).
Dilution
Adding additional liquid (usually normal saline) to achieve the desired concentration.
Gram (g)
Base unit for mass in the metric system.
gtt
Drop.
half-life
The time it takes for the concentration of the drug in the blood plasma to reduce by half.
IM
Inject the medicine into the muscle.
Inotropic
Modifying the force or speed of contraction of muscles.
Intradermal (ID)
Given directly into middle layer of skin (dermis).
Intramuscular (IM)
Injected deep into a muscle.
Intravenous (IV)
Administered into a vein using a syringe or IV infusion.
IV Bolus
A medical technique that delivers necessary fluid or medication directly into the bloodstream.
78 |
IV Push
An even quicker method than IV Bolus. The syringe's content is delivered within seconds directly into the
bloodstream.
Liter (L)
Base unit for volume in the metric system.
Meter (m)
Base unit for length in the metric system.
microdrip
60 gtt/mL.
Normal Saline (NS)
A sterile solution containing 0.9% sodium chloride (salt) in water.
PO
By mouth.
prn
Latin for "pro re nata" means depending on the pain.
stat
Immediately.
Sterile Water (SW)
A purified liquid used for reconstitution.
Subcutaneous (SC or subcut)
Injected into the innermost layer of skin (subcutis or hypodermis).
t.i.d
Three times a day.
therapeutic range
The concentration of the drug in the blood serum that produces the desired effect without causing toxicity.
Vial
The container holding the powdered medication.
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