Dosage Calc 360

micro (mc) =

0.000001 (5 zeros between decimal . and 1)

milli (m) =

0.001

centi (c) =

0.01

deci (d) =

0.1

When is the primary IV fluid intake commonly recorded?

1 hour prior to the end of shift

kilo (k) =

1,000

1 kilogram (kg) = ? grams (g)

1,000 g

1 milligram (mg) = ? micrograms (mcg)

1,000 mcg

1 gram (g) = ? milligrams (mg)

1,000 mg

The nurse is working the 0700 to 1500 shift and is recording the patient's intake. For breakfast, the patient takes 2 Tbs of gelatin, drinks 240 mL of coffee, and 4 oz of apple juice. For lunch, the patient drinks 180 mL of milk and 450 mL of water. Calculate the total intake for the shift in milliliters.

1,020 mL

The nurse monitors the patient's intake for the 0700 to 1500 shift. For breakfast, the patient drank 3 oz of juice, 60 mL of coffee, and 8 oz of milk. For lunch, the patient drank 6 oz of milk and ate 180 mL of ice cream. By the end of the shift, the patient drank 500 mL of water. Calculate the total intake for the shift in milliliters.

1,250 mL

What are some examples of enteral routes?

1. Oral 2. Sublingual / Buccal 3. Feeding Tube 4. Rectal

What are the 3 types of Recommended Doses?

1. Standard dose / Dosage range 2. Weight-based dose / dosage range 3. Based on Body Surface Area

The patient receives the following IVPBs: Nafcillin 1 g in 100 mL D5W IVPB every 6 hr at 0900 - 1500 - 2100 - 0300. Ondansetron 10 mg in 50 mL 0.9% NaCl IVPB at 1200 and 1700. Which of the following statements are true? Select all that apply.

1. The IVPB for the 1500 to 2300 shift is 250 mL. 2. The IVPB intake for the 2300 to 0700 shift is 100 mL. To determine which statements are true, calculate the total IVPB intake for each shift. For the 0700 to 1500 shift, the nurse will record the IVPB intake at 0900 (100 mL) and 1200 (50 mL). The total IVPB intake for this shift is 150 mL. Remember the nurse calculates the IV intake until 1 hour prior to the end of the shift, so the nurse on this shift will not record the intake at 1500. For the 1500 to 2300 shift, the nurse will record the IVPB intake at 1500 (100 mL), 2100 (100 mL), and 1700 (50 mL). The total IVPB intake for this shift is 250 mL. For the 2300 to 0700 shift, the nurse will record the IVPB intake at 0300 (100 mL). The total IVPB intake for this shift is 100 mL.

Standard Rules for Writing Metric Numbers

1. Use Arabic numbers, not roman numerals, with the metric symbols (e.g., 1 mg, 10 g, 3.5 L). 2. Always put a space between the Arabic number and the metric symbol (e.g., 1 g). 3. Always place the Arabic number before the metric symbol (e.g., 1 g or 2.5 mL). 4. Use decimal fractions (e.g., 0.5 mg or 0.75 cm), not fractional units (e.g., ½ mg or ¾ cm). 5. For decimal fractions, always place a leading zero before the decimal point (e.g., 0.5 mL or 0.3 L). 6. Omit trailing zeros (e.g., 1 mL, not 1.0 mL). 7. Write the symbols in the singular form (e.g., 15 mL, not 15 mLs, or 100 kg, not 100 kgs). 8. Use properly spaced commas for numbers in the thousands (e.g., 5,000 units). Use the word "thousand" for larger doses in the hundreds of thousands (e.g., 150 thousand) and the word "million" for numbers in the millions (e.g., 1 million units).

What are some drugs that should not be crushed, chewed, split, or broken?

1. time-released capsules (CR, ER, XR, XL, SA, SR, TR) 2. tablets with enteric coating 3. disintegrating tablets (ODT) 4. sublingual tablets 5. capsules

What is classified as output?

1. urine 2. emesis (vomit) 3. gastric drainage (NG tube, J-Tube, G-Tube drainage) 4. wound drainage (obtained from wound drainage devices) 5. chest tube drainage 6. diarrhea 7. colostomy or ileostomy drainage 8. fluid that is removed thru special procedures (thoracentesis or paracentesis drainage)

deka (da) =

10

hecto (h) =

100

1 tablespoon (Tbsp)

15 mL

1 glass or 1 cup =

180 mL (6 oz) ; 240 mL (8 oz)

The drug reference states the following about an antibiotic medication: Route/Dosage IV (Adults): Moderate-to-severe pneumonia: 1-2 g every 12 hr. Mild-to-moderate uncomplicated or complicated urinary tract infection: 0.5-1 g every 12 hr. Severe uncomplicated or complicated urinary tract infections, moderate-to-severe uncomplicated skin and skin structure infections, complicated intra-abdominal infections: 2 g every 12 hr. Empiric treatment of febrile neutropenia: 2 g every 8 hr. What is the highest recommended dose for a patient with severe urinary tract infection?

2

1 kilogram (kg) =

2.2 pounds (lb)

1 inch =

2.54 cm

1 ounce (oz) =

30 mL

The nurse begins 500 mL of 0.9% NaCl at 0800 to infuse at 50 mL/hr. The parenteral intake is closed at 1400. Calculate the IV intake for this time period.

300 mL

The nurse starts 500 mL of D5/0.9% NS at 100 mL/hr at 0100. At 0200, the hourly rate is decreased to 50 mL/hr per physician order. Parenteral intake is closed at 0600. Calculate the IV intake for the shift.

300 mL

During the shift, the patient drank one 5 oz glass of ice chips, 4 oz of milk, and ate 6 oz ice cream. Calculate the total intake for the shift in milliliters.

375 mL

During a shift, the patient consumed 3 oz of ice cream, 8 oz of milk, and one 6 oz glass of ice chips. Calculate the total intake for the shift (in mL).

420 mL First, remember that the ice chips melt to half their original volume, so 6 oz of ice chips is equal to 3 oz of liquid intake (6 ÷ 2 = 3). Then, you must convert all the oz units to mL. Remember that 1 oz is equal to 30 mL, so 3 oz of ice cream is equivalent to 90 mL (3 × 30 = 90), 8 oz of milk is equivalent to 240 mL (8 × 30 = 240), and 3 oz of liquid from the ice chips is equivalent to 90 mL (3 × 30 = 90). Once converted, add the numbers together. ➔ 3 oz ice cream: 90 mL ➔ 8 oz milk: 240 mL ➔ 3 oz ice chips: 90 mL ➔ 90 + 240 + 90 = 420 mL

During the 0700 to 1500 shift, the patient has an IV of D5/0.9% NaCl started at 1100 to infuse at 150 mL/hr. The I & O record is closed at 1400. Calculate the parenteral intake in milliliters.

450 mL

The physician's order states: "Continuous bladder irrigation at 50 mL/hr with 0.9% Normal Saline to keep urine free of clots." The nurse maintains the continuous bladder irrigation at 50 mL/hr for the 8-hour shift (0700-1500). At 1500, the end of the shift, the nurse empties 850 mL from the patient's urinary catheter. Calculate the urine output for the shift in milliliters.

450 mL

A patient is given tube feedings of 180 mL every 4 hours (0200, 0600, 1000, 1400, 1800, 2200) around the clock. The nurse gives 50 mL of water after each feeding. An additional 150 mL of water is administered at 1200 each day. What is the patient's intake in milliliters during the 1500 to 2300 shift?

460 mL

1 teaspoon (tsp) =

5 mL

During the 1500 to 2300 shift, a liter of 0.45% NaCl is started at 1600 to infuse at 75 mL/hr. At 2000, the IV hourly rate is increased to 100 mL/hr per the physician's order. Parenteral intake is closed at 2200. Calculate the IV intake for the shift.

500 mL

The patient has an IV of 0.45% NaCl started at 1600 to infuse at 100 mL/hr for 24 hours. At 2000, the IV infiltrates and is stopped. The primary IV of 0.45% NaCl was restarted at the same rate (100 mL/hr) at 2100. The nurse calculates parenteral intake at 2200, 1 hour before the end of the shift. What is the total IV intake for the 1500 to 2300 shift?

500 mL

Review the I & O Worksheet. What is the patient's urine output for the shift (in mL)?

525 mL The urine output total for the shift is 525 mL. It is found in the total row on the bottom.

During the 1500 to 2300 shift, the patient has an IV of Lactated Ringer's started at 1700 to infuse at 125 mL/hr for 4 hours. At 2100, the infusion rate is decreased to 75 mL/hr. The I & O record is closed at 2200, 1 hour prior to the end of the shift. What was the parenteral intake for the shift?

575 mL

1 oz = ? tsp

6 tsp

During the 0700 to 1500 shift, the patient has an IV of D5/0.9% NS started at 0800 to infuse at 100 mL/hr continuously. The I & O record is closed at 1400, 1 hour prior to the end of the shift. What was the parenteral intake for the shift?

600 mL

During the evening shift, an IV of 1,000 mL of 0.45% NaCl is started at 1700 to infuse at 125 mL/hr. The parenteral intake is closed at 2200. Calculate the IV intake for the 1500 to 2300 shift.

625 mL

The physician's order indicates: "Continuous bladder irrigation at 60 mL/hr with 0.9% Normal Saline to keep urine free of clots. May stop infusion if urine free of clots." The nurse starts the continuous bladder irrigation at 60 mL/hr at 0800. The irrigation is stopped at 1300. At 1500, the end of the shift, the nurse empties 925 mL from the patient's urinary catheter. What is the patient's urine output (in milliliters) for the shift?

625 mL

The patient drank 120 mL of coffee, 8 oz of orange juice, and 280 mL water during a shift. What was the patient's intake in milliliters?

640 mL

A patient is given 225 mL of tube feeding every 4 hours (0200, 0600, 1000, 1400, 1800, 2200) around the clock. The nurse gives 50 mL of water after each feeding. An additional 100 mL of water is administered at 1200 each day. What is the patient's intake in milliliters during the 0700 to 1500 (7:00 AM to 3:00 PM) shift?

650 mL

During a shift, a patient voids 300 mL at 0800 and 400 mL at 1100. His gastric tube drains 425 mL. What is the patient's urine output during the shift?

700 mL 300 mL + 400 mL = 700

The patient is receiving formula feedings through a feeding tube. She is given 300 mL every 4 hours (0400, 0800, 1200, 1600, 2000, 2400) around the clock. The nurse gives 100 mL of water after each feeding. What is the patient's intake in the 2300 to 0700 (11:00 PM to 7:00 AM) shift?

800 mL

formula for calculating Body Surface Area (BSA) in metric measurements

BSA (m²) = √weight (kg) * height (cm) / 3,600

The nurse is caring for a patient who weighs 46 kg and is 105 cm tall. What is the patient's BSA? metric

BSA (m²) = √weight (kg) * height (cm) / 3,600 √46 kg * 105 cm / 3,600 46 kg * 105 cm = 4,830 4,830 / 3,600 = 1.341 √1.341 = 1.158 = 1.16 (rounded to hundredths place) BSA = 1.16 m²

formula for calculating Body Surface Area (BSA) using household measurements

BSA (m²) = √weight (lb) * height (in) / 3,131

The nurse is caring for a patient who weighs 100 lb and is 62 in tall. What is the patient's BSA? household

BSA (m²) = √weight (lb) * height (in) / 3,131 √100 lb * 62 in / 3,131 100 lb * 62 in = 6,200 6,200/3,131 = 1.98 √1.98 = 1.407≈ =1.41 (rounded to hundredths place) BSA = 1.41 m²

The order is for Medication H 27 mg IV over 3 hours every 8 hr for 3 days for a patient who weighs 130 lb and is 5 feet 9 inches tall. The drug reference states the following: Medication H Usual Dose: 15 mg/m² as an infusion over 3 hours What is the recommended BSA-based dose for this patient?

BSA (m²) = √weight (lb) * height (in) / 3,131 √130 lb * 69 in / 3,131 = 130 * 69 = 8,970 = √8,970 / 3131 = √2.865 = 1.69 m² 15mg * 1.69m² = 25.35 mg The recommended BSA-based dose for this patient is 25.35 mg. The ordered dose is not safe; the nurse should consult with the physician. To verify safe dose, the nurse first calculates the patient's BSA and uses that to calculate recommended dose.

The patient's height and weight are 190.5 cm and 100 kg. What is the patient's BSA?

BSA(m²)=√100 kg×190.5 cm / 3,600​​ BSA(m²)=√19,050/3,600= √5.291666 = 2.300362≈ BSA = 2.30 m²

The nurse has an order for Medication K 90 mg IV every 4 weeks for a patient with ovarian cancer who has a BSA of 1.55 m². The drug reference for Medication K states: Medication K Dosage and Administration: IV (Adults): Metastatic ovarian cancer―40-50 mg/m² every 4 wk. Calculate the BSA-based recommended dosage range. Is the ordered dose safe?

The BSA-based recommended dosage range for this patient is 62-77.5 mg. The ordered dose is not safe. The ordered dose (90 mg) exceeds the BSA-based dosage range for this patient (62-77.5 mg). The nurse should contact the physician to clarify the ordered dose.

The nurse has an order for daunorubicin hydrochloride 80 mg IV on days 1, 2, and 3 of the first course of chemotherapy for a 67-year-old patient with a BSA of 1.9 m². The following package insert is available. Representative Dose Schedules and Combination for the Approved Indication of Remission Induction in Adult Acute Nonlymphocytic Leukemia For patients 60 years of age and above, daunorubicin hydrochloride 30mg/m²/day IV on days 1, 2 and 3 of the first course and on days... What is the BSA-based recommended dose for this patient? Is the ordered dose safe?

The BSA-based recommended dose for this patient is 57 mg. The ordered dose is not safe. In verifying safe dose, the nurse determines that the recommended individual BSA-based dose is 57 mg. The ordered dose is 80 mg. Since the ordered dose is more than the recommended BSA-based dose, the nurse should consult with the physician.

The patient receives the following IVPBs: Metronidazole 0.5 g in 100 mL D5W IVPB every 12 hr at 0800 and 2000. Potassium chloride 20 mEq in 250 mL D5W IVPB at 1300. What statement applies to IVPB intake for the 0700 to 1500 shift?

The IVPB intake is 350 mL.

The physician's order indicates: "Continuous bladder irrigation at 70 mL/hr with 0.9% Normal Saline to keep urine free of clots. May stop irrigation if urine is free of clots." The nurse starts the continuous bladder irrigation at 1600. The irrigation is stopped at 2200. At 2300, the end of the shift, the nurse empties 875 mL from the patient's urinary catheter. The nurse writes the output on the I & O worksheet. Select the statement that applies to the urinary output.

The actual urine output is 455 mL. The total actual urine output is 455 mL. Remember, you must subtract the irrigant infused from the total drainage. To determine the amount of irrigant used, multiply the amount infused per hour by the total number of hours; in this case the irrigation was only for part of the shift, from 1600 to 2200 (70 mL/hr × 6 hr = 420 mL). ➔ total drainage: 875 mL ➔ total irrigant: 420 mL ➔ 875 - 420 = ➔ actual urine output: 455 mL

The nurse records the output of the patient into the I & O record. After checking and calculating the totals on the I & O worksheet, the nurse enters the totals onto the electronic medical record. Select the statement that applies to the documentation of the intake and output.

The amounts recorded in the I & O record are not correct. The amounts recorded in the I & O record do not match the amounts on the I & O worksheet. The nurse entered the output totals in the wrong column on the I & O record. The totals for the urine output (650) and the emesis output (175) are correct on the worksheet.

The medication order is as follows for an adult patient with a middle ear infection: Cefdinir 500 mg PO daily. The drug reference states the following: Which of the following actions by the nurse demonstrates verification of safe dose?

The nurse compares the ordered dose with the recommended dose and administers the ordered dose. The ordered dose (500 mg daily) is less than the dose recommended in the drug literature (600 mg every 24 hours), so the dose is safe. There is enough information in the drug reference for the nurse to decide about the safety of the ordered dose; there is no need to check with the physician or pharmacist. The medication should not be held as there is enough information in the drug reference to determine that the ordered dose is safe.

The nurse has an order to administer Medication E 1.5 g PO daily. The drug reference states: Medication E Dosage and Administration: Adult: 0.02 g/kg PO every 24 hours. The patient weighs 80 kg. Calculate the weight-based recommended dose for this patient. Is the ordered dose a safe dose?

The weight-based recommended dose for this patient is 1.6 g daily. The ordered dose is safe. In verifying safe dose, the nurse determines that the individual weight-based dose is 1.6 g every 24 hr. The ordered dose is 1.5 g daily (less than is recommended). The ordered dose of Medication E is safe. 0.02 g * 80 kg = 1.6 g/day prescribed dose is 1.5 g/day 1.5 g < 1.6 g

The nurse has an order to administer Medication A 150 mcg IV daily. The adult patient weighs 50 kg. The drug reference states the following for Medication A: Medication A Dosage and Administration: Adult: 2.5 mcg/kg IV every 24 hours. Calculate the weight-based recommended dose for this patient. Is the ordered dose a safe dose?

The weight-based recommended dose for this patient is 125 mcg daily. The ordered dose is not safe. In verifying safe dose, the nurse determines that the individual weight-based dose is 125 mcg daily. The ordered dose is 150 mcg daily (more than is recommended). The ordered dose of Medication A is not safe. 150 mcg > 125 mcg

The nurse is caring for a patient who weighs 110 lb and has an order to administer Medication B 4.5 mcg IV twice a day. The package insert includes this information: Medication B Usual Dose: 0.1 mcg/kg IV twice daily. Calculate the weight-based recommended dose for this patient. Is the ordered dose a safe dose?

The weight-based recommended dose for this patient is 5 mcg twice daily. The ordered dose is safe. In verifying safe dose, the nurse determines that the individual weight-based dose is 5 mcg twice daily. The ordered dose is 4.5 mcg twice daily (less than is recommended). The ordered dose of Medication B is safe. 4.5 mcg bid < 5 mcg bid TIP: Before calculating, remember to convert 110 lb to kg (50 kg).

The nurse has an order for 650 mg of Medication C PO daily. The patient weighs 187 lb. Upon consulting the drug reference, the nurse finds the following for Medication C: Medication C Usual Adult Dosage: 8 mg/kg PO daily. Calculate the weight-based recommended dose for this patient. Is the ordered dose a safe dose?

The weight-based recommended dose for this patient is 680 mg daily. The ordered dose is safe. In verifying safe dose, the nurse determines that the individual weight-based dose is 680 mg daily. The ordered dose is 650 mg daily (less than is recommended). The ordered dose of Medication C is safe. TIP: Before calculating convert 187 lb to kg by dividing by 2.2 (resulting in 85 kg). 187/2.2 = 85 kg 8 mg * 85 kg = 680 mg/day prescribed dose is 650 mg/day.

During a shift, a patient voids 100 mL at 0900 and 150 mL at 1200 and 1400. He vomits twice, 25 mL at 1000 and 1300. His gastric tube drains 425 mL. The nurse totals the output for each category on the I & O Worksheet. Which of the following totals (in mL) will the nurse input on the I & O Record?

Urine: 400 Emesis: 50 Drainage (gastric): 425 The patient has voided a total of 400 mL (100 + 150 + 150 = 400); vomited a total of 50 mL (25 + 25 = 50); and the gastric tube drained a total of 425 mL.

Which of the following are correct about recommended doses in drug references? Select all that apply. a. Recommended doses are provided by the physician who writes the drug order. b. Recommended doses can be written as a single dose or a dosage range. c. Recommended doses can be written as a weight-based dose. d. Recommended doses are identified only for the pediatric and older adult populations. e. Recommended doses can be based on body surface area.

b. Recommended doses can be written as a single dose or a dosage range. c. Recommended doses can be written as a weight-based dose. e. Recommended doses can be based on body surface area. Recommended doses can be written as a single standard dose, a dosage range, a weight-based dose, or based on body surface area. Recommended doses are provided by the drug manufacturer for all drugs and all ages of patients. The recommended dose is found in a drug reference, the drug insert, or on the drug label.

How do you calculate ice chips for Intake? why?

divide the original volume in half. they will melt to about 1/2 their original volume

When using dimensional analysis for drug dose calculations, how would you first set up the conversion fraction?

dosage form / strength ex: 1 tablet / 250 mg

Single Dose means...

dose of medication administered at one time

Maintenance dose means...

dose required to sustain therapeutic effect

How do you calculate IV intake for changes in hourly rate?

find total IV intakes for each of the hourly infusion rate totals and add them together

Initial dose means...

first dose of a drug given to a patient

Example of how to calculate actual urine output?

➔ Dr orders continuous bladder irrigation to infuse at 50 mL/hr ➔ Saline starts at 0700, infuses irrigation for entire 8-hour shift ➔ at 1500, nurse empties a total of 925 mL from urinary drainage bag ➔ 50 mL/hr x 8 hours = 400 mL ➔ 925 mL - 400 mL = 525 mL actual urine output

Example of how to calculate total parenteral intake?

➔ IV of 1,000 mL is started at 0700 to infuse at 50 mL/hr. ➔ At 1400, 1 hour before end of shift, the intake is "closed" ➔ 50 mL/hr x 7 hours = ➔ 350 mL total IV intake

Divided dose means...

Fractional portion administered at specific intervals

The nurse is studying the Nomogram for Children of Normal Height for Weight. Choose the answer that correctly estimates the BSA for the corresponding line (A, B, C, or D) in the figure.

Line D: Weight = 24 lb BSA = 0.50 m² The Nomogram for Children of Normal Height for Weight uses a straight line from the child's weight in pounds (lb) across to the BSA. The answer for Line D is correct (Weight = 24 lb, BSA = 0.50 m²). The other answers each include one error: Line A: Weight = 70 lb BSA = 1.10 m² (not 1.01 m²) Line B: Weight = 44 lb (not 42 lb) BSA = 0.80 m² Line C: Weight = 32 lb (not 31 lb) BSA = 0.64 m²

The drug reference states the following about lenvatinib, when used as treatment for differentiated thyroid cancer: The recommended dose of 24 mg once daily for lenvatinib can best be described as a:

Standard dose The recommended dose of 24 mg once daily is identified as a standard dose. It is not a dosage range, nor is it based on the patient's size or weight. Safe dose refers to an ordered dose of medication that is the same as or less than the recommended dose. Effective dose refers to a dose of medication that is enough to produce the desired therapeutic effect.

The nurse receives the following order for a 39-year-old patient with a BSA of 2.1 m² who has non-Hodgkin's lymphoma: Bleomycin 2 units IV today and this Thursday. If no adverse reactions develop, give bleomycin 40 units IV weekly on Thursdays. What is the BSA-based recommended weekly maintenance dosage range of bleomycin for this patient? Is the ordered dose a safe dose?

The BSA-based recommended dosage range for this patient is 21-42 units. The ordered dose is safe. The ordered dose (40 units/weekly) is within the recommended dosage range (21-42 units/weekly). The ordered dose is safe.

The order is for oritavancin 1 g IV now for an adult patient with a bacterial skin infection. The drug reference states the following: IV (Adults > 18yr): 1,200 mg single dose Which of the following is a correct statement about this ordered dose?

The ordered dose is safe because it is less than the recommended dose The ordered dose (1 g) is less than the recommended dose (1,200 mg or 1.2 g). Therefore, the ordered dose of oritavancin is a safe dose.

The nurse is monitoring and recording the intake and output of a patient. Select the statement that applies to the measurement of output.

The output for each category (urine, vomitus, drainage, etc.) is identified and added separately at the end of the shift. Each category of output (urine, vomitus, drainage, etc.) is identified and added separately at the end of the shift. This provides a measurement of fluid loss from various sources. The measurement of all sources of output is important in providing information of the patient's fluid balance. The measurement of output can be done on a patient with or without a urinary catheter.

The nurse is validating the BSA of the patient using a standard BSA formula. BSA (m²) = √weight (kg) * height (cm) / 3,600 The patient's height and weight are 190.5 cm and 100 kg. What is the patient's BSA? Enter the numeral (not the unit) in your answer. Round your answer to the nearest hundredth.

The patient's BSA is 2.30 m²

What is weight-based dosing?

The recommended dose of medication is not the same for all patients but is based on the weight of the individual patient. usually in kilograms ex: 1 mg/kg

The order is to begin Medication G 0.375 mg PO twice a day. The patient is 9 years old and weighs 28 kg. The package insert says: Medication G Dosage and Administration: PO (Children <10 yr or 30 kg): Initial daily dose of 0.01-0.03 mg/kg/day (not to exceed 0.05 mg/kg/day) given in 2-3 equally divided doses. What is the recommended initial dosage range for this patient? Is the ordered dose safe?

The weight-based recommended dosage range for this patient is 0.14-0.42 mg twice daily. The ordered dose is safe. In verifying safe dose, the nurse determines that the individual weight-based dosage range is 0.14-0.42 mg twice daily. The ordered dose of 0.375 mg twice a day is safe. The drug reference gives the total daily dose and notes it should be given in 2 to 3 divided doses. The physician's order is for the medication to be given twice daily. Once you determine the dosage range for this patient, you will need to divide each number in the dosage range by 2. 28 kg * 0.01 mg = 0.28 mg 28 kg * 0.03 mg = 0.84 mg 0.28 / 2 = 0.14 mg 0.84 / 2 = 0.42 mg 0.375 mg bid is in between 0.14-0.42 mg

The nurse has an order for Medication J 220 mg IM every 4 hr. The patient weighs 33 lb. The package insert gives the following instructions: Medication J Dosage: IM, IV (Children and infants older than 3 months) Most infections—13.3-26.7 mg/kg every 4 hr. What is the recommended dosage range for this patient? Is the ordered dose a safe dose?

The weight-based recommended dosage range for this patient is 199.5 mg to 400.5 mg. The ordered dose is safe. In verifying safe dose, the nurse determines that the individual weight-based dosage range is 199.5 to 400.5 mg every 4 hr. The ordered dose 220 mg every 4 hr is within that range. The ordered dose of Medication J is safe. 33 lb / 2.2 = 15 kg 15 kg * 13.3 mg = 199.5 mg 15 kg * 26.3 mg = 400.5 mg 220 mg is between 199.5 and 400.5 ; it doesn't go over or below

The physician orders an initial dose of Medication M 500 mg PO twice a day for a 12-year-old patient with complex partial seizures who weighs 40 kg. The drug reference entry for Medication M states: Medication M PO (Adults and Children older than 10 yr): Single agent therapy (complex partial seizures)—Initial dose of 10-15 mg/kg/day in 1-4 divided doses; Increase by 5-10 mg/kg/day weekly until therapeutic response is achieved (not to exceed 60 mg/kg/day); when daily dose exceeds 250 mg, give in divided doses. What is the recommended initial dosage range for this patient? Is the ordered dose safe?

The weight-based recommended dosage range for this patient is 200-300 mg twice daily. The dose is not safe. In verifying safe dose, the nurse determines that the individual weight-based dosage range is 200-300 mg twice daily. The ordered dose of 500 mg is not safe. The drug reference gives the total daily dose and notes it should be given in 1 to 4 divided doses. The physician's order is for the medication to be given twice daily. Once you determine the dosage range for this patient, you will need to divide each number in the dosage range by 2. 40 kg * 10 mg = 400 mg 40 kg * 15 mg = 600 mg 400 / 2 = 200 600 / 2 = 300 200-300 mg bid < 500 mg bid

The nurse is caring for a 75-year-old patient who has been on levothyroxine 50 mcg for 3 months. The medication order is for Synthroid 50 mcg PO daily. Based on the information from the drug reference, what are the correct actions taken by the nurse? Select all that apply. a. Administer Synthroid 50 mcg PO daily. b. Hold the medication until TSH lab work is ordered. c. Hold the medication until the pharmacist can verify the correct dose. d. Inform the patient that Synthroid is the thyroid medication. e. Determine that the ordered dose is a safe dose for the patient.

a. Administer Synthroid 50 mcg PO daily. d. Inform the patient that Synthroid is the thyroid medication. e. Determine that the ordered dose is a safe dose for the patient. Synthroid is a brand name for levothyroxine and the patient has been taking levothyroxine 50 mcg at home, so the nurse is correct to administer Synthroid 50 mcg. The patient should be made aware of the Synthroid tablets and purpose of the drug since the tablets may look different than the levothyroxine tablets that they take at home. The patient has been taking levothyroxine for 3 months. The ordered dose represents an increase that is within the safe dosage range. The ordered dose does not need to be held for the TSH lab work unless the physician specifically orders to hold the drug until the lab results are available. The ordered dose is a safe dose for the patient and does not need to be verified by the pharmacist.

Which of the following are correct about drug doses based on a patient's body surface area (BSA)? Select all that apply. a. Recommended doses based on BSA are common for pediatric doses and oncology drugs. b. BSA must be based on current height and weight measurements. c. An individual's BSA can be determined by the use of a formula or a nomogram. d. The West Nomogram should be used rather than the Nomogram for Children of Normal Height for Weight for the greatest accuracy. e. There are two standard formulas for calculating BSA.

a. Recommended doses based on BSA are common for pediatric doses and oncology drugs. b. BSA must be based on current height and weight measurements. c. An individual's BSA can be determined by the use of a formula or a nomogram. e. There are two standard formulas for calculating BSA. Recommended doses based on BSA are common for doses of pediatric and oncology drugs. To be accurate, BSA must always be based on current height and weight measurements. An individual's BSA can be determined by use of one of the two standard BSA formulas (based on metric and household measurements) or a nomogram (West Nomogram or Nomogram for Children of Normal Height for Weight).

How do you calculate intermittent feeding intake?

add the total amount of formula given during the shift ex: 250 mL q 6 hours (0600, 1200, 1800, 2400) during 0600 to 1500 (6am to 3pm) shift ➔ only 0600 and 1200 feeding times are during this shift 250 mL + 250 ml = 500 mL intake during shift

What is Parenteral Intake?

any IV fluid that infuses into the pt. includes fluids from the primary line, IV piggybacks (IVPB), blood products or other IV fluids

What is included when calculating intake?

any food that is liquid or turns into liquid at room temperature ex: water, ice cream, gelatin, ice chips, coffee, juice

When are urinary catheters and wound drainage devices usually measured?

at the end of the shift

Loading dose means...

initial large dose administered to quickly achieve therapeutic drug levels

What does this symbol mean: µ and why do we typically not use it?

mc (micro). because may be misinterpreted for prefix "m", which would contribute to harmful medication errors

When calculating intake, you must convert everything into

milliliters (mL)

Dosage range means...

minimum and maximum safe and effective dose ex: 200,000 to 400,000 units according to package insert

The less diluent, the (less or more) concentrated the medication?

more concentrated

How do you calculate continuous feeding intake?

multiple hourly rate (mL/hr) by the # of hours that the formula infused during the shift ex: 50 mL/hr for 8 hours, continuously 50 x 8 = 400 mL

How do you calculate parenteral intake?

multiple the hourly IV rate by the # of hours the IV infused

What must the nurse do if the amount of drug ordered by a physician is not within the recommended dosage range?

must contact physician to clarify the dose. the communication ensures the pt's right dose of medication

1 drop (gtt) =

no equivalent (will be calculated differently in every pharmacy, facility, insurance, etc.)

Which standard household abbreviations must always be used in singular tense?

ounces, teaspoons and tablespoons ex: 1 oz, 6 oz, 1 tsp, 3 tsp, 1 Tbs, 2 Tbs

How do you calculate actual urine output?

subtract the amount of irrigant instilled from the total output collected in the urinary drainage bag

Total daily dose means...

total amount of medication to be given in 24 hours