Solutions Manual For Medical Dosage Calculations A Dimensional Analysis Approach 11th Ed June Olsen,

Solutions Manual For Medical Dosage Calculations A Dimensional Analysis Approach, Updated Edition, 11th Solution Manual For Anthony Giangrasso, Edition by June Olsen, Medical Dosage Calculations A Dimensional Analysis Approach, Updated Edition, 11th edition June L. Olsen, Anthony Giangrasso, Dolores Shrimptonv Shrimpton | Chapter 1-12 Chapter 1-12 With Exam(1 2) Chapter 1 Review of Arithmetic for Medical Dosage Calculations 3 5 ÷ 23 4

Chapter Overview

Chapter 1 reviews the arithmetic concepts needed for the rest of the textbook. It covers the basics of whole numbers, fractions, decimal numbers, and percents and includes a Diagnostic Test to evaluate the student’s knowledge of the arithmetic required for medical dosage calculation. This chapter can be omitted for those students who are proficient in basic arithmetic.

Instructor’s Notes 

The Diagnostic Test may be used in a number of ways. It can be given at the beginning of the first class, and the teacher or students themselves can grade the test whose answers can be found in Appendix A of the textbook. The Diagnostic Test results can then be used to initiate a discussion of those areas of arithmetic in which the students show weakness.



This chapter can also be assigned as independent study. Students can take the Diagnostic Test and then review those sections of the chapter that need review.

Subsequent class meetings could address areas of student concern.



The teacher could first present a review of basic arithmetic following the flow of topics and examples in the chapter, and then assign the Diagnostic Test for homework.

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

Rather than covering all the topics in this chapter, the instructor might choose to review only those topics with which the students might not be familiar. These could include ratios, complex fractions, percent of change, and the three methods of rounding (rounding off, down, and up).



Calculator keystroke sequences are provided to help students improve their calculator proficiency. Students should be encouraged to work the problems by hand, and then check their answers on a calculator.



Try These for Practice problems are designed to be done in class but may be designated for homework.



The Exercises and/or Additional Exercises can be given as homework or as inclass assignments. The answers to the Try These for Practice, and Exercises are in Appendix A of the textbook. Answers for Additional Exercises are not in the textbook for the instructor who prefers to give homework without answers provided.



The answers to Additional Exercises are in this Instructor’s Resource Manual.

Key Terms approximate answer canceling complex fraction denominator improper fraction numerator percentage percent of change Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

rounding down rounding up rounding off percentage rate ratio truncating Answers to Chapter 1 Additional Exercises 1.

11 20

2. 8 3. 1

4.

1 3

11 28

5. 40 6. 1

7.

3 5

1 6

8. 0.37 9. 0.64 10. 6.7 11. 0.015 12. 0.21 Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

13. 0.457 14. 0.0228 15. 2.8 16. 0.8 17. 0.9 18. 0.0625 19. 0.009 20. 1.50 21. 0.47 22. 4.7 23. 2.6 24. 53.84 25.

63 and 0.5 125

26. 17

1 and 17.3 3

27. 0.2,

28.

10 49

45 , 6.4 7

1 29. , 0.1 8 3 30. , 0.4 8 31.

1 2 Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

32.

2 3

33. 60 34. 6 35. 9.95 36. 0.83 37. 0.7 38. 16 39. 25% increase 40. 30% decrease Chapter 1 Examination Questions Convert these to fractions in lowest terms.

1. 0.35 2. 6 :10 Convert these fractions to decimals numbers rounded off to the nearest tenth.

3 8 73 4.

7 3.

Convert to decimal numbers rounded down to tenths.

5.

13.66 10

6.

0.0274 0.12

Multiply the numbers.

7. 2.3  0.03 Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

8. 9.2  1,000 Divide the decimal numbers and round off the answers to the nearest hundredth.

9. 0.23  0.03 10. 56.9  100 Write the answers as fractions in lowest terms.

11.

22 70 15   15 60 77

12. 0.525  0.84 Write the percentage as a decimal number.

13. 0.9% 14. 44% Write the percentage as a fraction in lowest terms.

15. 87.5% 16. 0.9% Simplify to the form of a simple fraction in lowest terms.

17.

2/3 6

18.

0.02 0.3

3 19. Which is the larger quantity? 0.8 or 4 20. What is 35% of 80?

4 ? = 21. 5 25 8 ? = 22. 64 16 8 - 4.002 = ?

23.

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7.5  2 24. Write the answer in mixed fractional form:

3 4

Answers to Chapter 1 Examination Questions 1.

7 20

2.

3 5

3. 0.4 4. 10.4 5. 1.3 6. 02 7. 0.069 8. 9,200 9. 7.67 10.0.57 11.

1 3

12.

5 8

13.0.009 14.0.44 15.

7 8

16.

9 1,000

17.

1 9

18.

1 15

19. 0.8

20.28 21.20 22.2 Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

23.3.998 24. 4

3 4

25.50%

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Chapter 2 Safe and Accurate Drug Administration

Chapter Overview Chapter 2 is a general introduction to the drug administration process. It introduces the student to the role of the person who administers patient medication and the various forms and routes by which medications are administered. The student will begin to develop a vocabulary of terms necessary to understand pertinent information about drugs and their administration, which will aid in understanding the responsibilities of administering drugs safely. Safety, documentation, and accuracy are stressed throughout the text. Recent Joint Commission recommendations are included, and the ―Six Rights‖ of medication administration are discussed extensively. The student will learn how to interpret drug prescription, medication order, medication administration record (MAR), drug label pack age inse rt, and milit ary time. The roles o f the F DA and other organizations concerned with decrea sing medication errors are discussed.

Instructor’s Notes 

The PowerPoint slides are particularly useful in presenting the material in this chapter. Slides of drug prescriptions, medication orders, medication administration records, drug labels, and package inserts can be projected as the instructor explains their various components.



Demonstrate actual examples of various forms of drugs (inhalers, tablets, capsules, Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

patches, suppositories), if available. 

Students who have learned this material in other courses may review this chapter quickly.



Discuss the abbreviations to be avoided in medication orders and documentation (the ―Do Not Use List‖).



Emphasize the importance of the need to be vigilant regarding drugs that ―Look Alike-Sound Alike.‖



The Nurse Alert newsletter of the Institute of Safe Medication Practice is a good reference for medication safety issues; see Appendix B.



Interpreting a drug order is very important for the rest of the course and should be stressed.



If the Internet is accessible in the classroom, pharmaceutical company web sites (for example, dailymed.nlm.nih.gov/) can be used to view actual labels and prescribing information for drugs.

Key Terms automated medication dispensing cart (A DC) A.M./P.M. bar code b.i.d. body surface area (B SA) buccal capsule computerized physician order entry (C POE) Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

controlled substance delayed-release (DR) dosage strength dry powder inhaler (DPI) elixir enteral enteric-coated epidural extended release (XL) Federal Drug Administration (FDA) generic name inhalation Institute for Safe Medication Practice (I SMP) intracardiac (IC) intradermal (ID) intramuscular (IM) intrathecal intravenous (IV) local/systemic lot number medication administration record (M AR) medication order metered dose inhaler (MDI) Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

meters squared (m2 ) military time national drug code (NDC) nebulizer oral (PO) package insert parenteral pharmacist prescriber prescription prn q.i.d. registration symbol (®) route safe dose range side effect standing order stat subcutaneous (subcut) sublingual (SL) suspension sustained release (SR) syrup Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

tablet t.i.d. topical trade name trademark (™) transdermal unit dose United States Pharmacopoeia (USP) Answers to Chapter 2 Additional Exercises 41. Lopinavir/Ritinavir 42. Kaletra 43. 100 mL 44. 200 mg / 5 mL 45. 80 mg / 20 mg per mL 46. a) Anusol supp b) 6 A.M. c) 4 d) Bonivar, Humulin N, Humul e) December 16 47. a) Omnicef & Glucophage b) 4 Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

c) 25 mg / h , transdermal d) by mouth e) 2 48. a) milnacipran HCl, tablets b) fibromyalgia c) 12.5 mg once d) No, Savella is not approved for use in pediatrics e) 200 milligrams daily 49.

Standard Time

Military Time

9:30 a.m.

0930h

2:43 p.m.

1443h

midnight

2400h

11:20 p.m.

2320h

9:48 a.m.

0948h

11:40 p.m.

2340h

8:42 p.m.

2042h

2:15 a.m.

0215h

12:02 a.m.

0002h

7:15 a.m.

0715h

50. a) Administer 500 mg of Glucophage (trade name) metformin (generic name) by mouth twice a day Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

b) Administer 10,000 units of heparin subcutaneously every 8 hours c) Administer one-half inch of NITRO-BID 2% (trade name) nitroglycerin ointment (generic name) to chest wall every 6 hours d) Administer 5 mg of Accupril (trade name) quinapril hydrochloride (generic name) by mouth once a day e) Administer 650 mg of Tylenol (trade name) acetaminophen (generic name) by mouth as needed when fever is over 101 degrees 51. a) Time and Route b) Route c) Time and Route d) Dose and Route e) Route 52. a) 10 mg b) 10 mg c) 10 mg d) 5 mg Chapter 2 Examination Questions Study the drug labels shown in • Figure 2.1 and supply the following information:

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 Figure 2.1 Drug Labels for Questions 1–5.

1. What is the generic name of Halaven?

2. How many tablets are in the bupropion container?

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3. What is the strength of the carboplatin?

4. What is the route of administration for eribulin mesylate?

5. What is the dosage strength for the drug whose N DC number is 0173-0178-55?

Study the portion of a MAR in • Figure 2.2 and answer questions 6–10 below.

Order

time

18

19

20

21

nifedipine 20 mg po b.i.d.

0900h

AD

AD

AD

AD

1700h

BK

BK

BK

BK

digoxin 0.25 m g po daily

0900h

X

AD

AD

AD

sucralfate 1 g po q.i.d.

0900h

AD

AD

AD

AD

1300h

BK

BK

BK

BK

1700h

BK

BK

BK

BK

2100h

WW

WW

WW

WW

Blank

Blank

Blank

Blank



Figure 2.2

6. How many drugs were administered at 1 P.M. on the 18th?

7. On what date and time was the digoxin first administered?

8. What are the initials of the nurse who administered the nifedipine at 5:00 P.M. on the 20th?

9. What was the route of administration of the sucralfate?

10. How many doses of nifedipine were administered on the 19th?

Use Figure 2.3 to answer questions 11 and 12.

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

Figure 2.3

Portion of a package insert for questions 11–12.

11. What is the generic name of the drug?

12. What is the form of the drug?

13. Interpret the following order: acarbose 75 mg po b.i.d.

14. What is missing from the following order: paroxetine 50 mg daily 15. Order: linezolid 600 mg po q12h. How many mg will you administer?

For the partial orders in questions 16–20, indicate how many milliliters you would administer.

16. 60 mL daily 17. 60 mL b.i.d.

18. 60 mL t.i.d.

19. 60 mL daily in two divided doses 20. 60 mL q12h

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

Answers to Chapter 2 Examination Questions 1. eribulin mesylate 2. 100 tab 3. 600 mg / 60 mL or 10 mg / mL 4. intravenous 5. 100 mg / tab 6. 1 (sucralfate) 7. 19th at 9:00 A.M. 8. BK 9. By mouth 10. 2 11. demeclocycline HCl 12. Capsule 13. Administer acarbose seventy-five mil 14. Route of administration 15. 600 mg 16. 60 mL 17. 60 mL 18. 60 mL 19. 30 mL 20. 60 mL

Chapter 3 Dimensional Analysis and Ratio & Proportion Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

2 h 60min  1 1h

Chapter Overview

Chapter 3 introduces the student to the method of Dimensional Analysis. The concepts in Chapter 3 are crucial because they provide the mathematical foundation for the remainder of the text.

The chapter uses everyday units of measurement familiar to the U.S. student.

The student is first shown how to use Dimensional Analysis to solve problems that involve converting among single units of measurement such as inches, feet, seconds, minutes, hours, months, years, ounces, and pounds.

The first technique to be mastered is the 

simple (one-step) conversion of a single unit of measurement (e.g., 120 seconds) to another equivalent single unit of measurement (e.g., 2 minutes) which requires one step.

Then then student is introduced to 

complex (multistep) converstion of a single unit of measurement (e.g., 7,200 seconds) to another equivalent single unit of measurement (e.g., 2 hours). This will require two steps.

Now, the notion of a rate which involves two different unit of measurement (e.g.,

3 ft/min) is introduced, and the student is shown how to change a given rate to another equivalent rate. 

simple (one-step) conversion of a rate (e.g., 24 in / min ) to another equivalent rate (e.g., 2 ft / min ) which requires one step.

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Then then student is introduced to 

complex (multistep) converstion of a rate (e.g., 1 in / min to an equivalent rate equivalent rate (e.g., 5 ft / h ). This will require two steps.

These techniques will be used throughout the textbook.

Instructor’s Notes 

The student must understand that a single unit of measurement can be changed to another single unit of measurement or that one rate can be converted to another rate.



Once the student has mastered the simple (one-step) conversions, then present the complex (multistep) problems.



In using Dimensional Analysis before canceling the numbers, be sure that the correct unit of measurement(s) is achieved.



Students may find changing Rates to Rates difficult. But do not get bogged down because the students will not encounter the application of Rates to Rates until chapter 10 (changing mL / h to gtt / min ). So, they will have some time to learn Rates to Rates before then.



Although some students may want to use their own method (eg., proportion) to solve the problems, encourage them to master the Dimensional Analysis technique because they will encounter problems in chapters 10 and 11 which will be difficult for them without Dimensional Analysis.



Once the student has mastered the simple (one-step) conversions, then present the complex (multistep) problems, which are solved by chaining together the necessary Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

unit fractions. 

You may want to identify the following items in a problem: the given unit of measurement, the equivalence that will be used to form the unit fraction, and the unit of measurement to be found.



Remind the students that equivalences (e.g., 1 min = 60 sec) are used to form the unit fractions needed for conversion.



An equivalence (eg., 1 min = 60 sec ) can be used to form two different unit fractions, namely:

1min 60 sec . or 60 sec 1min

Key Terms complex (multistep) problems dimensional analysis equivalence equivalent rate simple (one-step) problems single unit of measurement unit fraction unit of measurement Answers to Chapter 3 Additional Exercises 53. 12 min 54. 18 mon 55. 66 h Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

56. 84 oz 57. 900 sec 58. 12 in / min 59. 60 ft/h 60. 12 h 61. 30 pt/h 62. 70 oz 63.

3 h 8

64. 74 in 65. 1 wk 66. 5 ft 10 in 67. 2 qt/min 68. 120 pt/h 69. 6 qt/h 70. 10 ft/h 71. 0.875 lb/wk 72. 6 ft/h Chapter 3 Examination Questions 21. 48 months = ? years 22. 2 days = ? hours 23. 48 oz = ? lb 24. 5 ft = ? in Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

25. 1.5 hours = ? min 26.

1 h = ?sec 2

27. 3

ft in =? min min

28. 2

lb lb ? day week

29. 18 mon = __________ yr 30. 2 min = __________ sec 31. A person is gaining 8 oz/mon . What is this rate in pounds per year?

32. An IV solution has been infusing for 4 min. How many seconds is that?

33. Change 1h to seconds.

34. How many years in 480 months?

35. An insect is moving at 0.2 in/sec . How fast is this rate of speed in feet per minute?

36. If your patient has a height of 48 in, what does the patient measure in feet?

37. Convert 336 h to weeks.

38. An infant weighs 6 l b 2 oz at birth. What is the infant’s weight in ounces?

39. A person is 5 f t 1 in tall. Express this height in inches.

40. A speed of 4.4 in/min is equivalent to how many feet per hour?

Answers to Chapter 3 Examination Questions 21. 4 yr 22. 48h 23. 3 lb 24. 60 in Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

25. 90 min 26. 1,800 sec 27. 36 in

min

28. 14

29. 1

lb week

1 yr 2

30. 120 sec 31. 6 lb/yr 32. 240 sec 33. 3,600 sec 34. 40 years 35. 1 ft/min 36. 4 ft 37. 2 weeks 38. 98 oz 39. 61 in 40. 22 ft/h

Chapter 4 The Household and Metric Systems Chapter Overview

0.4 g = 400 mg

This chapter introduces the student to the two systems of measurement used in medication dosages (household and metric). All the units of measurement in the household and metric systems (and their abbreviations) are important. All the Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

equivalences in the tables provided in the chapter must be learned. In this chapter, the student will learn to convert quantities within each of the two systems.

The Apothecary system is excluded from this chapter because it has been phased out of use. For faculty who would like to include the Apothecary system, it is presented in the appendixes at the end of the textbook.

Instructor’s Notes 

The student must know all the equivalences in the Tables 4.1, 4.2, and 4.3 to convert units of volume, weight, and length in the household system.



The U.S. monetary system (like the metric system is base-10) is used to demonstrate the method of moving the decimal point to, for example, change 2,000 dimes to 2 ten-dollar bills.



You may want to identify the following items in a problem: the given unit of measurement, the equivalence that will be used to form the unit fraction, and the unit of measurement to be found.



Show the shortcut for converting in the metric system by moving the decimal point (usually) three places. Some students may prefer this method.



This is the first chapter to include the Cumulative Review Exercises at the end of the chapter. These can be assigned for homework or can be discussed in class. Their answers are in Appendix A.



Reinforce that in dimensional analysis the single unit of measurement being sought must be in the numerator of a unit fraction.

Key Terms Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

cubic centimetre (cc or cm3 ) cup fundamental unit gram (g) household kilogram (kg) liquid volume liter (L) measuring cup meter (m) microgram (mcg) milligram (mg) milliliter (mL) ounce (oz) pint (pt) pound (lb) quart (qt) tablespoon (T) or (tbs) teaspoon (t) or (tsp) Answers to Chapter 4 Additional Exercises 73. 56,000 mcg 74. 0.6 g 75. 4 qt Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

76. 56 mm 77. 72 oz 78. 5 g 79. 0.84 g 80. 250 mg 81. 7 pt 82. 12 t 83. 16 oz 84. 350 g 85. 500,000 mcg 86. 0.175 g 87. 0.028 g 88. 3 T 89. 0.08 g 90. 0.4 g 91. 3,100 g 92. Safe Chapter 4 Examination Questions 41. 2,500 g = ________________ kg 42. 1.2 L = ________________ mL 43. 0.007 g = ________________ mg 44. 450 mg =________________ g 45. 0.77 kg =________________ g Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

46. 3 qt =________________ pt 47. 2 oz =________________ t 48. 0.05 g = ________________ mg 49. 10,000 mcg = ________________ mg 50. 4,400 mL = ________________ L 51. 2 L = ________________ mL 52. 22 mm = ________________ cm 53. If a tablet of methotrexate contains 0.5 m g, how many micrograms of methotrexate are in 1 tab?

54. The order is triazolam 0.25 m g PO hs daily. How many micrograms of this sedative are in one dose?

55. The order is for guaifenesin 600 m g PO q4h. How many micrograms will the patient receive every 4 hours?

56. An intravenous solution contains 200 m L of D 5 W. How many liters are contained in this amount of solution?

57. A patient needs to receive

1 pint of water by mouth every hour. How many ounces 2

of water should be given every hour?

58. The patient must receive 0.5 m g of dexamethasone P O stat. What is the equivalent dose in micrograms?

59. How many grams are equivalent to 1,500 m g?

60. 10 cups = ________________ qt

Answers to Chapter 4 Examination Questions Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

41. 2.5 kg 42. 1,200 mL 43. 7 mg 44. 0.45 g 45. 770 g 46. 6 pt 47. 12 t 48. 50 mg 49. 10 mg 50. 4.4 L 51. 2,000 mL 52. 2.2 cm 53. 500 mcg 54. 250 mcg 55. 600,000 m cg 56. 0.2 L 57. 8 oz 58. 500 g 59. 1.5 g 60. 2

1 qt 2

Chapter 5 Converting from One System of Measurement to Another Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

Chapter Overview

1 kilogram (kg )  2.2 pounds (lb)

This chapter employs the techniques learned in Chapters 3 and 4 and focuses on conversions between the metric and household systems. Tables 5.1 and 5.2 provide approximately equivalent values for weight, volume, and length.

Instructor’s Notes 

The exercises in this chapter will reinforce the techniques of Dimensional Analysis that were introduced in the previous chapters.



The approximate equivalences in Tables 5.1 and 5.2 must be memorized.



Because of the approximate nature of the equivalences between the metric and household systems, students should be warned that different answers may be obtained depending on which approximations are used. For example, 1 pint may be approximated by 500 mL. However, using 1 cup  240 mL leads to

1 pint  2 cups   480 mL . Therefore, student answers may not always precisely agree with the answers in the textbook. 

Conversions between pounds and kilograms can be accomplished by using Dimensional Analysis. However, drugs prescribed based on body weight usually use kilograms (not pounds). Therefore, it is more common to convert pounds to kilograms than vice versa. Students may find that routinely dividing the weight in pounds by 2.2 is a quick method of doing the conversion to kilograms.



Students with good number sense should be encouraged to do simple problems mentally. For example, if 1T = 3 t , then it follows that twice as many T must equal Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

twice as many t (i.e., 2 T = 6 t ), or three times as many T must equal three times as many t (i.e., 3 T = 9 t ).

Key Terms approximate medication cup meniscus Answers to Chapter 5 Additional Exercises 93. 20 mL 94. 240 mL 95. 3 T 96.

1 cup 2

97. 68.2 kg 98. 1 t 99. 2 in 100.

2 oz

101.

3 in

102.

16 T

103.

172.5 cm

104.

3,182 g

105.

100 kg

106.

1.44 g

107.

6T Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

108.

0.36 g

109.

1,365 mL

110.

1 oz

111.

10 g

112.

24 doses

Chapter 5 Examination Questions 61. The diameter of a wound is 2 inches. What is the diameter of the wound in centimeters?

62. What is the weight in kilograms (rounded off to the nearest kilogram) of a person who weighs 180 pounds?

63. 15 mL = ? t 64. 3 T = ? mL 65. 2.5 pt = ? mL 66. 360 mL = ? cups 67. 6 lb = ? g 68. 45 kg = ? lb 69. 780 mg = ? g 70. 6 ft = ? cm 71. 3 t = ? mL 72. 45 mL = ? oz 73. 4 oz = ? mL 74. 60 mL = ? t Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

75. 24 oz = ? cups 76. 6 cups = ? pints 77. Order: fosamprenavir 700 mg po b.i.d. How many grams will the client receive per day?

78. A client with a bacterial infection must receive azithromycin po 500 m g on day 1, then 250 mg q24h for 4 more days. How many grams will the client receive over the 5 day period?

79. A person is 160 cm tall. What is this height in household units?

80. 177 lb = ? kg (round off to the nearest tenth of a kg)

Answers to Chapter 5 Examination Questions 61. 5 cm 62. 82 kg 63. 3 t 64. 45 mL 65. 1,250 mL 66. 1.5 cups 67. 2,727 g 68. 99 lb 69. 0.78 g 70. 180 cm 71. 15 mL 72. 1.5 oz 73. 120 mL Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

74. 12 t 75. 3 cups 76. 3 pt 77. 1.4 g 78. 1.5 g 79. 5 ft 4 in 80. 80.5 kg

Chapter 6 Oral Medications

Chapter Overview This chapter introduces the student to dosage calculations for P O (oral) medications.

Simple and complex problems involving drugs supplied in both solid and liquid forms are solved using the method previously introduced (Dimensional Analysis).

Drugs measured in milliequivalents (m Eq) are introduced. Dosages based on the size of the patient, as measured in kilograms of body weight or meters squared of body surface area (BSA), are calculated. The B SA is estimated using a formula. At the end of the chapter, the Practice Reading Labels questions provide students with an opportunity to hone their labelinterpreting skills.

Instructor’s Notes 

In this chapter many illustrative example solutions are provided.



For success with the material in Chapter 6, students should have mastered the technique of Dimensional Analysis from their study of the previous three chapters. Students will also need to Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

know how to interpret the information on drug labels, package inserts, medication orders, and MARs that they encountered in Chapter 2. 

Students must understand that in the examples in this chapter, the equivalence used to form the unit fraction comes from the strength of the drug as read from the drug label (e.g., 5 mg/tab or

200 mg/5 mL ). 

In Example 6.3, students encounter a “combination” drug. Emphasize that only one of the drugs of the combination needs to be used in the computations.



Example 6.5 involves a drug in the form of a solution. The students must understand that the strength of 100 mg/mL means that a weight of 100 mg of the drug is contained in a volume of 1 mL of the solution.



In Example 6.8, a drug measured in milliequivalents is ordered. These units of measurement are treated mathematically in the same way as other units of measurement.



For the complex (multistep) problems like Example 6.18, some students may find it easier to first list the unit of measurement that is given, any equivalences that are given or needed, and the unit of measurement that has to be found.



Remind the students that only scored tablets may be divided in half.



When an order contains an expression such as 15 mg/kg , students must understand that “15 mg” refers to the weight of the drug and “kg” refers to the weight of the client. Thus, 15 m g of the drug must be administered for each 1 kg of the client’s body weight.



Remind the students that whenever an order is based on the size of the client, start the calculations withe size of the client. Some students will be helped by using the formula:

Size × Order = Dose 

For orders based on the size of the patient, multiply the size of the patient (in kg or m ) by the 2

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

order to yield the amount of drug to administer, for example, 10 kg× 

3 mg = 30 mg . kg

The metric and household formulas provide approximations of BSA. The student needs a calculator with a square root key to compute the BSA.



The Practice Reading Labels portion of the Practice Sets will help the students learn to find the strength on a label and use it to determine a dose.



This is the first chapter to include a case study, which may be discussed in class or assigned for homework. Every chapter that follows will contain a Case Study.

Key Terms body surface area (B SA) body weight electrolyte milliequivalent (mEq) oral medication PO square meters (m2 )

Answers to Chapter 6 Additional Exercises 113.

3 tab

114.

4t

115.

2.2–2.6 mg/day

116.

No, it’s an overdose

117.

2t

118.

1.92 m2 Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

119.

Yes

120.

1.52 meters squared

121.

2 tab

122.

53.6 mL

123.

1 tab

124.

10 mL

125.

1 tab

126.

No

127.

1g

128.

1.58 square meters

129.

36 mL

130.

70 mL

131.

3 tab

132.

2 tab

Chapter 6 Examination Questions 81. Order: Baraclude (entecavir) 0.5 mg PO daily. The drug is an oral solution with strength of 0.05 mg/mL . How many mL will you administer?

82. A patient must receive 300 mg of drug PO daily in two divided doses. How many mg will you administer?

83. A patient must receive 300 mg of drug PO b.i.d. How many mg will you administer?

84. A patient has a BSA of 1.45 m2 and must receive 15 mg/m2 of a drug P O stat. If the strength of the drug is 2 mg/mL , how many milliliters will you prepare?

85. Calculate the body surface area of a person who is 5 f t 2 in tall and weighs 111 l b.

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

86. A patient must receive 50 mg of a drug PO t.i.d. The drug is supplied as 20 mg scored tablets. How many tablets will you administer?

87. The patient weighs 100 lb and must receive 15 mg/kg of a drug P O b.i.d. If the strength of the drug is 30 mg/mL , how many mL will you administer?

88. A drug is prescribed to be given 50 mg b.i.d. If the recommended dose is 50–75 mg per day, is the prescribed dose safe?

89. A drug is prescribed to be given 50 mg daily in 2 divided doses. If the recommended dose is 50–75 mg per day, is the prescribed dose safe?

90. Your patient is to receive 75 mg of a drug. Each scored tablet contains 50 mg. How many tablets will you administer to the patient?

91. Order: kanamycin 15 mg/kg per day IV in 2 equally divided doses. How many mg will you administer to a patient who weighs 70 k g?

92. Find the BSA of a patient who weighs 80 k g and is 166 cm tall.

93. A patient weighing 99 l b must receive 15 mg/kg PO of a drug. How many 700 mg tablets will you administer?

94. Order: naproxen 500 mg PO bid. If each scored tablet contains 250 mg, how many tablets will you administer per day?

95. The order reads 7 mg / kg of a drug PO t.i.d. The patient weighs 50 k g and each milliliter contains 30 mg. How many milliliters will you administer?

96. The order reads 0.9 mg/ kg of a drug PO b.i.d. The patient weighs 136 k g and the strength of the drug is 10 mg/mL . How many milliliters of this drug will you administer?

97. A patient weighs 122 l b and is 5 f t 6 inches tall. She must receive 1.25 mg/m2 of a Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

drug PO daily. How many tablets would you need for this patient for a week, if the strength of the tablets is 2 mg?

98. How many 0.4 mg tablets will contain 0.0016 g of the drug?

99. A patient is 185 cm tall and weighs 73 k g. If the order is 15 mg/m2 of a drug PO daily, how many 15 mg tablets of the drug will you administer?

100.

The order reads roflumilast 500 mcg PO daily. Each

tablet contains 250 m cg. How many milligrams will the patient receive in total over 5 days?

Answers to Chapter 6 Examination Questions 81. 10 mL 82. 150 mg 83. 300 mg 84. 10.9 m L 85. 1.48 m2 86. 2

1 tab 2

87. 22.7 m L 88. No, it’s an overdose 89. Yes, it is safe

1 90. 1 tab 2 91. 525 mg 92. 1.92 m2 Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

93. 1 tab 94. 4 tab 95. 11.7 m L 96. 12.2 m L 97. 7 tab 98. 4 tab 99. 2 tab 100.

2.5 mg

Chapter 7 Syringes

Chapter Overview In Chapter 7, the student gains a working knowledge of various standard types of syringes and learns how to read the scales on each. Examples include hypodermic syringes ranging in size from the 0.5 mL to the 35 mL syringe. Prefilled cartridge syringes, safety syringes, and insulin syringes are illustrated. A thorough discussion of insulin is provided for instructors who want to emphasize this topic. The student uses U SP units in calculations. The technique for mixing two types of insulin in one syringe is illustrated.

Instructor’s Notes 

Instructors who have syringes and vials of water or normal saline available can use these for hands-on practice.



Remember that the Joint Commission mandates the use of the abbreviation mL Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

instead of cc. 

Concentrate on teaching students how to read the various scales used on syringes.



Emphasize that the syringe reading is taken at the location where the fluid in the syringe meets the top ring of the plunger.



Insulin syringes generally have flat plunger tops, while hypodermic syringes have conical plunger tops.



Some students may have difficulty with reading the tuberculin syringe scale. For example, students may not understand what volume is halfway between 0.1 and 0.2.

If they think of 0.1 as 0.10, 0.2 as 0.20, it makes it easier for students to see that 0.15 is halfway between 0.10 and 0.20.



Explain the use of the dual scale insulin syringe in Figure 7.16 in the text.



The listing of the Types of insulin, and mixing two types of insulin



(Figure 7.28) contain material that might have been addressed in a previous course.

If that is the case, this material may be omitted.

Key Terms barrel bevel blood glucose bottom ring calibrations cartridge cylinder dual scale Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

gauge hollow needle hub hypodermic insulin pen insulin pump insulin syringe intradermal injection Lo-Dose needle needleless syringe plunger pre-filled puncture shaft sliding scale sterile syringe tip top ring tuberculin syringe U-100 USP units Answers to Chapter 7 Additional Exercises Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

133.

100-unit insulin syringe

134.

30-unit Lo-Dose insulin syringe

135.

5-mL syringe

136.

3-mL syringe

137.

12-mL syringe

138.

35-mL syringe Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

139.

30-unit Lo-Dose insulin syringe

140.

100-unit insulin syringe

141.

0.5-mL syringe

142.

100 unit dual scale insulin (odd side)

143.

12 mL

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

144.

1 mL

145.

12-mL syringe

146.

35-mL syringe

147.

1.5-mL

148.

50 units Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

149.

2 mL

150.

0.4 mL

151.

No, the arrow should be at 2 m L

152.

1.5 mL

Chapter 7 Examination Questions Identify the pictured syringe, and place an arrow at the indicated level of measurement on the syringe.

101.

syringe; 5.8 mL

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

102.

syringe; 1.2 mL

103.

syringe; 0.36 mL

104.

syringe; 88 units

105.

syringe; 2.4 mL

106.

syringe; 57 units

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

107.

syringe; 7.4 mL

108.

syringe; 62 units

109.

syringe; 1.2 mL

110.

syringe; 0.74 mL

111.

syringe; 46 units

112.

syringe; 16 mL

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

113.

syringe; 2.6 mL

114.

syringe; 0.3 mL

115.

syringe; 3.6 mL

116.

syringe; 19 units

In problems 17 through 20, read the order and use the appropriate label in • Figure 7.1 Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

 Figure 7.1 Drug Labels for Chapter 7 Examination Questions 17–20.

117.

Order: Morphine sulfate 2 mg subcut stat. How many m

L will you administer?

118.

Order: Cefoxitin 2 g IV 30 minutes before surgery. How

many vials will be needed?

119.

How many m g are in 2 m L of the octreotide solution?

120.

Order: cyproheptadine HCl 4 mg po t.i.d. How many

teaspoons will you administer?

Answers to Chapter 7 Examination Questions Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

101.

12 mL

102.

3 mL

103.

1 mL

104.

100-unit insulin

105.

3 mL

106.

100-unit insulin Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

107.

12 mL

108.

100-unit insulin

109.

3 mL

110.

1 mL

111.

50-unit insulin

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

112.

35 mL

113.

5 mL

114.

1 mL

115.

5 mL

116.

30-unit insulin Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

117.

0.4 mL

118.

1 vial

119.

1 mg

120.

2t

Chapter 8 Solutions

Chapter Overview Upon completion of Chapter 8, students will be familiar with the terminology associated with solutions and will be able to complete the calculations necessary to prepare solutions--a task generally done by the pharmacist or pharmaceutical company. Three quantities are associated with any solution: the strength of a solution, the amount of solute (drug) contained in the solution, and the volume of the solution. Given any two of these, the third can be found.

Students will learn how to determine the strength of a solution when the amount of solute (drug) and the volume of the solution are given, how to determine the amount of solute in a given volume of a solution of known strength, and how to determine the volume of a solution of known strength that contains a given amount of solute. The final section shows how to prepare stock solutions for irrigations, soaks, and oral feedings.

Instructor’s Notes Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.



Students will develop an understanding of solutions by considering everyday examples, such as making a cup of coffee from instant coffee crystals (pure drug) or making orange juice from a container of orange juice concentrate (diluting a stock solution).



An effective way to explain powdered medications uses a container with a small amount of salt. To demonstrate, add water to the container to dissolve the salt—you now have a sodium chloride solution. Take a teaspoon of salt (it has a weight of about 5 g) and dilute to 20 m L with water. This gives a 1: 4 or 25% solution.



Previously, the strength of a solution was given using a variety of labels (e.g., 5 mg / mL or 60 mcg / mL ). In this chapter, students must understand that when the

strength of a solution is represented as a pure number (with no labels) in the form of a fraction, ratio, or percent (for example, as

1 strength, 1: 2, or 50%), the amount of 2

drug is in the numerator and is expressed in either g or mL, and the volume of solution is in the denominator and is expressed in mL (in the case of

strength is 

1 strength, the 2

1g 1mL depending on the drug). or 2 mL 2 mL

Either Dimensional Analysis or Proportion can be used to solve the problems, as illustrated in the side-by-side solutions of the Examples.



If students find problems with liquid solutes difficult when using Dimensional Analysis, recommend that they use the Proportion method instead.



Emphasize to the students that they are able to cancel grams with milli-liters because 1 mL of water weighs 1 gram. They can also cancel ounces with fluid Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

ounces because 1 fluid ounce of water weighs 1 ounce. 

The strength of a solution is determined in Examples 8.1–8.4 in the text.



The amount of solute in a given volume of solution of known strength is determined in Examples 8.5 through 8.9. Emphasize that the given strength provides a unit fraction to be used.



The volume of a solution of known strength, which contains a given amount of solute is illustrated in Examples 8.10–8.12. Again, emphasize that the given strength provides a unit fraction to be used.



The new visuals in the margins of this chapter have proven very useful for students in organizing the information in a problem.



Emphasize that the strength of the solution will be used to create the unit fraction needed to convert back and forth between volume infused and duration of the infusion.

Key Terms diluent irrigation oral feeding percentage pure drug ratio soak solute solution Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

solvent stock solution strength of solution Answers to Chapter 8 Additional Exercises 153.

1 , 1: 4, 25% 4

154.

3 , 3 : 8, 37.5% 8

155.

3 , 3 : 50, 6% 50

156.

1 , 1: 3, 33 1/3% 3

157.

40 mg / mL

158.

6 mL

159.

Ratio

Fraction

Percent

1: 3

1 5 1 4

20%

1: 4

1 to 5 r atio

1 to 4 r atio

1: 10

10% 1 tenth

1 200

1 to 200 r ati o

9 : 1000

160.

25% 1 fourth

1 10

1 to 10 ratio

1: 200

1 fifth

9 to 1000 ratio

0.5% 1 two hundredth

9 1000

0.9% star t fr acti on 9 over 1000 end

140 mL Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

161.

0.4% should be 0.5%

162.

0.5 mL

163.

400 mg

164.

0.005%

165.

Use 2 cans of Sustacal and then add 2 cans of water

166.

Take 250 g of crystals, dissolve in water, the dilute with

water to 1 L 167.

Take eight 10-g tabs dissolve and dilute to 400 mL

168.

1,125 mg

169.

87 mg

170.

Yes

171. a. 8 mL b. 25 mg 172.

0.07 mL

Chapter 8 Examination Questions 121.

Express as a fraction, ratio, and percent the strength of

a solution that has 40 g of solute in 400 mL of the solution.

122.

Express as a fraction, ratio, and percent the strength of

a solution that has 15 mL of a drug in 60 mL of the solution.

123.

Express as a fraction, ratio, and percent the strength of

a solution that has 120 ounces of a nutrient in 240 ounces of the solution.

124.

Express as a fraction, ratio, and percent the strength of Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

a solution that has 800 mg of solute in 10 mL of the solution.

125.

How many grams of magnesium sulfate are contained

in 200 mL of a 1: 20 magnesium sulfate solution?

126.

How many grams of sodium chloride are contained in 1

L of a 0.9% solution?

127.

How many mL of a

2 strength Sustacal solution would 3

contain 240 mL of Sustacal?

128.

A 2-liter solution contains 18 grams of NaCl. What is the

strength of the solution expressed as a percent?

129.

Determine how many milliliters of a 2% solution will

contain 6 mg of epinephrine.

130.

How many ounces of a drug are contained in 25 ounces

of a 20% solution?

131. prepare 720 mL of 132.

Sustacal is supplied in 12-ounce cans. How would you

1 strength Sustacal?

2 Determine the number of grams of mannitol contained

in 200 mL of a 10% mannitol solution.

133.

Describe how to prepare 1 L of a 1: 50 solution of the

antiseptic potassium permanganate from 0.5-g potassium permanganate tablets.

134.

How many milliliters of 20% serum albumin solution will

contain 30 g of serum albumin?

135.

How many liters of 9 : 1000 Na Cl solution will contain Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

18 g of NaCl? 136.

If 20 g of pure drug are added to a container of sterile

water, and the total volume of this solution is 50 mL, what would be the strength of this solution expressed as a ratio and as a percent?

137.

How many milliliters of a 5% solution contain 10 g of

pure drug?

138.

How many grams of pure drug are contained in 60 mL

of a 10% solution?

139.

Describe how you would prepare 2,000 mL of a 1: 1000

aluminum acetate solution, an antiseptic, from 1-g aluminum acetate tablets.

140.

How would you prepare 480 mL of a

solution. The Isocal is available in 240 mL cans.

Answers to Chapter 8 Examination Questions 121.

1 , 1: 10 , 10% 10

122.

1 , 1: 4 , 25% 4

123.

1 , 1: 2 , 50% 2

124.

2 , 2 : 25 , 8% 25

125.

10 g

126.

9g

127.

360 mL Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

1 strength Isocal 4

128.

0.9 %

129.

300 mL

130.

5 oz

131.

To 1 can of Sustacal add 1 can of water.

132.

20 g

133.

Take 40 tab, and dilute to 1 L

134.

150 mL

135.

2L

136.

2 : 5 and 40%

137.

200 mL

138.

6g

139.

Take 2 tablets, dissolve, and dilute to 2 L.

140.

Take

1 1 can of Isocal and dilute with 1 cans of water.

2 2

Chapter 9 Parenteral Medications

Chapter Overview Parenteral medications, unlike the P O meds encountered in chapter 6, are delivered outside the alimentary canal.

While the dosage calculations in chapter 9 involve drugs administered I M or SUBCUT, they are quite similar to those in chapter 6. The reconstitution of drugs supplied in powered form is confusing for some students who overly focus on the quantity of diluent Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

added to the vile rather than on the strength of the reconstituted solution. Another drug measured in units (heparin) is introduced in this chapter.

Instructor’s Notes 

If available, bring vials and syringes into the classroom and demonstrate the reconstitution process.



Throughout the chapter, the student will calculate the volume of the solution to administer. Reinforce the idea that the strength of the drug is important. Emphasize that the strength of the solution provides a unit fraction for the dimensional analysis method.



Stress that the amount of diluent added to a vial to reconstitute a drug does not enter into the calculations performed when the directions provide the strength of the reconstituted solution.



The student should understand the concept of the displacement factor to fully understand the reconstitution process.



Be sure to teach students how to solve problems in which the strength is measured in units/mL, such as Example 9.10.



Remind the students that heparin is measured in units but is administered in a hypodermic syringe; never an insulin syringe.

Key Terms ampule diluent displacement factor mix-o-vial Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

parenteral reconstitute vial Answers to Chapter 9 Additional Exercises 173.

0.5 mL

174.

0.92 mL

175.

0.65 mL

176.

2.6 mL

177.

0.8 mL

178. a) 0.5 mL b) Use a 1 mL syringe

179. a) 2.6 mL b) Use a 3 mL syringe

180. a) 2 g b) 3.4 mL Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

c) 5 mL 181. a) 1.4 mL b) 3 mL c) no 182. a) 1.5 mL b) 3 full doses 183. a) 0.2 mL b) 0.5 mL c) 1 dose 184. a) 8.2 mL b) 250,000 units/mL c) 5 million units d) 1million units/mL e) 2 mL 185. a) 1 g b) 0.75 mL 186. a) 3 mL Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

b) 3 mL or 5 mL 187.

2.6 mL

188. a) 250 mg / 1.5 mL b) 3 mL 189. a) 15 units b) 1,000 units in the container 190.

4 units

191. a) 1.5 mg b) 2 mg 192. a) 0.25 mL b) 0.5 mL c) 0.5 mL Chapter 9 Examination Questions 141.

A patient is to receive vasopressin 10 units I M q8h. If

the label reads 20 units / mL, how many milliliters of this hormonal drug will you administer to the patient?

142.

The order reads: calcitonin 4 units / kg subcut q12h.

The label reads 200 units/ mL . How many milliliters will you administer to a patient who weighs 150 lb?

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

143.

A patient needs to receive 0.045 g of a drug IM. If the

drug vial is labeled 20 mg/ mL , how many milliliters will you prepare for the patient?

144.

The prescriber ordered clindamycin HCl 250 mg IM q6h

to treat a clostridium infection. The label reads 1 mL = 150 mg. How many milliliters will you give in total per day?

145.

The order reads: furosemide 20 mg IM daily in two

divided doses. The vial of furosemide is labeled 10mg / mL . How many milliliters would you prepare for the patient?

146.

The patient must receive diphenhydramine 40 mg IM

t.i.d. The vial is labelled 50 mg / mL. How many milliliters will you administer to this patient?

147.

After reconstituting with sterile water for injection, a vial

of estrogen (Premarin) contains 25 mg/5 mL . If the physician orders 5 mg / day IM in two divided doses, how many milliliters of this estrogen supplement will the patient receive?

148.

The strength of a certain drug is 750 mcg / mL . The

patient weighs 60 kg. The order indicates the patient is to receive 20 mcg/ kg of this drug IM daily. How many milliliters would you administer?

149.

A patient weighs 150 lb. The daily recommended safe

dose range for a drug is 0.02 to 0.05 mg / kg . Determine the minimum and maximum number of milligrams of the drug that this patient could receive per day.

150.

The label on the vial of a drug reads 5 mg / 2 mL . The

safe dose for this medication is 0.075 to 0.15 mg / kg / day, and the doctor orders 5 Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

mg IV daily. The patient weighs 120 l b. a) Is the ordered dose within the safe dose range? b) How many milliliters would you prepare for this patient?

151.

A patient has been prescribed 250,000 units of penicillin

G potassium. The instructions on the 10,000,000-unit vial are as follows: Add 19.6 m L of sterile diluent to vial; 1 mL = 500,000 units. How many milliliters would you withdraw from the vial to obtain the needed amount of this antibiotic?

152.

The prescriber ordered methadone HCl 5 mg IM q4h pr

n. The label on the 20-mL vial reads 10 mg/ mL. What is the maximum number of milliliters that the patient can receive over a 24-hour period?

153.

The order reads: Humulin R insulin 20 units

subcutaneous at breakfast and at dinner. How many units per day of this U-100 insulin is the patient receiving?

154.

The order reads: fluphenazine HCl 8 mg IM daily in 4

divided doses. How many mL of this antipsychotic drug will you prepare for a patient if the drug is available in 25 mg/ mL multiple-dose vials?

155.

Order: heparin 3,000 units subcut daily. The strength in

the vial is 10,000 units per milliliter. How many milliliters will you administer to the patient?

156.

Your patient is to receive 15 mg of dexamethasone

injected into a joint by the physician. If the vial is labeled 20 mg / mL, how many milliliters will the patient receive?

157.

The order is for 900 mg of a drug I M b.i.d. The Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

recommended dose for the drug is 10 to 15 mg / kg / day. Is this dosage safe for a patient who weighs 188 l b?

158.

Your patient has body surface area of 1.7 square

meters. The order indicates that 4 milligrams per meter squared must be given to the patient intramuscularly stat at a strength of 20 milligrams per milliliter. How many milliliters will be given to the patient?

159.

The order is ceftriaxone 2 g IM q12h. The package

insert says to add 4.2 mL of diluent to the 2-g vial and that after reconstitution the strength will be 350 mg / mL. How many milliliters will you administer?

160.

The order reads: methylergonovine maleate 0.2 mg IM

q2h for 24 hours. The drug label reads 0.2 mg/ mL. How many milliliters will the patient have received in total?

Answers to Chapter 9 Examination Questions 141.

0.5 mL

142.

1.4 mL

143.

2.3 mL

144.

6.7 mL

145.

1 mL

146.

0.8 mL

147.

0.5 mL

148.

1.6 mL

149.

1.4 - 3.4 mg / d

150.

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

a) yes b) 2 mL 151.

0.5 mL

152.

3 mL

153.

40 units / day

154.

0.08 mL

155.

0.3 mL

156.

0.75 mL

157.

No

158.

0.34 mL

159.

5.7 mL

160.

12 mL

Chapter 10 Flow Rates and Durations of Enteral and Intravenous Infusions

Chapter Overview This chapter introduces the student to the standard equipment and calculations for enteral and intravenous therapy. Dimensional analysis is used to calculate flow rates in drops per minute and milliliters per hour for intravenous infusions and enteral feedings.

Three quantities are involved in every infusion: the flow rate, the volume infused, and the duration of the infusion. Given any two of these quantities, the student must be able to determine the third quantity. Students should be able to perform the calculations Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

necessary to adjust a flow rate so that an infusion will finish on time.

Instructor’s Notes 

Because there are so many figures in this chapter, the PowerPoint slides might be a good option for classroom presentation of the equipment used for infusions and tube feedings.



The diagrams/schematics in the margins of this chapter will help students organize the information in the problems, and will help them ―see‖ the relationships involved.



Students should recognize that rates of flow always have a unit of time in the denominator (gtt / min, mL / h).



Normal saline can be written equivalently as N S or as 0.9% NaCl solution.

1 NS 2

may be written as 0.45% N aCl. 

Students should know that the size of the drop determines its drop factor.

Microdrops are a standard size and have a drop factor of 60 mcgtt / mL.



The first six Examples (10.1–10.6) of the chapter concern the calculations using pumps.



Examples 10.1 and 10.2 illustrate the method of finding flow rate for a pump ( mL /h ).

Examples 10.3 and 10.4 illustrate the method of finding the infused volume (mL).

Examples 10.5 and 10.6 illustrate the method of finding duration of the infusion.



Remind students that for Dimensional Analysis, the flow rate ( mL /h ) and the solution strength ( mg / mL ) are often used to create unit fractions.



The next seven Examples (10.7–10.15) deal with gravity systems. With gravity systems, the drop factor provides an equivalence that is used to construct unit Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

fractions. 

Examples 10.7–10.9 illustrate the method of converting flow rates measured in either gtt / min and mL / h. Examples 10.10 and 10.11 illustrate the method of finding the infused volume (mL). Examples 10.12 and 10.13 illustrate the method of finding duration of the infusion. Examples 10.14--10.15 illustrate the method of adjusting a flow rate.



Emphasize that no calculations are necessary to convert between mL /h and mcgtt / min (Example 10.9 illustrates this).



Fluid balance is a relatively simple topic and is discussed at the end of the chapter.

See Example 10.16.

Key Terms bolus clamp controller pumps dextrose drip chamber drop factor drops per minute (gtt/min) duration electronic infusion devices enteral solutions flow rate fluid replacement gastrostomy Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

tube infuse infusion pump infusion time intravenous set IV solution IV tubing macro drops microdrops milliliters per hour ( mL /h ) milliliters per minute ( mL / min ) milliunits (mU) nasogastric tube PCA pump percutaneous endoscopic gastrotomy (P EG) percutaneous endoscopic jejunostomy (P EJ) piggyback primary line primary IV infusion secondary line syringe pump tubing tube feeding Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

volumetric pumps Answers to Chapter 2 Additional Exercises 193.

63 mL / h

194.

125 mcgtt / min

195.

28 gtt / min

196.

30 mL / h

197.

80 mL

198.

42 mL / h

199.

28 gtt / min

200.

25 gtt / min

201.

33 gtt / min

202.

35 mcgtt / min

203.

150 mL

204.

7:15 pm Monday

205. a. 21 gtt / min b. 17 gtt / min c. yes 206.

40 mL

207.

9:00 am Thursday

208.

44 mL / h

209.

1300 h Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

210.

83 mL / h

211.

50 mcgtt / min

212.

140 mL

Chapter 2 Examination Questions 161.

An IV solution of 500 mL of NS must infuse in 5 hours.

What is the flow rate in mL /h ?

An IV is infusing at 50 mL / h. How long will it take for

162.

225 mL to infuse?

An IV is infusing at 40 mL / h. How many mL will infuse

163. in 2 hours and 20 minutes?

164.

An intravenous solution of D5 / W is infusing at a flow

rate of 30 gtt / min . The drop factor is 15 gtt / mL . What is the flow rate in mL /h ?

165.

An infusion of 1,000 mL of NS must infuse in 10 hours.

The drop factor is 20 gtt / mL. Find the flow rate in gtt/min.

166.

Order: D5W 1,000 mL IV infuse in 12 hours. After 7

hours, 600 mL are left in the bag (L IB). Recalculate the flow rate so that the infusion will finish on time.

167.

Order: For every 100 mL of urine output, replace with

60 mL of water via P EG tube q6h. The patient’s urinary output is 500 mL. What is the necessary replacement volume?

168.

The prescriber ordered: 200 mL D5W IV infuse in 4 h.

The drop factor is 15 gtt / mL. Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

a) Calculate the flow rate in milliliters per hour. b) Calculate the flow rate in drops per minute.

169.

The physician ordered a tube feeding of Ensure

240 mL / 4 h. At what flow rate in milliliters per hour would you set the pump?

170.

The prescriber ordered a tube feeding of Sustacal 480

mL in 6 h. The drop factor is 20 gtt / mL. . Calculate the flow rate in drops per minute.

171.

A patient has an order for total parenteral nutrition (T P

N) 1,000 mL of 20% dextrose solution to be administered over 24 h. At what rate in milliliters per hour will you set the pump to administer the T PN? 172.

The prescriber ordered: 1,000 mL D5W in 24 h IV. The

drop factor is 10 gtt / mL. Calculate the flow rate in drops per minute.

173.

Change 47 mcgtt / min to an equivalent flow rate in

milliliters per hour.

174.

The physician’s order reads: 400 mL Ensure via PEG to

infuse in 6 h. a) Calculate the flow rate in milliliters per hour. b) Calculate the flow rate in drops per minute if the drop factor is 20 gtt / mL.

175.

An IV of NS 500 mL is started at 2000h. The pump is

set at 50 mL / h. At what time will the infusion finish?

176.

The order reads 250 mL of NS IV in 8 h. How many

milliliters per hour is the patient receiving?

177.

An infusion of D5 W has been prepared for a patient.

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The flow rate is 15 gtt / min. The drop factor is 10 gtt / mL. How many milliliters per hour is this patient receiving intravenously?

178.

The order reads: 1,000 mL D5W IV over 12 h. The drop

factor is 20 gtt / mL. Calculate the flow rate in drops per minute.

179.

At 10 A.M., an infusion of 400 mL of IV fluid is started. It

is ordered to run at 30 mL / h. At what time will the IV finish?

180.

Order: D5W 1,000 mL IV infuse in 8 h. After 4 h, 600 m

L remain in the bag. Recalculate the flow rate so that the infusion will finish on time, and if the policy of the hospital is that changes to flow rates should never exceed 25% of the existing flow rate, what should be done?

Answers to Chapter 2 Examination Questions 161.

100 mL / h

162.

4h 30 min

163.

93 mL

164.

120 mL / h

165.

33 gtt / min

166.

120 mL / h

167.

300 mL

168. a) 50 mL / h b) 13 gtt / min 169.

60 mL / h Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

170.

27 gtt / min

171.

42 mL / h

172.

7 gtt / min

173.

47 mL / h

174. a) 67 mL / h b) 22 gtt / min 175.

0600h next day

176.

31mL / h

177.

90 mL / h

178.

28 gtt / min

179.

11:20 P.M. the same day

180.

change the flow rate to 150 mL / h

Chapter 11 Calculating Flow Rates for Intravenous Medications

Chapter Overview In Chapter 10, intravenous flow rates of the form volume/time (for example, mL / h and gtt / min ) were studied. In Chapter 11, medication is introduced into the I V solution and

students will calculate dosage rates of the form drug/time (for example, mg / min ). This chapter also introduces orders using compound rates (for example, 2 mg / kg / min,

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which for calculating purposes is written

2 mg and these orders will be treated in a kg g min

manner similar to the previous orders based on the size of the patient, i.e., size of the patient × compound rate = dosage rate (for example, 100 kg ´

2 mg 200 mg = ). min kg g min

This chapter also introduces flow rates for intravenous push. Titration tables are constructed. Schematic diagrams in the margins will help the visual learners to organize and understand the information in the examples. In the visuals quantities involving drus are in red.

Instructor’s Notes 

The PowerPoint slides are useful for illustrating the equipment needed for I VPB therapy.



Demonstrate IV equipment if available.



Dosage rates and flow rates are calculated in Examples 11.1--11.4.



Flow rates are converted to dosage rates in Examples 11.5--11.7



Example 11.8 and 11.9 find infused volumes and duration of infusions.



In the margin diagrams, drug amounts and dosage rates are in red to help students recognize that they are related.



The flow rates of I VP medications are included in Examples 11.10 and 11.11.



Compound rates are found in Examples 11.12–11.14. Explain that the compound rate 20 mg / kg / min means that 20 mg of the drug is administered for every kilogram of the client’s body weight, and this amount of drug is administered every minute.

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.



When the size of the client is multiplied by a compound rate, an ordinary dosage rate is obtained (for example, 2 m2 ´



5 mg 2

m g min

=

10 mg ). min

Emphasize that whenever an order is based on the size (Weight or B SA) of the patient, the first thing to do is to multiple the size of the client by the order.



Show the difference between the previous formula from chapter 6: Size of Client × Ordinary Rate = Dose, with the new formula in chapter 11: Size of Client × Compound Rate = Dosage Rate



Adding medication to the I VPB bag is discussed in examples 11.15–11.17.



Example 11.18 shows how to determine if the prescribed dose is safe.



The construction of a titration table is covered in Example 11.19.

Key Terms burette heplock intravenous piggyback (I VPB) intravenous push (IVP) peripheral lines port primary line safe dose range saline lock secondary IV infusion secondary line Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

secondary tubing syringe pump titration volume-control set Answers to Chapter 11 Additional Exercises 213.

56 gtt / min

214.

320 mcg / min

215.

60 mL / h

216.

1mg / min

217. a) 25 mL b) 23.9 mL c) 448 mL / h d) 30.3 mg / min 218.

33 mg / min

219.

17 mcgtt / min

220. a) 7.5 mL b) 0.75 mL c) 40 sec 221. a) 6 mg / min Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

b) 0.5 mL 222. a) 211mcg / min b) 16 mL / h

30 mL / h

223.

224. a) 25 mL / h b) 10 h 225. a) 5.7 mL b) 5.6 mL / min 226. a) 24 mcg b) 112 mL / h 227. a) 2.68 mg / h b) 13 mL / h 228.

17,818 units / day

229.

21h 44 min

230.

404 mL / h

231. mg / min

milligrams per mi nute

2 mg / min per mi nute

2 milligrams

mL / h

milliliters per hour

40 mL / h

40 milliliters per

hour

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

mg / min

mL / h

milligrams per mi nute

5 mg / min

5 milligrams

milliliters per hour

100 mL / h 100 milliliters per hour

per mi nute

8 mg / min

8 milligrams

160 mL / h 160 milliliters per hour

per mi nute

11 mg / min

220 mL / h

11

220 milliliters per hour

milligrams per mi nute

14 mg / min 14 milligrams per minute

280 mL / h 280 milliliters per hour

17 mg / min 17 milligrams per minute

340 mL / h 340 milliliters per hour

20 mg / min 20 milligrams per minute

400 mL / h 400 milliliters per hour

232. a) 166 mg b) 167 mL / h

Chapter 11 Examination Questions 181.

An IVPB bag has a strength of 5 g of a drug in 200 mL

of NS. The pump setting is 100 mL / h . Find the dosage rate in mg / min .

182.

An IVPB bag has a strength of 100 mg of a drug in 200

mL of NS. The dosage rate is 0.5 mg / min . Find the flow rate in mL / h .

183.

A patient who weighs 170 l b has an order for an I VPB

to infuse at the rate of 0.05 mg / kg / min. The medication is to be added to 100 mL N S and infuse over 30 minutes. How many grams of the drug will the patient receive?

184.

Order: digoxin 0.6 mg IVP stat over 5 min. The digoxin

vial has a concentration of 0.1mg / mL. How many mL will you push every 30 seconds?

185.

Order: oxytocin 10 units I VPB in RL 1,000 mL at Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

1 mU / min. Find the flow rate in mL / h.

186.

Order: cisplatin 100 mg / m2 in 1,000 mL D5/W IV to

infuse over 6h q 4w k. The patient has BSA of 1.75 m2 . At how many mL / h will the I V run?

187.

Order: aminophylline 250 mg in 250 mL D5W IVPB at

0.4 mg/ kg/ h. . What is the flow rate in mcgtt / min if the patient weighs 125 l b?

188.

The prescriber has ordered heparin 20,000 units in

1,000 mL D5W IV over 24 hours. a) How many units / hour will your patient receive? b) At how many mL / h will you run the IV pump?

189.

The physician orders a P CA drip of morphine sulfate

200 mg in 1,000 mL of D5W to be infused at a rate of 20 mcg/ kg/ h. . The patient weighs 90 kg. a) How many mg / h of the drug will the patient receive? b) How many mL / h of the solution will the patient receive?

190.

Order: epoetin alfa 100 units/ kg IV three times a week.

The vial has a strength of 2,000 units / mL. The patient weighs 132 l b. a) How many units should the patient receive? b) How many mL will you withdraw from the vial?

191.

Order: fluconazole 400 mg stat IVPB infuse over 1

hour. The premixed I V solution reads 2 mg / mL. The drop factor is 15 gtt / mL. What is the IV flow rate in drops per minute?

192.

The prescriber orders dopamine hydrochloride at a rate Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

of 3 mcg / kg/ min. The patient weighs 220 l b. The pharmacist sends a solution of dopamine hydrochloride 200 mg in 250 mL of D5 W . a) How many mcg / min will the patient receive? b) How many mL / h will the patient receive?

193.

Order: asparaginase 200 units/ kg/ day IV over 60 min

for 28 days. Add 10,000 units to 100 mL of D5 W . The patient weighs 100 l b.

Calculate the dosage rate in units / day .

194.

Order: Humulin R 100 units I VPB in 500 mL NS infuse

at 0.1 unit / kg / h. The patient weighs 100 k g. How long will it take for the infusion of this U-100 insulin to complete?

195.

A drug is ordered to start at a rate of 4 mcg / min IV.

This rate may, depending on the patient’s response, be increased by 2 mcg / min q 15 min to a max of 12 mcg / min. The IV strength is 5 mcg / mL. Construct a titration table for this order.

196.

A patient who weighs 197 l b is receiving medication at

the rate of 35 mL / h. The concentration of the I VPB solution is 200 mg in 50 mL NS. The recommended dosage range is 0.1– 0.3 mg /kg /min. Is the patient receiving a safe dose?

197.

The prescriber ordered doxycycline (Vibramycin) 200 m

g in 100 mL Lactated Ringer’s solution IV over 1 hour. The drop factor is 10 gtt / mL. Calculate the IV flow rate in drops per minute.

198.

A client is receiving a volume of 10 mL over 2 min IV Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

Push. How many mL will the client receive every 30 seconds?

199.

The medication order reads: heparin 6,000 units I V via

pump in 250 mL of D5W at 1,200 units / h. How many mL / h will the patient receive?

200.

Order: amikacin sulfate 5 mg / kg IVPB q8h in

200 mL D5W to infuse in 60 min. The vial reads 500 mg / 2 mL. Calculate the flow

rate in gtt/min if the patient’s weight is 200 l b and the drop factor is 10 gtt / mL.

Answers to Chapter 11 Examination Questions 181.

42 mg / min

182.

60 mL / h

183.

0.12 g

184.

0.6 mL

185.

6 mL / h

186.

167 mL / h

187.

23 mcgtt / min

188. a) 833 units / hour b) 42 mL / h 189. a) 1.8 mg / h b) 9 mL / h 190.

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a) 6,000 units b) 3 mL 191.

50 gtt / min

192. a) 300 mcg / min b) 23 mL / h 193.

9,091units / day

194.

10 hours

195. a) 48 mL / h b) Dose Rate ( mcg / min ) micrograms per mi nute

IV Rate ( mL / h )

milliliters per hour

4 mcg / min (initial) 6 mcg / min 8 mcg / min

4 micrograms per mi nute, initi al

6 micr ograms per mi nute

8 micrograms per mi nute

10 mcg / min

10 micrograms per minute

12 mcg / min (maximum)

48 mL / h 72 mL / h

96 mL / h

48 milliliters per hour

72 milliliters per hour

96 milliliters per hour

120 mL / h 144 mL / h

120 milliliters per hour

144 milliliters per hour

12 micrograms per minute, maxi mum

196.

No

197.

17 gtt / min

198.

2.5 mL

199.

50 mL / h

200.

34 gtt / min Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

Chapter 12 Pediatric Dosages

Chapter Overview In Chapter 12, students are introduced to pediatric dosages, which are usually smaller quantities than adult dosages. Pediatric dosages are often based on body weight or body surface area of the client. Calculations for administering medications with a volume control chamber and calculation of daily fluid maintenance are included in this chapter. Safety is stressed with the administration of pediatric medications.

Instructor’s Notes 

Because some facilities require that all pediatric doses be routinely rounded down (truncated) rather than rounded off, in this chapter all doses will be rounded down to give the students practice.



Demonstrate pediatric equipment, if available.



Emphasize that in medication administration safe doses are always of vital importance, and this is even more so with pediatric dosages.



The techniques used to solve the examples in this chapter are similar to those already used in the preceding chapters.



Explain the functioning of the volume control chamber (see Examples 12.10 and 12.11).



Explain how to use the formula for daily fluid maintenance (see Example 12.12 and 12.13).

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

Key Terms burette daily fluid maintenance Harriet Lane Handbook volume control chamber (V CC) 1

Answers to Chapter 12 Additional Exercises 233.

45 mL

234.

Yes, it is safe

235.

No, it is an overdose

236.

0.08 mL

237.

450 mg / day

238.

9.8 mL

239.

1,350 mL / day at 56 mL / h

240.

3 mL

241.

15 min

242.

100 mL / h

243.

0.65 mL

244.

40 mcgtt / min

245.

13.8 mL / h

246.

1 pop

247. a) safe b) 7.5 mL Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

248.

yes it is safe

249.

150 mL / h

250. a) 1 mL b) 84 mL / h 251.

24 mL / h

252.

3.6 units / h

Chapter 12 Examination Questions 201.

Order: erythromycin 50 mg / kg/ day po in equally

divided doses q6h. The strength of the reconstituted erythromycin in the vial is 200 mg / 5 mL. How many teaspoons will you administer to the child who weighs 32

kg?

202.

The physician’s order for a 40 l b 2-year-old is Tylenol

10 mg / kg PO q4h prn for pain. The label on the bottle of Tylenol suspension reads: 80 mg / 2.5 mL . How many milliliters will you administer to this patient?

203.

The physician’s order reads: cefuroxime axetil

30 mg / kg/ day PO in two divided doses. The child weighs 50 k g. How many

ounces of Ceftin will you give the child if the label reads 125 mg / 5 mL? 204.

The prescriber has ordered fentanyl citrate 2 mcg/ kg I

M 30 min before surgery. The label on the vial reads 50 mcg / mL. How many milliliters will you administer to a child whose weight is 60 lb?

205.

A child is being treated with cisplatin injection Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

20 mg / m2 IV daily for 5 days for metastatic cancer. If the child’s B SA is 0.87 m2 ,

how many milligrams should this child receive?

The physician ordered procarbazine HCl 100 mg / m 2 P

206.

O daily. The strength of the drug is 50 m g per capsule. How many capsules of this antineoplastic drug would you prepare for a child whose B SA is 0.51m2 ?

207.

Find the daily fluid maintenance for a child who weighs

88 lb.

208.

Order: ranitidine 30 mg IV q8h. The patient weighs 52 l

b. The package insert states that the recommended dose for pediatric patients is 2 – 4 mg / kg / day to be divided and administered every 6 to 8 hours up to a

maximum of 50 mg per dose. Is the prescribed dose safe?

209.

Order: Daily fluid maintenance I V D5/0.33% NS.

a) The child weighs 55 lb. If the child is NPO, what is the daily I V fluid maintenance? b) What is the rate of flow in mL / h for a continuous I V? 210.

A child has a BSA of 0.82 m2 The recommended dose

of a drug is 2 million units / m2 . How many units will you administer?

211.

Order: cefotamine sodium 1.2 g I VPB q8h. The safe

dose range for the solution concentration is 20 – 60 mg / mL to infuse over 15 to 30 minutes. What is the minimal amount of I V fluid needed to safely contain this dosage? (HINT: The minimal amount of I V fluid is the maximal safe concentration.)

212.

Calculate the daily fluid maintenance for an infant who

weighs 7 lb.

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Order: zidovudine 160 mg / m2 q8h PO. The child has a

213.

BSA of 1.1 m2 and the strength of the Retrovir is 50 mg / 5 mL. How many milliliters of this antiviral drug will you prepare?

214.

Order: D5W with KCl 20 mEq per liter, infuse at

30mL/ h. The child is 60 cm and weighs 9.1 kg. a) How many m Eq of KCl would you add to a 500 mL IV bag? b) The label on the K Cl vial reads 2 mEq / mL. How many milliliters will you add to the IV? c) How many mEq / h will the child receive?

215.

Order: erythromycin estolate 125 mg PO q4h. The child

weighs 15 kg. The recommended dosage is 30 – 50 mg / kg / day in equally divided doses. Is the ordered dose safe?

216.

A child has to receive an I V bolus of 2% lidocaine,

1mg / kg stat. How many milliliters will you prepare for a child with a weight of 21 k

g?

217.

The prescriber has ordered ticarcillin disodium and

clavulanate potassium 200 mg/ kg/ day in divided doses every 6 h I VSS for a child, based on ticarcillin content. The label states that when dissolved, the concentration of ticarcillin will be approximately 200 mg / mL. If the child weighs 30 k g, how many milliliters will you administer?

218.

The prescriber has ordered metoclopramide HCl

0.1 mg/ kg direct IV push stat. If the vial is labeled 5 mg / mL and the child weighs

39 kg, how many milliliters will you prepare of this gastrointestinal stimulant?

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219.

Order: meperidine HCl (Demerol ) 1.5 mg / kg IM stat

for pain has been prescribed for a child whose weight is 62 lb. The label on the vial reads 100 mg / mL. How many milliliters of this narcotic analgesic would you prepare?

220.

Find Daily Fluid Maintenance for a 66 lb child.

Answers to Chapter 12 Examination Questions 201.

2t

202.

5.6 mL

203.

1 oz

204.

1 mL

205.

17.4 m g

206.

1 cap

207.

1,900 mL / day

208.

yes

209. a) 1,600mL / day b) 66 mL / h 210.

1,640,000 units

211.

20 mL

212.

318 mL / day

213.

17.6 mL

214. a) 10 mEq Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

b) 5 mL c) 0.6 mEq / h 215.

Yes

216.

1 mL

217.

7.5 mL

218.

0.78 mL

219.

0.42 mL

220.

1,700 mL / day

Final Exam 1 Final Exam 1 253.

A neonate weighs 4 pounds and 6 ounces. Express the

weight of this baby in ounces.

254.

10 mL = ?t

255.

Read the label in • Figure F.1 and determine the

number of micrograms in 1 milliliter of Namenda.

 Figure F.1 Drug label for Namenda.

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

256.

Order: Humulin N NPH U-100 insulin 40 units subcut

stat. What is the route of administration?

257.

General George Washington was 1.85 meters tall. What

was his height in feet and inches?

258.

Order: gentamicin 100 mg IV q8h. If the first dose is

administered at 6 a.m., at what time should the next dose be administered?

259.

A neonate weighs 3,100 grams. Convert this weight to

pounds and ounces (rounded off to the nearest ounce).

260.

Order: potassium chloride 40 mEq po daily. The

strength is 20 mEq per 15 mL. How many tablespoons will you administer?

261.

The prescriber ordered 150 mg / m2 of a drug PO q6h

for 5 days for a patient who has a B SA of 1.4 m2 . How many grams will the patient receive in total for the 5 days?

262.

Order: amoxicillin and clavulanate potassium 500 m g

PO q8h. The strength on the label is 250 m g per 5 mL. How many milliliters of this antibiotic will you administer? Draw a line at the correct measurement on the medication cup in • Figure F.2.



Figure F.2 Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

Medication cup for question 10.

263.

The prescriber ordered donepezil HCl 10 mg PO daily

at bedtime for a patient who has Alzheimer’s disease. Read the label in • Figure F.3 and determine how many tablets you will administer.



Figure F.3

Drug label for Aricept.

264.

Estimate the BSA for a person who is 150 c m tall and

weighs 110 kg.

265.

What is the strength of an Isocal solution made by

adding 1 can of Isocal to 3 cans of water? Express as a fraction.

266.

How many milligrams of lidocaine are contained in 2 m L

of 2% lidocaine solution?

267.

How many milliliters of a 0.5% solution contain 4 grams

of a drug?

268.

Indicate a dose of 0.16 m L with an arrow on the

syringe.

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269.

The prescriber ordered oxytocin 20 units I M stat. The

strength of the label is 10 units per m L. a) Calculate how many milliliters you will prepare. b) What size syringe will you use?

270.

Order: metoprolol tartrate 100 mg po b.i.d. The label

reads 50 mg per tab. How many tablets will the patient receive in one day?

271.

A 500 mL IV starts at 9 P.M. and runs at 33 g tt / min

with a drop factor of 10 gtt /mL. How long will the infusion take to finish?

272.

How many milliliters will infuse in 4 hours at the rate of

50 mcgtt / min ?

273.

An IVPB bag containing 50 m g of drug in 100 m L of

solution must infuse at the rate of 2 mg / min . If the infusion begins at 0800 h, when will it finish?

274.

Order: tobramycin 8 mg IV q 6h has been ordered for an

infant weighing 5,000 grams. The recommended dose is 1.5 – 1.9 mg / kg q8h. How many milligrams is the maximum single dose for this infant?

275.

A drug is ordered at 0.3 mg/ kg/ min. If the patient

weighs 148 kg, find the dosage rate in mg / min.

Order: vincristine sulfate 2 mg / m2 IV stat. The child

276.

has BSA of 0.9 m2 . The Oncovin vial has strength of 1mg / mL. How many m L will you administer?

277.

Order: Daily fluid maintenance for a 40 k g child. Find

the pump setting in mL / h.

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Answers to Final Exam 1 221.

70 oz

222.

2t

223.

2,000 mcg

224.

subcutaneously

225.

6 f t 2 in

226.

2 P.M. the same day

227.

6 lb 13 oz

228.

2T

229.

4.2 g

230.

10 mL

231.

2 tab

232.

2.14 m2

233.

1 strength 4

234.

40 mg

235.

800 mL

236.

0.16 m L

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

237. a) 2 m L b) 3 m L 238.

4 tab

239.

2 h 32 min

240.

200 mL

241.

0825h the same day

242.

9.5 mg

243.

44 mg / min

244.

1.8 mL

245.

79 mL / h

Final Exam 2 Final Exam 2 278.

8 cups = ? pints

279.

48 mm = ? cm

280.

Read the label in • Figure F.4 and determine the

number of micrograms in 1 tablet of Diflucan.

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

Figure F.4

Drug label for Diflucan.

281.

Order: alogliptin 25 mg PO daily. This dipeptidyl

peptidase-4 (DPP-4) inhibitor is used in the treatment of type II diabetes mellitus.

How many grams of alogliptin will the patient receive in 1 week?

282.

The patient is 140 cm and 90 kg. Estimate his body

surface area.

283.

Order: Kynamro (mipomersen sodium) 200 milligrams

subcut once weekly. How many grams will the patient receive each week?

284.

A woman is 5 f t 2 inches tall. What is her height in

centimeters?

285.

Order: Ravicti (glycerol phenylbutyrate) 15 m L PO in

three equally divided dosages. How many teaspoons will you administer?

286.

The prescriber ordered 500 mg / m2 of a drug PO q6h

for a patient who has a B SA of 1.7 m2 . How many grams will the patient receive in one day?

287.

Order: Augmentin (amoxicillin and clavulanate

potassium) 500 m g PO q12h. The strength on the label is 125 m g per 5 mL. How many millilitres of this antibiotic will you administer? Draw a line at the correct measurement on the medication cup in • Figure F.5.

Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.



Figure F.5

Medication cup for question 10.

288.

The prescriber ordered Provera (medroxyprogesterone

acetate) 10 mg PO daily. Read the label in • Figure F.6 and determine how many tablets you will administer.



Figure F.6

Drug label for Provera.

289.

Estimate the BSA for a person who is 6 feet 3 inches

tall and weighs 200 l b.

290.

What is the strength of a 200 m L solution expressed as

a percent if it contains 40 g of a drug?

291.

How many milligrams of sodium chloride are contained

in 1 liter of 0.9% sodium chloride solution?

292.

How many milliliters of a 2% solution contain 40 m g of a

drug?

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293.

Indicate a dose of 0.44 m L with an arrow on the

syringe.

294.

The prescriber ordered dexamethasone sodium

phosphate 1.5 mg IV q12h. The strength on the vial is 4 mg / mL. Calculate how many millilitres you will prepare.

295.

Order: Epogen (epoetin alfa) 100 units / kg subcut three

times a week. The label reads 10,000 units per m L, and the patient weighs 200 pounds. a. How many milliliters will you administer? b. What size syringe will you use?

296.

A 200 mL IV starts at 10 P.M. and runs at 30 gtt / min

with a drop factor of 10 gtt / mL . How long will the infusion take to finish?

297.

How many milliliters will infuse in 2 hours at the rate of

30 gtt/min with a drop factor of 15 gtt / mL ?

298.

An IVPB bag containing 100 m g of drug in 200 m L of

solution must infuse at the rate of 2 mg / min . If the infusion begins at 1300 h, when will it finish?

299.

A dosage of 4 mcg/ kg/ min has been ordered for an

adult weighing 83 k g. The solution used has a strength of 100 m g in 250 mL. Calculate the dosage rate in mcg / min and the flow rate in mL / h.

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300.

A drug is ordered at 0.7 mg / kg / min. If the patient

weighs 78 kg, find the dosage rate in mg / min.

301.

Order: Pediapred (prednisolone sodium phosphate)

60 mg/ m2 / day PO in three divided doses for 4 weeks. Calculate how many

milliliters of this anti-inflammatory agent you will administer to a child with B SA of 0.59 m2 who has nephrotic syndrome. The strength on the vial is 5 m g per 5 m L.

302.

Order: Daily fluid maintenance for an 88-lb child. Find

the pump setting in mL / h.

Answers to Final Exam 2 246.

4 pt

247.

4.8 cm

248.

100,000 m cg

249.

0.175 g

250.

1.87 m2

251.

0.2 g

252.

155 cm

253.

1t

254.

3.4 g

255.

20 mL

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256.

4 tab

257.

2.19 m2

258.

20%

259.

9,000 mg

260.

2 mL

261.

0.44 m L

262.

0.38 m L

263. a) 0.91 m L b) 1 m L 264.

11:07 P.M. the same day

265.

240 mL

266.

1350h the same day

267.

332 mcg / min, 50 mL / h

268.

54.6 mg / min Copyright © 2022 by Pearson Education, Inc. All Rights Reserved.

269.

11.8 m L

270.

79 mL / h

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