MATHS WORKBOOK QUESTIONS AND ANSWERS

MATHS WORKBOOK QUESTIONS AND ANSWERS Abbreviations (as found on medication chart): Morning- Mane- 0800 Night- Nocte- 1800 or 2000 Twice a day- BD- 0800 & 2000 Three times a day- TDS- 0800, 1400 & 2000 Four times a day- QID- 0800, 1200, 1800 & 2200 Regularly 6 hourly- 6 hrly Regularly 8 hourly- 8 hrly 0800, 1600 & 2400 PO- orally, per oral SC- Subcutaneously IMI- Intramuscular IV- Intravenous PR- per rectal SL- Sublingual (under tongue) The 5 rights: To help reduce the risk of medication errors, nurses are taught the “Five Rights of Medication Administration”. Also known as the “5Rs”, these principles help to ensure the right drug, right dose, right route, and right patient, at the right time. Right Drug: Double-check the medication label against the medication order. It can be easy to accidentally give the wrong medication. Right Dose: Most of the time, this can be achieved just by double- checking the label to see what dose needs to be given. However, a liquid medication can be a bit trickier because the person giving it must measure the dose. Right Time: With so many medications to keep track of, it can be difficult to remember which medicine to give and when to give it. Always check the medication order Right Route: While it may seem unimaginable, we are often called about medications being administered via an unintended route. For example, eardrops administered as eye drops, or swallowing medication intended to be used with an inhaler. Be sure to double-check the label to ensure that the right medication is being administered via the right route. Right Person/ Patient: Take a careful second look to ensure that the name on the medication chart matches the patient ID chart. Check allergies Formulas for conversion Drug calculations mL = millilitre L = litre microg = microgram/s mg = milligrams g = gram/s 1 MG = 1000 MCG 1 GM = 1000 MG 1 L = 1000 ML Reading labels Dosage calculation is important in nursing. The most important piece of information you need to figure out is how many tablets or how many mls if a liquid will be given to a patient using the dosage strength. The dosage strength is on the medication label. There are 4 basic pieces of information on a medication label: the trade name, the generic name, the dosage strength, and the total number of tablets. I created a generic medication label below to help see where to get the dosage strength. Trade name also known as the brand name : the BIG ( brand) word on the label • Written on top of the generic name. • Usually bigger in font size than the generic name. • Written sometimes in capital letters. Generic name: • generally found underneath the brand name • the generic name or official name is usually written in lower case letter. Dosage & number of tablets in bottle • The unit for the dosage strength is mostly expressed in mg (milligrams) and sometimes mcg (micrograms). • That is how you will recognize it • The dosage strength is the strength of 1 tablet. For example: Brand name: Headanol Generic name: paracetamol Dosage: 500mg Tablets: 20 Formulas for Mixtures and Solutions Drug calculations Strength required (SR) / Strength in stock (SS) X Stock volume = amount to be given An easy way to remember this formula is Sun rise SR / divided by Sun set SS X times volume SR / SS X VOL = ANSWER For example: The dosage strength is 100 mg and there are 200 tablets in the bottle. If the doctor orders 300 mg, how many tablets will you give? 300 mg / 100 mg = 3 tablets. Example 2; Say the dosage strength is 200 mg and there are 100 tablets in the bottle. If the doctor orders 0.4 g, how many tablets will you give? Before you use the formula above, all units should be the same. Thus, convert 200 mg to g. 200 mg = 0.2 g number of tablets to give = 0.4 g / 0.2 g number of tablets to give = 400mg/ 200mg = 2 tablets Formulas for Intravenous fluids Drug calculations For when you are using a pump: mls/hr = Volume in mls divided by time in hours For example: 500ml/6 hours = 83.33mls/hr For when you are using drip factor giving set: Drops per minute = volume in mls divided by time in minutes x drop factor Please note there are two drop factors commonly used: 1. Micro drop factor – 60 drops per minute 2. Macro drop factor – 20 drops per minute For example: 500mls/360 minutes (6 hours) x micro DF (60) = 83.33 drops per minute Rounded to = 83 DPM Or 500mls/360 minutes x macro DF (20) = 27.77 drops per minute Rounded to 28 DPM Rounding Please remember: Rounding to a whole number use: If 5 and above round up If 4 and below the amount stays the same eg: 83.3ml/hr = 83ml/hr CONTEXUALISED DRUG CALCULATION: Practice Test 1 QUESTION 1: Define the following abbreviations: a) Nocte evening/night b) P.V per vaginal c) Q.I.D four times per day d) T.D.S Three times per day e) O.D once daily f) B.D twice per day QUESTION 2: List the Five Rights of medication administration: a) Right patient b) Right dose c) Right time d) Right route e) Right drug QUESTION 3: Convert the following: a) 1 g = 1000 mg b) 300 microg = 0.0003 g c) 4000 mL = 4 L d) 20 mg = 20000 microg QUESTION 4: a) A patient is ordered 10 mg metoclopramide IMI for nausea. The ward stock strength is 10mg/2mL. What volume of metoclopramide will you administer to the patient? 10mg/10mg x2ml = 2ml QUESTION 5: The following questions relate to the medication below. a) What is the strength of each tablet contained in this box? 200mg b) What is this medication used for? Headache, fever, muscle and joint pain c) If a patient is ordered 400mg of Ibuprofen orally calculate how many tablets you would dispense? 400mg/200mg = 2 tabs d) Are these tablets able to be crushed or cut in half? No enteric coated e) Your patient refuses to take the ordered medication, what would you do? How would you document this on the medication chart? Ask why/ educate/ document and inform dr QUESTION 6: The following questions relate to the medication below. a) What is the brand name of the medication in the above image? flagyl b) What is the generic name of the medication in the above image? metronidazole c) What is the name of the company that manufactures this medication? Sanofi aventis d) How many tablets does this box contain? 21 e) What is the strength of each tablet contained in this box? 200mg f) A patient is ordered 450mg of Metronidazole orally calculate how many tablets would you dispense to administer. 450mg/200mg = 2.25 tablets g) If administering this medication are you able to crush the medication or cut in half? No, check mimms or speak with pharmacy QUESTION 7: The following question relates to the image below. a) How many mL of medication is in the medication cup? 20ml QUESTION 8: The following question relates to the image below. a) The glass in the above image did contain 200 mL of water. The patient has since consumed half. How many mL has the patient consumed? 100ml QUESTION 9: a) A child weighing 22kg is ordered ibuprofen suspension 150mg every 6- 8 hours as required. The ward stock strength is 100mg/5mL. How many mL of ibuprofen suspension is required for one dose? 150mg/100mg x5ml = 7.5ml QUESTION 10: a) A patient is ordered paracetamol 1g for pain and fever relief. The ward stock strength is 500mg per tablet. How many tablets will you administer to the patient? 1g x 1000 = 1000mg 1000mg/500mg = 2 tablets Question 11: Using the fluid order above answer the following: a) What is the name of the intravenous fluid ordered? 5% dextrose b) What is the volume of intravenous fluid ordered? 1000mls c) What is the time the intravenous fluid is to be administered over? 10 hours d) Using an infusion pump calculate the rate in ml per hour Round your answer to 1 decimal place. 1000ml/10hours = 100ml/hr CONTEXUALISED DRUG CALCULATION: Practice Test 2 Question 1. Convert the following: a) 90 mg = 0.09 g b) 2500 mL = _2.5 L c) 60 microg = 0.06 mg Question 2. Answer the following questions about the medication above. a) What is the generic name of this medication? amoxicilin b) What is the brand name of this medication? amoxicillin c) By what route can this medication be given by? oral Question 3. Using the medication package and order above answer the following questions. a) What is the generic name of the medication ordered? amoxicillin b) What is the brand name of this medication? amoxil c) The doctor orders 25mg/kg/day for the child that weighs 25kg. What is the dose of the medication ordered in 24 hours? 25mgx 25kg = 625mg d) the medication needs to be broken up into 3 equal doses. How many mg will be given each dose? 625mg/3= 208.33 Rounded down to 208mg per dose e) Calculate the number of mls to be administered in EACH dose? 208mg/50mgx1 = 4.16mls Question 4. A child weighing 10 kg is ordered cephalexin at midday. The recommended dose for this child is 25mg of chephalexin for each kilogram given in 3 divided dose. a) What dose in mg does this child require in 24 hours ? 25mgx 10kg= 250mg in 24hrs b) What dose in mg does this child require in EACH 8 hours ? 250mg/3doses= 83.333mg Round down to 83mg per dose c) Using the medication label above, calculate the volume in mL of CEPHALEXIN that you will need to draw up for this child per dose? 83mg/250mg X 5ml= 1.66ml d) For the dose of CEPHALEXIN please draw a line across the syringe to indicate the volume of medication required QUESTION 5: List the Five Rights of medication administration: a) Right paient b) Right drug c) Right dose d) Right route e) Right time Question 6. Using the fluid order above answer the following: a) What is the name of the intravenous fluid ordered? 0.9% Sodium chloride b) What is the volume of intravenous fluid ordered? 1000mls c) What is the time the intravenous fluid is to be administered over? 6hrs d) Using an infusion pump calculate the rate in ml per hour, round to the nearest whole number. 1000ml/6hrs = 166.66 Round Up to 167ml/hr Question 7. Using the fluid order above answer the following: a) Using an infusion pump calculate the rate in ml per hour, round to the nearest whole number. 1000ml/8hours =125ml/hr b) Using a micro giving set (60) calculate how many drops per minute you will give. Round to a whole number. 8 hours= 480mins 1000ml/480mins x60 (DF) = 125 drops per minute c) Using a macro giving set (20) calculate how many drops per minute you will give. Round to a whole number. 8 hours = 480mins 1000ml/480mins X 20 (DF) = 41.66 Round up to 42 Drops per minute THE END CONTEXUALISED DRUG CALCULATION: Practice Test 3 QUESTION 1: Define the following abbreviations & what time do you give the medication? a) Mane morning b) P.O per oral c) 4TH Hourly _every 4 hours d) Daily daily e) O.D once per day f) TDS three times per day QUESTION 2: List the Five Rights of medication administration: a) Right patient b) Right drug c) Right route d) Right dose e) Right time QUESTION 3: Convert the following: a) 10 g = 10000 mg b) 3000 microg = 0.003 g c) 400 mL = 0.4 L d) 200 mg = _ mcg QUESTION 4: a) A patient is ordered 10 mg metoclopramide IMI for nausea. The ward stock strength is 10mg/2mL. What volume of metoclopramide will you administer to the patient? 10mg/10mg x 2ml = 2mls QUESTION 5: The following questions relate to the medication below. a) What is the strength of each tablet contained in this box? 200mg b) What is this medication used for? Headache, fever, muscle and joint pain c) If a patient is ordered 400mg of Ibuprofen orally calculate how many tablets you would dispense 2 tabs d) Are these tablets able to be crushed or cut in half? no enteric coated e) Your patient refuses to take the ordered medication, what would you do? How would you document this on the medication chart? Ask why/ educate / document and inform doctor QUESTION 6: The following questions relate to the medication below. a) What is the brand name of the medication in the above image? zofran b) What is the generic name of the medication in the above image? ondansetron c) What is the name of the company that manufactures this medication? glaxosmithkline d) How many tablets does this box contain? 10 e) What is the strength of each tablet contained in this box? 8mg f) A patient is ordered 4mg of ONDANSETRON orally calculate how many tablets would you dispense to administer. 4mg/8mg = 0.5 tablet/ half a tablet g) If administering this medication are you able to crush the medication or cut in half? Check with MIMMS or Pharmacist QUESTION 7: The following question relates to the image below. a) How many mL of medication is in the medication cup? 25mls QUESTION 8: The following question relates to the image below. a) The patient is on a fluid restriction of 1.2l. The patient has since consumed half of this bottle. How many mLs can the patient consume to be within the limit of his fluid restriction? 1500ml/2 = 750ml 1200ml – 750ml = 450mls QUESTION 9: a) A child weighing 22kg is ordered ibuprofen suspension 150mg every 6- 8 hours as required. The ward stock strength is 100mg/5mL. How many mL of ibuprofen suspension is required for one dose? 150mg/100mg x 5ml = 7.5ml QUESTION 10: a) A patient is ordered paracetamol 1g for pain and fever relief. The ward stock strength is 500mg per tablet. How many tablets will you administer to the patient? 2 tablets Question 11: Using the fluid order above answer the following: a) What is the name of the intravenous fluid ordered? 5% dextrose b) What is the volume of intravenous fluid ordered? 1000mls c) What is the time the intravenous fluid is to be administered over? 10 hours d) Using an infusion pump calculate the rate in ml per hour Round your answer to 0 decimal place. 1000ml/10hours= 100mls/hr