Nursing Pharmacology Chapter 5 Medications and Calculations – Flashcards

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Metric system is
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a decimal system based on the power of 10
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The basic units of measure are
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gram (g, gm, G, GM) for weight; liter (l,L) for volume; and meter (m,M) for linear measurement or length.
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Prefixes indicate
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the size of the units in multiples of 10
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Kilo is a prefix used for _______ units.
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larger
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Milli, centi, micro and nano are prefixes used for _______ units.
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smaller
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Kilo stands for
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thousands
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Milli stands for
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one thousandths
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Centi stands for
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one hundredth
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The difference between degrees of magnitude is always a multiple of
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10
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Metric units most frequently used in drug notation are the following:
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1 g = 1000 mg 1 L = 1000 mL 1 mg = 1000 mcg
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Gram (weight)
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1 kilgram (kg, Kg) = 1000 g 1 gram (g, gm, G, Gm) = 1 g 1 milligram (mg) = 0.001 g 1 microgram (mcg) = 0.000001 g 1 nanogram (ng) = 0.000000001 g
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Liter (volume)
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1 kiloliter (kl, KL) = 1000 L (l) 1 liter (L,l) = 1 L (l) 1 milliliter (mL) = 0.001 L (l)
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Meter (length)
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1 kilometer (km) = 1000 m 1 meter (m, M) = 1 m 1 centimeter (cm) = 0.01 m 1 millimeter (mm) = 0.001 m
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When converting larger units to smaller units in the metric system, move the decimal one space to the ______ for each degree of magnitude.
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right (this does not apply to micro and nano units)
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When converting smaller units to larger units in the metric system, move the decimal point one space to the ______ for each degree of magnitude of change.
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left
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Household measurement is not as accurate as the
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metric system
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Ounces are ______ ounces in the household measurement.
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fluid
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When converting larger units to smaller units within the household system, ________ the requested number by the basic equivalent value.
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multiply
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When converting smaller units to smaller units within the household system, _______ the requested number by the basic equivalent value.
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divide
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Apothecary system is
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no longer used
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Household equivalents in fluid volume
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1 measuring cup = 8 ounces (oz) 1 medium size glass = 8 ounces (oz) 1 coffee cup (c) = 6 ounces (oz) 1 ounce (oz) = 2 tablespoons (T) 1 tablespoon (T) = 3 teaspoons (t) 1 teaspoon (t) = 60 drops (gtt) 1 drop (gtt) = 1 minim (min or m)
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The four general methods for the calculation of drug doses are the
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1. basic formula 2. ratio and proportion 3. fractional equation and 4. dimensional analysis
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(BW)
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body weight
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(BSA)
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body surface area
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The brand name is written in _____ letters.
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large
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The generic name is written in _______ letters.
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small
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(BF)
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basic formula
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Most frequent method of calculating drug dosages is the
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basic formula
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Basic formula
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D/H x V = A
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D in the BF is
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the desired dose (drug dose ordered by the physician)
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H in the BF is
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the on hand dose (drug dose on the label of container)
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V in the BF is
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the vehicle (drug form in which the drug comes)
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A in the BF is
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the amount calculated to be given to the client
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When using the metric system to convert the ordered drug and the drug on hand
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be sure to convert the ordered drug to the on hand drug before calculating the equation with the BF
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The oldest method currently used in the calculation of drug dosages
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ratio and proportion
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(RP)
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ration and proportion
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H in the RP is
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the drug on hand
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V in the RP is
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the vehicle or drug form (250mg/5mL, the 250 mg will be the drug on hand and the 5 mL will be the vehicle)
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D in the RP is
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the desired dose
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X in the RP is
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the unknown amount to give
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:: in the RP is
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the "as" or "equal to"
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RP equation
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H : V :: D : X (you multiply the extremes first which will be H x X and then the means which will be V x D; x does not have a number)
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Similar to ratio and proportion except it is written as a fraction
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fractional equation (FE)
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Fractional equation
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H/V = D/X H/V dosage on hand/vehicle = D/X desired dosage/unknown
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Calculation method known as units and conversions
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dimensional analysis (DA) (the advantage of DA is that it decreases a number of steps required to calculate a drug dosage)
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Dimensional analysis example
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1 cap x 500mg (order) Cap = ______________________ = 2 capsules 250mg (on hand) x 1 (250 goes into 500 two times and in itself 1 time, then multiply across)
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Calculation allows for the individualization of the drug dose
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body weight (BW)
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Body weight equation involves 3 steps
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1. convert pounds to kilograms if necessary (lb / 2.2 = kg) 2. determine drug dose per BW by multiplying as follows: drug dose x body weight =clients dose per day 3. follow the basic formula, ratio and proportion, fractional equation or dimensional analysis method to calculate the drug dosage
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Considered the most accurate way to calculate the drug dose for infants, children, older adults and clients who are on antineoplastic agents or whose BW is low
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body surface area (BSA)
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Body surface area equation
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drug dose ordered x (BSA) m^2 = mg/day
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The formula for BSA using the square root
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BSA = height (inches) x wt (lb) (square root ) _______________________ 3131 (constant)
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When administering oral medications via nasogastric tube, use ___ of fluid to mix it with.
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30 mL (do not mix with time released or sustained release drugs)
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Drop factor
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the number of drops per milliliter
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Macrodrip set
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an IV infusion set that delivers large drops per milliliter (10 to 20 gtt/mL)
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Microdrip set
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an IV infusion set that delivers small drops per milliliter (60 gtt/mL)
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The macrodrip set is usually used when administering at what rate?
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100mL/h or more. (anything less a microdrip set is used)
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(KVO)
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keep vein open
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(TKO)
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to keep open
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KVO or TKO is usually regulated to administer at what rate?
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10mL/h
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Which method is preferred for calculating IV flow rate?
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method II
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Method II has how many steps?
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2 steps
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Method II consists of:
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1. amount of fluid _______________ = milliliters per hour (mL/h) hours to administer 2. milliliters per hour x drops per milliliter (IV set) ______________________________________________ 60 minutes = drops/minute (gtt/min)
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Intermittent IV therapy is when
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you have two IV lines hooked up to each other, the primary line is for the solution and the secondary line is for the medication
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(IVPB)
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IV piggyback
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Secondary IV tubing is used to infuse
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50 to 250 mL
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Buretrol tubing is used to infuse
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150 mL (pediatric tubing)
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IV push
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medications given via IV route
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Electronic intravenous regulators
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pumps
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Volumetric regulators
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delivers a specific volume of fluid at a specific rate, in milliliters per hour
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Non-volumetric regulator
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is designed to infuse at a drop rate in drops per minute
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To figure the minutes for administration use:
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Order: 5 mg Drug available: 10 mg/mL. IV infusion not to exceed 10 mg/4 min 10 mg : 4 min :: 5 mg : x 10x = 20 x = 2 min
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(PCA)
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Patient controlled analgesia
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Secondary set problem solve for gtt/min
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amount of solution x drops per milliliter (set) ____________________________________________ minutes to administer
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Volumetric infusion pump rate problem solve
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amount of solution + the dose to be given x 60 minutes per hour/ minutes to administer = mL/h
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To verify that the dose is within safe drug parameters you must
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first check the parameters with the weight based calculation: (3 kg x 65 = 195 mg/day) second calculate client daily dose: (50 mg x 3 = 150 mg/day) 150 mg/day is less than 195 mg/day, therefore it within safety parameters
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What are the routes of administration for insulin and heparin?
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subQ and intravenous
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After use of a prefilled cartridge and tubex injector, which pieces of equipment should be discarded?
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cartridge
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The nurse is preparing an IM injection for an adult. What should be used for the needle gauge and length?
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19, 20, 21 gauge; 1, 1 1/2, 2 inches in length
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Subcutaneous injections can be administered at which degree angles?
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45 degree, 60 degree and 90 degree angles
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If the infusion rate is less than 100 mL/hr, the preferred IV set is _________.
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microdrip
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KVO means __________________. The preferred size of IV bag for KVO is _______.
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keep vein open; 250 mL
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Intermittent IV administration is prescribed when a drug is administered in a ________ volume of IV fluid over a ______ period of time.
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small; short
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The buretrol is a ___________. It is used in __________
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calibrated cylinder with tubing; intermittent IV drug
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