Is Peds in Nursing a hard subject? Please share your experience.

Drug Calculation: Let's see if you are giving correct dosage of medication.

Order: Give acetaminophen (Tylenol) 650 mg PO every 4 hours.
Drug available: 325 mg per 1 mL

How much mL of acetaminophen would you give to your patient?

Let's see if your patient is safe in your care.

I have a big quiz tomorrow.

Wish me luck guys. Thank you.

Update: I passed my big math drug calculation quiz yesterday. Thank you all.

Nursing Care Plan. Needs help?

I can offer personal assistance in writing your nursing care plan if you wanting help. Just let me know if you have any question on how to make a care plan.

Free Basic Tutorials for EKG interpretations.

Although, I am not a cardiologist or an electrophysiologist (EP), but I've been watching and interpreting patients heart rhythm daily at work. This will help you in your nursing program for cardiac rhythm interpretations - ECG or EKG.

Let's start:

First we have to know the anatomy of the heart. Once you know them.., it's a piece of a pie.

This is called a cardiac cycle. Every beat of your heart is forming a wave like this. It's the electrical conduction of the heart.

If your heart has no problem. The rhythm is likely this... It's called Normal Sinus Rhythm.

Normal Sinus Rhythm is always regular.If you know this as a baseline you can tell that the rest of the rhythm is abnormal. 

Next rhythm and most common arrhythmia is Atrial Fibrillation also known as A-Fib. A-Fib is more likely like this...remember A-Fib is always irregular and has no P waves. This means that the problem originates in atrium. 

Will continue...

Free Nursing Drug Calculation Tutorials

Just visit my blog and leave a comment for any help or question.

Nursing Drug Calculations

            Four Methods for Drug Calculation 

Before drug dosage can be calculated, units of measurement must be converted to one system. If the drug is ordered in grams and comes in milligrams, then grams are converted to milligrams or milligrams are converted to grams.
Four methods for calculating drug dosages include basic formula, ratio and proportion, fractional equation, and dimensional analysis. The ratio and proportion and fractional equation methods are similar. For drugs that require individualized dosing, body weight and body surface area are used. When body weight and body surface area calculations are used, one of the first four methods for calculation is necessary to determine the amount of drug needed from the container.

Method 1: Basic Formula 

The basic formula is the most commonly used method, and it is easy to remember.

D or desired dose: drug dose ordered by physician or health care providers (HCPs).

H or house dose: drug dose on label of container (bottle, vial, ampule)

V or vehicle: form and amount in which the drug comes (tablet, capsule, liquid)

Order: Acetaminophen 500 mg every 4 hours.

Drug available: 250 mg per tablet

How many tablet(s) would you give per dose?

Basic formula:      

Method 2: Ratio and Proportion

Ratio and proportion (RP) is the oldest method used for calculating dosage problems:

H and V: On the left side of the equation are the known quantities, which are dose on hand and vehicle.

D and X: On the right side of the equation are the desired dose and the unknown amount to give.

Multiply the means and the extremes. Solve for X.

PROBLEM 1: Order: erythromycin  0.5 g, po, q4h.

Drug available: 250 mg per 1 tablet

 To convert grams to milligrams, move the decimal point three spaces to the right'

Method 3: Fractional Equation

The fractional equation (FE) method is similar to RP, except it is written as a fraction.

• H: the dosage on hand or in the container
• V: the vehicle or the form in which the drug comes (tablet, capsule, liquid)
• D: the desired dosage
• X: the unknown amount to give

Cross multiply and solve for X.

Order: valproic acid (Depakene) 100 mg, po, tid.
Drug available: valproic acid (Depakene) 250 mg/5 mL suspension.

No unit conversion is needed.

Answer: valproic acid (Depakene) 100 mg = 2 mL

Method 4: Dimensional Analysis

The advantage of DA is that it decreases the number of steps required to calculate a drug dosage. It is set up as one equation.

• 1. Identify the unit/form (tablet, capsule, mL) of the drug to be calculated. If the drug comes in tablet, then tablet = (equal sign)
• 2. The known dose and unit/form from the drug label follow the equal sign.Example order: Amoxicillin 500 mg. On the drug label: 250 mg per 1 capsule.
• 
  
• 
  
  
• 
  
•  The milligram value (250 mg) is the denominator and it must match the NEXT numerator, which is 500 mg (desired dose or order). The NEXT denominator would be 1 (one) or blank.

Cancel out the mg, 250 and 500. What remains is the capsule and 2. Answer: 2 capsules.

 Metric and Household Conversions

METRIC
Grams (g)	Milligrams (mg)
1	1000
0.5	500
0.3	300 (325)
0.1	100
0.06	60 (64 or 65)
0.03	30 (32)
0.015	15 (16)
0.010	10
0.0006	0.6
0.0004	0.4
0.0003	0.3
Liquid (Approximate)
30 mL = 1 oz = 2 tbsp (T) = 6 tsp (t)
15 mL = ½ oz = 1 T = 3 t
1000 mL = 1 quart (qt) = 1 liter (L)
500 mL = 1 pint (pt)
5 mL = 1 tsp (t)

Household to Metric Conversions (Approximate)

Standard Household Measure	Apothecary	Metric Volume	Metric Weight
⅛ teaspoon	7-8 gtt/1/48 OZ	0.6 mL	0.6 g
¼ teaspoon	15gtt/1/24 OZ	1.25 mL	1.25 g
½ teaspoon	30 gtt/1/12 OZ	2.5 mL	2.5 g
1 teaspoon	60 gtt/1/6 OZ	5 mL	5g
1 tablespoon/3 teaspoons	½ OZ	15 mL	15 g
2 tablespoons/6 teaspoons	1 OZ	¼ dL/30 mL	30 g
¼ cup/4 tablespoons	2 OZ	½ dL/60 mL	60 g
⅓ cup/5 tablespoons	2½ OZ	¾ dL/75 mL	75 g
½ cup	4 OZ	1 dL/120 mL	120 g
1 cup	8 OZ	¼ L/250 mL	230 g
1 pint	16 OZ	½ L/480-500 mL
1 quart	32 OZ	1 L/1000 mL
2 quarts/½ gallon	64 OZ	2 L/2000 mL
1 gallon	128 OZ	3¾ L/3840-4000 mL