INTRODUCTION
Weight is the measure of the gravitational force acting on a body and it is directly proportional to
its mass.
Measure refers to the measurement of volume of drug.
Unit of mass
1 kilogram = 1000 g
1 Gram = 1000 mg
Unit of capacity
1 Liter = 1000 ml
Domestic measures
1 tea spoon = 5 ml
1 table spoon = 15 ml
1 cup = 8 ounce= 240 ml
1 pint = 500 ml
1 ounce = 30 ml
Methods of Calculation
Basic Formula: Frequently used to calculate drug dosages.
D = dose ordered or desired dose
H = dose on container label or dose on hand
V = form and amount in which drug comes (tablet, capsule, liquid)
Example: Order-Dilantin 50mg p.o. TID
Drug available-Dilantin 125 mg/5ml
Calculating Tablet Dosages
In calculating tablet dosages, the following formula is useful:
Desired dosage ÷ stock strength = number of tablets.
The desired dosage is the dosage ordered by the physician, while the stock strength is the amount
of drug present in each tablet. Stock strength is also known as stock dose.
Example:
The patient is ordered to have 2 g of potassium chloride. The drug is available in 500 mg tablets.
How many tablets should be given?
Convert 2 g to mg = 2 x 1,000 = 2,000 mg
Desired dosage ÷ stock strength = number of tablets
2,000 mg ÷ 500 mg = 4 tablets
Calculating Mixtures and Solutions
The following formula is useful in calculating mixtures and solutions:
Desired dosage ÷ stock strength x stock volume = amount of solution to be given
The desired dosage is the dosage ordered by the physician. The stock strength is the amount of
drug present in the preparation, while the stock volume is the amount of the solution where the
drug is diluted.
Example:
The physician orders 375 mg of cefuroxime for the patient. The drug is available in 750 mg
vial. You plan to dilute it in 10 mL of sterile water. How much should you give to your
patient?
[Desired dosage ÷ stock strength] x stock volume = amount of solution to be given
[375 mg ÷ 750 mg] x 10 mL = amount of solution to be given
0.5 mg x 10 mL = 5 mL
ii) formula used to calculate number of drops per minute delivered by IV infusion
drops per minute = volume (ml) * drops/ml
time (hr) * 60
Example: 1000 ml over 8 hrs
IV set = 15 gtts/ml
Two Step
Step 1 - 1000 divided by 8 = 125
Step 2 -
One Step
Example:
You are going to regulate D5 0.9 NaCl 500 mL solution for 7 hours. The macrodrip used
has 15-drop factor. You should regulate the IV fluid for how many drops per minute?
[Total IV volume ÷ time (minute) ] x drop factor = drops per minute
[500 mL ÷ 7 hours] x 15 = drops per minute
[500 mL ÷ {7 hours x 60}] x 15 = drops per minute
[500 ÷ 420] x 15 = drops per minute
1.19 x 15 = 17 to 18 drops per minute
iii) In infusion if you are asked for volume, time and rate
a) Volume (ml) = rate (ml/hr) * time (hr)
b) Rate = volume (ml) / time (hr)
c) Time = volume (ml) / rate (ml/hr)
Example:
You are going to start IV infusion with Plain Lactated Ringer’s Solution 1 L. By regulating
it for 11 hours, how much fluid are you going to infuse per minute?
Total IV volume ÷ time (hour or minute) = mL per minute
1 L ÷ 11 hours = mL per minute
[1 L x 1,000] ÷ [11 hours x 60] = mL per minute
1,000 mL÷ [11 hours x 60] = mL per minute
1,000 mL ÷ 660 = 1.5 mL per minute
iv) Amount in IV Fluid
Formula:
Concentration %
x Volume (mL) = Y (Dosage Amount in g)
100
Example: Calculate the amount of dextrose in 1000 mL D5W.
Concentration %
x Volume (mL) = Y (Dosage Amount in g)
100
5%
x 1000 mL = 50 g
100
Example: Calculate the amount of sodium chloride in 2000 mL NS.
Recall NS is 0.9% NaCl (sodium chloride)
0.9%
x 2000 mL = 18 g
100
PRACTICE QUESTIONS
Example: Infuse 250 mL over the next 120 minutes by infusion pump.
Volume (mL)
= Y (Flow Rate in mL/hr)
Time (hr)
Convert 120 minutes to hours.
min → hr ( ÷ by 60 )
120 min ÷ 60 = 2 hr
250 mL
= 125 mL/hr
2 hr
Summary
Many nurses have difficulty with drug calculations. Mostly because they don’t enjoy or
understand math. Practicing drug calculations will help nurses develop stronger and more
confident math skills. Many drugs require some type of calculation prior to administration. The
drug calculations range in complexity from requiring a simple conversion calculation to a more
complex calculation for drugs administered by mcg/kg/min. Regardless of the drug to be
administered, careful and accurate calculations are important to help prevent medication errors.
Many nurses become overwhelmed when performing the drug calculations, when they require
multiple steps or involve life-threatening drugs. The main principle is to remain focused on what
you are doing and try to not let outside distractions cause you to make a error in calculations. It is
always a good idea to have another nurse double check your calculations. Sometimes nurses
have difficulty calculating dosages on drugs that are potentially life threatening. This is often
because they become focused on the actual drug and the possible consequences of an error in
calculation. The best way to prevent this is to remember that the drug calculations are performed
the same way regardless of what the drug is. For example, whether the infusion is a big bag of
vitamins or a life threatening vasoactive cardiac drug, the calculation is done exactly the same
way.
ADVANCED NURSING PRACTICE
WARD TEACHING
ON
BLOOD TRANSFUSION
Submitted to, Submitted by,
Mrs. Prathibha Rani, Mrs. Yashly Varghese,
Asst. Professor, 1st year MSc Nursing,
Govt. College Of Nursing, Govt. College Of Nursing,
Thrissur. Thrissur.
Submitted on ,
12-01-2018
