Now do some practice exercises to check what you learned

A. Practice Problems:
1. 2.5 liters to milliliters
2. 7.5 grams to milligrams
3. 10 milligrams to micrograms
4. 500 milligrams to grams
5. 7500 micrograms to milligrams
6. 2800 milliliters to liters
7. 165 pounds to kilograms
8. 80 kilograms to pounds
B. Practice Problems: Use the method you have chosen to calculate the
amount to give.
1. Order-Dexamethasone 1 mg
Drug available-Dexamethasone 0.5 mg per tablet
2. Order-Tagamet 0.6 gm
Drug available-Tagamet 300 mg per tablet
3. Order-Phenobarbital 60 mg
Drug available-Phenobarbital 15 mg per tablet
4. Order-Ampicillin 0.5 gm
Drug available-Ampicillin 250 mg per 5 ml
5. Order-Dicloxacillin 125 mg
Drug Available-Dicloxacillin 62.5 mg per 5 ml
6. Order-Medrol 75 mg IM
Drug Available-Medrol 125 mg per 2 ml
7. Order-Lidocaine 1 mg per kg
Patient’s weight is 152 pounds
8. Order- 520 mg of a medication in a 24 hour period. The drug is
ordered every 6 hours.
How many milligrams will be given for each dose?
C. Practice Problems:
1. Order-1000 ml over 6
hrs IV set 15 gtts/ml
2. Order-500 ml over 4
hrs      IV set 10 gtts/ml
3. Order-100 ml over 20
min. IV set 15 gtts/ml

D. Practice Problems:
1. Dopamine 400 mg in 250 cc D5W to infuse at 5 mcg/kg/min. The
patient’s weight is 200 pounds. How many cc/hour would this be
on an infusion pump?
 2. A Dopamine drip (400mg in 250 cc of IV fluid) is infusing on your
80 kg patient at 20 cc/hour. How many mcg/kg/min are infusing
for this patient?
3. A Nitroglycerin drip is ordered for your patient to control his
chest pain. The concentration is 100 mg in 250 cc D 5W. The order
is to begin the infusion at 20 mcg/min. What is the rate you would
begin the infusion on the infusion pump?
4. A Nitroglycerin drip (100mg in 250 cc D5W) is infusing on your
patient at 28 cc/hour on the infusion pump. How many mcg/min
is your patient receiving?
5. A procainamide drip is ordered (2gms in 250 cc D 5W) to infuse at
4 mg/min. The patient weighs 165 pounds. Calculate the drip rate
in cc/hour for which the infusion pump will be set at.
6. A Lidocaine drip is infusion on your 90 kg patient at 22 cc/hour.
The Lidocaine concentration is 2 grams in 250 cc of D 5W. How
many mg/min is your patient receiving?

Summary
Many nurses have difficulty with drug calculations. Mostly because they don’t
enjoy or understand math. Practicing drug calculations will help nurses
develop stronger and more confident math skills. Many drugs require some
type of calculation prior to administration. The drug calculations range in
complexity from requiring a simple conversion calculation to a more complex
calculation for drugs administered by mcg/kg/min. Regardless of the drug to
be administered, careful and accurate calculations are important to help
prevent medication errors. Many nurses become overwhelmed when
performing the drug calculations, when they require multiple steps or involve
life-threatening drugs. The main principle is to remain focused on what you
are doing and try to not let outside distractions cause you to make a error in
calculations. It is always a good idea to have another nurse double check your
calculations. Sometimes nurses have difficulty calculating dosages on drugs
that are potentially life threatening. This is often because they become focused
on the actual drug and the possible consequences of an error in calculation.
The best way to prevent this is to remember that the drug calculations are
performed the same way regardless of what the drug is. For example, whether
the infusion is a big bag of vitamins or a life threatening vasoactive cardiac
drug, the calculation is done exactly the same way.

Many facilities use monitors to calculate the infusion rates, by plugging the
numbers in the computer or monitor with a keypad and getting the exact
infusion titration chart specifically for that patient. If you use this method for
beginning your infusions and titrating the infusion rates, be very careful that
you have entered the correct data to obtain the chart. Many errors take place
because erroneous data is first entered and not identified. The nurses then
titrate the drugs or administer the drugs based on an incorrect chart. A
method to help prevent errors with this type of system is to have another
nurse double check the data and the chart, or to do a hand calculation for
comparison. The use of computers for drug calculations also causes nurses to
get “rusty” in their abilities to perform drug calculations. It is suggested that
the nurse perform the hand calculations from time to time, to maintain her/his
math skills.

Answers to Practice Problems