Drug calculation exercises
Dr. Suresh Kumar S.
Learning outcomes
• To elucidate different clinical scenarios on drug/dose calculations
encountered during nursing practice
• To appraise the rationale and method of drug calculations for
common clinical scenarios
Case Scenario 1 - Converting Dosages
• Mrs. Smith, a 45-year-old patient, has been prescribed 500 mg of a
pain medication for postoperative care. The pharmacy provides you
with 250 mg tablets.
• How many tablets should you administer to Mrs. Smith?
Case Scenario 1
Answer:
• Administer 2 tablets (500 mg ÷ 250 mg = 2).
Case Scenario 2 - IV Drip Rate Calculation
• Mr. Johnson is admitted to the hospital with dehydration. The doctor
orders 1,000 mL of IV normal saline to be infused over 8 hours. The IV
tubing set has a drop factor of 15 drops/mL.
Question:
• At what drip rate (in drops per minute) should you set the IV?
Case Scenario 2
• The IV should be set at 31 drops per minute
• 1,000 mL ÷ 480 minutes × 15 drops/mL ≈ 31
Case Scenario 3 - Pediatric Dose Calculation
• A 6-year-old child weighing 20 kg is diagnosed with an ear infection.
The physician prescribes Amoxicillin 250 mg by mouth every 8 hours.
The recommended dosage for Amoxicillin is 20 mg/kg/day, divided
into three doses.
Question:
• Is the prescribed dose safe for this child?
Case Scenario 3
Answer
• The prescribed dose is too high.
• The recommended dose is 133.33 mg per dose (20 mg/kg/day × 20 kg
÷ 3 doses = 133.33 mg), while the order is 250 mg
Case Scenario 4: Insulin Calculation
• A patient with type 1 diabetes is in need of insulin. The doctor orders
8 units of rapid-acting insulin to be given before a meal. You have a
vial of insulin labelled 100 units/mL.
Question:
• How many mL of insulin will you draw up?
Case Scenario 4:
Answer:
• You will administer 0.08 mL of insulin (8 units ÷ 100 units/mL = 0.08 mL)
Case Scenario 5 : Oral Medication Calculation
• You are caring for a pediatric patient who needs a dose of ibuprofen
for fever. The doctor orders 400 mg of ibuprofen. You have ibuprofen
suspension available, labeled as 100 mg per 5 mL.
Question:
• How many mL of the suspension will you administer?
Case Scenario 5
Answer:
• You will administer 20 mL of ibuprofen suspension (400 mg ÷ 100
mg/5 mL = 20 mL).
Case Scenario 6: Body Surface Area (BSA) Calculation
• A patient in the oncology ward is prescribed 50 mg/m² of a
chemotherapy drug. The patient’s body surface area (BSA) has been
calculated as 1.5 m².
Question:
• How many mg of the medication should you administer?
Case Scenario 6:
Answer:
• You will administer 75 mg of the medication (50 mg/m² × 1.5 m² = 75 mg)
Case Scenario 7: Infusion Time Calculation
• Your patient is receiving 500 mL of an IV antibiotic solution. The
infusion pump is set to deliver the fluid at a rate of 75 mL/hour.
Question:
• How long will it take to complete the infusion?
Case Scenario 7
Answer:
• The infusion will take 6.67 hours (500 mL ÷ 75 mL/hour = 6.67 hours).
Case Scenario 8: teaspoon
• You are caring for a 5-year-old child, Sarah, who has been diagnosed
with a cold. The doctor prescribes a cough syrup, 10 mL to be taken
every 6 hours. However, Sarah’s parents only have a teaspoon at
home for measuring.
• Question:
How many teaspoons should Sarah’s parents give her per dose?
Case Scenario 8
• Answer:
Since 1 teaspoon = 5 mL, Sarah’s parents should give her 2 teaspoons
per dose (10 mL ÷ 5 mL = 2 teaspoons).
Scenario 9: teaspoons and/or tablespoons
• You are administering a pediatric medication to a 3-year-old child
named Lucy. The prescription is for 15 mL of an antibiotic syrup to be
given once daily. The child’s mother only has a teaspoon and a
tablespoon at home for measuring.
• Question:
How many teaspoons and/or tablespoons can Lucy’s mother use to
measure the 15 mL dose?
Scenario 9
• Answer:
Since 1 tablespoon = 15 mL, Lucy’s mother can give 1 tablespoon per
dose. Alternatively, she can use 3 teaspoons (15 mL ÷ 5 mL = 3
teaspoons).
Case Scenario 10
• Mrs. James calls the clinic because she’s been giving her child 1
tablespoon of a prescribed syrup for fever, thinking it’s the correct
amount. The doctor’s order was for 5 mL of syrup to be given every 4
hours as needed for fever.
• Question:
Has Mrs. James been giving the correct dose? If not, how much has she
been over-administering?
Case Scenario 10
• Answer:
No, Mrs. James has been giving too much.
• Since 1 tablespoon = 15 mL and the prescription is for 5 mL, she has
been giving 3 times the prescribed dose (15 mL ÷ 5 mL = 3)
