Med-Math Dosage-Calculation, Preparation-&-Administration

Med-Math Dosage-Calculation, Preparation-&-Administration SeventhEdition 7th Susan-Buchholz , RN , MSN Associate Professor, Georgia Perimeter College Clarkston, Georgia. Title Henke’s, Med=Math Dosage-Calculation, Preparation & Administration 7th SeventhEdition Susan Buchholz, RN, MSN Associate Professor Georgia Perimeter College Clarkston, Georgia Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the author, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations. The author, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of informa- tion relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly impor- tant when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research Acknowledgments and Dedication iv Preface Learning math can be summed up in one simple phrase: Practice makes perfect There are many ways to learn math. There are several ways to calculate dosages. Ultimately, the more you prac- tice, the better you get. I have tried to make this the focus of this book. Whether you are a beginning nursing student or one who is confident in math abilities, or an experienced nurse or healthcare professional, I encourage you take advantage of the self-tests and proficiency tests in this text. Each chapter will walk you through the various methods of calcula- tion and then give you an opportunity to practice. Each chapter stands alone, so you may work ahead at your own pace. The text is organized as such: Chapter 1: Arithmetic needed to calculate doses Chapter 2: Systems of measurement Chapter 3: Drug abbreviations, labels and packaging Chapter 4: Oral medication calculations Chapter 5: Liquid injection calculations Chapter 6: IV drip calculations Chapter 7: Advanced IV drip calculations Chapter 8: Pediatric medication calculations Chapter 9: Medication administration information Chapter 10: Medication administration procedures Key Features • Clinical dosage problems • Easy-to-learn formulas • Step-by-step approach in solving methods • Demonstration of four methods of calculation (formula, proportion expressed as two ratios, proportion expressed as two fractions, dimensional analysis) • Self-tests in each chapter with answers at the end of the chapter • Proficiency tests in each chapter with answers in Appendix A • Simple to complex organization of the text • Joint Commission-approved abbreviations • Test Your Clinical Savvy—“what if ” situations that stimulate critical thinking • Glossary with definitions and common abbreviations • Putting It Together—case studies with application of dosage calculations and critical thinking questions with suggested answers in Appendix B • Handy quick reference plastic card with common conversions and formulas v New to This Edition • The four calculation methods are presented side by side for each problem. • Drug labels and drug names have been updated. • The chapters have been reorganized to bring similar material together and to introduce calculation problems earlier in the text. • Research Points have been added. These are a summary of journal articles that highlight evidence-based practice concerning dosage calculations, medication administration, and safe practice. Resources and aids for students and faculty are provided on thePoint at: • Please send any comments and suggestions to me, as I appreciate any feedback and “proofreading” that will help make each edition better. I hope that this book helps anyone involved in calculating correct and safe medication dosages. Susan Buchholz, RN, MSN Decatur, Georgia vi Preface Contents Arithmetic Needed for Dosage 1 Multiplying Whole Numbers 2 Dividing Whole Numbers 2 Fractions 3 Decimals 9 Percents 14 Fractions, Ratio, and Proportion 17 Proficiency Test 1 Arithmetic 20 Answers to Self-Tests 21 Metric, Apothecary, and Household Systems of Measurement 31 Metric System 31 Apothecary System 39 Household System 41 Liquid Measures 41 Other Conversions 43 Proficiency Test 1 Exercises in Equivalents and Mixed Conversions 46 Answers to Self-Tests 47 Drug Abbreviations, Labels, and Packaging 49 Interpreting the Language of Prescriptions 49 Time of Administration of Drugs 49 Routes of Administration 53 Metric and SI Abbreviations 55 Apothecary Abbreviations 56 Household Abbreviations 56 Terms and Abbreviations for Drug Preparations 57 1 2 3 CHAPTER CHAPTER CHAPTER ls 58 Drug Packaging 61 vii viii Contents Equipment to Measure Doses 69 Proficiency Test 1 Abbreviations/Military Time 74 Proficiency Test 2 Reading Prescriptions/Interpreting Written Prescriptions 75 Proficiency Test 3 Labels and Packaging 77 Answers to Self-Tests 81 Calculation of Oral Medications—Solids and Liquids 83 Oral Solids 84 Converting Order and Supply to the Same Weight Measure 89 Clearing Decimals When Using the Formula Method 90 Special Types of Oral Solid Orders 93 Oral Liquids 94 Special Types of Oral Liquid Orders 100 Oral Solid and Liquid Problems Without Written Calculations/“Common Sense” Calculations 100 Research Point 102 Putting It Together 102 Proficiency Test 1 Calculation of Oral Doses 104 Proficiency Test 2 Calculation of Oral Doses 106 Proficiency Test 3 Calculation of Oral Doses 108 Answers to Self-Tests 109 Liquids for Injection 131 Syringes and Rounding 131 Special Types of Problems in Injections From a Liquid 141 Injections From Powders 148 Distinctive Features of Injections From Powders 150 Where to Find Information About Reconstitution of Powders 151 Insulin Injections 160 Research Point 170 Critical Thinking Test Your Clinical Savvy 170 Putting It Together 171 Proficiency Test 1 Calculations of Liquid Injections 173 Proficiency Test 2 Calculations of Liquid Injections and Injections From Powders 176 Proficiency Test 3 Calculations of Liquid Injections 179 Proficiency Test 4 Mental Drill in Liquids-for-Injection Problems 180 Answers