Sample Medication Calculation Problems (Need practice with IV calculations? Scroll farther down for IV Calculation Problems) Do as many or as few as you need to increase your confidence in nursing calculations Problem #1 Your 4 year old pediatric patient weight 40 pounds. She is febrile. You need to administer acetaminophen (Tylenol) 15mg/kg. How many mg will you administer? (answer on next page) Problem #2 The acetaminophen (Tylenol) packages come in liquid form 160 mg/5 mL. How many mL will you administer to your 40 pound patient? (answer on next page) Problem #3 Your patient has an order for terbutaline (Brethine) 0.25 mg subcut. The pharmacy delivers a syringe with 1mg/mL. How much will you waste in order to give the correct dose? (answer on next page) Problem #4 Your hospice patient has an order for 7.5 mg of oxycodone (OxyContin) q 6 hours PRN. The tablets provided are 15 mg tablets. How many tablets will you give for each dose? (answer on next page) Problem # 5 You receive an order for 60 mg of meperidine (Demerol) IM for your post surgical patient. The injectible syringe is pre-packaged with 75 mg/ mL. How much will you administer? (answer on next page) Problem #6 Your patient has been receiving digoxin (Lanoxin)125 mcg Q AM. Today his doctor writes a new order: Digoxin 0.25 mg PO Q AM start now How many 125 mcg tablets will you administer? (answer on next page) Problem #7 Your patient has an order for vasopressin (Pitressin) 5 units subcut TID You have on hand a 0.5 mL vial labeled 20 units/mL How many mL will you administer? (answer on next page) Answers Answer to Problem #1 First convert 40 pounds into kilograms. Method #1: Ratio Proportion 1 kg 2.2 pounds = x kg 40 pounds Cross-multiply and solve for x. 1 kg 2.2 pounds = Method #2: Formula Method 40 pounds 2.2 pounds X 1 kg = x kg x = 18.18 kg x kg 40 pounds 2.2x = 40 x = 18.18 kg Since you will administer 15mg of acetaminophen per 1 kg, you should multiply 15mg with the weight of 18.18 kg. 15mg x 18.18kg = 272.7. You will administer 272.7 mg. Answer to Problem #2 (You know you need 272.7 mg from the previous question) Method #1: Ratio Proportion 160 mg 5 mL = 272.7 mg x mL Method #2: Formula Method 272.7 mg 160 mg x 5 mL = x mL Cross-multiply and solve for x. x = 8.521875 mL 120 mg 5 mL Round. You should administer 8.5 mL. = 272.7 mg x mL 160 x = 1363.5 x = 8.521875 mL Round. You will administer 8.5 mL. You will administer 8.5 mL. Answer to Problem #3 Method #1: Ratio Proportion 1 mL 1 mg = x mL 0.25 mg Cross-multiply and solve for x. 1 mL 1 mg = Method #2: Formula Method 0.25 mg 1 mg X 1 mL = x mL x = 0.25 mL x mL 0.25 mg 0.25 x = 1 x = 0.25 mL Since you are given a syringe with 1 mg/mL and you only need 0.25 mg, then you also just need 0.25 mL. You need to dispose (waste) 0.75 mL when the syringe is filled 1 mL and then administer the rest of the syringe to the patient. You will waste 0.75 mL. Answer to Problem #4 Method #1: Ratio Proportion 15 mg 1 tablet = 7.5 mg x tablet Method #2: Formula Method 7.5 mg 15 mg x Cross-multiply and solve for x. Solve for x. 15 mg 1 tablet x = 0.5 tablet = 7.5 mg x tablet 15 x = 7.5 x = 0.5 (or ½ tablet) You will administer one-half a tablet. 1 tablet = x tablet Answer to Problem #5 Method #1: Ratio Proportion 75 mg 1 mL = 60 mg x mL Method #2: Formula Method 60mg x 75 mg Cross-multiply and solve for x. Solve for x. 75 mg 1 mL x = 0.8 mL = 60 mg x mL 1 mL = x mL . 75 x = 60 x = 0.8 mL You will administer 0.8 mL. Answer to Problem #6 Method #1: Ratio Proportion 0.125 mcg 1 tablet = 0.25 mcg x mL Method #2: Formula Method 0.25 mg 0.125 mg Cross-multiply and solve for x. Solve for x. 0.125 mcg 1 tablet x = 0.25 0.125 = 0.25 mg x tablet 0.125x = 0.25 x = .0.25/0.125 x = 2 tablets You will administer 2 tablets. x 1 tablet x= 2 tablets = x tablet Answer to Problem #7 Method #2: Formula Method Method #1: Ratio Proportion 20 units 1 mL = 5 units x mL 5 units 20 units x Cross-multiply and solve for x. Solve for x. 20 units 1 mL x = 5 x 20 20x = 5 = 5 units x mL 1 mL = x mL 1 = 1 x 1 = 0.5 4 4 x= 0.25 mL x = 5/20 x = 0.25 mL You will administer 0.25 mL of vasopressin. Remember, the amount in the vial (in this case 0.5 mL) does not enter into the calculation. The important point is the concentration (the amount of drug per mL). IV Calculations IV Problem #1 Your patient has an IV ordered to be delivered at a rate of 150mL/ hr. Your infusion set delivers 15 gtt (drops)/mL. How many drops per minute will you set the IV for? (answer on next page) IV Problem #2 Your patient has an IV ordered to be delivered at 75mL/hr. The infusion set delivers 10 gtt (drops)/mL. How many drops per minute will you set the IV for? (answer on next page) IV problem #1 Rationale: Volume to be infused (mL) x drip rate 60 minutes 150 x 15 60 = 2250 60 = = # gtt/min 37.5; or round to 38 drop per minute OR 60-minute Clock Method ¦ 10 gtts/mL 15 gtts/mL ¨ 60 gtts/mL 60 divided by 10 = 6 60 divided by 15 = 4 60 divided by 60 = 1 Divide mL/hr by 6 Divide mL/hr by 4. Divide mL/hr by 1 (or simply recognize that with a 60 gtts/mL drip set, the number of mL/hr = the number of gtts/min) 150 = 4 37.5; round to 38 drops per minute IV problem #2 75 x 10 = 750 = 12.5; round to 13 drops per minute 60 60 60-minute Clock Method ¦ 10 gtts/mL 15 gtts/mL ¨ 60 gtts/mL 60 divided by 10 = 6 60 divided by 15 = 4 60 divided by 60 = 1 Divide mL/hr by 6 Divide mL/hr by 4. Divide mL/hr by 1 (or simply recognize that with a 60 gtts/mL drip set, the number of mL/hr = the number of gtts/min) 75 = 12.5; round to 13 drops per minute 6 End