Medical Dosage Calculation A Dimensional Analysis Approach Tenth

Directory • Classroom Response System Questions • Lecture Note Presentation Medical Dosage Calculations: A

Classroom Response System Questions Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June

Question #1 The prescriber ordered penicillin G 300, 000 unit IM every 12 hours.

Question #1 Choices 1. 2. 3. 4. 0. 2 m. L 0. 3 m.

Question #1 Response 1. 2. 3. 4. 0. 2 m. L 0. 3 m.

Question #2 The prescriber has ordered 4 milligrams of the analgesic drug, butorphanol tartrate

Question #2 Choices 1. 2. 3. 4. 4 m. L 5 m. L 6

Question #2 Response 1. 2. 3. 4. 4 m. L 5 m. L 6

Question #3 The order: clindamycin 400 mg IM twice a day for 5 days.

Question #3 Choices 1. 2. 3. 4. 2. 4 m. L 2. 5 m.

Question #3 Response 1. 2. 3. 4. 2. 4 m. L 2. 5 m.

Question #4 The order reads: a drug 0. 025 g IM three times a

Question #4 Choices 1. 2. 3. 4. 2. 4 m. L 2. 5 m.

Question #4 Response 1. 2. 3. 4. 2. 4 m. L 2. 5 m.

Question #5 The label on the vial reads: penicillin G 1, 000 units. The

Question #5 Choices 1. 2. 3. 4. 2 m. L 3 m. L 20

Question #5 Response 1. 2. 3. 4. 2 m. L 3 m. L 20

Lecture Note Presentation Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L.

Learning Outcomes 1. 2. 3. 4. 5. Calculate doses for parenteral medications in liquid

Figure 9. 1 Ampules. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June

Figure 9. 2 Vials. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June

Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony

Parenteral Medications Supplied as Liquids Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition

Example 1 • The prescriber ordered 3 milligrams of Dolophine (methadone hydochloride) subcut stat.

Example 1 • The label reads 10 milligrams per milliliter. This strength will be

Example 2 • The prescriber ordered 0. 002 gram of a drug IM stat.

Example 3 • Determine the quantity of solution to be withdrawn from the vial

Example 3 • You want to convert 250 milligrams to milliliters. 250 mg ?

Example 3 2. 5 m. L So, you would withdraw 2. 5 m. L

Parenteral Medications Supplied in Powdered Form Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth

Powdered Parenteral Medication • Some parenteral medications are supplied in powdered form in sealed

Figure 9. 38 Drug label for Pfizerpen. (Reg. Trademark of Pfizer Inc. Reproduced with

Example 5 • The prescriber ordered 150 mg of a drug IM stat. The

Example 5 • You want to convert 150 mg to m. L. Using the

Figure 9. 8 Reconstitution of ceftriaxone. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth

Heparin Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen •

Example 4 • The prescriber ordered: heparin 5, 000 units subcut q 12 h.

Example 4 (continued) • You want to convert 5000 units to milliliters. 5, 000

Example 4 (continued) 1 2 So, 0. 5 milliliter contains 10, 000 units of

Chapter Summary • Medications supplied in powdered form must be reconstituted following the manufacturer’s

Chapter Summary • After reconstituting a multiple-dose vial, label the medication vial with the

Chapter Summary • When directions on the label are provided for both IM and

Chapter Summary • It is especially important that heparin orders be carefully checked with

Chapter Summary • Heparin sodium and heparin flush solutions are different and should never

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Medical Dosage Calculation A Dimensional Analysis Approach Tenth Edition 9 CHAPTER Parenteral Medications Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Directory • Classroom Response System Questions • Lecture Note Presentation Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Classroom Response System Questions Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #1 The prescriber ordered penicillin G 300, 000 unit IM every 12 hours. The label reads 600, 000 units per milliliter. How many milliliters will you administer to the patient? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #1 Choices 1. 2. 3. 4. 0. 2 m. L 0. 3 m. L 0. 4 m. L 0. 5 m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #1 Response 1. 2. 3. 4. 0. 2 m. L 0. 3 m. L 0. 4 m. L 0. 5 m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #2 The prescriber has ordered 4 milligrams of the analgesic drug, butorphanol tartrate (Stadol), IM every four hours PRN. The ampule reads 2 mg per 2 m. L. How many milliliters will equal 4 milligrams? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #2 Choices 1. 2. 3. 4. 4 m. L 5 m. L 6 m. L 7 m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #2 Response 1. 2. 3. 4. 4 m. L 5 m. L 6 m. L 7 m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #3 The order: clindamycin 400 mg IM twice a day for 5 days. The label reads 150 mg/m. L. How many milliliters will you administer to your patient? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #3 Choices 1. 2. 3. 4. 2. 4 m. L 2. 5 m. L 2. 6 m. L 2. 7 m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #3 Response 1. 2. 3. 4. 2. 4 m. L 2. 5 m. L 2. 6 m. L 2. 7 m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #4 The order reads: a drug 0. 025 g IM three times a day. If the label states 10 milligrams per milliliter, how many milliliters will you prepare for the patient? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #4 Choices 1. 2. 3. 4. 2. 4 m. L 2. 5 m. L 2. 6 m. L 2. 7 m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #4 Response 1. 2. 3. 4. 2. 4 m. L 2. 5 m. L 2. 6 m. L 2. 7 m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #5 The label on the vial reads: penicillin G 1, 000 units. The instructions are as follows: Add 19. 6 m. L of sterile dilutent to stock solution 1 m. L = 50, 000 units. How many milliliters contains 100, 000 units? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #5 Choices 1. 2. 3. 4. 2 m. L 3 m. L 20 m. L 40 m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Question #5 Response 1. 2. 3. 4. 2 m. L 3 m. L 20 m. L 40 m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Lecture Note Presentation Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Learning Outcomes 1. 2. 3. 4. 5. Calculate doses for parenteral medications in liquid form. Interpret the directions on drug labels and package inserts for reconstituting medications supplied in powdered form. Label reconstituted multi-dose medication containers with the necessary information. Choose the most appropriate diluent volume when reconstituting a multiple-strength medication. Calculate doses of parenteral medications measured in units. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Figure 9. 1 Ampules. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Figure 9. 2 Vials. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Parenteral Medications Supplied as Liquids Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 1 • The prescriber ordered 3 milligrams of Dolophine (methadone hydochloride) subcut stat. The strength is 10 mg per m. L. How many milliliters would you administer to the patient? 3 mg = ? m. L Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 1 • The label reads 10 milligrams per milliliter. This strength will be used as the unit fraction 0. 3 m. L So, 0. 3 milliliter contains 3 milligrams of methadone, and you would administer 0. 3 milliliter of the drug to the patient. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 2 • The prescriber ordered 0. 002 gram of a drug IM stat. The strength is 1 mg per m. L. Calculate the number of milliliters of this solution you would administer. • You want to convert 0. 002 grams to its equivalent in milligrams, and then change milligrams to milliliters 0. 002 g ? mg Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton ? m. L Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 2 0. 002 g = 0 0 0 2 mg = 2 mg • Because the strength is 1 mg = 1 m. L, no further calculations are needed to determine that 2 mg = 2 m. L • You would administer 2 milliliters of the solution IM, which would contain 0. 002 gram of the prescribed drug. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 3 • Determine the quantity of solution to be withdrawn from the vial if the medication order reads 250 milligrams of 10% calcium chloride. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 3 • You want to convert 250 milligrams to milliliters. 250 mg ? m. L 2 5 0 gram The strength of “ 10%” means that 10 grams of calcium chloride are in 100 milliliters of solution. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 3 2. 5 m. L So, you would withdraw 2. 5 m. L from the vial. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Parenteral Medications Supplied in Powdered Form Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Powdered Parenteral Medication • Some parenteral medications are supplied in powdered form in sealed vials. The powder cannot be removed from these vials. You must add sterile water or saline (diluent) to the vial and dissolve the powder to form a solution. You then withdraw from the vial the liquid volume of prepared solution that contains the proper amount of the drug. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Figure 9. 38 Drug label for Pfizerpen. (Reg. Trademark of Pfizer Inc. Reproduced with permission. ) Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 5 • The prescriber ordered 150 mg of a drug IM stat. The directions on the 500 mg vial read, “Add 9. 7 m. L NS and the strength will be 100 mg/m. L. ” How many milliliters of the reconstituted solution will you administer? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 5 • You want to convert 150 mg to m. L. Using the strength of 100 mg/m. L. So, you would administer 1. 5 m. L of the solution. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Figure 9. 8 Reconstitution of ceftriaxone. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Heparin Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 4 • The prescriber ordered: heparin 5, 000 units subcut q 12 h. • The label on the vial reads 10, 000 units per milliliter. How many milliliters will you administer to the patient? Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 4 (continued) • You want to convert 5000 units to milliliters. 5, 000 units = ? m. L • The label on the vial reads 10, 000 units per milliliter, so the strength is Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Example 4 (continued) 1 2 So, 0. 5 milliliter contains 10, 000 units of heparin and you would administer 0. 5 milliliter of the solution to the patient subcutaneously. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Chapter Summary • Medications supplied in powdered form must be reconstituted following the manufacturer’s directions. • You must determine the best dosage strength when there are several options for reconstituting the medication. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Chapter Summary • After reconstituting a multiple-dose vial, label the medication vial with the dates and times of both preparation and expiration, storage directions, your initials, and strength. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Chapter Summary • When directions on the label are provided for both IM and IV reconstitution, be sure to read the order and the label carefully to determine the necessary amount of diluent to use. • Heparin is measured in USP units. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Chapter Summary • It is especially important that heparin orders be carefully checked with the available dosage strength before calculating the amount to be administered. • A tuberculin (1 m. L) or a 0. 5 m. L syringe should be used when administering heparin. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.

Chapter Summary • Heparin sodium and heparin flush solutions are different and should never be used interchangeably. Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton Copyright © 2012, © 2008 by Pearson Education, Inc. All rights reserved.