Oral Dose Calculations

calibrated dropper

1 mL to 5 mL of medication.

Heparin is commonly available in many concentrations, from

10 units/mL (used for flushing an IV line) to 40,000 units/mL (higher concentrations are used in anticoagulant therapy

Cylindrical Dosing Spoon

1mL to 10 mL and equivalent measurements in teaspoons

oral syringe

3mL to 10 mL

The smallest calibrated dose in a medicine cup is

5 mL

Have a gelatin-like covering that holds the powdered form of the drug

Capsules

Include a softgel variation, used specifically for liquid or oil-based drug ingredients

Capsules

May contain tiny beads or pellets that are dissolved and released over time, allowing the drug's active ingredient to enter into the bloodstream at a slower and steadier rate

Capsules

a measuring device with calibration lines from 1 mL to 10 mL and equivalent measurements in teaspoons. It is designed with a spoon end shape for ease of medication administration.

Cylindrical Dosing Spoon

Best practices recommend using unit-dose and ready-to-administer medications; however, sometimes a multi-dose vial of powdered medication will be used. CDC recommendations include identifying specific information on the reconstituted vial:

Date and time of reconstitution Type and amount of diluent added Dosage strength of reconstituted drug Expiration date and time (beyond-use or discard date and time) Initials of the nurse reconstituting the drug Because the multiple-strength reconstitution medication has several dosage strengths based on the amount of diluent used, the nurse must circle the amount of diluent added and the resulting dosage strength. put storage information on the label (IV)

The first time a multidose vial is used, the nurse should put the following information on the drug label:

Date and time the vial was opened The initials of the nurse first using the vial The beyond-use date of the vial.

measured in milliequivalents (mEq).

Electrolytes

pass through the digestive process of the gastrointestinal tract

Enteral

An anticoagulant drug used to prevent blood clots. It is a high alert medication indicating an increased risk for patient harm. Safe and effective practice requires nurses to carefully follow standards when calculating and administering heparin.

Heparin low molecular weight heparins, or LMWHs

ordered in IU (international units)

LMWH drug dalteparin (Fragmin)

ordered in milligrams

LMWH drug enoxaparin (Lovenox)

used to hold oral medications, including liquid and solid forms. It is marked with calibrated units used to measure dosages. The most commonly used units to measure volume include milliliters (mL), teaspoons (tsp), tablespoons (Tbs), and fluid ounces (oz).

Medicine Cup

This facilitates rapid absorption of the medication through the mucous membranes.

Sublingual/buccal

Contain the drug's active ingredient in a compressed form Come in a variety of shapes and sizes May be scored May have an enteric coating Includes a variation called a caplet, which is small and has a smooth covering that makes it easier to swallow

Tablets

The first time a multi-dose vial is used, the nurse puts the date and time the vial was opened and the initials of the nurse first using the vial. What other information should the nurse put on the label?

The beyond-use or discard date of the vial.

Which of the following statements about multiple-strength reconstitution is correct? Select all that apply.

The dosage strength of the medication varies depending on the amount of diluent added. The less diluent added, the more concentrated the mixed medication. As the nurse, you will determine the concentration of the mixed medication based on the medication order, the needs of the patient, the route of administration, and other individual factors

The prescriber orders Glucotrol XL 3.75 mg PO q.AM. The pharmacy supplies the following medication. The nurse calculates that the patient should receive 1.5 tablets. What is the appropriate action by the nurse?

The medication is a time-released medication and should not be broken. The nurse should initially call the pharmacy.

It is important to recognize key differences between standard drug labels and the powdered medication label.

The powdered medication label highlights the total amount of drug in the vial, rather than the dosage strength. The dosage strength is found on the side of the label or in the package insert. The powdered drug label may include specific directions for mixing the powdered drug.

If a dose is ordered for IV use, the nurse will need to find the directions for IV reconstitution. For this drug, the IV directions are in the package insert, not on the drug label.

True

the part of the drug that produces the therapeutic effect

active ingredient

Time-released medications are identified on a drug label with words and abbreviations such as extended-release (ER), controlled release (CR), etc., indicating that the active ingredient of the drug enters into the

bloodstream at a slower and steadier rate.

Placement of a medication between the gum and the inner lining of the cheek

buccal

designed to facilitate oral medication administration, especially in children. Sizes vary. It often measures 1 mL to 5 mL of medication.

calibrated dropper

mall and has a smooth covering that makes it easier to swallow

caplet

controlled-release (), continuous-release (), extended-release (, , or ), sustained-action (), sustained-release (), and time-release ().

controlled-release (CR), continuous-release (Contin), extended-release (ER, XR, or XL), sustained-action (SA), sustained-release (SR), and time-release (TR).

Addition of a fluid to a denser substance, causing the fluid to be dispersed. The effect of displacement in reconstitution of powdered medications is that the total volume of the powder plus diluent is unknown after mixing.

displacement

a mixture of the drug mixed with water, alcohol, and flavored substances

elixir

The most common types of liquid oral medications are

elixirs, syrups, and suspensions

A special covering on the tablet that allows the tablet to be dissolved and absorbed in a particular place in the gastrointestinal tract.

enteric coating

Tube introduced directly into the stomach through the abdominal wall for feeding or medication administration

gastrostomy tube

In the administration of enteral medications, the nurse recalls that these medications:

include the oral, feeding tube, and rectal routes of administration.

measured in units.

insulin Parenteral penicillin Heparin

Tube introduced directly into the jejunum for feeding or medication administration

jejunostomy tube

The horizontal center of a liquid when placed in a curved container such as a medicine cup.

meniscus

A powdered medication that lists different amounts of diluent, each of which determine the concentration and dosage strength of the medication.

multiple-strength reconstitution

tube that is introduced from the nose into the stomach for feeding or medication administration

nasogastric tube

administered by mouth into the stomach and are absorbed in the gastrointestinal tract and then enter into the body.

oral

a measuring device, available in various sizes ranging from 3 mL to 10 mL capacity. The tip of the syringe allows for easy administration. The____ is needleless.

oral syringe

The process of preparing a _____ medication involves adding a liquid (diluent) to the powdered medication and is known as reconstitution.

powdered

mixing of a powder with a liquid so that the medication can be administered

reconstitution

May be broken along an indented line on the tablet. Each part of the tablet will contain an equal amount of the active ingredient of the drug.

scored tablet

A powdered medication that has only one amount of diluent and one resulting dosage strength.

single-strength reconstitution

Oral medications come in

solid, liquid, and powdered forms.

medications to be placed under the tongue

sublingual

a liquid that contains small particles of the drug that cannot be dissolved

suspension

contains the drug in a viscous liquid preparation consisting largely of purified water and sucrose or a sugar substitute for a more pleasant taste

syrup

A reconstituted oral medication may contain several doses of medication. The nurse who initially mixes the medication should identify the following on the bottle:

the date the medication was reconstituted the time the medication was reconstituted the initials of the nurse.

The expiration date indicates

the last day that an unopened vial can be used