Basic Dosage Calculation Made Easy

BASIC DOSAGE CALCULATIONS MADE EASY BROUGHT TO YOU BY www.rn101lpnquestionbank.com www.rn101questionbank.com www.rn101.net www.facebook.com/RN101reels www.instagram.com/jimbriant/ @jimbriantbanusan @rn101 @rn101.net@yahoo.com By purchasing this material, you agree to the following terms and conditions: you agree that this book and all other media produced by RN101 are simply guides and should not be used over and above your course material and teacher instruction in nursing school. When details contained within these guides and other media differ, you will defer to your nursing school’s faculty/staff instruction. Hospitals and universities may differ on lab values; you will defer to your hospital or nursing school’s faculty/staff instruction. These guides and other media created by RN101 LLC are not intended to be used as medical advice or clinical practice; they are for educational use only. 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Table Of Contents 11 Drug Label Tablets & Capsules 15 Parenteral Dosage 19 21 Divided Dosage 27 Intravenous Flow Rate 30 Calculating mL/h Pediatric Dosage 32 A lot of Practice Questions 37 3 2024 RN101 Sharing and distributing this copyrighted materials is illegal. NOTES “Today is your OPPORTUNITY to build the tomorrow that you WANT.” 4 2024 RN101 Sharing and distributing this copyrighted materials is illegal. dosage calculations 5 2024 RN101 Sharing and distributing this copyrighted materials is illegal. drug nomenclature STEM CLASSIFICATION EXAMPLES -pam Anti-anxiety Lorazepam, Diazepam -lol Beta-blockers Timolol, Atenolol -ide Diuretics Bumetanide, Furosemide -ase Enzymes Alglucerase, Dornase -caine Local anesthetics Lidocaine, Dibucaine -cillin Antibiotics Ampicillin, Pinicillin -zole Antifungals Fluconazole, Oxiconazole -one Corticosteroids Prednisone, Betametasone -grel Platelet aggregation inhibitor Clopidogrel, Prasugrel -parin Heparin derivatives Heparin, Dalteparin -prazole Proton-pump inhibitor Omeprazole, Lansoprazole -pril ACE inhibitors Captopril, Lisinopril -profen NSAIDs Ibuprofen, Flurbiprofen -sartan ARBS Losartan, Irbesartan -statin HMG-CoA reductase inhibitor Atorvastatin, Simvastatin -terol Bronchodilators Albuterol, Salmeterol -vir Antiviral Acyclovir, Oseltamivir -tocin Synthetic oxytocin Pitocin, Syntocinon 6 2024 RN101 Sharing and distributing this copyrighted materials is illegal. DRUG side-effects MEDICATION Anti-platelets COMMON SIDE-EFFECTS Bleeding (GI bleeding, ecchymosis, hematuria) Antacids Constipation/diarrhea, flatulence, stomach cramps Opioids Respiratory depression, nausea, constipation NSAIDS Stomach pain, diarrhea/constipation, N/V, ulcers Antiangina Hypotension, headache, dizziness Antiemetics Drowsiness, dry mouth, urinary retention Antihypertensives Hypotension, Syncope or orthostatic hypotension Corticosteroids (Inhaler) Oral candidiasis (thrush), URTI, Throat or sinus irritation Lipid-Lowering Drugs Muscle pain, Abdominal cramps (digestive problems) Bronchodilators Nervousness or shakiness (tremors), headache, throat or nasal irritation, and tachycardia Antibiotics Rash, diarrhea, dizziness, nausea, or yeast infections Acetaminophen Nausea, stomach pain, liver damage (high dose) Anti-anxiety Drowsiness, weight gain, confusion Hypoglycemia, headache, weight gain Insulin ACE inhibitors Non-productive cough, hypotension, metallic taste Betablockers Fatigue, hypotension, dizziness, depression Digoxin Bradycardia, nausea, vomiting Antipsychotics Drowsiness, dizziness, weight gain, EPS 7 2024 RN101 Sharing and distributing this copyrighted materials is illegal. DRUG side-effects MEDICATION POSSIBLE SIDE-EFFECTS Diuretic Hypokalemia Betablockers Bradycardia Antihyperlipidemic Abdominal distention Aspirin Stomach upset, heartburn, bleeding Antiulcer Constipation Short-acting bronchodilator Tremors Antidepressants Antidiabetic Weight gain Tremors Anxiolytic Hypotension (orthostatic) Lipitor (Atorvastatin) Muscle pain or weakness Laxative Abdominal cramps Metformin (Glucophage) Gastrointestinal upset (diarrhea, nausea) Levothyroxine (Synthroid) Insomnia, weight changes, nervousness Omeprazole (Prilosec) Headache, nausea, stomach pain Amlodipine (Norvasc) Swelling in the ankles or feet, dizziness, flushing Warfarin (Coumadin) Increased risk of bleeding, purple toes syndrome Diphenhydramine (Benadryl) Drowsiness, dry mouth, blurred vision Tamsulosin (Flomax) Dizziness, headache, retrograde ejaculation 8 2024 RN101 Sharing and distributing this copyrighted materials is illegal. Drug CLASSES & INDICATION MEDICATION INDICATION Antidiabetic Control hyperglycemia Antianginal Prevention and treatment of angina attack Antiplatelet Prevention and treatment of thromboembolism and treatment of unstable angina and myocardial infarction Anticonvulsant Reduction in frequency and severity of epileptic seizures Opioid analgesics Relief on moderate or severe pain Antiparkinsonians Relief of extrapyramidal effects Antihyperlipidemic Treatment of primary hypercholesterolemia and mixed dyslipidemia Treatment of hypertension and edema due to heart failure Diuretics Beta blocker Treatment of hypertension, angina pectoris, and heart failure Bronchodilator Treatment of reversible airway obstruction due to asthma and COPD Antidepressants Treatment of various forms of mood disorder Treatment of mild to moderate pain, fever, and various inflammatory diseases NSAID Treatment of nausea and vomiting Antiemetic Antipsychotic Anxiolytics Treatment of acute and chronic psychosis, and treatment of schizophrenia Treatment of general anxiety disorders 2024 RN101 Sharing and distributing this copyrighted materials is illegal. 9 ABBREVIATIONS TIMES OF MEDICATIONS ac pc daily bid tid qid qh ad lib stat q2h q4h q6h prn hs PLE M A EX before meals after meals every day two times a day three times a day four times a day every hour as desired immediately every 2 hours every 4 hours every 6 hours as needed at bedtime Order: Dilantin 100 mg PO TID Question: How many mg the patient will receive in one day? Remember: TID = 3X a day Answer: Give 100 mg of dilantin 3X a day, that’s 100 mg x 3 = 300 mg per day ROUTES OF ADMINISTRATION PO IM PR subQ SL ID GT IV IVP IVPB NG DRUG PREPARATION by mouth intramuscular per rectum subcutaneously sublingual intradermal gastrostomy tube intravenous intravenous push intravenous piggyback nasogastric tube HOUSEHOLD METRIC tab(s) tablet cap(s) capsule gtt drop EC enteric coated CR controlled release susp suspension elix elixir supp suppository SR sustained release ER extended release g mg mcg kg lbs L mL mEq. gram milligram microgram kilogram pounds liter milliliter milliequivalent 1 tsp (teaspoon) = 5 mL 1 tbsp (tablespoon) = 15 mL 1 oz (ounce) = 30 mL 1 cup = 250 mL 1 qt (quart) = 1 L 1 pt (pint) = 473 mL 1 gal (gallon) = 3785 mL 10 2024 RN101 Sharing and distributing this copyrighted materials is illegal. drug label QTY 30 Total amount Drug Identification Number LASIX Brand name Generic name DIN 00527033 Code 2440 Medication instruction Description: Each tablet contains 20 mg of furosemide. Direction for use: See package insert Storage: Store at 20-25°C (Furosemide) Form Dosage strength Tablets 20 mg Barcode Manufactured & distributed by: n Lot # 00012345 Expiration 01/2080 Total volume SHEFFORD, CANADA Lot number and expiration date DIN 00527033 Code 2440 2 mL furosemide Injection USP H 20 mg/2mL D H X Q D: Doctor’s order H: Medication on Hand Q: Quantity of medication Lot # 00012345 Expiration 01/2080 Supply dosage For VolumeRelated Dosage Orders = Answer 10 mg/mL Dosage strength RN101PHARM Q 2024 RN101 Sharing and distributing this copyrighted materials is illegal. 11 CONVERSION BASED ON VOLUME THE METRIC SYSTEM 1 mg = 1,000 mcg 1 g = 1,000 mg LARGE unit to small unit move decimal to the RIGHT 1 oz = 30 mL small unit to LARGE unit move decimal to the LEFT 8 oz = 1 cup 1 tsp = 5 mL MOVING TO A LARGER UNIT? 1 dram = 5 mL Move the decimal place to the Left 1 tbsp = 15 mL (Ex: mcg - mg) 1 tbsp = 3 tsp PLE M 1 L = 1, 000 mL A 1500 mcg = _____ mg EX A mg is larger than a mcg therefore you move decimal 3 places to the Left 1500. mcg = 1.500 mg (1.5 mg) BASED ON WEIGHT 1 kg = 2.2 lbs 1 lb = 16 oz lb kg DIVIDE by 2.2 kg lbs MULTIPLY by 2.2 120 lbs = _____ kg 120 lbs / 2.2 = 54.545 kg 45.6 kg = _____ lbs 45.6 kg x 2.2 = 100.32 lbs 12 2024 RN101 Sharing and distributing this copyrighted materials is illegal. dosage calculation rules 1 Leading zeros must be places before any decimal point. The decimal point may be missed without the zero .2 mg should be 0.2 mg E MPL WHY? .2 could appear to be 2 A X E (0.2 mg of morphine is VERY different than 2 mg of morphine!) 2 No trailing zeros. 0.2 mL NOT 0.20 mL PLE 2 mg NOT 2.0 mg M A EX WHY? 2.0 could appear to 20! 3 Do not round until you have the final answer! If the number in the thousands place is 5 or GREATER If the number in the thousands place is 4 or LESS The # in the hundredth place is rounded up 1.995 mg is rounded to 2 mg 1.985 mg is rounded to 1.99 mg The # is dropped DECIMAL REFERENCE GUIDE 34.732 thousandths tens ones 0.992 mg is rounded to 0.99 mg hundredths tenths 13 2024 RN101 Sharing and distributing this copyrighted materials is illegal. formula method For Volume-Related Dosage Orders D H X Q = Answer ! Desired or Doctor’s order D = EXAMPLE: “The physician orders 120 mg...” Some medications like heparin and insulin are prescribed in units/h “the dosage of available medication” H = Hand EXAMPLE: “The medication is supplied as 100 mg/5mL” of medication is available in Q = Quantity EXAMPLE: “The medication is supplied as 100 mg/5mL” ! You should assume that all questions are asked “per dose” unless the question gives a timeframe (example: “how many tablets will you give in 24 hours?”) EXAMPLE 1 EXAMPLE 2 Order: digoxin 0.125 mg PO daily Supply: digoxin 0.25 mg tablets Give: ________ tablet(s) D H X Q= 0.125 mg 0.25 mg FINAL ANSWER: X 0.5 tabs 1 tabs Order: heparin 8000 units subq BID Supply: heparin 10000 units/mL Give: ________ tablet(s) D H X 8000 units Q = 10000 units FINAL ANSWER: X1 mL 0.8 mL 14 2024 RN101 Sharing and distributing this copyrighted materials is illegal. QUIZ 1 ! Tablets and Capsules Three-Step Approach to Dosage Calculations Step 1: CONVERT Ensure that all measurements are in the same size unit of measurement. If not convert before proceeding. Step 2: THINK Estimate what is a reasonable amount of the drug to administer. Step 3: CALCULATE Apply the formula: D ! H x Q 1 Order: cephalexin 0.5 g PO q6h. Available: Novo-Lexin (cephalexin) 500 mg per capsule. Give: _______ capsule(s) 5 Order: amoxicillin 0.5 g PO QID Available: amoxicillin 250 mg capsule Give: _______ capsule(s) 2 Order: levothyroxine 75 mcg PO Available: levothyroxine sodium 0.15 mg, scored tablets Give: _______ tablet(s) 6 Order: Synthroid 0.05 mg PO daily Available: Synthroid 25 mcg tabs Give: _______ tablet(s) 3 Order: furosemide 10 mg PO BID Available: furosemide 20 mg per tablet Give: _______ tablet(s) 7 Order: hydrochlorothiazide 37.5 mg PO each morning Available: APO-hydro (hydrochlorothiazide) 25 mg tabs Give: _______ tablet(s) 4 Order: acetaminophen 650 mg PO Available: acetaminophen 325 mg per tablet Give: _______ tablet(s) 8 Order: rosuvastatin 3000 mcg PO ac Available: rosuvastatin 2 mg tab Give: How many tablet(s) will you administer in 24 hours? 15 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers ! 1 g = 1000 mg 0.5 g x 1000 = 500 mg (or move the decimal point three places to the right) 500 mg x 1 cap = 1 capsule 500 mg 2 1 mg = 1000 mcg 0.15 x 1000 = 150 mcg 1 g = 1000 mg 0.5 g x 1000 = 500 mg (or move the decimal point three places to the right) 5 ! 1 6 75 mcg x 1 tab = 0.5 tablet 150 mcg 500 mg x 1 cap = 2 capsules 250 mg 1 mg = 1000 mcg 0.05 mg x 1000 = 50 mcg (or move the decimal point three places to the right) 50 mcg 25 mcg 3 D H 10 mg 20 mg 4 D H 650 mg 325 mg 7 xQ D H xQ 37.5 mg x 1 tab = 0.5 tablet 25 mg x 1 tab = 2 tablets Move decimal point to make D a whole number. Move decimal point in H by adding “0” 375 mg = 250 mg x 1 tab = 1.5 tablets 8 xQ x 1 tab = 2 tablets 1000 mcg = 1 mg 3000 mcg ÷ 1000 = 3 mg (or move the decimal point three places to the left) 3 mg = 1.5 tab x 3 = 4.5 tablets 2 mg The medication is ordered to be given AC, which means before each meal. Since there are 3 meals in a day (24 hours), the answer must be multiplied by 3. 2024 RN101 Sharing and distributing this copyrighted materials is illegal. 16 QUIZ 2 Tablets and Capsules 1 The physician writes an order for nitrofurantoin 0.1 g PO QID. The drug container label reads nitrofurantoin 100 mg tablets. Give: _________ tablet (s) 2 The doctor ordered minoxidil 7.5 mg PO stat and you have available minoxidil 10 mg and 2.5 mg scored table. Which available tablet you will select? ________ mg tablets Give: ________ tablet (s) 3 The doctor ordered warfarin sodium 5 mg PO daily. Warfarin sodium 2.5 mg tablets is available. Give: ________ tablet (s) 4 The doctor ordered levothyroxine sodium 0.1 mg PO. Levothyroxine sodium 50 mcg is available. Give: ________ tablet (s) 5 The doctor ordered levofloxacin 0.5 g PO daily. Levofloxacin is available in 500 mg tablets. Give: ________ tablet (s) 6 The doctor ordered phenobarbital sodium 45 mg PO daily. You have available phenobarbital 30 mg and 60 mg scored tablets. Which available table you will select? _________ mg tablets Give: ________ tablet (s) 17 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers ! 0.1 g = 0.1 x 1000 = 100 mg Supply: 100 mg/tab D H xQ 100 mg x 1 tab = 1 tablet 100 mg 2 4 2.5 mg tablets 2.5 + 2.5 + 2.5 = 7.5 mg Give 3 tablets ! 1 5 Note: It will be difficult to cut the 10 mg tablet to get the 7.5 mg and the result will be inaccurate. 3 D H 5 mg 2.5 mg 100 mg x 1 tab = 2 tablets 50 mg 1 g = 1000 mg 0.5 g x 1000 = 500 mg (or move the decimal point three places to the right) 500 mg 500 mg 6 xQ 1 mg = 1000 mcg 0.1 x 1000 = 100 mcg (or move the decimal point three places to the right) 30 mg tablets 30 + 15 = 45 mg D H x 1 tab = 2 tablets x 1 tab = 1 tablet 45 mg 30 mg xQ Note: It will be difficult to cut the 60 mg tablet to get the 45 mg and the result will be inaccurate. x 1 tab = 1.5 tablets 18 2024 RN101 Sharing and distributing this copyrighted materials is illegal. QUIZ 3 1 Parenteral Dosage The physician writes an order for hydroxyzine hydrochloride 100 mg IM stat. You have available hydroxyzine hydrochloride for injection 50 mg/mL in a 1-mL vial. How many millilitres should be administered to the patient? 2 The doctor ordered nalbuphine hydrochloride 5 mg subcutaneous q3h prn for pain. The 1 mL unit dose vial is labelled nalbuphine hydrochloride 10 mg per mL injection. How many millilitres should be given subcutaneous as needed for pain every 3 hours? 3 The doctor ordered meperidine hydrochloride 60 mg IM q4h prn for pain. Meperidine hydrochloride injection 75 mg/mL. How many millilitres should be given intramuscularly every 4 hours as needed for pain? 4 The physician writes an order for heparin sodium 8000 units subcutaneous BID. A vial of heparin sodium injection 10000 units/mL is available. How many millilitres should be administered to the patient subcutaneously? 5 The doctor ordered glycopyrrolate 150 mcg. A vial of glycopyrrolate 0.2 mg/mL is available. How many millilitres should be administered to the patient intramuscularly immediately? 6 The patient has an order for morphine sulfate 10 mg IM q4h prn for pain, and the label on the vial states morphine sulfate mg/mL. How many millilitres should be given intramuscularly every 4 hours as needed for prn? 19 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers ! 1 D xQ H 4 20 mg x 1 mL = 2 mL 10 mg D H xQ 8000 units x 1 mL = 0.8 mL 10000 units ! 2 D xQ H 5 mg 10 mg 3 D H 60 mg 75 mg 5 x 1 mL = 0.5 mL 150 mg x 1 mL = 0.75 mL 200 mg 6 xQ x 1 mL = 0.8 mL 1 mg = 1000 mcg 0.2 mg x 1000 = 200 mcg (or move the decimal point three places to the right) D H 10 mg 25 mg xQ x 1 mL = 0.4 mL 20 2024 RN101 Sharing and distributing this copyrighted materials is illegal. QUIZ 4 1 Divided Dosage A physician has prescribed lorazepam 4 mg IM in six divided doses. How much will you give per dose? 2 A healthcare provider has prescribed ondansetron HCl 24 mg orally daily in divided doses every 8 hours. How much will you give per dose? 3 You are working with a young adult patient. The physician has prescribed Adderall XR capsules 60 mg daily in divided doses BID. How many capsules will the client take per dose? 21 2024 RN101 Sharing and distributing this copyrighted materials is illegal. QUIZ 4 Divided Dosage You’re working with a 16-year-old 4 patient. The physician has written a prescription for phenytoin oral suspension 7 mg/kg/day by mouth in divided doses TID. The patient weighs 125 pounds. How many mL will the patient take per dose? 5 6 Your adult patient has a prescription for amoxicillin oral suspension 1300 mg by mouth daily in three divided doses. How many mL of the reconstituted medication will you give per dose? Your patient is taking Adderall XR 45 mg daily in divided doses at 0600, 1100, and 1400. How many capsules will the patient take per dose? 22 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 D xQ H 4 mg 4 mg x 1 mL = 1 mL per day in 6 doses 1 mL / 6 doses = 0.166 mL per dose = 0.17 mL per dose 2 D xQ H 24 mg x 5 mL = 30 mL per day 4 mg The medication is prescribed every 8 hours, or 3 x per day 30 mL / 3 doses = 10 mL per dose 3 D xQ H 60 mg 15 mg x 1 capsule = 4 capsules per day The medication is prescribed BID, or 2 x per day 4 capsules / 2 doses = 2 capsules per dose 23 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 4 Convert lbs to kg = 125 lbs / 2.2 kg = 56.82 kg 56.82 kg x 7 kg/mg/day = 397.73 mg/day D xQ H 5 397.73 mg x 5 mL = 15.909 mL 125 mg D xQ H The medication is prescribed TID, or 3 x per day 15.909 mL / 3 doses = 5.3 mL per dose 1300 mg x 5 mL = 5.2 mL per day 250 mg The medication is prescribed daily in 3 divided doses 5.2 mL / 3 doses = 1.7 mL per dose 6 D xQ H 45 mg 15 mg x 1 capsule = 3 capsules per day The medication is prescribed TID, or 3 x per day 3 capsules / 3 doses = 1 capsule per dose 24 2024 RN101 Sharing and distributing this copyrighted materials is illegal. QUIZ 5 1 2 3 Intravenous medications A nurse is caring for a hospitalized adult patient who weighs 150 pounds. The physician has written a prescription for dantrolene sodium IV 1 mg/kg every four hours. How many mL will the nurse give per dose? A patient has a prescription for 10 million units of penicillin G potassium IV daily in four divided doses. The bottle of penicillin G potassium available on the unit was reconstituted using 75 ml of sterile water. How many ml will the nurse give per dose? A patient has a prescription for 20 million units of penicillin G potassium IV daily in six divided doses. The nurse uses 33 mL of sterile water to reconstitute a new bottle of penicillin G potassium. How many mL will the nurse give per dose? 25 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 Convert lbs to kg = 150 lbs / 2.2 kg = 68.18 kg 68.18 kg x 1 kg/mg/day = 68.18 mg/day D xQ H 2 68.18 mg x 1 mL = 1.36 mL = 1.4 mL 50 mg D xQ H 10000000 units 250000 units The medication is not prescribed in divided doses Reconstitution yields 50 mg/mL (see label) x 1 mL = 40 mL per dose The medication is prescribed daily in 4 divided doses 40 mL / 4 doses = 10 mL per dose 3 D xQ H 20000000 units 500000 units x 1 mL = 40 mL per dose The medication is prescribed daily in 6 divided doses 40 mL / 6 doses = 6.66 = 6.7 mL per dose 26 2024 RN101 Sharing and distributing this copyrighted materials is illegal. IV flow rates mL/hour Volume (mL) mL/hr = Time (hr) ! If the question is asking for flow rate and you’re given units of mL, you need to write the answers in mL/hr! Volume (mL) Time (min) x 60 = mL/hr (minutes) mL/hr is always rounded to the nearest whole number! EXAMPLE 1 EXAMPLE 2 Ordered: 1000 mL D5W to infuse over 3 hours. What will the flow rate be? Ordered: Infuse 3 grams of Penicillin in 50 mL normal saline over 30 minutes. 1000 mL 3 hr = 333.333 mL/hr FINAL ANSWER: Volume (mL) Time (min) gtt/min What if the question is given in MINUTES? Since there are 60 minutes in one hour, use this formula: 333 ml/hr x ! 50 mL x 60 min = 100 mL /hr 30 min FINAL ANSWER: drop = gtt/min factor 100 ml/hr What if the question is given in HOURS? Since there are 60 minutes in one hour, use this formula: Convert hours to minutes! EXAMPLES: 1 hour = 60 minutes 2.5 hours = 150 minute EXAMPLE 1 EXAMPLE 2 Ordered: 1000 mL of Lactated Ringer’s to infuse at 50 mL/hr. Drop factor for tubing is a 5 gtt/mL. (Convert: 1 hour = 60 min) Ordered: 100 mL of Metronidazole to infuse over 45 minutes. The tubing you are using has a drop factor of 10 gtt/mL. 50 mL x 5 gtt/mL = 4.166 gtt/min 60 min FINAL ANSWER: 4 gtt/min 100 mL x 10 gtt/mL = 22.222 gtt/min 45 min FINAL ANSWER: 22 gtt/min 27 2024 RN101 Sharing and distributing this copyrighted materials is illegal. quiz 1 Drops per minute ! Order: D5W IV @125 mL/h. The infusion set is calibrated for a drop factor of 10 gtt/min. Calculate the IV flow rate in gtt/min. 5 2 Order: Lactated Ringer’s IV @ 150 mL/h. The drop factor 15 gtt/mL. Calculate the IV flow rate in gtt/min. 6 Order: 3000 mL D5W IV @125 mL/h Drop factor: 10 gtt/mL Calculate the IV flow rate in gtt/min. 3 Order: ampicillin 500 mg IV in 100 mL of NS, infuse over 20 min. The drop factor is 10 gtt/mL. Calculate the IV flow rate in gtt/min. 7 Order: 150 mL NS bolus IV to infuse in 45 min Drop factor: 15 gtt/mL Calculate the IV flow rate in gtt/min. ! 1 4 Order: NS IV 3000 mL/24 h. Drop factor is 15 gtt/min. Calculate the IV flow rate in mL/h and gtt/min. 8 Order: Total parenteral is ordered for 1240 mL to infuse in 12 hours using an infusion set with tubing calibrated to 15 gtt/mL. Calculate the IV flow rate in mL/h and gtt/min. Order: Two 500 mL units of whole blood IV to be infused in 4 h. Drop factor: 10 gtt/mL. Calculate the IV flow rate in gtt/min. 28 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 125 mL x 10 gtt/mL = 20.8 gtt/min 60 min 5 103 mL x 15 gtt/mL = 25.7 gtt/min 60 min = 21 gtt/min 2 150 mL x 15 gtt/mL = 37.5 gtt/min 60 min 1240 mL = 103.3 mL/h = 103 mL/h 12 h = 26 gtt/min 6 125 mL x 10 gtt/mL = 20.8 gtt/min 60 min = 38 gtt/min 2 1000 gtt 100 mL x 10 gtt/mL = 20 min 20 min = 21 gtt/min 7 150 mL x 15 gtt/mL = 50 gtt/min 45 min = 50 gtt/min 4 3000 mL = 125 mL/h 24 h 125 mL 60 min x 15 gtt/mL = 31.3 gtt/min = 31 gtt/min = 50 gtt/min 8 Two 500 mL units of blood = 1000 mL total volume mL/h = 1000 mL = 250 mL/h 4h 250 mL x 10 gtt/mL = 41.6 gtt/min 60 min = 42 gtt/min 2024 RN101 Sharing and distributing this copyrighted materials is illegal. 29 quiz 2 mL/h ! 1 An order was written to infuse a litre (1000 mL) of IV fluid every 8 hours, what rate would the IV pump be set for? 2 A nurse have recieved a new admission from the E.R. The patient has class IV CHF and the doctor has ordered a loading dose of Inocor® (amrinone lactate). The loading dose is to be administered over 3 minutes. Pharmacy has brought the loading dose as a 50 mL IVPB. At what rate should the IVPB be infused? 3 The volume of the fluid is 1 000 mL and the IV pump set at 62 mL/hour. How long will it take for the fluid to run? 4 A patient is ordered to received 1,000 mL of NSS to be administered at 125 mL/hour. How many hours will pass before the nurse change the IV bag? 30 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 Volume Hour 1000 mL 8 hours = 125 mL/hr 2 Volume x 60 min Hour 50 mL x 60 min 3 min = 1000 mL/hr 3 Volume Hour 1000 mL 62 mL/hour = 16 hours Volume Hour 1000 mL 125 mL/hour = 8 hours 4 31 2024 RN101 Sharing and distributing this copyrighted materials is illegal. cALCULATING PEDIATRIC DOSAGE ! Three-Step Approach to Dosage Calculations Step 1: CONVERT Convert the child’s weight from pounds to kilograms (rounded to tenths) Step 2: MULTIPLY Multiply mg/kg by child’s weight in kg. Step 3: CALCULATE Apply the formula: D ! H x Q EXAMPLE 1 You have on hand hydromorphone (Dilaudid) 4 mg/mL. You need to administer 0.015 mg/kg to a patient who weighs 150 pounds. Question: How many mL should you administer? Convert 150 lbs to kilograms by dividing it with 2.2 to get 68.18 kg. Calculate recommended dose: 68.18 kg x 0.015 mg/kg to get 1.022 mg. D x H Q = 1.022 mg 4 mg x 1 mL = 0.255 mL FINAL ANSWER: 0.26 mL Single Dosage Range - Verify Safe Pediatric Dosage EXAMPLE 2 Order: hydroxyzine hydrochloride 20 mg IM q4h, prn for nausea. The child weighs 44 lb. A reputable drug resource indicates that the usual IM dosage is 0.5 mg to 1 mg/kg/dose. Supply: hydroxyzine hydrochloride 50 mg/mL Question: Is this a safe dosage? How many mL will you administer? Convert 44 lbs to kilograms by dividing it with 2.2 to get 20 kg Calculate the recommended dose: D x Minimum per dose: 0.5 mg/kg/dose x 20 kg = 10 mg/dose Maximum per dose: 1 mg/kg/dose x 20 kg = 20 mg/dose H The recommended dosage range is 10 mg to 20 mg, 20 mg x 1 mL = 50 mg and the ordered dosage of 20 mg is within this range. Q FINAL ANSWER: YES, the dose is safe FINAL ANSWER: 0.4 mL 32 2024 RN101 Sharing and distributing this copyrighted materials is illegal. quiz 1 ! A primary healthcare provider ordered ceftriaxone (Rocephin) for a 4-year-old child with lower respiratory tract infection. The dose required is 20 mg/kg/day divided twice a day, administered per dose via IV. The child’s weight is 29 lbs. The drug comes prediluted in a concentration of 10 mg/ml. ! 1 Question How much of the medication will you administer in mL per dose? 2 A primary healthcare provider ordered Augmentin 10 mg/kg PO every 12 hours for an 8-year-old child. When Augmentin is reconstituted it yields 125 mg/mL. The child weighs 25 kg. Question: How many mL will you give? 3 A primary healthcare provider ordered valproic acid 150 mg PO BID for a child who is 10 years old and weighs 64 lb. The recommended dosage for adults and children 10 years and older is 10-15 mg/kg/day up to maximum of 60 mg/kg/day. If the total daily dosage exceeds 250 mg, divide the dose. The drug is available in 50 mg/mL. Question How much is the recommended minimum daily dose? How much is the recommended maximum daily dose? Is the dosage order safe? How many mL will you give? 33 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers ! Convert lb to kg: 29 lb ÷ 2.2 = 13.2 kg Calculate recommended dose: 13.2 kg x 20 mg/kg/day = 264 mg/day Calculate the volume of medication: D H x Q = 264 mg 10 mg x 1 mL = 26.4 mL/day ! 1 Divided twice a day: 26.4 ÷ 2 = 13.2 mL 2 13.2 mL No conversion needed Calculate recommended dose: 25 kg x 10 mg/kg = 250 mg Calculate the volume of medication: D H 3 FINAL ANSWER: x Q = 250 mg 125 mg x 1 mL = 2 mL FINAL ANSWER: 2 mL Convert lb to kg: 64 lb ÷ 2.2 = 29.9 kg = 29.1 kg Calculate recommended minimum dose: 29.1 kg x 10 mg/kg/day = 291 mg/day Calculate recommended maximum dose: 29.1 kg x 15 mg/kg/day = 436.5 mg/day Is the dosage order safe? The ordered dosage is SAFE. Child will received 300 mg in a 24-hour period in divided doses of 150 mg BID. D H x Q = 150 mg 50 mg x 1 mL = 3 mL FINAL ANSWER: 3 mL 34 2024 RN101 Sharing and distributing this copyrighted materials is illegal. quiz 2 ! Calculate the dose of amoxicillin suspension in mLs for otitis media for a 1-yr-old child weighing 22 lb. The dose required is 40 mg/kg/day divided BID and the suspension comes in a concentration of 400 mg/5 mL. ! 1 Question How much of the medication will you administer in mL per dose? 2 Calculate the dose of ceftriaxone in mLs for meningitis for a 5-yrold weighing 18 kg. The dose required is 100 mg/kg/day given IV once daily and the drug comes prediluted in a concentration of 40 mg/mL. Question: How many mL will the nurse give? 3 The suggested dosage of tobramycin (Nebcin) is 4 mg/kg/day for a neonate who weighs 3 kg. If the dosage must be divided and given every 12 hours, how many milligrams will the child receive in each dose? 35 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers ! Convert lb to kg: 22 lb ÷ 2.2 = 10 kg Calculate recommended dose: 10 kg x 100 mg/kg/day = 400 mg/day Calculate the volume of medication: D H x Q = 400 mg 400 mg x 5 mL = 5 mL/day ! 1 Divided twice a day: 5 mL ÷ 2 = 2.5 mL 2 2.5 mL No conversion needed Calculate recommended dose: 18 kg x 10 mg/kg = 1800 mg Calculate the volume of medication: D H 3 FINAL ANSWER: x Q = 1800 mg 40 mg x 1 mL = 45 mL FINAL ANSWER: 45 mL No conversion needed Calculate recommended dose: 3 kg x 4 mg/kg = 12 mg Calculate the volume of medication: Divided twice a day: 12 mg ÷ 2 = 6 mg FINAL ANSWER: 6 mg 36 2024 RN101 Sharing and distributing this copyrighted materials is illegal. Exercises let’s practice more tablets & capsules The physician orders 0.2 g of misoprostol. On hand are 200 mg misoprostol tablets. The nurse should administer how many tablet (s) per dose? 2 The physician orders pemoline 37.5 mg PO. The pharmacy sends 18.75 pemoline tablets. The nurse should administer how many tablet (s) per dose? 3 The physician orders diltiazem hydrochloride SR 90 mg PO BID. On hand are diltiazem HCL SR capsules labeled 90 mg per capsule. The nurse should administer how many capsule (s) per dose? 4 The physician orders warfarin sodium 5 mg by mouth every day. The pharmacy sends 2.5 mg warfarin sodium tablets. The nurse should administer how many tablet (s) per dose? 5 The physician orders calcitriol 0.5 micrograms PO QD at AM. The pharmacy sends 0.25 mcg calcitrol capsules. The nurse should administer how many capsule (s) per dose? ! 1 6 The physician orders nitroglycerin 0.3 g sublingual PRN at onset of chest pain. Dose may be repeated in 5 minutes at maximum of 3 doses. On hand are 300 mg nitroglycerin tablets. The nurse should administer how many tablet (s) per dose? 38 2024 RN101 Sharing and distributing this copyrighted materials is illegal. tablets & capsules The physician orders allopurinol 0.6 g PO QD. On hand are 300 mg allopurinol tablets. The nurse should administer how many tablet (s) per dose? 8 The physician orders amoxicillin 250 mg q8h. On hand are 125 mg chewable amoxicillin tablets. The nurse should administer how many tablet (s) per dose? ! 7 9 The physician orders amoxicillin/potassium clavulanate 20 mg/kg/day in 4 divided doses to a child weighing 66 pounds. The pharmacy sends 150 mg amoxicillin/potassium clavulanate tablets. The nurse should administer how many tablet (s) per dose to this child? 10 The physician orders ampicillin sodium 0.5 g PO 4 times a day. On hand are 500 mg ampicillin capsules. The nurse should administer how many capsule (s) per dose? 11 The physician orders anastrozole 1000 mcg PO once daily. On hand are 1 mg anastrozole tablets. The nurse should administer how many tablet (s) per dose? 12 The physician orders acetaminophen 650 mg q4h as needed for pain. Available are 325 mg acetaminophen tablets. The nurse should administer how many tablet (s) per dose? 39 2024 RN101 Sharing and distributing this copyrighted materials is illegal. tablets & capsules The physician orders atorvastatin calcium 10 mg PO once a day. Available are 0.01 g atorvastatin calcium tablets. The nurse should administer how many tablet (s) per daily dose? ! 13 14 The physician orders atenolol 100 mg PO once a day. Available are 50 mg atenolol tablets. The nurse should administer how many tablet (s) per daily dose? 15 The physician orders carvedilol 3.125 mg BID. The pharmacy sends the nurse 6.25 mg carvedilol tablets. The nurse should administer how many tablet (s) per dose? 16 The physician orders ampicillin sodium 0.5 g PO 4 times a day. On hand are 500 mg ampicillin capsules. The nurse should administer how many capsule (s) per dose? 17 The physician orders celecoxib 200 mg PO in 2 divided doses per day. On hand are 100 celecoxib capsules. The nurse should administer how many capsule (s) per dose? 18 The physician orders fexofenadine 120 mg PO in 2 divided doses per day. Available are 60 mg fexofenadine capsules. The nurse should administer how many capsule (s) per dose? 40 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 Convert g to mg: 0.2 x 1000 = 200 mg 4 D xQ H D xQ H 5 D H 6 xQ 90 mg x 1 cap = 1 capsule 90 mg x 1 tab = 2 tablets D xQ H 0.5 mcg x 1 cap = 2 capsules 0.25 mg 37.5 mg x 1 tab = 2 tablets 18.75 mg 3 xQ 5 mg 2.5 mg 200 mg x 1 tab = 1 tablet 200 mg 2 D H Convert g to mg: 0.3 x 1000 = 300 mg D H xQ 300 mg x 1 tab = 1 tablet 300 mg 41 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers ! 7 Convert g to mg: 0.6 x 1000 = 600 mg 10 D xQ H Convert g to mg: 0.5 x 1000 = 500 mg D H 600 mg x 1 tab = 2 tablets 300 mg xQ 500 mg 500 mg x 1 cap = 1 capsule ! 8 D xQ H 11 D H 250 mg x 1 tab = 2 tablets 125 mg 9 Convert lbs to kg: 66 ÷ 2.2 = 30 Calculate recommended dose: 30 kg x 20 mg/kg/day = 600 mg/day Calculate the volume of medication: D H xQ Convert mcg to mg: 1000 ÷ 1000 = 1 mg 1 mg 1 mg 12 D H xQ x 1 tab = 1 tablet xQ 650 mg x 1 tab = 2 tablets 325 mg 600 mg x 1 tab = 4 tablets 150 mg 4 divided doses: 4 ÷ 4 = 1 tablet 42 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers ! 13 Convert g to mg: 0.01 x 1000 = 10 mg 16 Convert g to mg: 0.5 x 1000 = 500 mg D xQ H 10 mg 10 mg 14 D H D H 500 mg x 1 tab = 1 tablet 500 mg x 1 tab = 1 tablet 17 xQ D xQ H 2 divided doses: 2 ÷ 2 = 1 capsule 18 3.125 mg x 1 tab = 0.5 tablet 6.25 mg D xQ H 200 mg x 1 cap = 2 capsules 100 mg 100 mg x 1 tab = 2 tablets 50 mg 15 xQ D xQ H 120 mg x 1 cap = 2 capsules 60 mg 2 divided doses: 2 ÷ 2 = 1 capsule 43 2024 RN101 Sharing and distributing this copyrighted materials is illegal. liquid preparation The physician writes an order for acetaminophen 240 mg PO for an elderly adult. You have on hand 80 mg acetaminophen oral liquid in 0.8 ml. The nurse should administer how many ml per dose? ! 1 2 The physician orders acetaminophen 280 mg PO for a child. You have on hand acetaminophen 80 mg per 2.5 mL. How many mL should you administer? 3 The physician orders 180 acyclovir PO. The pharmacy supplies acyclovir suspension 200 mg/5 mL. The nurse should administer how many mL per dose? 4 The physician orders amoxicillin 275 mg PO. The pharmacy supplies amoxicillin suspension 250 mg/5mL. The nurse should administer how many mL per dose? 5 6 The physician orders amoxicillin 350 mg PO. The pharmacy filled the prescription with amoxicillin suspension 400 mg/5mL. The nurse should instruct the patient to take how many mL per dose? The physician orders amphetamine sulphate 20 mg TID for attention deficit disorder. The pharmacy supplies 10 mg tablets. The patient is unable to swallow tablets so the nurse crushes each tablet in 2 mL of water and a drop of cherry syrup. The nurse should administer how many mL for each dose? 44 2024 RN101 Sharing and distributing this copyrighted materials is illegal. liquid preparation The physician orders atovaquone 1.5 g PO once daily. The pharmacy fills the patient’s prescription with atovaquone 750 mg/5ml suspension. The nurse should administer how many ml per dose? ! 7 8 9 The physician orders 1200 mg amprenavir BID PO. The pharmacy supplies amprenavir oral liquid 15 mg/mL for this patient who is unable to swallow capsules. How many mL should you administer? The physician orders amoxicillin/potassium clavulanate 100 mg PO q12h. The pharmacy fills the patient’s prescription with amoxicillin/potassium clavulanate 125 mg/5 mL suspension. The nurse should administer how many mL per dose? 10 The physician orders azithromycin 300 mg QD for 5 days PO. The pharmacy fills the patient’s prescription with azithromycin 200 mg/5mL. The nurse should administer how many mL per daily dose? 11 The physician orders acetaminophen 320 mg PO for a child’s temperature elevation. The mother purchases acetaminophen liquid 80 mg/2.5 mL. The mother should administer how many teaspoon per dose? 12 The physician orders amoxicillin 250 mg PO. The pharmacy supplies amoxicillin suspension 250 mg/5mL. The nurse should instruct the patient to take how many teaspoon per dose? 45 2024 RN101 Sharing and distributing this copyrighted materials is illegal. liquid preparation The physician orders 1350 mg amprenavir BID PO. The pharmacy supplies amprenavir oral liquid 15 mg/mL. The nurse should instruct the patient to take how many ounce per dose? ! 13 14 The physician orders cefaclor 2 g via gastric tube in two divided doses. The pharmacy sends cefaclor 375 mg/5mL suspension. How many mL the nurse should administer? 15 The physician orders cefadroxil monohydrate 750 mg PO BID for a child weighing 50 kg. The pharmacy sends cefadroxil monohydrate 500 mg/5mL. The nurse should administer how many mL per dose? 16 The physician orders cefpodoxime proxetil 200 mg q12h PO. The pharmacy sends cefpodoxime proxetil 100 mg/5mL. The nurse should administer how many mL per dose and mL per day? 17 18 The physician orders ceprozil 112.5 mg PO BID for 10 days for a child weighing 15 kg. The pharmacy sends ceprozil suspension 125 mg/5 mL. The nurse should administer how many mL per dose? The physician orders cefaclor 750 mg PO QD for 10 days for a child weighing 25 kg. The pharmacy fills the prescription with cefaclor 187 mg/5 mL. The nurse should administer how many mL per dose? 46 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers ! 1 D xQ H 4 240 mg x 0.8 mL = 2.4 mL 80 mg 2 D H D xQ H 180 mg 200 mg = 4.4 mL 6 x 5 mL = 4.5 mL D xQ H 350 mg x 5 mL = 4.375 mL 400 mg 280 mg x 2.5 mL = 8.75 mL 80 mg = 8.8 mL 3 xQ 275 mg x 5 mL = 5.5 mL 250 mg 5 xQ D H D xQ H 20 mg 10 mg x 2 mL = 4 mL 47 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers ! 7 Convert g to mg: 1.5 x 1000 = 1500 mg 10 D xQ H D H 11 xQ D xQ H 100 mg 125 mg 1 teaspoon is equal to 5 mL = 2 teaspoon 12 x 5 mL = 4 mL D xQ H 320 mg x 2.5 mL = 10 mL 80 mg 1200 mg x 1 mL = 80 mL 15 mg 9 xQ 300 mg x 5 mL = 7.5 mL 200 mg 1500 mg x 5 mL = 10 mL 750 mg 8 D H D xQ H 250 mg x 5 mL = 5 mL 250 mg 1 teaspoon is equal to 5 mL = 1 teaspoon 48 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 13 D xQ H 16 1350 mg x 1 mL = 90 mL 15 mg 200 mg 100 mg 1 ounce is equal to 30 mL = 3 ounce 14 Convert g to mg: 2 x 1000 = 2000 mg D H D xQ H x 5 mL = 10 mL/dose q12h means 2x in 24h = 20 mL/day 17 xQ D xQ H 112.5 mg x 5 mL = 4.5 mL 125 mg 2000 mg x 5 mL = 26.66 mL 375 mg In two divided doses = 13.3 mL 15 D xQ H 750 mg 500 mg 18 x 5 mL = 7.5 mL D xQ H 750 mg x 5 mL = 20.05 mL 187 mg = 20.1 mL 49 2024 RN101 Sharing and distributing this copyrighted materials is illegal. subcutaneous & intramuscular The physician orders 10 units of regular insulin and 15 units of NPH insulin SC qAM. What is the total number of units of insulin the nurse will draw up in the syringe and administer? ! 1 2 The physician orders 40 units of 70/30 insulin to be administered SQ qAM. The nurse must use a standard syringe because no insulin syringe is available. The label on the 70/30 insulin says there are 100 u/mL. The nurse will administer how many mL SC? 3 The physician orders amikacin sulfate 300 mg IM. The amikacin sulfate Im solution comes in a concentration of 250 mg/mL. The nurse will administer how many mL of amikacin sulfate? 4 The physician orders morphine sulfate 2 mg IV now. The morphine sulfate tubex contains 4 mg/ml. The nurse should administer how many mL IV bolus? 5 6 The physician orders amitriptyline HCL 30 mg IM stat. The amitriptyline injectable comes in a concentration of 10 mg/mL. The nurse should administer how many mL? The physician orders 450 IU of antihemophilic factor (Factor VIII) IV QD. The pharmacy supplies the antihemophilic factor in a concentration of 75 IU/5 mL. The nurse should administer how many mL bolus? 50 2024 RN101 Sharing and distributing this copyrighted materials is illegal. subcutaneous & intramuscular The physician orders kanamycin sulfate 0.4 g IM. The vial label on the kanamycin sulfate states 500 mg/2 mL. The nurse should administer how many mL IM? ! 7 8 The physician orders ardeparin sodium 7500 U SC BID. The vial label on the ardeparin sodium reads 5000 U/0.5 mL. The nurse will administer how many mL SC? 9 The physician orders amikacin sulfate 500 mg IM. The amikacin sulfate IM solution comes in a concentration of 250 mg/mL. The nurse will administer how many mL of amikacin sulfate? 10 The physician orders amikacin 125 mg IM. The amikacin sulfate IM solution comes in a concentration of 62.5 mg/mL. The nurse should administer how many mL IM? 11 12 The physician orders orders 2500 units heparin sodium SC BID. The pharmacy sends heparin sodium 10000 units/mL. The nurse should administer how many mL SC? The physician orders ardeparin sodium 8000 units SC BID. The pharmacy supplies ardeparin sodium 10000 units/0.5 mL. The nurse should administer how many mL SC? 51 2024 RN101 Sharing and distributing this copyrighted materials is illegal. subcutaneous & intramuscular The physician orders heparin sodium 3000 units SC BID prophylaxis. The pharmacy supplies heparin sodium 5000 units/0.5 mL. The patient should receive how many mL SC? ! 13 14 The physician orders enoxaparin sodium 30 mg SC BID. The pharmacy sends enoxaparin sodium 60 mg/0.6 mL. The patient should receive how many mL SC? 15 The physician orders enoxaparin sodium 50 mg SC QD. The pharmacy sends enoxaparin sodium 100 mg/mL. The should administer how many mL SC each day? 16 The physician orders enoxaparin sodium 40 mg SC QD. The pharmacy sends enoxaparin sodium 40 mg/0.4 mL. The patient should receive how many mL SC each day? 17 18 The physician orders heparin sodium 7000 units SC BID. The pharmacy sends heparin sodium 5000 units/0.5 mL. The nurse should administer how many mL SC? The physician orders desmopressin acetate 15 mcg SC in two divided doses. The pharmacy sends desmopressin acetate 15 mcg/mL. The nurse should administer how many mL SC per dose? 52 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 4 1 10 units R + 15 units NPH = 25 units 2 D H 40 units 100 units 3 6 x 1 mL = 1.2 mL x 1 mL = 0.5 mL D xQ H 30 mg 10 mg x 1 mL = 0.4 mL D xQ H 300 mg 250 mg 2 mg 4 mg 5 xQ D xQ H x 1 mL = 3 mL D xQ H 450 IU 75 IU x 5 mL = 30 mL 53 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 7 Convert g to mg: 0.4 x 1000 = 400 mg D H xQ 400 mg 500 mg 8 D H 11 xQ 125 mg 62.5 mg 12 x 1 mL = 2 mL D xQ H 2500 units x 1 mL = 0.25 mL 10000 units x 0.5 mL = 0.75 mL D xQ H D xQ H 125 mg x 1 mL = 2 mL 62.5 mg x 2 mL = 1.6 mL 7500 units 5000 units 9 10 D xQ H 8000 units 10000 units x 0.5 mL = 0.4mL 54 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 13 D H 16 xQ 3000 units 5000 units 14 D H 30 mg 60 mg 15 17 18 x 1 mL = 0.5 mL x 1 mL = 0.4 mL D xQ H 7000 units 5000 units x 0.6 mL = 0.3 mL D xQ H 50 mg 100 mg 40 mg 40 mg x 0.5 mL = 0.3 mL xQ D xQ H x 0.5 mL = 0.7 mL D xQ H 15 mcg 15 mcg x 1 mL = 1 mL In two divided doses: 0.5 mL 55 2024 RN101 Sharing and distributing this copyrighted materials is illegal. drug reconstitution The physician orders acyclovir 200 mg IV. A vial of 500 mg of acyclovir come in powder form with directions to reconstitute with 5 mL of normal saline. How many milliliters would contain the ordered amount? ! 1 2 The doctor orders 112.5 mg of cefazolin IV. A 500 mg vial of cefazolin powder has instructions to reconstitute with 2 mL of sterile water. How many milliliters would contain the ordered amount? 3 The physician orders 500 mg of ceftazidime IV. The label on the 2 g vial of cetazidime reads to reconstitute with 10 mL of sterile water. How many milliliters would contain the ordered amount? 4 The label on the 1 g vial of ampicillin reads to reconstitute with sodium chloride achieve a concentration of 125 mg/5 mL. How many milliliters of sodium chloride should be added to the vial to achieve this concentration? 5 6 The label on the 2 g vial of ampicillin reads to reconstitute with sodium chloride to achieve a concentration of 1000 mg/100 mL. How many milliliters of sodium chloride should be added to the vial to achieve this concentration? The physician orders ampicillin 0.5 g. The label on the 1 g vial of ampicillin reads to reconstitute with water to achieve a concentration of 125 mg/5 mL. How many milliliters would contain the ordered amount? 56 2024 RN101 Sharing and distributing this copyrighted materials is illegal. drug reconstitution The physician orders azithromycin 0.5 g PO. The label on the vial azithromycin reads to reconstitute with sterile water to achieve a concentration of 200 mg/5 mL. How many milliliters will achieve the ordered dose? ! 7 8 9 10 11 12 The physician orders cefaclor 250 mg PO. The vial of ceflacor powder for reconstitution reads to reconstitute with sterile water to achieve a concentration of 375 mg/5 mL. How many milliliters will achieve the ordered dose? The label on the 2 g vial of cefadroxil monohydrate powder reads to reconstitute with sterile water to achieve a concentration of 125 mg/5 mL. How many milliliters of diluent should be added to achieve this concentration? The physician orders cefotetan disodium 200000 mcg IV q12h. The label on the 1 g vial of powdered cefotetan disodium reads to reconstitute with sterile water to achieve a concentration of 1 g/10 mL. How many milliliters of sterile water should be added to the powder to achieve the ordered dose? The label on the 2 g vial of cefoxitin sodium powder reads to reconstitute with 50 mL of sterile water. This provides a concentration of how many mg/mL? The physician orders cefpodoxime proxetil 200 mg PO q12h. The label on the vial of granules of cefpodoxime proxetil reads to reconstitute with distrilled water to achieve a concentration of 50 mg/5mL. The nurse should administer how many mL of reconstituted medication to achieve the ordered dose? 57 2024 RN101 Sharing and distributing this copyrighted materials is illegal. drug reconstitution The label on the 250 mg vial of ceprozil reads to reconstitute with 5 mL distilled water. This will provide a concentration of how many mg/mL? ! 13 14 15 16 17 18 The physician orders ceftazidime 1 g IV. The powder for injection of ceftazidime is ina vial that is labeled to reconstitute with 50 mL of normal saline for injection to achieve a concentration of 10 mg/mL. How many milliliters will be required to achieve the ordered dose? The physician orders ceftizoxime sodium 0.5 g IV q12h. The label on the vial of powder for reconstitution of ceftizoxime sodium reads to reconstitute with sterile water to achieve a concentration of 10 mg/mL. The nurse should prepare to administer how many mL to achieve the ordered dose? The physician orders cefuroxime axetil 250 mg suspension. The label on the vial of cefuroxime axetil powder reads to reconstitute with distilled water to achieve a concentration of 0.12 g/5 mL. How many milliliters of this concentration will be needed to achieve the ordered dose? The physician orders 500 mg cephalexin monohydrate suspension PO q12h. The label on the vial of cephalexin monohydrate powder reads to reconstitute with sterile water to achieve a concentration of 125 mg/4.5 mL. How many milliliters of reconstituted medication the nurse administer to achieve the ordered dose? The label of the 1 g vial of cephadine powder reads to reconstitute with 40 mL of distilled water for oral suspension. This will provide a concentration of how many mg/mL? 58 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 D xQ H 200 mg 500 mg 4 Convert g to mg: 1 x 1000 = 1000 D xQ H x 5 mL = 2 mL 1000 mg 125 mg 2 D xQ H 5 112.5 mg x 2mL = 0.45 mL 500 mg 3 Convert g to mg: 2 x 1000 = 2000 D xQ H 500 mg 2000 mg D xQ H 2000 mg 1000 mg 6 x 5 mL = 40 mL x 100 mL = 200 mL Convert g to mg: 0.5 x 1000 = 500 D xQ H x 10 mL = 2.5 mL 500 mg 125 mg x 5 mL = 20 mL 59 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 7 Convert g to mg: 0.5 x 1000 = 500 10 1 g is equal to 1000000 mcg D xQ H D xQ H 500 mg 200 mg 8 200000 mcg x 10 mL = 2 mL 1000000 mcg x 5 mL = 12.5 mL D xQ H 11 2000 mg 50 mL 250 mg x 5 mL = 3.3 mL 375 mg 9 Convert g to mg: 2 x 1000 = 2000 D xQ H 2000 mg 125 mg x 5 mL = 80 mL Convert g to mg: 2 x 1000 = 2000 12 = 40 mg/mL D xQ H 200 mg 50 mg x 5 mL = 20 mL 60 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 13 16 Convert g to mg: 0.12 x 1000 = 120 D xQ H 250 mg 5 mL D xQ H = 50 mg/mL 120 mg 14 Convert g to mg: 1 x 1000 = 1000 D xQ H 1000 mg x 1 mL = 100 mL 10 mg 15 Convert g to mg: 0.5 x 1000 = 500 D xQ H 500 mg 10 mg 250 mg 17 x 5 mL = 10.4 mL D xQ H 500 mg x 4.5 mL = 18 mL 125 mg 18 Convert g to mg: 1 x 1000 = 1000 D xQ H x 1 mL = 50 mL 1000 mg 40 mL = 25 mg/mL 61 2024 RN101 Sharing and distributing this copyrighted materials is illegal. Intravenous infusions: Hourly rate Doctor’s order: 1000 mL D5W to infuse over 8 hours How fast should the nurse run the infusion? 2 Doctor’s order: 250 mL vancomycin 500 mg to infuse over 60 minutes How fast should the nurse run the infusion? 3 Doctor’s order: 250 mL NS to infuse over 2 hours How fast should the nurse run the infusion? 4 Doctor’s order: 125 mL of D10W to infuse over 60 minutes How fast should the nurse run the infusion? 5 Doctor’s order: 1500 mL D5W 1/2 NS to infuse over 12 hours How fast should the nurse run the infusion? 6 Doctor’s order: 250 mL of vancomycin 500 mg to infuse over 90 mins How fast should the nurse run the infusion? 7 Doctor’s order: 3000 mL D5W NS to infuse over 24 hours How fast should the nurse run the infusion? 8 Doctor’s order: 90 mL D5W 1/2 NS to infuse over 2 hours How fast should the nurse run the infusion? 9 Doctor’s order: 750 mL NS to infuse over 8 hours How fast should the nurse run the infusion? 10 Doctor’s order: 50 mL cefazolin sodium 1 gram to infuse over 15 minutes How fast should the nurse run the infusion? 11 Doctor’s order: 100 mL gentamycin 80 mg to infuse over 30 minutes How fast should the nurse run the infusion? 12 Doctor’s order: 25 mL diphenhydramine 500 mg to infuse over 60 minutes How fast should the nurse run the infusion? ! 1 62 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 4 1000 mL 8h 2 There is ONE 60 mins in 1 hour: Use that to multiply it with the available solution. 125 mL x 1 = 125 mL/h = 125 mL/h 250 mL x 60 mins = 250 mL/h 60 mins 5 1500 mL There is ONE 60 mins in 1 hour: Use that to multiply it with the available solution. 250 mL x 1 = 250 mL/h 3 125 mL x 60 mins = 125 mL/h 60 mins 12 h = 125 mL/h 6 250 mL 2h = 125 mL/h 250 mL x 60 mins = 167 mL/h 90 mins 63 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 7 10 3000 mL 24 h There are FOUR 15 mins in 1 hour: Use that to multiply it with the available solution. 50 mL x 4 = 200 mL/h = 125 mL/h 8 11 90 mL 2h 12 750 mL 8h = 94 mL/h 100 mL x 60 mins = 200 mL/h 30 mins There are TWO 30 mins in 1 hour: Use that to multiply it with the available solution. 100 mL x 2 = 200 mL/h = 45 mL/h 9 50 mL x 60 mins = 200 mL/h 15 mins 25 mL x 60 mins = 25 mL/h 60 mins There is ONE 60 mins in 1 hour: Use that to multiply it with the available solution. 25 mL x 1 = 25 mL/h 64 2024 RN101 Sharing and distributing this copyrighted materials is illegal. Intravenous infusions: using drip factors Doctor’s order: 1000 mL D5W to infuse over 8 hours. Drip factor: 20 gtt/mL How fast should the nurse run the infusion in gtt/min? 2 Doctor’s order: 500 mL D5NS to infuse over 6 hours. Drip factor: 60 gtt/mL How fast should the nurse run the infusion gtt/min? 3 Doctor’s order: 250 mL NS to infuse over 2 hours. Drip factor: 10 gtt/mL How fast should the nurse run the infusion gtt/min? 4 Doctor’s order: 2000 mL D5W to infuse over 10 hours. Drip factor: 15 gtt/mL How fast should the nurse run the infusion gtt/min? 5 Doctor’s order: 1500 mL D5W NS to infuse over 12 hours. Drip factor: 10 gtt/mL How fast should the nurse run the infusion gtt/min? 6 Doctor’s order: 3000 mL D5W to infuse over 24 hours: Drip factor: 20 gtt/mL How fast should the nurse run the infusion gtt/min? 7 Doctor’s order: 50 mL cefazolin sodium 1 gram to infuse over 15 minutes. Drip factor: 10 gtt/mL. How fast should the nurse run the infusion gtt/min? 8 Doctor’s order: 100 mL gentamycin 80 mg to infuse over 30 minutes. Drip factor: 20 gtt/mL. How fast should the nurse run the infusion gtt/min? 9 Doctor’s order: 25 mL diphenhydramine 25 mg to infuse over 30 minutes. Drip factor: 15 gtt/mL. How fast should the nurse run the infusion gtt/min? 10 Doctor’s order: 100 mL ampicillin 500 mg to infuse over 40 minutes. Drip factor: 20 gtt/mL. How fast should the nurse run the infusion gtt/min? 11 Doctor’s order: 750 mL D5W to infuse over 4 hours. Drip factor: 10 gtt/mL How fast should the nurse run the infusion gtt/min? 12 Doctor’s order: D5W 1/2 NS with 20 mEq KCL to infuse at 25 mL/h. Drip factor: 60 gtt/mL. How fast should the nurse run the infusion gtt/min? ! 1 65 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 1000 mL ÷ 8 hours = 125 mL/hour 125 mL x 20 gtt/mL 60 min 4 2000 mL ÷ 10 hours = 200 mL/hour 200 mL x 15 gtt/mL Co to n ve r mi t nu ed te s 60 min = 50 gtt/min = 42 gtt/min Another method 2 500 mL x 60 gtt/mL 6 h x 60 min 5 An hour = 60 min 125 mL x 10 gtt/mL 30000 gtt 60 min 360 min = 21 gtt/min = 83 gtt/min 3 250 mL ÷ 2 hours = 125 mL/hour 125 mL x 10 gtt/mL 60 min = 21 gtt/min 1500 mL ÷ 12 hours = 125 mL/hour 6 3000 mL ÷ 24 hours = 125 mL/hour 125 mL x 20 gtt/mL 60 min = 42 gtt/min 66 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 7 50 mL 15 mins x 60 mins = 200 mL 10 200 mL x 10 gtt/mL 60 mins 50 mL 15 mins x 60 mins = 200 mL/h 11 30 mins 750 mL ÷ 4 hours = 188 mL/hour 188 mL/h x 10 gtt/mL 60 min = 31 gtt/min = 33 gtt/min 25 mL x 60 mins = 150 mL/h = 50 gtt/min 200 mL x 10 gtt/mL 60 mins 9 40 mins 150 mL x 20 gtt/mL 60 mins = 33 gtt/min 8 100 mL x 60 mins = 50 mL/h 12 25 mL x 60 gtt/mL 60 min 50 mL x 15 gtt/mL 60 mins = 25 gtt/min = 13 gtt/min 67 2024 RN101 Sharing and distributing this copyrighted materials is illegal. PEDIATRIC DOSAGE USING WEIGHT NOTE: Dosages are not safe if they exceed the safe dosage range. The dosage can be less than the safe dosage range. 1 ! The physician orders amprenavir 650 mg TID for a child weighing 66 pounds. The safe dosage for this drug is 22.5 mg/kg of body weight. What is the safe dose for this child? Is the ordered dose safe for this child? 2 The physician orders cefixime oral 100 mg q12h for a child weighing 12 kg. The safe maximum dose for cefixime oral is 4 mg/kg q12h. What is the safe dose for this child? Is the ordered dose safe? 3 The physician orders gentamycin 80 mg IV q8h for a child weighing 22 pounds. The safe dosage range is 6-7.5 mg/kg of body weight per 24 hours. What is the safe dosage range for this child? Is the ordered dose safe for this child? 68 2024 RN101 Sharing and distributing this copyrighted materials is illegal. PEDIATRIC DOSAGE USING WEIGHT 4 Buprenorphine hydrochloride 0.3 mg IV is ordered for a child weighing 50 kg. The safe range of this drug is 2-6 mcg kg/dose ! What is the safe dosage range for this child? Is the ordered dose safe for this child? 5 Zidovudine IV 12 mg/h is ordered to infuse a child weighing 12 kg. The safe range for this drug is 0.5-1.8 mg/kg/h. What is the safe dosage rate for this child? Is the ordered dose safe? 6 Vancomycin sulfate hydrochloride is ordered for a child weighing 34 kg. The safe dose for this drug is 10 mg/kg/dose. What is the safe dose for this child? 69 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 Convert lbs to kg: 66 ÷ 2.2 = 30 kg Calculate recommended dose: 30 kg x 22.5 mg/kg = 675 mg 675 mg What is the safe dose for this child? _________ The ordered dose is 650 mg YES Is the ordered dose safe for this child? _________ 2 No conversion needed Calculate recommended dose: 12 kg x 4 mg/kg = 48 mg 48 mg What is the safe dose for this child? _________ The ordered dose is 100 mg NO Is the ordered dose safe for this child? _________ 3 Convert lbs to kg: 22 ÷ 2.2 = 10 kg Calculate recommended MINIMUM dose: 10 kg x 6 mg/kg = 60 mg Calculate recommended MAXIMUM dose: 10 kg x 7.5 mg/kg = 75 mg 60 mg-75 mg What is the safe dosage range for this child? ____________ NO Is the ordered dose safe for this child? _________ The ordered dose is 80 mg 70 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 4 Convert mcg to mg: 2 ÷ 1000 = 0.002 mg and 6 ÷ 1000 = 0.006 mg Calculate recommended MINIMUM dose: 50 kg x 0.002 mg/kg/dose = 0.1 mg Calculate recommended MAXIMUM dose: 50 kg x 0.006 mg/kg/dose = 0.6 mg 0.1 mg - 0.6 mg What is the safe dosage range for this child? _____________ Is the ordered dose safe for this child? _________ YES 5 No conversion needed Calculate recommended MINIMUM dose: 12 kg x 0.5 mg/kg/h = 6 mg/h Calculate recommended MAXIMUM dose: 12 kg x 1.8 mg/kg/h = 21.6 mg/h 6 mg - 21.6 mg What is the safe dosage range for this child? _____________ Is the ordered dose safe for this child? _________ YES 6 The ordered dose is 0.3 mg The ordered dose is 12 mg/h No calculation needed Calculate recommended dose: 34 kg x 10 mg/kg/dose = 340 mg/dose 340 mg/dose What is the safe dose for this child? ______________ 71 2024 RN101 Sharing and distributing this copyrighted materials is illegal. intravenous drug concentrations 1 ! The physician orders regular insulin to infuse intravenously at 10 units/hour. The pharmacy sends 500 units of regular insulin in 100 mL of 0.9% normal saline. The intravenous infusion pump should be programmed to infuse how many milliliters to deliver the ordered dose? 2 The physician orders heparin sodium to infuse intravenously at 1100 units/h. The pharmacy sends 25,000 units of heparin in 500 mL of 1/2 normal saline solution. The intravenous infusion pump should be programmed to infuse how many milliliters/hour to deliver the ordered dose? 3 The physician orders potassium chloride to infuse at 10 mEq/hour. The pharmacy sends 50 mEq of potassium chloride in 250 mL of 5% dextrose in water. The intravenous infusion pump should be programmed to infuse how many ml/h to deliver the ordered dose? 72 2024 RN101 Sharing and distributing this copyrighted materials is illegal. intravenous drug concentrations 4 ! Aminophylline 500 mg in 1000 mL of 5% dextrose in water to infuse at 25 mg/h. The intravenous infusion pump should be programmed to infuse how many ml/h to deliver the ordered dose? 5 The physician orders heparin sodium 800 units/h intravenously. The pharmacy sends 20,000 units heparin sodium in 500 mL of 5% dextrose in water. How many mL/h should be infused to deliver the ordered rate? 6 The physician orders regular insulin to infuse at 9 units/h. The pharmacy sends 100 units regular insulin in 240 mL of 0.9% normal saline. The intravenous infusion pump should be programmed to deliver how many mL/h? 73 2024 RN101 Sharing and distributing this copyrighted materials is illegal. intravenous drug concentrations 7 ! The physician orders aminophylline to infuse intravenously at 300 mcg/min. Aminophylline 500 mg in 1000 mL of 5% dextrose in water is sent from the pharmacy. The intravenous infusion pump should be programmed to deliver how many mL/h? 8 The physician orders diltiazem hydrochloride to infuse IV at 10 mg/h. The pharmacy sends 125 mg diltiazem hydrochloride in 250 mL of 0.9% normal saline. The intravenous infusion pump should be programmed to deliver how many mL/h? 9 The physician orders aminophylline to infuse at 30 mg/h. The pharmacy sends 250 mg aminophylline in 500 mL of 5% dextrose in water. The intravenous infusion pump should be programmed to deliver how many many mL/h? 74 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 D x Q = 10 units/h H 500 units x 100 mL = 2 mL/h 2 mL/h ! FINAL ANSWER: 2 D xQ= H 1100 units/h 25000 units x 500 mL = 22 mL/h FINAL ANSWER: 22 mL/h 3 D xQ= H 10 mEq/h 50 mEq x 250 mL = 50 mL/h FINAL ANSWER: 50 mL/h 75 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 4 D xQ= H 25 mg/h 500 mg x 1000 mL = 50 mL/h ! FINAL ANSWER: 50 mL/h 5 800 units/h D xQ= H 20000 units x 500 mL = 20 mL/h FINAL ANSWER: 20 mL/h 6 D xQ= H 7 units/h 100 units x 100 mL = 7 mL/h FINAL ANSWER: 7 mL/h 76 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 7 D xQ= H 35 mg/h 500 mg x 1000 mL = 70 mL/h 70 mL/h ! FINAL ANSWER: 8 D xQ= H 10 mg/h 125 mg x 250 mL = 20 mL/h FINAL ANSWER: 20 mL/h 9 D xQ= H 30 mg/h 250 units x 500 mL = 60 mL/h FINAL ANSWER: 60 mL/h 77 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 1 ! 1 ! A six-year-old child weighting 10.9 kg is admitted to the pediatric care unit for heart failure. The LPN must administer the following prescription: antiarrhythmic (digoxin) 30mcg/kg PO BID 0.05 mg/ml. Calculate the exact dose in ml of the antiarrhythmic medication to be administered? 2 The physician orders 0.125 mg orally of digoxin. The medication is available in tablets containing 0.25 mg of digoxin. How many tablet (s) should be given to the patient? 3 An 18-month-old child weighing 22lbs receives an outpatient surgery for a radial fracture. Upon returning from the recovery room, the child is crying out while holding his arm. The LPN consults the file and finds the following prescription: Analgesic (Ibuprofen) 40 mg/kg/day in divided doses, to administer 4 times a day, available at 100mg/5 ml. How many mL should be given to the patient per dose? 78 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 1 ! 4 ! The physician orders erythromycin suspension 250 mg PO. The pharmacy delivers 100-mL bottles with the label stating 5 mL contains 125 mg of erythromycin. How many mL should be given to the patient? 5 The physician writes an order for secobarbital 0.2 g prn for sleep. Each secobarbital capsule is labeled 100 mg. The nurse should administer how many capsule (s) per dose? 6 The physician ordered 1000 mL D5W to infuse over 8 hours. The drip factor is 20 gtt/mL. How much should the nurse run the IV in gtt/min? 79 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 1 ! A patient is hospitalized in palliative care and has abundant secretions in his airways. Yesterday, he received a STAT prescription of 2 ml of an anticholinergic (glycopyrrolate), which greatly relieved him. The physician then prescribed the following medication to be administered on a regular basis: Anticholinergic (glycopyrrolate) 0.2mg SC Q4H PRN if bronchial discomfort, available 0.2 mg/ml. Calculate the exact dose in ml of the medication to be administered? ! 7 8 The physician prescribes phenytoin 100 mg PO each day. On hand are phenytoin capsules labeled 0.1 gram. How many capsule (s) the nurse should administer per dose? 9 The physician ordered 500 mL D5NS to infuse over 6 hours. The drip factor is 60 gtt/mL. How much should the nurse run the IV in gtt/min? 80 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 1 ! 10 ! The physician prescribed phenytoin 200 mg PO each day. On hand are capsules labeled 0.1 grams of phenytoin. The nurse should administer how many capsule (s) per dose? 11 The physician prescribes orders amoxicillin/potassium clavunate 20 mg/kg/day in 4 divided doses by mouth to a child weighing 44 pounds. The pharmacy sends 50 mg tablets amoxicillin/potassium clavunate. The nurse should administer how many tablet (s) per dose to this child? 12 The physician orders acetaminophen 650 mg q4h as needed for pain. The nurse has 325 mg acetaminophen tablets available. The nurse should administer how many tablet (s) per dose? 81 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers Convert mcg to mg: 30 mcg ÷ 1000 mcg/mg = 0.03 mg Calculate recommended dose: 10.9 kg x 0.03 mg/kg/day = 0.327 mg/day Calculate the volume of medication: D H x Q = 0.327 mg x 1 mL = 6.54 mL/day 0.05 mg ! 1 FINAL ANSWER: 6.5 mL 2 D H x Q = 0.125 mg x 1 tab = 0.5 tablet 0.25 mg FINAL ANSWER: 3 0.5 tablet Convert lbs to kg: 22 lbs ÷ 2.2 = 10 kg Calculate recommended dose: 10 kg x 40 mg/kg = 400 mg/day Calculate the volume of medication: D H x Q = 400 mg 100 mg x 5 mL = 20 mL Divided 4x a day: 20 mL ÷ 4 = 5 mL FINAL ANSWER: 5 mL 82 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 4 x 5 mL = 10 mL ! D x Q = 250 mg 125 mg H FINAL ANSWER: 5 Convert g to mg: 0.2 g x 1000 = 200 mg Calculate the volume of medication: D H 6 10 mL x Q = 200 mg 100 mg x 1 cap = 2 capsules FINAL ANSWER: 2 capsules FINAL ANSWER: 42 gtt/min 1000 mL ÷ 8 hours = 125 mL/hour 125 mL x 20 gtt/mL 60 mins = 41.66 gtt/min 83 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 7 0.2 mg 0.2 mg x 1 mL = 1 mL ! D xQ= H FINAL ANSWER: 8 Convert g to mg: 0.1 g x 1000 = 100 mg Calculate the volume of medication: D H 9 1 mL x Q = 100 mg 100 mg x 1 cap = 1 capsule FINAL ANSWER: 1 capsule FINAL ANSWER: 83 gtt/min 500 mL ÷ 6 hours = 83 mL/hour 83 mL x 60 gtt/mL 60 mins = 83.33 gtt/min 84 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 10 Convert g to mg: 0.1 g x 1000 = 100 mg Calculate the volume of medication: x 1 cap =2 capsules ! D x Q = 200 mg 100 mg H FINAL ANSWER: 2 capsules 11 Convert lbs to kg: 44 lbs ÷ 2.2 = 20 kg Calculate the recommended dose: 20 kg x 10 mg/kg/day = 200 mg/day 200 mg/day in 4 divided doses = 50 mg/dose The pharmacy sends 50 mg tablets amoxicillin/potassium clavunate 12 FINAL ANSWER: per dose 1 tablet D xQ H 650 mg 325 mg x 1 tablet = 2 tablets FINAL ANSWER: 2 tablets 85 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 2 ! 1 ! An 82-year-old beneficiary at a CHSLD must receive an antibiotic to treat a urinary tract infection. The patient has a gastrostomy and cannot take anything by mouth. The LPN must administer the first dose of antibiotic according to the following prescription: Antibiotic (ampicillin) 0.5g q6h by gastrostomy x 14days 125mg/ml. Calculate the exact dose in ml of the medication to be administered? 2 The physician prescribes acyclovir 0.8 g po q4h. On hand are acyclovir tablets labeled 200 mg. How many tablet (s) should be given to the patient for each dose? 3 The physician ordered 250 mL NS to infuse over 2 hours. The drip factor is 10 gtt/mL. How much should the nurse run the IV in gtt/min? 86 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 2 ! A 28-year-old patient is admitted to the psychiatric unit for schizophrenia with paranoid delusions. He’s been having visual hallucinations for the past hour. He speaks loudly and threatens another patient in the activity room. The RN asked the LPN to administer an injectable antipsychotic according to the following prescription: Haloperidol (Haldol) antipsychotic 4mg IM STAT, the available medication is 5mg/ml. Calculate the exact dose in ml of the medication to be administered? ! 4 5 The physician prescribes alprazolam 1 mg po TID. On hand are 0.5 mg alprazolam tablets. How many tablet (s) should be given to the patient for each dose? 6 The physician ordered 2000 mL D5W 1/2 NS to infuse over 10 hours. The drip factor is 15 gtt/mL. How much should the nurse run the IV in gtt/min? 87 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 2 ! 7 ! At the day surgery unit, an LPN must install an IV infusion to a patient who will soon leave the department for surgery. The physician gives the following prescription: 0.9% NaCl for KVO (30 ml/h). Calculate the flow rate in gtt/min for a drop factor of 60 gtt/ml? 8 The physician prescribes 600 mg of acyclovir PO q4h. On hand are acyclovir tablets labeled 200 mg. How many tablet (s) should be given to the patient for each day? 9 The physician ordered 1500 mL D5W 1/4 NS to infuse over 12 hours. How much should the nurse run the IV in mL/h? 88 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 2 ! 10 ! The physician orders digoxin 0.25 mg PO qAM. The nurse has on hand 250 mcg digoxin tablets. The nurse should administer how many tablet (s) every morning after counting the patient’s apical pulse? 11 The physician writes an orer for acetaminophen 200 mg PO for an elderly adult. You have on hand acetaminophen oral liquid 80 mg in 0.8 mL. The nurse should administer how many mL? 12 The physician orders cefaclor 2 g via gastric tube in 2 divided doses. The pharmacy sends cefaclor 375 mg/5 mL suspension. The should administer how many mL per dose? 89 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers Convert g to mg: 0.5 g x 1000 g/mg = 500 mg Calculate the volume of medication: D H x Q = 500 mg 125 mg x 1 mL = 4 mL ! 1 FINAL ANSWER: 2 Convert g to mg: 0.8 g x 1000 g/mg = 800 mg Calculate the volume of medication: D H 3 4 mL x Q = 800 mg 200 mg x 1 tab = 4 tablets FINAL ANSWER: 4 tablets FINAL ANSWER: 21 gtt/min 250 mL ÷ 2 hours = 125 mL/hour 125 mL x 10 gtt/mL 60 mins = 20.8 gtt/min 90 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 4 4 mg 5 mg x 1 mL = 0.8 mL ! D xQ= H FINAL ANSWER: 0.8 mL 5 D H 6 xQ= 1 mg 0.5 mg x 1 tab = 2 tablets FINAL ANSWER: 2 tablets FINAL ANSWER: 50 gtt/min 2000 mL ÷ 10 hours = 200 mL/hour 200 mL x 15 gtt/mL = 50 gtt/min 60 mins 91 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 7 30 mL x 60 gtt/mL 60 mins = 30 gtt/min FINAL ANSWER: 8 D H x Q = 600 mg 200 mg 30 gtt/min x 1 tab = 3 tablets The medication is given q4h 24 h ÷ 4 h = 6 3 tablets x 6 = 18 tablets/day FINAL ANSWER: 18 tablets FINAL ANSWER: 125 mL/h 9 1500 ml ÷ 12 hours = 125 ml/h 92 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 10 Convert mg to mcg: 0.25 x 1000 = 250 mg Calculate the volume of medication: D H x Q = 250 mcg x 1 tab = 4 1ablet 250 mcg FINAL ANSWER: 1 tablet FINAL ANSWER: 2 mL 11 D H 12 x Q = 200 mg 80 mg x 0.8 mL = 2 mL Convert g to mg: 2 x 1000 = 2000 mg Calculate the volume of medication: D H x Q = 2000 mg x 5 mL = 26.7 375 mg In 2 divided dose: 26.7 ÷ 2 = 13.3 mL per dose FINAL ANSWER: 13.3 mL/dose 93 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 3 ! 1 ! The physician orders morphine sulfate 4 mg/h intravenously. The pharmacy sends morphine sulfate 50 mg in 500 mL of 5% dextrose in water. How many ml/h should be infused to deliver to ordered rate? 2 The physician prescribes regular insulin 5 units per hour intravenous to be administered at the rate of 25 ml/h. Available is 500 mL of 0.9% normal saline and a vial of regular insulin. How many units of insulin would you add to the IV solution to deliver the ordered rate? 3 Aminophylline 500 mg in 1000 mL of 5% dextrose in water to infuse at 25 mg/h. The intravenous infusion pump should be programmed to infuse how many ml/h to deliver the ordered dose? 94 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 3 ! 4 ! A 600 mL of IV solution is in the IV bag when you start your shift at 0700. The infusion rate is 100/mL/h. At what rate will this infusion be completed? 5 A 1060 mL of total parenteral nutrition is programmed to infuse at 53 mL/h. How long will this infusion last? 6 A 180 mL of 20% intralipids is programmed to infuse at 10 mL/h. How long will this infusion last? 95 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 3 ! 7 ! Doctor’s order: 50 mL cefazolin sodium 1 gram to infuse over 15 minutes Drip factor: 60 gtt/min How much will the nurse run the infusion in gtt/min? 8 Doctor’s order: 150 mL of NS to infuse over 4 hours. Drip factor: 60 gtt/min How much will the nurse run the infusion in gtt/min? 9 Doctor’s order: 1500 mL D5W 1/4 NS to infuse over 12 hours Drip factor: 10 gtt/min How much will the nurse run the infusion in gtt/min? 96 2024 RN101 Sharing and distributing this copyrighted materials is illegal. COMPREHENSIVE REVIEW 3 ! 10 ! Doctor’s order: 1000 mL D5W to infuse over 8 hours Drip factor: 20 gtt/min How much will the nurse run the infusion in gtt/min? 11 Doctor’s order: 25 mL of diphenhydramine to infuse over 20 minutes How much will the nurse run the infusion in mL/h? 12 Doctor’s order: 25 mL of ondansetron to infuse over 15 minutes How much will the nurse run the infusion in mL/h? 97 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 1 D H xQ= 4 mg/h x 500 mL = 40 mL/h 50 mg FINAL ANSWER: 2 D H 40 mL/h xQ= 5 units/h x 500 mL = 100 mL/h 25 mL/h FINAL ANSWER: 3 D H 100 mL/h xQ= 25 mg/h x 1000 mL = 50 mL/h 500 mg FINAL ANSWER: 50 mL/h 98 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 4 600 mL = 6 hours 100 mL/h FINAL ANSWER: 13:00 PM 5 1060 mL = 20 hours 53 mL/h FINAL ANSWER: 20 hours 6 180 mL = 18 hours 10 mL/h FINAL ANSWER: 18 hours 99 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 7 50 mL 15 min x 60 min/h = 199.8 mL/h = 200 mL/h 200 mL x 10 gtt/mL = 33.33 gtt/min 60 min FINAL ANSWER: 33 gtt/min FINAL ANSWER: 38 gtt/min FINAL ANSWER: 21 gtt/min 8 150 mL 4h = 37.5 mL/h =. 38 mL/h 38 mL x 60 gtt/mL = 38 gtt/min 60 min 9 1500 mL = 125 mL/h 12 h 125 mL x 10 gtt/mL = 20.8 gtt/min 60 min 100 2024 RN101 Sharing and distributing this copyrighted materials is illegal. answers 10 1000 mL = 125 mL/h 8h 125 mL x 20 gtt/mL = 41.66 gtt/min 60 min FINAL ANSWER: 42 gtt/min FINAL ANSWER: 75 mL/h FINAL ANSWER: 100 mL/h 11 25 mL x 60 min/h = 75 mL/h 20 min 12 25 mL x 60 min/h = 100 mL/h 15 min 101 2024 RN101 Sharing and distributing this copyrighted materials is illegal. warning "Sharing and distributing copyrighted materials without proper authorization is illegal and violates intellectual property rights. It's important to respect the creative work of others and adhere to copyright laws. Unauthorized distribution of copyrighted materials can result in legal consequences. Please ensure that you have the necessary permissions or licenses before sharing or distributing copyrighted content." 102 2024 RN101 Sharing and distributing this copyrighted materials is illegal. thank You "Thank you for choosing my book! Your support means the world to me and my Family." 514-632-4228 www.rn101.net 1651 route 241, Shefford, Qc, Ca