Nursing Skills Computation

1. Celsius to Farenheit = C x 1.8 + 32

2. Farenheit to Celsius = F - 32 / 1.8

3. How much fluid is lost if a person lost 1.8kg?

Answer: 1 Liter and 800 ml

Rationale: 1 Liter of fluid is equal to 1kg

1ml is equal to 1 gram

4. 1cc = 1ml

5. 1kg = 2.2lbs

6. 1 foot = 12 inch
1 inch = 2.54 cm
100 cm = 1 m

Ex. Client 6 ft and 8 inch. Compute in centimetre and meter.

6ft 12 inch = 72 inch

1ft
↓
72 inch + 8 inch = 80 inch
↓
80 inch 2.54cm = 203.2 cm
1inch
↓
203.2 cm 1m___ = 2.032 m
100cm
↓
Ex: 5 ft 8 inch
145 lbs

a. kg: 65.90 kg
145 / 2.2 = 65.90 kg

b. cm: 172.72 cm

c. m: 1.73 m

d BMI = kg__ = kg__ = 65.9 kg = 65.9 kg = 22.33 or 21.9 = Normal BMI

m2 m2 (1.72)2 2.95

BMI: ↓ 20 = underweight
20 – 25 = Normal
↑ 26 = overweight
7. How many tablespoons (tbsp) in 30 teaspoon (tsp)
1 tbsp = 3tsp
1 tbsp = 15 ml
1 tsp = 5ml

Ex: 30 tsp 1 tbsp = 30 tbsp = 10 tbsp

3 tsp 3

8. How many cc in 23 tsp?

23 tsp 5 cc_ = 115 cc
1 tsp

9. 1 gm = 15 grain
1 grain = 65 ml

Ex: 5 gms Nitroglycerin → gr?

5 gms 15 gr_ = 75 gr
1gm

DOSAGE COMPUTAtIONS FOR NURSING EXPERTS OR MATH EXPERTS OUT THERE and please
explain tome as well !!! URGENT!!? 1.The physician's oreder reads: ADMINISTER D5LR 3L for 24
hours

a. how many gtts/min will you regulate the IVF?

b. how many mls/hr will be infused????

2. A patient must receive 1mg/min. of lidocaine (xylocaine). If 1200 mg has been added to 500 ml of
D5W and the gtt factor is 60mcgttlml, what will be the flow rate of the IVF?

3.How many calories will the patient receive from the D5W 1L?

4. How many mls of drug is needed to prepare 1gal of 5% of solution??? How many mls of water should
you add to the pure drug????

THANKS I OWE YOU

Standard IV administration sets have a drip factor of 10, 15, or 20 drops/cc. A microdrip or minidrip
administration set has a drip factor of 60 drops/cc and is used primarily for low IV rates, such as those
used for pediatric clients.?

Key info missing is how many drops in a ml?

There are many ways to approach the problem.

Let's assume 15 gtts/ ml

1) a. (gtts / min) = (15 gtts / ml) * (3L/24 hrs) * (1,000 ml/L) * (1 hr/60 min) = 31.25 gtts / min
b. (mls / hr) = (1,000 ml/L) * (3L/24 hrs) = 125 ml / hr

2) (gtts / min) = (60 gtts/ml) * (500 ml/1200mg) * (1mg/min) = 25 gtts / min

3) calories = (4 calories / g carbohydrate) * ( 5 g / 100 ml) * (1,000 ml/L) = 200 cal

4) mg / gal = (1200 mg/500 ml) * (1,000 ml/L) *(3.7854 L/gal) = 9,085 mg

Add 3.7854 gal to pure drug
xample 2.      
A 70 kg patient is prescribed Dopamine, 10 micrograms per kilogram per
minute.  The stock solution is 800 mg Dopamine in 500 ml Glucose 5%. 
Calculate the rate in ml per hour to the nearest ml
Step One:   Calculate the total dose per hour
=70kg (body weight) 10x micrograms (dose) x  60 (minutes)
    =   42000 micrograms (Total dose per hour)
       
Convert this to milligrams, so that the dose required and the
Step Two:   amount of Dopamine in the stock solution are in the same
units
    =          42000 / 1000  
    =          42 mg  
       
Use the formula Drip Rates (in Millilitres Per Hour) to
Step Three:  
determine the ml per hour.
42
  =
800
x 500
105
  =  
4
  =26 ml per hour (to the nearest ml)
Site owner Jane Hadfield
Site author Shay Walsh

Common Conversions:
1 Liter = 1000 Milliliters
1 Gram = 1000 Milligrams
1 Milligram = 1000 Micrograms
1 Kilogram = 2.2 pounds

Methods of Calculation
Any of the following three methods can be used to perform drug
calculations. Please review all three methods and select the one that
works for you. It is important to practice the method that you prefer to
become proficient in calculating drug dosages.

Remember: Before doing the calculation, convert units of measurement

to one system.

I. Basic Formula: Frequently used to calculate drug dosages.

D (Desired dose)
 H (Dose on hand)
V (Vehicle-tablet or liquid)
D
x V = Amount to Give
H
D = dose ordered or desired dose
H = dose on container label or dose on hand
V = form and amount in which drug comes (tablet, capsule,
liquid)
Example: Order-Dilantin 50 mg p.o. TID
Drug available-Dilantin 125 mg/5ml
D=50 mg H=125 mg V=5 ml
50  250
x5= = 2 ml
125 125

II. Ratio & Proportion: Oldest method used in calculating dosage.

Known   Desired

H : V :: D : X

    Means    

Extremes
III. Left side are known quantities
IV. Right side is desired dose and amount to give
V. Multiply the means and the extremes
HX = DV
DV
X=
H
Example: Order-Keflex 1 gm p.o. BID
Drug available-Keflex 250 mg per capsule
VIII. D=1 gm (note: need to convert to milligrams)
1 gm = 1000 mg
IX. H=250 mg
X. V=1 capsule
25
: 1 :: 1000 : X
0

XI. 250X = 1000

1000
X=
250

XII. X = 4 capsules
XIII. Fractional Equation
 H D
=
V X

XIV. Cross multiply and solve for X.

H D
=
V X
HX = DV
DV
X=
H
Example: Order - Digoxin 0.25 mg p.o. QD
Drug Available - 0.125 mg per tablet
D=0.25 mg H=0.125 mg V=1 tablet
0.125 0.25
=
1 X

XX. 0.125X = 0.25

0.25 
X=
0.125

XXI. X = 2 tablets
XXII. Intravenous Flow Rate Calculation (two methods)

Two Step

Step 1 - Amount of fluid divided by hours to administer = ml/hr

ml/hr x gtts/ml(IV set)
Step 2 - = gtts/min
60 min

One Step

amount of fluid x drops/milliliter (IV set)

hours to administer x minutes/hour (60)
Example: 1000 ml over 8 hrs
IV set = 15 gtts/ml

Two Step

1000
Step 1 - = 125
8
125 x 15
Step 2 - = 31.25 (31 gtts/min)
60
One Step
1000 x 15 15,000
= = 31.25 (31gtts/min)
8 hrs x 60 480
XXIII. How to Calculate Continuous Infusions

A. mg/min (For example - Lidocaine, Pronestyl)

Solution cc x 60 min/hr x mg/min

= cc/hr
Drug mg
    Drug mg x cc/hr    
= mg/hr
Solution cc x 60 min/hr
Rule of Thumb

Lidocaine, Pronestyl
2 gms/250 cc D5W

1 mg = 7 cc/hr
2 mg = 15 cc/hr
3 mg = 22 cc/hr
4 mg = 30 cc/hr

D. mcg/min (For example - Nitroglycerin)

Solution cc x 60 min/hr x mcg/min

= cc/hr
Drug mcg
    Drug mcg x cc/hr    
= mcg/hr
Solution cc x 60 min/hr
Rule of Thumb

NTG 100 mg/250 cc

1 cc/hr = 6.6 mcg/min

NTG 50 mg/250 cc

1 cc/hr = 3.3 mcg/min

G. mcg/kg/min (For example - Dopamine, Dobutamine, Nipride, etc.)

1. To calculate cc/hr (gtts/min)

Solution cc
x 60 min/hr x kg x mcg/kg/min = cc/hr
Drug mcg
Example: Dopamine 400 mg/250 cc D5W to start at 5 mcg/kg/min.
Patient’s weight is 190 lbs.
    250 cc    
x 60 min x 86.4 x 5 mcg/kg/min = 16.2 cc/hr
400,000 mcg
4. To calculate mcg/kg/min

      Drug mcg/ x cc/hr      

= mcg/kg/min
Solution cc x 60 min/hr x kg
Example: Nipride 100 mg/250 cc D5W was ordered to decrease your
patient’s blood pressure.
The patient’s weight is 143 lbs, and the IV pump is set at 25
cc/hr. How many mcg/kg/min of Nipride is the patient
receiving?
100,000 mcg x 25 cc/hr 2,500,000
= = 2.5 mcg/kg/min
250 cc x 60 min x 65 kg 975,000

A. How to calculate mcg/kg/min if you know the rate of the infusion

Dosage (in mcg/cc/min) x rate on pump

= mcg/kg/min
Patient’s weight in kg

B. For example:

1600 mcg/cc
400mg of Dopamine in 250 cc D5W =
60 min/hr
   
= 26.6 mcg/cc/min

C. 26.6 is the dosage concentration for Dopamine in mcg/cc/min

based on having 400 mg in 250 cc of IV fluid. You need this to
calculate this dosage concentration first for all drug calculations.
Once you do this step, you can do anything!

D. NOW DO THE REST!

E. If you have a 75 kg patient for example...

26.6 mcg/cc/min x 10 cc on pump

= 3.54 mcg/kg/min
Patients’s weight in kg (75 kg)
  = 3.5 mcg/kg/min (rounded down)

F. How to calculate drips in cc per hour when you know the

mcg/kg/min that is ordered or desired

mcg/kg/min x patient’s weight in kg

= rate on pump
dosage concentration in mcg/cc/min

G. For example:

H. 400 mg Dopamine in 250 cc D5W = 26.6 mcg/cc/min

 3.5 mcg/kg/min x 75 kg
= 9.86 cc
26.6 mcg/cc/min
= 10 cc rounded up

I. ALWAYS WORK THE EQUATION BACKWARDS AGAIN

TO DOUBLE CHECK YOUR MATH!

J. For example:

10 cc x 26.6 mcg/cc/min
= 3.5 mcg/kg/min
75 Kg
Dosage (in mcg/cc/min) x rate on pump
= mcg/kg/min
Patient’s weight in kg

L. For example:

M. 400mg of Dopamine in 250 cc D5W = 1600 mcg/cc 60 min/hr =

26.6 mcg/cc/min

N. 26.6 is the dosage concentration for Dopamine in mcg/cc/min

based on having 400 mg in 250 cc of IV fluid. You need this to
calculate this dosage concentration first for all drug calculations.
Once you do this step, you can do anything!

O. NOW DO THE REST!!

P. If you have a 75 kg patient for example

26.6 mcg/cc/min x 10 cc on pump

= 3.54 mcg/kg/min
Patients’s weight in kg (75 kg)

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 D5W. 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
A. Practice Problems
1. 2500 mL
2. 7500 mg
3. 10,000 mcg
4. 0.5 gm
5. 7.5 mg
6. 2.8 L
7. 75 kg
8. 176 lbs
B. Practice Problems
1. 2 tablets
2. 2 tablets
3. 4 tablets
4. 10 mL
5. 10 mL
6. 1.2 mL
7. 69 kg = 69 mg
8. 130 mg for 4 doses
C. Practice Problems
1. 41.6 (42)
2. 20.8 (21)
3. 75
D. Practice Problems
1. 17 cc/hr
2. 6.65 mcg/kg/min
3. 3 cc
4. 186.5 mcg/min
5. 30 cc/hr
6. 3 mg/min