Nurses routinely use addition, fractions, ratios and algebraic equations each workday to deliver the right amount of medication to their patients or monitor changes in their health. Nursing schools often test new students on their mathematical prowess, requiring a remedial course in medical math if necessary. Even in state-of-the-art medical facilities, successful nurses must have sharp mathematical skills.
Calculating Dosages-Nurses with an order to "Give 750 mg every 4 hours as needed for pain" may receive 250 mg tablets from the pharmacy, requiring them to calculate the number of pills to administer. They also need to calculate the amount of medicine to give when drawing up liquid medicine for injection. An order to give 7.5 mg must be compared to the vial, which states, "5 mg per cc." Some medication orders require the nurse to calculate the dosage based on the patient's weight.
Converting Between Systems-Most Americans think in terms of household or apothecary measurements: pounds, ounces, Fahrenheit
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An order may read, "Give 1,000 cc every 8 hours," necessitating a calculation of the proper drip rate. A small bag of antibiotic medicine may have an instruction to "Give 500 mg over 30 minutes." When IV medicine must be given without an electric pump, the nurse must calculate the correct number of drops per minute to administer.
Drug Titration-Certain drugs are titrated, meaning that the dose varies according to parameters set by the physician or protocol. In the intensive-care unit, a patient may need a varying amount of intravenous drug that is calculated by factoring in his urinary output per hour, for example. Insulin may be titrated depending on the patient's ever-changing blood-glucose reading. Drug titration requires the nurse's full concentration on her mathematical skills and is often limited to nurses with special training or
So any time you use a 15 gtts/ml drip set just divide the amount of solution per hour by 4. 80 6 = 20 gtts/min The 20 gtts/ml drip set is calculated the same way except you divide by 3 since there are three 20 minute periods in one hour. 20 goes into 20 once and 20 goes into 60 three times. Observe the example below: 80 ml (amount) X 20 gtts/ml (drip set) 60 (divided my time in minutes – over 1 hour) = The answer is 26.6 or rounded off to 27 gtts/minute. This means all you need to do is divide the amount of solution per hour by 3 to get the gtts/min. Summary • Drip sets used in medicine are based on the 60 minute clock for timing and calculations. All you need to do is divide the amount to be infused each hour by how many time periods the drip set has in one hour which is based on the clock. The drip sets include the minidrip set, 60 gtts/ml, and three regular drip sets which include the 10 gtts/ml set, 15 gtt/ml set, and the 20 gtts/ml set. There is one (1) 60 minute period in one hour, six (6) 10 minute periods in one hour, four (4) 15 minute periods in one hour, and three (3) 20 minute periods in one hour. When reducing fractions to allow easier calculations
physician orders an IV to be started with 0.45% normal saline, and orders a serum
As a pharmacist I would ask them to determine if their doctor has an emergency after hour’s line that I can call for a prescription. I could also require the patient to bring their prescription bottle as verification for a few day supply emergency refill. Later, I would fax the doctor’s office for a new prescription. When I receive the prescription I would subtract the emergency supply from the quantity to fill.
First, the medical assistant should convert the doctor’s prescription into layman’s terms for Doris. Medication A is two teaspoons by mouth every four hours. Medication B is 2.5 milliliters by mouth three times daily (Fulcher, Fulcher, & Soto, 2012, p. 1b). Doris should be cautious of confusing her medication dosages as that could lead to possible overdose. If Doris is afraid of mixing her medications, the medical assistant should convert to the unit that Doris is more comfortable with. For example, if Doris prefers milliliters, she should take around 9.8 milliliters of medication A. Alternatively, medication B could be taken at .5 teaspoons (Fulcher, Fulcher, & Soto, 2012, p. 131). Patients taking multiple medications should have a medication
However, there are additional guidelines in terms of assessing the patient for prolonged catheter use. There should be frequent assessment and evaluation of the patient’s need for continued use. It is important to note that in addition to determining the patient’s need for catheterization, prior to insertion the nurse should also complete the following:
In college, a nurse must take certain mathematics classes for preparation of the job. Firstly, a nurse must be able to perform basic calculations. This includes using addition, subtraction, multiplication, and division, as well as fractions and decimals on a daily basis. Furthermore, a nurse should be skilled in calculating conversions. They have conversion tables memorized, which allows them to convert measurements. Stoichiometry, a branch of chemistry, focuses on the concept of balancing chemical equations and conversions. Nurses use stoichiometry in drug calculations. College algebra is based on line equations, algebraic expressions, and polynomial functions, which is why many institutions
Double checking of medications with a senior nurse is a strategy that is used to improve patient safety by reducing medication errors. This is especially important for paediatric medication administration. It is important that staff members both do dosage calculations separately, as this is how errors are discovered before the medications are administered (Lan, Wang, Yu, Chen, Wu, & Tang,
The intravenous dosage in this case is 0.5 - 1 mg/kg IV (range: 0.5 - 2 mg/kg).
rights, health, and safety of the patient.” This provision, identifying patients, medication safety are related because it is a nurse’s responsibility to protect the patient from harm and promote safety. Nurses are taught to use multiple checks before administering a drug and use two identifiers. These checks include checking the medication against the order when obtaining it, checking again when preparing the medication and the last check is done at the patient’s bedside prior to giving the medication. Also it is imperative to question any medication order that does not seem fit. The order should include a date, time, name of the medication, dosage strength, the route for
Providers have left some of the discretion in the hands of the nurse in regards to how much medication the patient receives. This can cause issues if all staff do not communicate or are not trained in how to assess pain. For example, the day shift nurse provides the patient with two tablets of Percocet after their procedure. Once the night shift nurse comes in they decide the patient should not be getting two tablets and one should be sufficient. The patient may develop feeling of resentment or feel that the second nurse is judging them or not providing proper care. Having a variable dose can be a positive thing if the nurse starts with the lowest dose and if that is insufficient they can administer a second dose. Also, the plan of care must be discussed openly with the patient. The nurse who is attempting to transition a patient from intravenous pain medication to something that can be taken by mouth must communicate this with the patient and explain why this is important. If the patient is not provided with the information they may not understand and communication may break
Dosages of the drug vary from one extreme to another based upon the patients needs.
Daily drug dosages are given at specified times during a day, such as twice a day (b.i.d.), three times a day (t.i.d.), four times a day (q.i.d.), or every 6 hours (q6h), so that the plasma level of the drug is maintained at a therapeutic level. (BOOK )Medication timing also accounts for medication errors and is of the utmost importance while administering medication to a patient. Timing of medication delivery to patients is arranged strategically though pharmacy according to the physician’s orders. Attention is placed on the type of medication along with interaction a medication may have with other prescribed medication on a patients chart. Nursing are pulled in many different directions, answering physcians calls, admitting new patient and dealing with emergent situations that often times takes them off schedule. It is impossible to give every patient on the floor medication at the expected time charted on the electronic medication chart. Most facilities allot nursing staff the flexibility to pass medication one hour before and one hour after medication stated due on the electronic record. Performing the necessary research for hospital facility guidelines as regards to medication distribution and abiding by those, help illuminate medication time errors. Giving medication at the appropriate rate encompasses the appropriate time of delivery. Correctly determining how fast are slow a
commonly in ml/hr. You already have the amount and the time to be infused. All you do now is choose the appropriate drip set, using a simple formula you can come up with a quick answer: Amount of Solution (in ml) X drip set (gtts/ml) = x drops/min (gtts/min)
When I say this, however, most people would picture the nurse giving the wrong medication due to lack of focus on the tasks at hand. While this could happen, I have noticed during my time at hospitals that the doctor orders are still hand written for the most part. Consequently, they can be very hard to be read legibly much less correctly translated into proper medication dosages. The first suggestion I would give to an organization would be that they required all orders to be submitted securely, by the doctors, to the pharmacy be electronic means.
Just as important as conversions, ratios and proportions also play a huge role in the medical field. Nurses use ratios and proportions when giving medication based on their patient’s weight and height. A doctor may give the order 25 mcg/kg/min. If a patient weighs 114 pounds, how many milligrams of medication should he/she be given per hour? To figure this, his/her nurse would begin by changing micrograms into milligrams. If one microgram is equal to 0.001 milligrams, the nurse can find the amount of milligrams in twenty-five micrograms by setting up a