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Objective 1: Convert within and between

measurement systems as required
Œetric System

u Œetric The metric system is based on units of 10

Components of the gram (g):
AHS 129: Unit I u Household
u Kilogram (kg)
Objectives 1-7 u Gram (g) 
u Œilligram (mg) 
Review of Concepts from u Œicrogram (mcg)  
 
AHS 126 Health Calculations
Components of the liter (L):
u Liter (L)
u Œilliliter (mL)


Tip for Success Practice converting within Œetric* Answers

If your order is in micrograms, and your 1. 0.3 mg = ________ microgram 1. 300 micrograms
available is in grams, meet in the middle and 2. 100 g = ________ kg 2. 0.1 kg
convert both of these to milligrams! To 3. 700 microgram = _______ mg 3. 0.7 mg
convert micrograms to milligrams, you divide 4. 15 mg = ________ g
by 1,000 (easy to do on your calculator). To 4. 0.015 g
5. 900 mL = _________ L
convert grams to milligrams, multiply by 5. 0.9 L
6. A drug is ordered in 200 microgram. The medication
1,000! is available only in mg. How many mg is 200 6. 0.2 mg
microgram?
*Answers on next slide

Tip for Success Household System Tip for Success

Remember that, in the clinical setting, you
must put a zero before the decimal point and
you don͛t use ͞trailing͟ zeros.
On your practice tests and attempts, patients
u The only conversion relevant for this course is: will weigh in whole numbers! If they don͛t,
Weight conversion you did something wrong͙recheck this!
u 2.2 lb = 1 kg
Remember the rounding
guideline͙kg are rounded to
the tenth!

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Objective 2: Apply rounding guidelines to all

Practice converting between Systems Answers dosage calculations answers (Course Œaterials -
http://www.tridenttech.edu/Student_Course_Œaterials_nu4006.pdf )

Guideline 1: Dosage calculation answers greater than one:

1. 0.2 L Round to the nearest tenth or one place to the right of the decimal point
Example: 1.57 is rounded to 1.6
1. 200 mL = _______ L 2. 99 lbs 3.85 is rounded to 3.9
5.34 is rounded to 5.3
2. 45 kg = _______ lbs 3. 65.9 kg
Guideline 2: Dosage calculations answers less than one
Round to the nearest hundredth or two places to the right of the decimal point
3. 145 lbs = _______kg Example: 0.399 is rounded to 0.4
0.567 is rounded to 0.57
* Answers on next slide 0.323 is rounded to 0.32
0.455 is rounded to 0.46
Exceptions:
1. Tablets and suppositories would be rounded to the nearest half given the tablet or suppository
is scored.
2. Drops per minute (gtts.min) infusion rates are rounded to the whole number.

Practice problems for applying rounding

Rounding Is this a calculation
guidelines:
Answers
dealing with gravity
Guidelines (drops/min)?
1. 3.45 mL = ______ mL
1. 3.5 mL
for Answers 2. 0.679 mL = ______ mL
2. 0.68 mL
3. 15. 3 mL = ______ mL
NO, see the next Yes, ROUND to the
question WHOLE number. 4. 7.25 mL = ______ mL 3. 15.3 mL
5. 0.523 mL = ______ mL 4. 7.3 mL
6. 0.099 mL = ______ mL 5. 0.52 mL
Is the answer greater Is the answer less
than 1? than 1? 7. 28.8 gtts/min = _____ gtts/min 6. 0.1 mL
i.e. 1.25, 1.756 i.e. 0.234, 0.568 8. 0.99 mL = ______ mL
7. 29 gtts/min
9. 0.996 mL = ______ mL
Yes, ROUND to the Yes, ROUND to the *Answers on next page
8. 0.99 mL
TENTH (one) place HUNDREDTH (two) 9. 1 mL
after the decimal places after the
place. decimal point.

Objective 3: Solve dosage calculations

Ratio & Proportion: Written Horizontally Tip for Success
using preferred method
You can use the last part of the previous slide
u The terms in the proportion are called the means to check your work to be sure you have the
u Ratio & Proportion is used to calculate dosages and
and extremes
convert dosages between different system means are the middle two numbers
right answer. In this example, if you get
u îatio = relationship between 2 numbers. extremes are the end (or outside) two numbers something other than 24, you would know
Written vertically, i.e. 1 : 2 , 3 : 4, 5 : 8 9
 
 that you made a mistake!
Written horizontally as a fraction, i.e. 1, 3 3: 4 = 6 :8
e xp ressio n

2 4  

u Îroportion = equation of 2 ratios of equal value, i.e. Œeans equals 4 times 6 equals 24
1:2 = 2:4 Extremes equals 3 times 8 equals 24

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Steps to solve dosage calculation

Ratio and Proportion: Written Vertically Example using ratio and proportion
using ratio and proportion
1. State the known ratio (o r w h a t u 2:80
i s available)
u Fractions which are written vertically use cross u 2:80 = x:55 1. If there are 5 pennies in 1 nickel, how many
2. Add the incomplete ratio (o r
multiplication to solve for the answer w h a t is desired)
pennies are in 2 nickels?
u Example: 3 6 3. Label terms and keep in u 2 mL:80 mg=x mL: 55 mg
 same order 2. Œedication order: Heparin 5,000 units SC
4 8 u 110 = 80x
4. Œultiply the means and u 110 80x
Available medication: 10,000 units/mL
u Again, 3 times 8 equals 24 extremes (h o ri zontal e xpressio n) 
u And 4 times 6 equals 24 80 80 How many mL will you give the patient?
5. Divide by the number in
u Given both horizontal and vertical calculations and front of the equation. u 1.375 = x
when three values are known, the fourth value can be Label & apply rounding u 1.4 mL = x
guidelines
Apply the rounding guidelines (Answers on next
easily calculated.
page).

Dimensional analysis to solve dosage Steps to solve dosage calculation using

Answer (& Tip for Success) calculations dimensional analysis
1. 10 pennies (Tip: just to show you that you do 1. What is desired? u X
 =
use ratio & proportion every day) u You need to know 2. What is available? u x mL = V

What is desired? The available 

2. 0.5 mL (Tip: Before you solve a problem, numerator͛s unit
What is available?
a
 and look at your numbers. In this matches the desired
u The available numerator͛s unit matches the desired unit
example, where you have 10,000 units/mL unit
3. What is ordered?
and you want 5,000 units, will your answer What is ordered? u x mL = 2 mL  **

The ordered unit
be greater than or less than one? This will u The ordered unit matches the previous denominator͛s matches the previous 80 mg 1 mL
help you check your answer). unit denominator͛s unit u x = 2 x 55
Work the math and apply the rounding guidelines. 4. Work math & apply 80
rounding guidelines u x = 1.375 = 1.4 mL

Objective 4: Calculate weight-based

Example using dimensional analysis
1. If there are 5 pennies in 1 nickel, how many
pennies are in 2 nickels?
2. Œedication order: Heparin 5,000 units SC
Available medication: 10,000 units/mL
How many mL will you give the patient?
Apply the rounding guidelines
dosages for a 24-hour period
u Dosages for pediatrics, as well as adults, are often
ordered based on weight and recommended
dosing is given for a 24-hour period. Examples:
25-50 mg/kg/day in 4 divided doses
10-25 mg/kg/day in equally divided doses q6h
12.5 mg/kg/day in divided doses q4h
u Ordered doses must be verified that they are ap
safe based on the person͛s weight.
Steps to Solve . . . .
u What is the weight in kilograms?
u What is the recommended daily dosage range?
u What is the divided dosage range?
u Compare the ordered dose to the daily
dosage range.
u Is the ordered dosage safe?
u When calculating the dose, apply rounding guidelines.
u Use a dosage calculation method to solve

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Example 1: Weight-based Answer Example 2: Weight-based

Œedication order: Gentamicin 50 mg IVPB q 8 hr for a child
weighing 40 lb
Recommended Daily dose: 6 - 7.5 mg/kg/24 hrs in 3
equally divided doses
Available: 50 mg Gentamicin in 100 mL NS
u What is the weight in kilograms? Apply rounding guidelines
u What is the recommended daily dosage range?
u What is the divided dosage range?
u Is the ordered dosage safe?
u What is the weight in kilograms? 18.2 kg
u What is the recommended daily dosage
range? 109.2 mg ʹ 136.5 mg/day
u What is the divided dosage range? 36.4 mg ʹ
45.5 mg/dose
u Is the ordered dosage safe? No
>




  

a
 
  
Œedication order: Dicloxacillin 55 mg q 6 hrs for a child
weighing 37 lb
Recommended dose: Dicloxacillin 12.5 mg/kg/day in 4
divided doses for children weighing less than 40 kg
Available: Dicloxacillin 62 mg per 5 mL
Is the ordered dose safe?
*See next slide for answer
 
 
 a 
*Answers next slide
Answers
u What is the weight in kilograms? 16.8 kg
u What is the recommended daily dosage?
210 mg/day
u What is the divided dosage? 52.5 mg
u Is the ordered dosage safe? No
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Tip for Success
Always be sure that you are comparing the
ordered dose to a recommended dose or the
amount you would give per day to the
recommended daily dose. Don͛t get these
mixed up!
Objective 5: Calculate intravenous (IV)
flow rates in drops per minute (gtt/min)
u Gtts/min infuse into the vein using the
concept of gravity to aid the flow.
u Physician͛s order will contain the needed
information
Type of fluid
Volume or amount of fluid
Time period
 



a  u IV tubing ͞drop factor͟

 
  10, 15, 20, and 60 gtt/mL

Vormula A: IV infusions (gtts/min) Example 1: flow rate gtts/min
Physician order: Administer an IV fluid at
amount of solution (mL) x drop factor = x gtt/min 100 mL/hour.
Drop factor : 20 gtt/mL
time in minutes
What are the 3 elements needed to
100 mL x 12 gtt/mL = 1200 = 20 gtt/min solve this problem?
60 min. 60 How many drops per minute will you
Rounding guideline alert: Drops are always regulate the IV?
Apply the rounding guidelines
whole numbers!!!
*Answers for all examples follow.
Example 2: flow rate gtts/min
Infuse 150 mL/hr of D5RL 1,000 mL
Drop factor: 10 gtt/mL
u How many drops per minute will you regulate
the IV?
u Apply the rounding guidelines
u How many hours will it take to infuse 1,000
mL?

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How many hours will it take?
Why would you want to know this? Well, you
might need to anticipate and order a new bag
of IV fluids, or you might want to include this
in your report to the next shift. To calculate
this, just take the total volume (1,000 mL) and
divide it by the hourly rate (150 mL/hr).
Answers
u Example 1: 33 gtts/min
u Example 2: 25 gtts/min; 6.7 hours to infuse
u Example 3: 26 gtts/min
u Example 4: 75 gtts/min
Primary fluid Example 1: flow rate mL/hr
Order: 1000 mL bolus of 0.9% normal saline
Give over 3 hours
u How many mL/hr will the IV pump be set?
u Apply the rounding guidelines
*Answers found at the end of these examples
Example 3: flow rate gtts/min
Infuse 2,500 mL of D5W in 24 hours
Drop factor: 15 gtt/mL
u How many drops per minute will you regulate
the IV?
u Apply the rounding guidelines
Objective 6: Calculate intravenous (IV)
flow rates in milliliter per hour (mL/hr)
IV infusing devices or IV pumps deliver
fluids in amounts per hour and there is
NO need to know the drop factor. A
dosage calculation method is needed
to find the answer.
IV piggyback Example 2: mL/hr
Œedication order: Ancef 1 g every 8 hours over
20 minutes
Available: Ancef 1 g in 100 mL
u How many mL/hr will you set the IV pump?
u Apply the rounding guidelines
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Example 4: flow rate gtts/min
Œedication Order: Piperacillin 1 g in 50 mL IV
piggy back over 40 minutes
Drop Factor: 60 gtt/mL
u How many drops per minute will you regulate
the IV piggyback flow rate?
u Apply the rounding guidelines
Infusion pump or IV Pump Settings:
The order reads:
Infuse 1000 mL of NS at 150 mL/ hr.
There are 2 settings that will be entered into the IV
pump:
1. The mL per hour to infuse is 150
2. The total amount to be infused is

950 (Usually a number less than the total

volume is entered so the IV
does not ͞run dry.͟
IV piggyback Example 3: mL/hr
Œedication Order: Piperacillin 1 g in 100 mL IV
piggy back over 40 minutes
u How many mL/hr will you set the IV pump?
u Apply the rounding guidelines
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IV Example 4: Total fluid Answers Tip for Success

950 mL of fluid is infusing at 80 mL/hr
u How long will it take for the IV bag to finish?
u Example 1: 333.3 mL/hr When solving problems that involve an IVPB that is
given over minutes, convert 1 hour into sixty
u Example 2: 300 mL/hr
minutes. This way, you will be dealing with whole
u Example 3: 150 mL/hr numbers. If you do convert minutes into a part of an
u Example 4: 11.9 hours hour͙DON͛T ROUND!
Look at example 2 above. If you convert 20 minutes
to a part of an hour (20/60) you get 0.3333333. If
you round this to 0.3 and then divide 100 by this, you
get 333, which is much different than the answer of
100! Dividing 100 by 0.3333333 does equal 300.

Review questions: Question Two Question Three

Question 1 (Answers at end)
Œedication order: Kantrex 200 mg IVPB q8h.
Available: Kantrex 75 mg per 2 mL
Safe dose is 15 mg/kg/day in divided doses q8h.
Child͛s weight is 35 kg.
u What is maximum safe dose for 24 hours?
u What is the divided dose?
u Is the ordered dose safe?
Œedication order: Phenobarbital 10 mg q12h for a child
weighing 9 lb. Recommended dose is 3-5 mg/kg/day
in divided doses q12h.
u What is the weight in kilograms rounded to tenth?
u What is the recommended daily dosage range?
u What is the divided dosage range?
u Is the ordered dosage safe?
u Phenobarbital elixir is available in dose strength 20 mg
per 5 mL How many mL will you administer for one
dose?
u Apply the rounding guidelines.
Œedication order: Vancomycin 200 mg IV q6h for a
child whose weight is 38 lb. Recommended dose for
Vancomycin is 40 mg/kg/24 hrs in divided doses
q6h.
u What is the weight in kilograms rounded to the
nearest tenth?
u What is the recommended daily dosage?
u What is the divided dosage?
u Is the ordered dosage safe?

Question Four Question Five Question Six

Œedication order: Erythromycin 200 mg in 250
mL of D5W to infuse over 1 hour. The IV
tubing delivers 10 gtts/mL
u What are the gtts/minute?
u Apply the rounding guidelines.
Œedication order: Clindamycin 900 mg in 75 mL Œedication order: Clindamycin 900 mg in 75 mL
D5W to infuse over 30 minutes. D5W to infuse over 40 minutes.
The gtt factor is 10 gtt/mL u How many mL/hr will you set the IV pump?
u What is the gtt/minute? u Apply the rounding guidelines.
u Apply the rounding guidelines.

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Answers Answers cont. End

u Question 1: u Question 3:
What is maximum safe dose for 24 hours? 525 mg What is the weight in kilograms rounded to the nearest
What is the divided dose? 175 mg tenth? 17.3 kg
Is the ordered dose safe? No What is the recommended daily dosage? 692 mg
What is the divided dosage? 173 mg
u Question 2:
Is the ordered dosage safe? No
What is the weight in kilograms rounded to tenth? 4.1 kg
What is the recommended daily dosage range? 12.3 ʹ 20.5 u Question 4: 42 gtts/min
mg/day
What is the divided dosage range? 6.2 mg ʹ 10.3 mg/dose u Question 5: 25 gtts/min
Is the ordered dosage safe? Yes u Question 6: 112.5 mL/hr
Phenobarbital elixir is available in dose strength 20 mg per 5
mL How many mL will you administer for one dose? 2.5 mL

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