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

Time For Self-interrogation. Will Help You Pass Your First Nursing Semester.

Life is like a nursing process: Assessment, Diagnosis, Planning, Implementation and Evaluation - also known as "ADPIE." Life is an ongoing process that can end at any stage if the problem is solved. As a nursing student, it is very critical to align your priorities in life in order to cope the new chapter of challenges in your life. Literally speaking.., everything in nursing is applications - just like life is. Everything we do in life is applicable and can influence every action we make regardless of the consequences. Enough about life.., let's move to how to become one of the proud students who passed their  first nursing semester.

Using an ADPIE processes will help you with your journey in the first semester or perhaps this may help you in your program how to apply ADPIE when you are solving your patients problem in class. As I mentioned, it's all about applications. What would you do if...Using this process will help you achieve your plan at the end.

 Life of a nursing student can be toughed but you don't have to be miserable but instead make it enjoyable. Believe me, I been watching lots of movies in Netflix while I was in my first semester of nursing program and I worked full time as well. Not only that, my son was 8 months old when I started my nursing school. In short, my life was very busy at that time. Regardless what you have in life right now, embrace the fact that life is full of ups and downs.

Let put this "ADPIE" applications in your shoe.
A- Assessment: Have a clear assessment of what's going on in your life. The purpose of this stage is to identify your current problems. It could be anything. It doesn't matter if it's small or big. As simple as asking yourself " Can I do this?". Of course you can do this. Same application when you are working on your patient. You need to assess if your patients can do things that they are able considering their limitations. Let's accept the fact that we all have our own limitations. By looking at your situations right now, you can definitely tell if you can make this possible. Again, of course you can. This is the vital step in determining your problem and moving to the next stage.

D- Diagnosis: This is the second vital step in your nursing program. This process is all about your perception as whole. It's diagnosing yourself capabilities. In nursing diagnosis, this often evidence based practice. But for now this is based on your self-evidence experience. For example, if you did not do well in your test, try to diagnose what went wrong. Did you over study or under study the materials. This also applicable to your method of studies.

P - Planning: Once you determine the cause of the problem, it is the right time to plan. What can you do to excel or pass the class? May be you want to join the group study or perhaps find other materials that will help you pass the test. because I did use other resources to study for my tests. I didn't solely rely on my textbook. of course the materials on the test are coming from the textbook but believe me that only portions of it because almost all questions are applications type questions. Memorization only offer little help in your nursing studies.

I- Implementation: Once you determine what went wrong and the plan is in placed. It is time to implement it. Implementation is simple as how your goal will be achieved. For example, you plan to join the group study to help you pass the test, it is good idea to create or make a group to entice everybody to study together.

E- Evaluation: Once you implemented your plan, it is time to evaluate if everything you went through is working.  Of course the best way to determine this is if " you did great in your exam." If this steps didn't work - it is time to repeat the entire nursing processes.


Note: Nursing process is a cycle and ongoing process. It may require repetitions until goal is achieved or  problems are solved. If you have questions. Please leave a comment.

First Semester in the Nursing Program.Feeling excited?

I'll tell you my experience of being a student in my first semester. First, chill out nursing students.., as we know, life can be hard especially if there are many conflicts that makes our life complicated. We can talk about these conflicts and it's going to a never ending. By the way, as a nursing student, you may face uncertainties and hardships coping in your new environment towards fulfillment of your dream to "serve people" and "be served." Anyways, my motivation to move one step forward to fulfill my desire to become a nurse someday is my family and the people that I interacted everyday. For me, this is the best profession that a person can have in life. Although, working as nurse someday may not make you a millionaire but your heart will be filled with millions of appreciations because you are making a difference in every patient's life. Let's be real, those nurses who went to nursing school may say that nursing is a "piece of a cake," and I agree that a piece of a cake is good and yummy, but for some (myself too) this is "bitter" than swallowing a handful of salt.