Ncm 100 dosage calculations

DRUG ADMINISTRATION:
Standards, Practices and
Principles
Fundamentals in Nursing
Practice

LEARNING OBJECTIVESLEARNING OBJECTIVES
 At the end of the lecture discussion, RNs are expected to:
 Enumerate principles, standards, guidelines in drug preparation and
administration
 Identify vital functions, roles & responsibilities as RNKs in drug
preparation and administration
 Calculate with 100 percent accuracy, completeness & organization
based on standardized conversion system, equation and units of
measurement
 Appreciate the value and virtue of patience, humility, cooperation,
respect and dignity for human life in congruence with drug
preparation and administration

FLORENCE NIGHTINGALE’SFLORENCE NIGHTINGALE’S
PLEDGEPLEDGE
 I solemnly pledge myself before God and the presence of this
assembly to pass my life in purity and to practice my
profession faithfully. I will abstain from whatever is deleterious
to mind and body and not take or knowingly administer any
harmful drugs. I will do all in my power to hold in confidence all
personal matters committed to my keeping and all family affairs
coming to my knowledge in the practice of my profession.
 With loyalty will I endeavor to aid the physician in his work and
devote myself to the welfare of those committed to my care”.
Thus…

KNOWLEDGE, SKILLS, ATTITUDES AND VALUESKNOWLEDGE, SKILLS, ATTITUDES AND VALUES
• Promotion of health
• Prevention of illness
• Restoration of physiologic processes
• Provision of palliative effect
• Maintenance & sustenance of wellness
• Aid in diagnosis
• Treatment of diseases
Pharmacologic
aspects in
nurses’
contextualities

Rules and Techniques for Giving MedicinesRules and Techniques for Giving Medicines
 Verify all new or questionable orders on the medication administration
record (MAR) against the physician orders for completeness
 Prepare medications in a quiet environment
 Wash hands thoroughly before measuring or preparing a medication
 Collect all necessary equipments
 Review MAR carefully (medication, dosage, route, expiration, date and
frequency)
 Research drug compatibilities, purposes, contraindications, S/E, &
appropriate routes
 Find medication for individual client
 Accurate calculation is needed
 Check expiration dates and signs of decomposition

Rules and Techniques for Giving Medicines
 Compare labels three times
• When removing package from drawer
• Before preparing the medication
• After preparing the medication
 Be sure medications are identified for each client
 Check for any allergies and perform special assessment before
administration
 Confirm patient’s identity
• Ask the name
 Check the identification wrist band
• Check the bed tag (least reliable)
• Check the photo in bed

 Observe 10 Rights in giving
each medication
 Do not give medicine that
someone else prepared.
• Institution policies may require
having a colleague double
check medication such as
insulin or heparin
 If using a computer – controlled
dispensing system, follow
agency policy

Guides to the Administration of Some Specific AgentsGuides to the Administration of Some Specific Agents
 Cough syrups are given undiluted in small
amount and in frequent doses
 Laxatives or cathartics are given between
meals and on an empty stomach; those that
act quickly be given just before breakfast or
those requiring a longer time for action
should be given at night (laxative lubricant
12-18 hours action)
 Bitter or unpleasant tasting drugs are given
in capsule form as a coated pill or in
effervescent preparations
 Oils taken in liquid form should be chilled
• Castor oils taken with a lemon juice ¼ NAHCO3 in
effervescing action

Guides to the Administration of Some Specific AgentsGuides to the Administration of Some Specific Agents
 Drugs that are destroyed by digestive juices are given in
enteric coated pills
 Drugs are given several hours after meals for rapid action
 Drugs to aid digestion are given one half before meals
 Fe and Iodine preparations are given diluted and given with a
straw
 Sedatives are given with warm milk to increase and hasten
desired effect of the drug
 Bitter stomachaches, given to stimulate appetite should be
given undiluted and with no attempt to disguise the taste

Rules for Measuring Medications
 Measure the amount of drug ordered,
using a calibrated measure
 Do not converse while preparing the
medication
 Make sure that medicine glasses are dry
before pouring or measuring a
medication
 Cleanse the mouth of every bottle after
use before replacing it
 Measure drops
 Hold the medicine glass at eye level

Rules on Labels
 Give medication only from a
clearly labeled container
 Read the label three times
 Never give a drug from an
unmarked bottle or box
 Pour medicine from the bottles
on the side opposite the label
 Labels on medicine containers
should be changed only by the
pharmacists
 If a drug has two commonly
used names, both names
should appear on the label

Rules for Giving MedicationsRules for Giving Medications
 Give the medication at the time for which it is ordered
 Always identify the patient before giving the medication
 If medication is refused or cannot be administered, notify the lead
head nurse
 Remain at the bedside until the patient has taken the medication
 Administer only those medicines which you have measured, poured
and prepared
 Never give two drugs together, unless ordered to do so
 When a patient goes to the OR, all orders for medication are DC
 When special tests are being done, medications due at the particular
time are omitted they are resumed when next due
 A mistake in medication must be reported immediately to the lead
head nurse or charge nurse

Rules for Recording Drugs AdministeredRules for Recording Drugs Administered
 Record if an ordered medication is refused or if cannot be
administered
 Record each dose of medicine soon after it is administered
 Use standard abbreviations in recording medications
 Record only those medicines which you have administered
 Record time, kind and dose of drug given
 Record effect, especially any unusual effect
 Never record a medication as given before it has been
administered “IF IT WAS NOT DOCUMENTED, IT WAS NOT
DONE.”

Care of Drugs and Medicine CabinetCare of Drugs and Medicine Cabinet
Bottles, boxes & other containers Must be kept closed
Ointments, liniments, talcum
powder, rubbing alcohol
Must be kept in a separate
environment
Oils, serums, vaccines, liver
extracts
Must be placed in a refrigerator
Extreme colds prevents them from
becoming rancid and makes the oil
a little more palatable
Emergency Drugs Must be kept in a box or tray,
readily attainable
Labels Defaced or soiled should be
changed by the pharmacists
Medicines in unusual appearance Returned to the pharmacy &
discarded

Care of Drugs and Medicine CabinetCare of Drugs and Medicine Cabinet
Floor Drugs Checked twice daily
Two containers for each floor drug
Unused drugs for a patient being dismissed Should be sent back to the pharmacy
Medicines sent home for patients Complete directions are employed
Medicine Cabinet
Individual basis (UNIT DOSE FORM)
Opiates & narcotics
Poison
Adjacent to sink
Adequate light
Shallow
Proper drug classification of drug supplies
Drug per container/patient
Separate compartment & locked
Narcotic nurse with the key
Label POISON, separate and roughened surface
DRUG SUPPLY - UNIT DOSE FORM System of packaging and labeling each dose by pharmacy
supplied in a 24 hour time period
Replacement, constant monitoring of availability
DRUG SUPPLY – STOCK SUPPLIED Dispensed and labeled in large quantities
Stock supplies kept in a secured area

RNKs CAN
ALLAY PATIENT’S SUFFERING
THROUGH WRONG MEDICATION
AND NON COMPLIANCE TO
STANDARDS, PRINCIPLES AND
GUIDELINES
D
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N
I
F
I
E
D
D
E
A
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H

TEST DRILLTEST DRILL
APPLICATION, CRITICAL THINKING, RECALL AND RECOGNITIONAPPLICATION, CRITICAL THINKING, RECALL AND RECOGNITION
1. A nurse makes a medication error. The best action is to
A. Document in the patient’s record the error by either noting the
omission of a drug or adding the drug given if it does not
appear on the medication record
B. Document in the patient’s record the error by either noting the
omission of a drug or adding the drug as given even if it does
not appear on the medication record; describe the
circumstances surrounding the error.
C. Do not document any error on the patient’s record. Document
only on the incident or quality assurance report.
D. Document in the patient’s record the error by either noting the
omission of a drug or adding the drug as given if it does not
appear on the MAR; also document on the incident or quality
assurance report.

2. Among the following patient’s right, which is not
included?
A. Right route
B. Right medicine
C. Right site of administration
D. Right patient

3. Which of the following nursing actions is
most helpful for the patient with dysphagia?
A. Placing the patient in a sitting position
B. Mixing the medication with food
C. Turning the patient toward you
D. Dissolving the medication in a glass of
water

4. It is important not to leave medication at the
bedside because
A. You will not be able to document that the
patient actually took the medication
B. It may fall on the floor
C. The patient may forget to take it
D. It takes time to return and check with the
patient later

APPLICATION, CRITICAL THINKING, RECALL ANDAPPLICATION, CRITICAL THINKING, RECALL AND
RECOGNITIONRECOGNITION
5. Buccal medications are those
A. Placed between the cheek and the
gum
B. Placed under the tongue
C. Injected into the buttocks
D. Swallowed with water

6. Topical rinses have of the following
actions:
A. Systemic effect when swallowed
B. Decreased microorganisms and
tooth decay
C. Increased the ability to taste
D. Local effect through exposure to the
mucous membrane

7. Administration of which of the following requires the
use of sterile technique?
(1) Ophthalmic medications (2) Nasal medications
(3) Vaginal medications (4) Rectal medication
A. 1 only
B. 1, 2, and 3
C. 1 and 3
D. 2, 3, and 4

8. For safety and accuracy of medication being
administered to the patient, one of the
considerations is the three checks. Which of the
following is not applicable?
A. Reading the label after the medications has been
administered.
B. Reading the label before preparing.
C. Reading the label before picking the medication in
the locker.
D. Reading the label after withdrawing the
medication from the container.

APPLICATION, CRITICAL THINKING, RECALL ANDAPPLICATION, CRITICAL THINKING, RECALL AND
RECOGNITIONRECOGNITION
9. Which is the following route has the
faster effect?
A. Sublingual
B. Intravaginal
C. Inhalers
D. Intravenous

10. It is a medication order that is to be given once at specified time.
A. Stat order
B. Single order
C. Standing order
D. PRN order
11. “Multivitamins 1 tab daily” is an example of:
A. Stat order
B. Single order
C. Standing order
D. PRN order
12. A finely divided drug particles dispersed in liquid medium, when suspension is left
standing, particles settle at the bottom of container
A. Aqueous
B. Suspension
C. Syrup
D. Powder

13. Requires that the effectiveness of the medication be administered by client’s
response to the medication; it is appropriate to determine the extent of side
effects and adverse reaction supports which of the following medication golden
rule?
A. Right evaluation
B. Right assessment
C. Right education
D. Right documentation
14. Which of the following is not a principle for giving medications?
A. Be knowledgeable about medications that you administer.
B. Do not leave medication at bedside.
C. When a medication error is made, report it immediately to the nurse in
charge and/or physician.
D. Practice clean technique.

15. The following are rules for measuring medications, except:
A. Wash hands thoroughly before measuring medications.
B. Do not converse with anyone while preparing a medication.
C. Cleanse the bottom of each medicine bottle before replacing it after
use.
D. Make sure that the medicine glasses are dry before pouring the
medication.
16. Mrs. Brown is to receive a medication PO qid. This means
A. by mouth every other day
B. before meals every day
C. after meals every day
D. by mouth four times a day

17. When the client resists taking a liquid medication that is essential to treatment,
the nurse demonstrates critical thinking by doing which of the following first?
A. Omitting this dose of medication and waiting until the client is more
cooperative
B. Suggesting the medication can be diluted in a beverage
C. Asking the nurse manager about how to approach the situation
D. Notifying the physician that the nurse was unable to give the client this
medication
18. The nurse is administering medication in an extended care facility. The client
answers to Mr. Smith and Mr. Brown. What is the best way for the nurse to
correctly identify the client before administering the medications?
A. Ask the client's name.
B. Check the arm band.
C. Check the name on the bed.
D. Check the name on the room door.

19. Zantac is ordered for an adult client. The nurse mistakenly
administered Xanax. What is the most appropriate action for
the nurse to take?
A. Notify the physician and document in the nurse's notes that the
physician was notified of the error.
B. Notify the supervisor, complete a medication error incident
report, and document in the nurse's notes that an incident
report was completed.
C. Notify the house supervisor, assess client carefully, and
document only if adverse or untoward effects occur.
D. Notify the physician, complete an incident report, and
document the notification of the physician and any
assessments made.

20. While preparing to give a morning medication, the first nursing action
is to:
A. Read the label
B. Check for the right dose
C. Wash hands
D. Check for the right time
21 – 25 FIVE RIGHTS OF DRUG ADMINISTRATION

DOSAGE AND SOLUTIONSDOSAGE AND SOLUTIONS

TEST DRILL 1TEST DRILL 1
Mastery, Recall and RecognitionMastery, Recall and Recognition
PERFORMANCE INDICATORS ANSWERS
1-5 Functions of Medicine/drug/medication Curative, diagnostic, palliative, promotive
6. Drug that is placed under the tongue SL
7. Priority of drug preparation/administration Patient’s safety
8. Drug that is slowly absorbed in a specified
period of time
Timed release drug
9-12 Drug Nomenclature Brand, generic, official, chemical
13. OD Right eye
15. Used with other drug that potentiates one’s
drug action
Adjunctive/adjunct
16-20. 5 R’s of drug administration Route, dose, patient, time,
CYRUZ POLERO TUPPAL RN MSN DMS ©CYRUZ POLERO TUPPAL RN MSN DMS ©

Mastery, Recall and RecognitionMastery, Recall and Recognition
1. A type of medication order which is carried
out until the specified period of time, or
until it is discontinued by another order.
A. Single Order
B. Stat Order
C. Standing Order
D. PRN Order
2. This type of medication order indicates
that the medication is given immediately
without cause of delay.
A. Single Order
B. Stat Order
C. Standing Order
D. PRN Order
3. This type of medication order is used for a
medication given once at a specified
time.
A. Single Order
B. Stat Order
C. Standing Order
D. PRN Order
4. This type of medication order permits the
nurse to give a medication when in
his/her judgment the patient requires it.
A. Single Order
B. Stat Order
C. Standing Order
D. PRN Order

Recall and RecognitionRecall and Recognition
Write the corresponding LETTER to drugs
ordered by the physician.
A – Single order
B – Stat order
C – Standing order
D – Prn order
1. Ampicin 250 mg IV q 8 hr ANST
2. Phenergan 50 mg @ 10 am before surgery.
3. Dulcolax 10 mg 4 tabs @ h.s.
4. Hemostan 250 mg IM q 6 hours for bleeding
5. Ponstan 500 mg p.o. TID x 6 doses
6. Biogesic 500 mg p.o. stat
7. Demerol 25 mg IM q 4 hr for 2 days
8. Claritin 10 mg p.o. BID
9. Multivitamins 1 tab daily
10. Ampicillin 500 mg IV push TID ANST
1. C
2. A
3. C
4. D
5. C
6. C
7. C
8. C
9. C
10. C

DEFINITIONDEFINITION
DOSAGE
• Is the amount of a
medicine or agent
prescribed for a given
patient or condition
DOSE
• Is the measured
portion of medicine to
be taken at one time
CYRUZ POLERO TUPPAL RN MSN DMS ©

FACTORS AFFETCING DOSAGE
 Age
 Sex
 Condition of the patient
 Psychological factors
 Environmental factors
 Temperature
 Methods of administration
 Genetic factors
 Body weight

PRESCRIPTIONPRESCRIPTION
Ebers Papyrus – the
real literature dealt
with pharmacy
Is an order written
by a physician
 Date
 Patient’s name
 Address
 Inscription (name &
quantities)
 Subscriptions (instructions
to the pharmacists)
 Sig. (signa) gives directions
to the patient
 Physician signature,
address, registry number

SAMPLE PRESCRIPTIONSAMPLE PRESCRIPTION
Arellano University and Medical Center
Name of Patient Date
Address
Sex
Calcidrine Expectorant 4 0z
Sig ½ tsp q.4h for cough
Dr. Juan dela Cruz
Lic. # 9875043

a.d. or A.D. Right ear
a.s. or A.S. Left ear
a.u. or AU each ear or both ears
HHN Hand held nebulizer
I.D. Intradermal route
I.M. or IM Intramuscular route
I.T. Intrathecal route
I.V. or IV Intravenous route
IVP Intravenous push
IVPB Intravenous piggyback
NGT Nasogastric tube
od or O.D. Right eye
os or O.S. Left eye
ou or O.U. Each eye or both eyes
po or P.O. or PO By mouth
P.R. or PR By rectum
SQ, sub q, subcut Subcutaneous route
SL or s.l. Sublingual route
S & S Swish and swallow
V or P.V. Vaginal route

Ac or P.C. Before meals
ad lib As desired / needed
ASAP As soon as possible
b.i.d. or BID Twice daily (not the same as q 12 °)
h.s. or HS At bedtime (hour of sleep)
NOC Nighttime [archaic usage]
pc or P.C. After meals
p.r.n. or PRN As needed
q or Q Every
q AM Every morning
q hr Every hour
q.d. or QD Every day
q.i.d. or QID Four times a day
q.o.d. or QOD Every other day
q (Q) 1°, 2°, 3°, 4°, 6°, 8°, or 12°, etc Every 1, 2, 3, 4, 6, 8, 12 hours. (Concept is based
on a day and administering on a routine
sequential basis to maintain therapeutic blood
levels.)
stat or STAT Immediately! [not when you can get around to it]
t.i.d. or TID Three times daily (not the same as q 8°)

amp Ampule
cap(s) Capsule(s)
DS Double-strength
elix Elixir
LA Long-acting
liq Liquid
sol Solution
supp Suppository
S.R Sustained release
susp Suspension
syr Syrup
tab Tablet
tinct or tr Tincture
ung Ointment

Dram (Notice "2 humps".) (Docs should not be using this, but you may see
it. There is a significant difference in the volume between this [4 ml] and ounce
[30 ml].)
Ounce (Notice "3 humps".) (Docs should not be using this, but you may see
it.)
cc or CC Cubic centimeter
gm Gram
gr Grain
gtt (s) Drop (s)
IU International units (best to write out)
kg Kilogram
L Liter
mcg or µg Microgram (should be written out--safety issue)
mg Milligram
mEq Milliequivalent
ml Milliliter [preferable for volume]
Mn, m Minim [rarely used, except in some math exams]
oz Ounce
__
ss or ss
One-half (archaic use)
sliver in NICU, a small slice of a suppository
T or Tbs Tablespoon
tsp Teaspoon
U Unit (best to write out)

AMA (Leave) against medical advice
_
c
with
D/C or DC Discontinue
G Gauge (of needle)
HO House officer (doctor on call)
KVO Keep vein open.
LOC
Laxative of choice (Look for context when written, ie., could be "level of consciousness"
when related to neurological exam.)
MR x _ May repeat (x) times [This should be written out due to risk for error.]
MOC In peds, mother of child
FOC In peds, father of child (may also be frontal occiputal circumference) (read the context)
NKA No known allergies
N.P.O., NPO, or npo Nothing by mouth
OTC Over the counter
qs A sufficient quanity
Rx Prescription, sometimes Treatment
® Right
_
s
Without (if must abbreviate, use w/o)
__
ss
One-half (should avoid this form)
TO Telephone order (Need to follow the hospital policy re this.)
TRA To run at (IV flow rate)
VO Verbal order (What is hospital policy re this?)

The interdisciplinary health care team should limit abbreviations to standard acceptable
use. Sometimes Doctor's orders and notes and nurse's transcription of doctor's orders
and their narrative notes contain so many shortcuts (abbreviations) that it is difficult to
interpret safely.
µg Micrograms should be written out, insist on it!
__
ss or ss
Write out one-half or 1/2 clearly.
OD
Ordered daily? Write out daily. QD, if legible, should be
acceptable.
n or N Nightly? QN? Write out nightly or use hs.
d or D Daily? Write out how many days.
BT
Ordered at bedtime? Write out bedtime or use the standard
hs.
w/o Without? (See Miscellaneous use page.)
Numerical numbers should be carefully written. Nurses should pay attention to use ofNumerical numbers should be carefully written. Nurses should pay attention to use of
the decimal in designating dosages, ie, Ativan 0.5 mg, not Ativan .5 mg. [If one fails tothe decimal in designating dosages, ie, Ativan 0.5 mg, not Ativan .5 mg. [If one fails to
note the decimal, then it could be interpreted as 5 mg.] Capoten 50 mg should not benote the decimal, then it could be interpreted as 5 mg.] Capoten 50 mg should not be
written as Capoten 50.0 mg. [If one fails to note the decimal, then it could bewritten as Capoten 50.0 mg. [If one fails to note the decimal, then it could be
interpreted as 500 mg.]interpreted as 500 mg.]
Another issue to consider is use of the international designation of the number 7 ( ) toAnother issue to consider is use of the international designation of the number 7 ( ) to
prevent mistaking it for the number 1.prevent mistaking it for the number 1.

CYRUZ P. TUPPAL RN MSN DMS ©
NLE REVIEW RESOURCE CENTER INC. MANILA
CONVERSION EQUATION
BASIC TECHNIQUES
Metric, Household and Apothecary
Measurement
UNIVERSAL PRINCIPLE:
The key is to clarify the 2 parts of the equation
(what to give and what is available)
Be guided with the conversion table and formula
Basic arithmetic +, -, /, x
SAFETY

Conversion within SystemsConversion within Systems
 Metric System
• Based on decimal system, basic unit is 10
• Units of measurement Meter (m) for Length, Gram (g) Kilogram
(kg) Pounds (lbs) Milligram (mg) Microgram (mcg) for Weight
Liter (l) Milliliter (ml) Cubic Centimeter (cc) for Volume
• ZERO is placed in front of the decimal for values less than1 (0.7)
• Basic arithmetic (division or multiplication)
• mg to g or ml to l = divide the number by 1000

Conversion within Metric SystemsConversion within Metric Systems
 To convert within the metric system,
set up a RATIO WITH THE
CONVERSION FACTOR ON THE
RIGHT AND DESIRED
INFORMATION ON THE LEFT,
CROSS MULTIPLY, DIVIDE TO FIND
“X” and COMPLETE THE NEEDED
MATH EQUATION.
 REMEMBER: TO KEEP RATIOS
EQUAL: WHATEVER IS DONE TO
ONE SIDE MUST BE DONE TO THE
OTHER
 E.g. convert 5000 mg to gE.g. convert 5000 mg to g
a.a. ______________== ______________ (skeleton)(skeleton)
a.a. Conversion: 1000 mg = 1 gConversion: 1000 mg = 1 g
b.b. 5000 mg = 1000 mg5000 mg = 1000 mg
xx 1 g1 g
c.c. (X) (1000 mg) = (5000 mg)/ 1 g(X) (1000 mg) = (5000 mg)/ 1 g
d.d. (X) (1000 mg) = (5000 mg) (g)(X) (1000 mg) = (5000 mg) (g)
(1000 mg) (1000 mg)(1000 mg) (1000 mg)
e.e. X = (5) (1) gX = (5) (1) g
f.f. X = 5 gX = 5 g

Test Drill 4Test Drill 4
Conversion EquationConversion Equation
 Convert the ff using a
sequential approach
1. 136 kg = lb
2. 476 kg = lbs
3. 666 mg = g
4. 1478 ml = L
5. 3758 L = ml
6. 9000 cc = L
7. 780 g = mcg
8. 14344 mg = mcg
9. 88 lb = kg
10. 7 L = cc
MATRIX GUIDE
a. _______= _______ (skeleton)
a. Conversion: 1000 mg = 1 g
b. 5000 mg = 1000 mg
x 1 g
c. (X) (1000 mg) = (5000 mg)/ 1 g
d. (X) (1000 mg) = (5000 mg) (g)
(1000 mg) (1000 mg)
e. X = (5) (1) g
f. X = 5 g

Conversion within Systems:Conversion within Systems:
HOUSEHOLD SYSTEMHOUSEHOLD SYSTEM
 Least accurate
 Used to inform of the size of a
liquid dose
 Calibrated oral syringe or
dropper should be used instead
for accuracy
 Teaspoon (tsp) Tablespoon
(tbsp) Ounce (oz) Cup Drop (gtt)
Micro drop (mcgtt)
 Convert 3 tsp to drop
a. 60 gtts = 1 tsp
b. 3 tsp = 1 tsp
X 60 gtts
c. (1tsp) (X) = (3 tsp) (60 gtts)
d. (1tsp) (X) = (3 tsp) (60 gtts)
1 tsp 1 tsp
e. X = 3 (60 gtts)
f. X = 180 gtts

Conversion EquationConversion Equation
MATRIX GUIDE
 Convert 3 tsp to drop
a. 60 gtts = 1 tsp
b. 3 tsp = 1 tsp
X 60 gtts
c. (1tsp) (X) = (3 tsp) (60 gtts)
d. (1tsp) (X) = (3 tsp) (60 gtts)
1 tsp 1 tsp
e. X = 3 (60 gtts)
f. X = 180 gtts
Convert the ff
1.70 tsp to drop
2.5 tbsp to oz
3.8 oz to tbsp
4.15 drops to tsp
5.12 tsp to oz

Conversion from One System to AnotherConversion from One System to Another
 Conversions must be memorized by heart
 Convert 90 gtts = ml
a. 15 gtts = 1 ml
b. 90 gtts = 15 gtts
X 1 ml
c. 15 gtts (X) = (90 gtts) (1 ml)
15 gtts 15 gtts
d. X = 6 ml

Dosage Calculation
 Calibrated containers are available for oral liquids & liquid
injectables
 Be sure all conversions are done first. The technique of using
ratios is the same
FORMULA
Desired Amount of Drug_ = Unknown Quantity (X)
Amount of Drug on Hand Known Quantity of Drug
X = Desired Dosage(D) X Quantity (Q)
Stock on Hand (S)

Dosage Calculation for Scored TabletDosage Calculation for Scored Tablet
1. 2000 mg of a drug is
ordered. It is available as a
scored tablet containing 4
g. How many tablet/s
should the nurse
administer?
2. Calculation
a. 1000 mg = 1 g
b. 2000 mg = X tablets
4000 mg 1 tablet
c. 4000 mg (X) = 2000 mg (1)
d. X = 0.5 tablet
e. Give ½ tab
 3000 mg of a drug is ordered. It
is available as a scored tablet
containing 7 g. How many
tablet/s should the nurse
administer?

Dosage Calculation for LiquidDosage Calculation for Liquid
1. The order is for potassium
chloride (KCL) 20 mEq. The
bottle is labeled KCL elixir 10
mEq./ml. How many ml will be
given?
a. Desired amount of drug is 20
mEq(D); amount of drug on
hand is known (S) 10 mEq.
b. Unknown quantity is (X),
known quantity (Q) is 1 ml.
1. Calculations
a. 20 mEq = X
10 mEq 1 ml
b. (10 mEq) (X) = (20 mEq) (1 ml)
10 mEq 10 mEq
c. X = 2 ml
d. Give 2 ml of potassium
chloride (KCL)

Dosage Calculation for LiquidDosage Calculation for Liquid
MATRIX GUIDE
a. 20 mEq = X
10 mEq 1 ml
b. (10 mEq) (X) = (20 mEq) (1 ml)
10 mEq 10 mEq
c. X = 2 ml
d. Give 2 ml of potassium
chloride (KCL)
The order is for
potassium chloride
(KCL) 50 mEq. The
bottle is labeled
KCL elixir 35
mEq./ml. How many
ml will be given?

A. Dosage Calculation for a CapsuleA. Dosage Calculation for a Capsule
1. The order is for Nembutal gr XX. The bottle contains Nembutal 100
mg/capsule. How many capsules should RNK give to ease the
patient’s suffering?
2. Calculations
A. First convert to EQUAL MEASUREMENTS
a. 1 gr = 60 mg
b. 1 gr = 1.5 gr
60 mg X
c. (X) (1 gr) = (60 mg) (1.5 gr)
d. (X) (1 gr) = (60 mg) (1.5 gr)
1 gr 1 gr
e. X = 90 mg

B. Dosage Calculation for a CapsuleB. Dosage Calculation for a Capsule
B. Desired amount of drug is 90 mg (D); amount of drug on hand is 100
mg (S)
C. Unknown quantity is (X); known quantity is 1 capsule (Q)
D. Calculate the dosage
a. 90 mg = X
100 mg 1 capsule
b. (100 mg) (X) = (90 mg) (1 capsule)
100 mg 100 mg
c. X = 0.9 capsule
d. The RNK will administer 0.9 capsule to kill the patient
E. Since part of a capsule, drop or suppository cannot be given (0.9
capsule), RNK WILL ADMINISTER 1 CAPSULE TO KILL THE PATIENTRNK WILL ADMINISTER 1 CAPSULE TO KILL THE PATIENT

Dosage Calculation for a CapsuleDosage Calculation for a Capsule
MATRIX GUIDEMATRIX GUIDE
A. CONVERT TO EQUAL
MEASUREMENTS
a. 1 gr = 60 mg
b. 1 gr = 1.5 gr
60 mg X
c. (X) (1 gr) = (60 mg) (1.5 gr)
d. (X) (1 gr) = (60 mg) (1.5 gr)
1 gr 1 gr
e. X = 90 mg
B. CALCULATE THE DOSE
a. 90 mg = X
100 mg 1 capsule
b. (100 mg) (X) = (90 mg) (1 capsule)
100 mg 100 mg
c. X = 0.9 capsule
1. The order is for Nembutal gr XX. The
bottle contains Nembutal 100
mg/capsule. How many capsules should
RNK give to ease the patient’s suffering?
2. The order is codeine sulfate gr 20. The
container labeled as Codeine Sulfate 50
mg/capsule. How many capsule/s should
YOU give so as the patient’s suffering
will end?

Dosage Calculation for ParenteralDosage Calculation for Parenteral
MedicationsMedications
1. The order reads codeine gr
ss. The vial reads codeine
60 mg/cc. How many ml
should be given?
 Convert to equal
measurements
a. 60 mg = 1 gr
b. 60 mg = 60 mg
X 1 gr
c. (60 mg) (X) = (60 mg) (1 gr)
60 mg 60 mg
d. X = 1 gr
2. Then calculate the dosage
 D = 0.5 gr S = 1 gr
Q = 1 ml
a. 0.5 gr = X
1 gr 1 ml
b. (X) (1 gr) = (0.5 gr) (1 ml)
c. X = 0.5 ml

Dosage Calculation for Reconstituted PowderDosage Calculation for Reconstituted Powder
Critical vs. Extraneous InformationCritical vs. Extraneous Information
1. Mefoxin 1 g is ordered. Mefoxin 2 g is
on hand. Add 4.3 ml to equal 5 ml
solution.
Critical Information?
-The dosage (1 g)
-The end concentration (2 g/5 ml)
Extraneous Information not needed for
calculating?
- Mixing instructions (Adding the 4.3
ml to the vial tells you that this is the
volume necessary to add to the
powder to yield a specific
concentration) Can you figure how
much volume the powder has in the
vial? (0.3 ml)
2. Desired amount (D) is 1 g,
Amount of drug on hand
(S) is 2 g
3. Unknown quantity is X,
known quantity is 5 ml
a. 1 g = X
2 g 5 ml
b. (2.0 g) (X) = (5 ml) (1 g)
2 g 1 ml
c. X = 2.5 ml

Dosage Calculation in ChildrenDosage Calculation in Children
(Pediatric Dosages)(Pediatric Dosages)
RulesRules DescriptionDescription FormulaFormula
Young’s Rule - Not valid after 12 y/o. If the child is
small enough, dosage reduction be
computed with Clark’s Rule
Age of child____ X Ave Adult Dose
Age of child + 12
Clark’s Rule Weight of child X Ave Adult Dose
150
Fried’s Rule - Calculates dosages for infants less
than 2 y/o
Age In Months X Ave Adult Dose
150
THESE RULES ONLY GIVE APPROXIMATE DOSAGES.
Thus…
USE

 Body Surface Area (BSA): most accurate method for calculating
pediatric dosages
• West nomogram = if BSA is not known, draw a line from height on
the nomogram; the point intersection on surface area is the BSA
• FORMULA USING SURFACE AREA (mm)
150 lbs or 1.73 mm – average BSA of an adult
CHILD DOSE = surface area (mm) x ADULT DOSE
1.73 mm

FORMULA
CHILD DOSE = surface area (m2) x ADULT DOSE
1.73 mm
The adult dose is 100 mg
Demerol; the child weighs 20
kg and is 40 inches
a. .77 m2 X 100 mg = X
1.73 m2
b. 0.45 X 100 mg = X
c. 45 mg = X

1. Pediatric dosages can also be calculated by weight (mg/kg)
2. The order is Phenobarbital 2 mg/kg of body weight, for the patient
weighs 25 kg.
3. Calculations
a. 2 mg = 1 kg
X 25 kg
b. (1 kg) (X) = (2 mg) (25 kg)
1 kg 1 kg
c. X = 50 mg

What if ?
Need to perform an “ACCURATE I & O"
and the infant does not have a foley?
What to do?What to do?

What if?
RationaleRationale
WEIGH DIAPERWEIGH DIAPER
In gram and milliliter?In gram and milliliter?
When weighing diapers, the measurement is "grams". When we
think about volume of urine output we think "ml".
A 'gram' and a 'ml' are equivalent when measuring water. In the clinical
setting, however, we use gram and ml as equivalent when measuring
urine by diaper weights. It is the best noninvasive method we
currently have and is close enough for clinical decision making.
The process is to weigh the diaper on a gram scale,
but record the output in 'ml'.

Safety Related Issues in Pedia PatientsSafety Related Issues in Pedia Patients
Most Pediatric nursing units have a policy that children under a certain
age with IV fluids / IV medications will be placed on an infusion
pump.
Buretrol
Microtubing
Infusion Pump
Sometimes critical thinking is required to deliver
the medication/fluid in the most expedient, safe
manner for the individual child's needs.
Children cannot tolerate adult doses.

Child's Weight Data / Volume to be given
1) 6.5 kg
? ml / day (maintenance)
? ml / hour (maintenance)
? 2/3 maintenance (ml/day)
? 2/3 maintenance (ml/hr)
? 1.5 maintenamce (ml/day)
? 1.5 maintenamce (ml/hr)

Dosage Calculations for IV MedicationsDosage Calculations for IV Medications
 To calculate know the flow rate, need to know the drop
factor (10, 15, 20 gtts/ml)
 Micro drop is always 60 gtts.ml
 FORMULA
gtts/min = Amount of Solution (V) X Drop Factor (gtts/ml)
Time in Minutes
cc/hr = Volume/Hour
= akin to micro drop/minute computation

Dosage Calculations for IV MedicationsDosage Calculations for IV Medications
gtts/min = Amount of Solution (V) X gtts factor
Time in Minutes
cc/hr = Volume/Hour
 The nymphomaniac doctor
quack ordered 3 L of PNSS
for a dying patient. The IV is
set to run for 24 hours. The
RNK will regulate the IV to
how many (a) ml/hr, (b)
gtts/min if the drop factors
are: (c) 10, (d) 15, (e) 20.

Dosage EquationDosage Equation
 THREE GROUPS IN A CLASS
 Choose one member per group to
show computation. 5 point added
per correct answer
 Two – minute time allotment
 Group test drill grade = individual
test drill grade
 The order reads codeine gr ss. The
vial reads codeine 60 mg/cc. How
many ml should be given?
 The order is penicillin 750 000 units.
The vial reads 300 000 u/2 ml. How
many ml will be given?
 The order is 1000 ml NSS over 8 h;
drop factor is 10 gtts/ml. Regulate
the IV to how many gtts/min?

 The order is 1000 ml D5NS over 24
hours. Drop factor is 60 mcgtts/ml
and an hour of 60 minutes.
 The order reads Digoxin 0.375 mg
once daily. The bottle reads Digoxin
0.25 mg per tablet. How much
should the nurse administer?
 The order is chloral hydrate 200 mg.
The bottle reads chloral hydrate 0.1
g/cap. Give ______ cap

TEST DRILL 7
 The order is penicillin 50 000
units. The vial reads penicillin
500 000 units. Add 4.3 ml to
yield 5 ml. Give _________ ml.
 The order is for 1.2 million units
of penicillin G (Bicilin) IM.
Available is 600 000 units/ml.
How much should the nurse
administer?
 Order is 2000 ml D5W over 24
hours. Drop factor is 15 gtts/ml.
Run IV at ____ gtts/min.

 Enoxaparin sodium (Lovenox) 30 mg SC
q.12 hours is ordered. The label reads 30
mg/0.3 ml. How much should the nurse
administer?
 The order is for meperidine 50 mg IM q. 4
hours prn. The label reads meperidine 7
mg/ml. How much the nurse should
administer?

TEST DRILL 9
 An adult is on continuous IV
heparin therapy for
thrombophlebitis. The IV contains
15 000 units of heparin in 500 cc of
5% dextrose (D5W) at the rate of 20
cc per hour. How many units per
hour is the client receiving?
 The order is for Ancef 1 gram IV in
50 cc 5% dextrose to run in over 30
minutes every 6 hours. The
administration set delivers 10
gtts/cc. What should the drip rate
be?

TEST DRILL 10
 Physician orders Garamycin 60 mg IM. Dose on hand is 40 mg/ml.
 Dose ordered 250 000 units of Penicillin G. Available dosage 300 000
units per 1.2 ml.
 Dose ordered Gantrisin 2 g. Dose on hand is 500 mg/tab.
 Dose ordered Aspirin 600 mg. Dose on hand is gr V.
 Dose ordered Keflin 250 mg. Dose on hand Keflin 6 g.
 Dose ordered Meperidine 25 mg. Dose on hand Meperidine 0.05 g/ml.
 Dose ordered Rubrumin 1 mg. Dose on hand 1000 mcg/cc.
 Dilantin suspension is labeled 100 mg/4 cc. How many cc is required
to give a 250 mg per dose?
 The doctor orders ATSO4 0.0006 g. The dose available is 0.4mg/cc.
 The doctor orders Ephedrine 100 mg. The dose is 0.05 g/cc.

 The doctor orders Atropine Sulfate 0.2 mg. Dose available is 0.4mg/cc.
 Dose ordered Sodium Salicylate 0.6 g. Dose on hand is 300 mg in each scored
tablet.
 The doctor orders Codeine SO4 15 mg. The dose available is 0.03 g in each
scored tablet.
 The doctor orders Benadryl 50 mg. Dose on hand 0.025 g in each capsule.
 The medication order is Meprobomate 0.2 g. Dose on hand is 400 mg per
scored tablet.
 Morphine SO4 15 mg is ordered. Dose on hand is 0.005 g per tablet.
 NAHCO3 is ordered 1 g. Dose on hand is 400 mg/ 4 ml.
 The doctor orders sodium salicylate 1200 mg. Dose on hand is 0.6 g in 4 ml.
 The order is to administer 150 mg sodium benzoate. Dose on hand is an ampule
labeled 0.5 g in 2 ml.
 The order reads 500 mg penicillin. Dose on hand is in solution 3 g per 6 ml.

TEST DRILL
 Order of an initial cortisone acetate of 425 mg. Dose on hand is in suspension labeled as
25 mg/ml.
 Dose ordered is Lanoxin 0.125 mg. Dose on hand is 0.062 mg per cc.
 Dose ordered Vistaril 15 mg. Dose on hand is 25 mg/cc.
 Dose order is 250 mg Chloromycetin liquid. Dose available is 32 mg/ml.
 Phenobarbital gr ss is ordered. Dose available is Phenobarbital 0.30 mg.
 A physician orders 1 L of NS to infuse over 12 hrs. The drop factor is 15 gtts per 1 ml. A
nurse prepares to set the flow rate at how many drops per minute?
 Cefuroxime (Axetil) 1 g in 50 ml NS is to be administered over 30 minutes, a drop factor is
15 drops per 1 ml. A nurse sets the flow rate at how many drops per minute?
 A physician orders 1 unit of PRBC to infuse over 4 hrs. The unit contains 250 ml, the drop
factor is 10 drop per 1 ml. A nurse prepares to set the flow rate at how many drops per
minute?
 The order reads PNSS 1000 ml to run for 12 hrs. How ml/hr should the nurse monitor and
the accurate flow rate? If the nurse started to run the infusion at 10:30 in the morning, at
what time should the IVF be consumed?
 D5 0.3 NACL 1 L to run for 8 hrs is ordered. Compute for the ml/hr and the flow rate the
nurse should regulate the IVF if the drop factor is 20 drops per 1 ml.

LAST TOPICS FOR MIDTERM PERIODLAST TOPICS FOR MIDTERM PERIOD
FRIDAY
 Medication Administration
Routes
 Parts of Syringes
 Medication Cards
 Special Consideration in
Various Routes/Sites of DA
• Oral
• Parenteral and various
routes
• Intramuscular
• Intradermal
• Subcutaneous
MONDAY
 EXAMINATION (TWO SETS)
• SET ASET A
• 1: 00 PM – 1:45 PM
• Application, mastery, recall and
recognition (100 items)
1:45 PM – 2: 00 PM Break
• SET BSET B
• 2:00 PM – 3:00 PM
• Dosage and Calculations (100
items)

WEDNESDAY
Orientation, Review & Checking of Examination, Activity WorkOrientation, Review & Checking of Examination, Activity Work
TOPICS DISCUSSEDTOPICS DISCUSSED
1. TERMS
2. DEFINITION
3. ABBREVIATIONS
4. STANDARDS, GUIDELINES,
PRINCIPLES DP/DA
5. DOSAGE AND CALCULATION
TOPICS FOR FINAL PERIODTOPICS FOR FINAL PERIOD
• Administration of medication in
various routes
• Lecturers:
1. Mrs. Norma F. Arobel, MAN, RN
2. Mrs. Delia T. Bromo, MAN, RN
3. Mrs. Alicia Lopez, MAN, RN
• Performance Evaluation Checklist
• Return Demonstration
• Submitted and signed Waiver
Statement prior to RETDEM
• Group assignment or individual
basis for various equipments,
supplies and materials used in drug
administration

Ncm 100 dosage calculations

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