Dosage Calculations / Edition 9

by Gloria D. Pickar, Amy Pickar-Abernethy

Overview

Best-selling DOSAGE CALCULATIONS, 9th Edition features the three-step approach to basic and advanced Formula Method calculations that nursing and other health care professionals prefer, along with a reader-friendly writing style and handy "work text" format. In addition to easing readers into the math with a thorough review, the book uses a logic-based process to build confidence and limit anxiety. Featuring full-color images of drug labels, critical thinking assessments, and extensive clinical examples, DOSAGE CALCULATIONS, 9th Edition provides the skills needed to master dosage calculations in any clinical setting!

Product Details

ISBN-13:	9781111319595
Publisher:	Cengage Learning
Publication date:	01/01/2012
Edition description:	New Edition
Pages:	592
Sales rank:	566,352
Product dimensions:	8.40(w) x 10.80(h) x 1.20(d)

About the Author

Gloria D. Pickar, R.N., Ed.D., is President and Chief Academic Officer of Compass Knowledge Group in Orlando, Florida. She is a former Academic Dean at Seminole State College in Sanford, Florida. She is also the author of nine editions of best-selling DOSAGE CALCULATIONS.


Amy Pickar Abernethy, MD, is Associate Professor of Medicine and Nursing at Duke University in Durham, North Carolina.

Table of Contents

Preface vi

Acknowledgments xi

Introduction to the Learner xii

Using This Book xiii

Section 1 Pretest and Mathematics Review 1

Essential Skills Evaluation: Pretest 3

Essential Skills Evaluation: Pretest Answer Sheet 21

Mathematics Diagnostic Evaluation 28

1 Fractions and Decimals 31

Fractions 31

Types of Fractions 32

Equivalent Fractions 33

Conversion 34

Comparing Fractions 35

Addition and Subtraction of Fractions 38

Multiplication of Fractions 41

Division of Fractions 43

Decimals 47

Decimal Fractions and Decimal Numbers 47

Comparing Decimals 50

Conversion between Fractions and Decimals 51

Addition and Subtraction of Decimals 54

Multiplying Decimals 56

Dividing Decimals 57

Rounding Decimals 58

2 Ratios, Percents, Simple Equations, and Ratio-Proportion 63

Ratios and Percents 64

Ratios 64

Percents 64

Converting Among Ratios, Percents, Fractions, and Decimals 64

Comparing Percents and Ratios 66

Solving Simple Equations for X 68

Ratio-Proportion: Cross-Multiplying to Solve for X 72

Finding the Percentage of a Quantity 76

Section 1 Self-Evaluation 80

Section 2 Measurement Systems, Drug Orders, and Drug Labels 83

3 Systems of Measurement 85

Metric System 85

Apothecary and Household Systems 89

Other Common Drug Measurements: Units and Milliequivalents 91

4 Conversions: Metric and Household Systems 97

Identifying Need for Unit Conversion 98

Converting from One Unit to Another Using the Conversion Factor Method 99

Converting within the Metric System 100

Approximate Equivalents 105

Converting Between Systems of Measurement Using the Conversion Factor Method 105

5 Conversions for Other Clinical Applications: Time and Temperature 113

Converting Between Traditional and International Time 113

Converting Between Celsius and Fahrenheit Temperature 116

6 Equipment Used in Dosage Measurement 123

Oral Administration 123

Medicine Cup 123

Calibrated Dropper 124

Pediatric Oral Devices 125

Parenteral Administration 125

3 mL Syringe 125

Prefilled Single-Dose Syringe 126

Insulin Syringe 127

1 mL Syringe 128

Safety Syringe 128

Intravenous Syringe 129

Needleless Syringe 130

7 Interpreting Drug Orders 141

Medical Abbreviations 142

The Drug Order 143

Medication Order and Administration Forms 146

Computerized Medication Administration Systems 148

8 Understanding Drug Labels 157

Brand and Generic Names 158

Dosage Strength 158

Form 159

Supply Dosage 160

Total Volume 160

Administration Route 161

Directions for Mixing or Reconstituting 161

Label Alerts 162

Name of the Manufacturer 162

Expiration Date 163

Lot or Control Numbers 163

National Drug Code (NDC) 163

Controlled Substance Schedule 164

Barcode Symbols 164

United States Pharmacopeia (USP) and National Formulary (NF) 164

Unit- or Single-Dose Labels 164

Combination Drugs 165

Supply Dosage Expressed as a Ratio or Percent 165

Checking Labels 166

9 Preventing Medication Errors 177

Prescription 178

Verbal Orders 180

Transcription 180

Safe Medication Administration 185

Right Patient 185

Right Drug 185

Right Amount 188

Right Route 190

Right Time 191

Right Documentation 191

The Nurse's Critical Role in Medication Error Prevention 191

Section 2 Self-Evaluation 199

Section 3 Drug Dosage Calculations 205

10 Oral Dosage of Drugs 207

Tablets and Capsules 210

Three-Step Approach to Dosage Calculations 213

Oral Liquids 227

11 Parenteral Dosage of Drugs 255

Injectable Solutions 256

High-Alert Parenteral Medications 276

Heparin 277

Insulin 281

Insulin Labels 281

Insulin Action Times 282

Premixed, Combination Insulin 284

Interpreting the Insulin Order 285

Insulin Administration 285

Measuring Insulin in an Insulin Syringe 286

Combination Insulin Dosage 290

Insulin Coverage-The "Sliding Scale" 294

Prefilled U-100 Insulin Pens 295

U-500 Insulin 298

Avoiding Insulin Dosage Errors 302

12 Reconstitution of Solutions 321

Solution Properties 322

Reconstitution of Injectable Medications in Powder Form 323

Types of Reconstituted Parenteral Solutions 325

Single-Strength Solution 326

Multiple-Strength Solution 328

Reconstituted Parenteral Solutions with Various Routes 332

Drugs with Injection Reconstitution Instructions for Either IM or IV 332

Drugs with Different IM and IV Reconstitution Instructions 334

Drugs with Instructions to "See Package Insert" for Dilution and Administration 337

Reconstitution of Noninjectable Solutions 351

Solution Concentration 351

Calculating Solutions 352

Topical Solutions and Irrigants 352

Oral and Enteral Feedings 354

Diluting Ready-to-Use Nutritional Liquids 354

13 Pediatric and Adult Dosages Based on Body Weight 367

Administering Medications to Children 368

Converting Pounds to Kilograms 368

Body Weight Method for Calculating Safe Pediatric Dosage 369

Single-Dosage Drugs 370

Single-Dosage-Range Drugs 371

Routine or Round-the-Clock Drugs 372

Daily-Dosage-Range Drugs 373

Daily-Dosage-Range Drugs with Maximum Daily Allowance 374

Underdosage 375

Combination Drugs 376

Adult Dosages Based on Body Weight 378

14 Alternative Dosage Calculation Methods: Ratio-Proportion and Dimensional Analysis 399

Converting Using the Ratio-Proportion Method 400

Using Ratio-Proportion to Calculate Dosages 402

Using Dimensional Analysis to Calculate Dosages 406

Section 3 Self-Evaluation 423

Section 4 Advanced Calculations 437

15 Intravenous Solutions, Equipment, and Calculations 439

IV Solutions 440

Solutions Components 440

Solution Strength 440

Solution Additives 443

Calculating Components of IV Solutions When Expressed as a Percent 446

IV Sites 447

Monitoring IVs 448

Primary and Secondary IVs 448

Blood Administration Tubing 450

IV Flow Rate 450

Electronically-Regulated IVs 450

Calculating Flow Rates for Infusion Pumps in mL/h 456

Manually-Regulated IVs 458

Calculating Flow Rates for Manually-Regulated IVs in gtt/min 461

Formula Method 461

Shortcut Method 464

Adjusting IV Flow Rate 468

Intermittent IV Infusions 474

IV Piggybacks 474

Saline and Heparin IV Locks for IV Push Drugs 475

ADD-Vantage System 477

Calculating IV Infusion Time and Volume 480

16 Body Surface Area and Advanced Pediatric Calculations 489

Body Surface Area Method 490

BSA Formula 490

BSA Nomogram 491

BSA Dosage Calculations 494

Pediatric Volume Control Sets 497

Intermittent IV Medication Infusion via Volume Control Set 498

Minimal Dilutions for IV Medications 501

Calculation of Daily Volume for Maintenance Fluids 503

17 Advanced Adult Intravenous Calculations 513

Calculating IV Dosages and Flow Rates Using Clinical Protocols 514

IV Heparin Protocol 515

IV Insulin Protocol 523

Insulin Overdose 527

Critical Care IV Calculations: Calculating Flow Rate of an IV Medication to Be Given over a Specified Time Period 530

IV Medication Ordered per Minute 530

IV Medication Ordered per Kilogram per Minute 532

Titrating IV Drugs 532

Verifying Safe IV Medication Dosage Recommended per Minute 534

Limiting Infusion Volumes 538

Section 4 Self-Evaluation 549

Essential Skills Evaluation: Posttest Answer Sheet 557

Comprehensive Skills Evaluation 565

Answers 581

Essential Skills Evaluation 581

Mathematics Diagnostic Evaluation 587

Chapter 1 588

Chapter 2 591

Chapter 3 594

Chapter 4 595

Chapter 5 597

Chapter 6 597

Chapter 7 601

Chapter 8 602

Chapter 9 603

Chapter 10 605

Chapter 11 612

Chapter 12 625

Chapter 13 633

Chapter 14 639

Chapter 15 647

Chapter 16 655

Chapter 17 660

Comprehensive Skills Evaluation 670

Appendix A Study Guide 677

Appendix B Apothecary System 687

Index 689

Drug Label Index 697

Editorial Reviews

4 Stars! from Doody

This fifth edition of the dosage calculations workbook provides opportunities for both nursing students and practicing nurses to increase their precision in calculating safe drug doses for various age groups and improving their proficiency in medication administration using various methods of delivery. This edition expands coverage of pediatric, obstetric, heparin, and critical care IV calculations. The purpose is to provide a practical workbook to assist readers to practice independently and improve their accuracy and confidence with dosage calculations and determinations about whether prescribed drugs are within safe recommended dosing ranges. This book is targeted for nursing students and nursing professionals in various healthcare settings who want to improve their dosage calculation skills and critical thinking related to interpretation of prescribed medications and administration techniques. This user-friendly workbook walks the participant through the calculation process step by step. The book describes two alternative formula methods and provides actual drug labels for use in the calculation process. It features real clinical dosage calculation patient situations to enhance the nurse's critical thinking skills and accuracy. Actual size photography of syringes and other equipment are featured to more clearly illustrate content. A CD-ROM interactive disc is also included. This is an excellent workbook for healthcare personnel interested in improving their accuracy and proficiency in dosage calculation and medication administration. In addition to providing practice in drug calculation, the book includes practice problems in conversion of measurements, analysis of prescribedmedication orders for safe dose range, selection of various methods of medication administration, and case studies and practice tests to enhance the reader's precision and critical thinking skills. This book is appropriate for nursing students (especially those in introductory skills lab courses) and for nursing libraries.

Deborah Ann Adams

Reviewer: Deborah Ann Adams, PhD, RN (Boston College School of Nursing)
Description: This fifth edition of the dosage calculations workbook provides opportunities for both nursing students and practicing nurses to increase their precision in calculating safe drug doses for various age groups and improving their proficiency in medication administration using various methods of delivery. This edition expands coverage of pediatric, obstetric, heparin, and critical care IV calculations.
Purpose: The purpose is to provide a practical workbook to assist readers to practice independently and improve their accuracy and confidence with dosage calculations and determinations about whether prescribed drugs are within safe recommended dosing ranges.
Audience: This book is targeted for nursing students and nursing professionals in various healthcare settings who want to improve their dosage calculation skills and critical thinking related to interpretation of prescribed medications and administration techniques.
Features: This user-friendly workbook walks the participant through the calculation process step by step. The book describes two alternative formula methods and provides actual drug labels for use in the calculation process. It features real clinical dosage calculation patient situations to enhance the nurse's critical thinking skills and accuracy. Actual size photography of syringes and other equipment are featured to more clearly illustrate content. A CD-ROM interactive disc is also included.
Assessment: This is an excellent workbook for healthcare personnel interested in improving their accuracy and proficiency in dosage calculation and medication administration. In addition to providing practice in drug calculation, the book includes practice problems in conversion of measurements, analysis of prescribed medication orders for safe dose range, selection of various methods of medication administration, and case studies and practice tests to enhance the reader's precision and critical thinking skills. This book is appropriate for nursing students (especially those in introductory skills lab courses) and for nursing libraries.

Doody's Review Service