PART I

BASIC MATH REVIEW

1

Number Systems

2

Arabic System

2

Roman System

2

Conversion of Systems

2

Fractions

3

Proper, Improper, and Mixed Fractions

3

Multiplying Fractions

4

Dividing Fractions

4

Decimal Fractions

4

Decimals

6

Multiplying Decimals

6

Dividing Decimals

7

Ratio and Proportion

7

Percentage

8

Post-Math Test

11

Roman and Arabic Numerals

11

Fractions

11

Decimals

12

Ratio and Proportion

13

Percentage

13

PART II

SYSTEMS, CONVERSION, AND METHODS OF DRUG CALCULATION

17

Chapter 1

Systems Used for Drug Administration

18

Metric System

19

Apothecary System

23

Household System

24

Chapter2

Conversion within The Metric, Apothecary, and Household Systems

28

Units, Milliequivalents, and percents

28

Metric, Apothecary, and Household Equivalents

29

Conversion In Metric and Household Systems by Liquid Volume

30

Conversion in Metric and Household Systems by Length

32

Chapter 3

Interpretation of Drug Labels, Drug orders, Bar Codes, Mar and Emar, Automation of Medication Dispensing Administration, and Abbreviations

37

Interpretation of Drug Labels

38

Military Time Versus Traditional (Universal) Time

42

Drug Differentiation

43

Drug orders

44

Unit-Dose Dispensing System (UDDS)

46

Computer-Based Drug Administration (CBDA)

47

Computerized Prescriber order System (CPOS)

48

Bar Code Medication Administration

48

Medication Administration Record (Mar and eMAR)

50

Automation of Medication Dispensing Administration

50

Abbreviations

52

The Joint Commission (TJC)

52

Drug Measurements and Drug forms

54

Routes of Drug Administration

54

Times of Administration

55

Chapter4

Prevention of Medication Errors

57

Preventing Medication Errors

57

The Rights in Drug Administration

59

Right Patient

59

Right Drug

59

Right Dose

59

Right Time

60

Right Route

60

Right Documentation

61

Right to Refuse Medication

61

Chapter 5

Alternative Methods for Drug Administration

63

Transdermal Patch

64

Purpose

64

Types of Inhalation

65

Purpose

65

Types

65

Nasal Spray and Drops

66

Purpose

66

Eye Drops and Ointment

68

Purpose

68

Ear Drops

70

Purpose

70

Pharyngeal Spray, Mouthwash, and Lozenge

71

Purpose

71

Topical Preparations: Lotion, Cream, and Ointment

71

Purpose

71

Rectal Suppository

73

Purpose

73

Vaginal Suppository, Cream, and Ointment

74

Purpose

74

Chapter 6

Methods of Calculation

75

Drug Calculation

76

Method 1

Basic formula

76

Method 2

Ratio and Proportion

78

Method 3

Fractional Equation

80

Method 4

Dimensional Analysis

81

Additional Dimensional Analysis (Factor Labeling)

88

Chapter 7

Methods of Calculation for Individualized Drug Dosing

93

Calculation for Individualized Drug Dosing

94

Body Weight (BW)

94

Body Surface Area (BSA or M2)

95

Idea! Body Weight (IBW)

96

Adjusted Body Weight (ABW)

99

Lean Body Weight (IBW)

99

PART III

CALCULATIONS FOR ORAL, INJECTABLE, AND INTRAVENOUS DRUGS

107

Chapter 8

Oral and Enteral Preparations with Clinical Applications

108

Tablets and Capsules

109

Pill/Tablet Cutter

109

Calculation of Tablets and Capsules

111

Liquids

113

Calculation of Liquid Medications

113

Buccal Tablets

115

Sublingual Tablets

115

Calculation of Sublingual Medications

115

Enteral Nutrition and Drug Administration

131

Enteral Feedings

131

Chapter 9

Injectable Preparations with Clinical Applications

148

Injectable Preparations

149

Vials and Ampules

149

Syringes

149

Needles

153

Intradermal Injections

155

Subcutaneous Injections

155

Calculations for Subcutaneous Injections

156

Insulin Injections

159

Types of Insulin

160

Mixing Insulins

165

Insulin Pen Devices

167

Insulin Pumps

169

Intramuscular Injections

170

Drug Solutions for Injection

171

Reconstitution of Powdered Drugs

173

Mixing of Injectable Drugs

174

Chapter 10

Intravenous Preparations with Clinical Applications

198

Intravenous Access Sites

199

Intermittent Infusion Add-On Devices

202

Direct Intravenous Injections

203

Continuous Intravenous Administration

207

Intravenous Infusion Sets

207

Calculation of Intravenous Flow Rate

210

Safety Considerations

210

Adding Drugs Used for Continuous Intravenous Administration

211

Types of Solutions

211

Tonicity of IV Solutions

211

Intermittent Intravenous Administration

215

Secondary Intravenous Sets

216

Adding Drugs Used for Intermittent Intravenous Administration

276

Add-Vantage System

217

Electronic Intravenous Infusion Pumps

219

Flow Rates for Infusion Pumps and Secondary Sets

221

Infusion Pumps

221

Secondary Sets

221

PART IV

CALCULATIONS FOR SPECIALTY AREAS

239

Chapter 11

Pediatrics

240

Factors Influencing Pediatric Drug Administration

241

Oral

241

Intramuscular

242

Intravenous

243

Pediatric Drug Calculations

244

Dosage per Kilogram Body Weight

244

Dosage per Body Surface Area

247

Pediatric Dosage from Adult Dosage

259

Body Surface Area formula

259

Age Rules

260

Chapter 12

Critical Care

270

Calculating Amount of Drug or Concentration ofaSolution

272

Calculating Units per Milliliter

272

Calculating Milligrams per Milliliter

272

Calculating Micrograms per Milliliter

273

Calculating Infusion Rate for Concentration and Volume per Unit Time

275

Concentration and Volume per Hour and Minute withaDrug in Units

276

Concentration and Volume per Hour and Minute withaDrug in Milligrams

276

Concentration and Volume per Hour and Minute withaDrug in Micrograms

277

Calculating Infusion Rates of a Drug for Specific Body Weight per Unit Time

279

Micrograms per Kilogram Body Weight

280

Basic Fractional formula

281

Using Basic formula to Find Volume per Hour or Drops per Minute

281

Using Basic formula to Find Desired Concentration per Minute

281

Using Basic formula to Find Concentration of Solution

281

Titration of Infusion Rate

283

Determine Titration Factor Using Infusion Pump

284

Increasing or Decreasing Infusion Rates Using Infusion Pump

284

Determine Titration Factor Using a Microdrip IV Set

285

Increasing or Decreasing Infusion Rates Using a Microdrip IV Set

285

Total Amount of Drug Infused Over Time

288

Chapter 13

Pediatric Critical Care

304

Factors Influencing Intravenous Administration

305

Calculating Accuracy of Dilution Parameters

305

Chapter 14

Labor and Delivery

313

Factors Influencing Intravenous Fluid and Drug Management

314

Titration of Medications with Maintenance Intravenous Fluids

314

Administration by Concentration

314

Administration by Volume

316

Intravenous Loading Dose

316

Intravenous Fluid Bolus

318

Chapter 15

Community

322

Metric to Household Conversion

323

Preparing a Solution of a Desired Concentration

325

Changing a Ratio to Fractions and percentages

326

Calculating a Solution from a Ratio

327

Calculating a Solution from a percentage

327

Preparing a Weaker Solution from a Stronger Solution

328

Guidelines for Home Solutions

329

Hydration Management

330

Calculate Daily Fluid Intake for an Adult

330

Standard formula for Daily Fluid Intake

330

Calculate Daily Fluid Intake foraFebrile Adult

331

Body Mass Index (Bm1)

331

Calculate Body Mass Index Using Two formulas

331

Part V

Post-Test: oral Preparations, Injectables, Intravenous, and Pediatrics

339

Oral Preparations

340

Injectables

346

Direct IV Administration

352

Intravenous

353

Pediatrics

356

Appendix A

Guidelines for Administration of Medications

369

General Drug Administration

370

oral Medications

370

Injectable Medications

371

Intravenous Fluid and Medications

372

Appendix B

Nomograms

374

References

377

Index

381