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Unit Conversions

* Mass
mcg→mg→g→kg (÷ by 1,000)

mcg←mg←g←kg (x by 1,000)
EX: Convert 5,000mcg to mg

mcg→ mg →g →kg (÷ by 1,000)

5,000mcg ÷ 1,000= 5mg

* Weight
lb→kg (÷ by 2.2)

lb←kg (x by 2.2)
EX: Convert 74.8lb to kg

74.8lb ÷ 2.2 = 34kg

* Volume
mcL→ mL→ L→ KL (÷ by 1,000)

mcL← mL← L← KL (x by 1,000)


EX: Convert 0.003L to mcL
mcL← mL← L← KL (x by 1,000)
Convert L to mL then mL to mcL
0.003L X 1,000=3mL
3mL X 1,000=3,000mcL

* Time
min→ hr (÷ by 60)

min← hr (x by 60)
EX: Convert 5 hours to minutes
min← hr (x by 60)
5hrX60=300min
Dosage Calculations
Mass for mass questions
* Given an amount of mass per tablet, how many tablets do you require?
Formula: Ordered
--------------- = tablets required
Have

Example: Lopressor, 25mg by mouth, is ordered. Lopressor is available as


50mg tablets. How many tablets would the nurse give?

25mg
--------------- = 0.5 tablets
50mg

Mass/Liquid for Liquid questions


*Given an amount of mass per liquid, how much liquid do you require?
Formula: Ordered
--------------- X volume Per Have= liquid required (mL)
Have

Example: Dilantin, 0.1g by mouth , is ordered to be given through a nasogastric


tube. Dilantin is available as 30mg/5mL. How much would the nurse give?
1. Convert 0.1g to mg
mcg←mg←g←kg (x by 1,000)
0.1g X 1,000=100mg
2. Plug numbers into formula
100mg
--------------- X 5mL = 16.7mL
30mg
Parenteral Dosage of Drugs
*Given an amount of mass per liquid, how much liquid do you require for
injection? Apply the same steps used for the calculation of oral dosages.
Formula: Ordered
--------------- X volume Per Have= liquid required (mL)
Have

Example: Ordered: Lasix 40mg IV push now. Available: 80mg in 1mL


40mg
--------- X 1mL=0.5mL
80mg

*Rule: The maximum dosage volume to be administered per IM injection site:


1. Average 150lb adult = 3mL (maximum for deltoid is 2mL)
2. Children 6 to 12 years = 2mL
3. Children birth to 5 years = 1mL

*Rule: As you calculate Parenteral dosages:


1. If the amount is greater than 1mL, round the amount to be given to the tenths
(ex: 1.3mL). Measure it in a 3mL syringe.
2. If the amount is less than 1mL, round the amount to be given to hundredths
(ex: 0.65mL). Measure it in a 1mL syringe.
3. Amounts of 0.5 to 1mL, calculated in tenths (ex: 0.6mL), can be measured in
either a 1mL or 3mL syringe.

Important IV Terms and Abbreviations


*IV Terms:
gtts- drops
Drop Factor- Number of drops per volume of IV fluid.
Measured in gtts/mL
Drop factor is stated on the IV tubing package.
Macrodrop factors- 10, 15, or 20 gtt/mL
Microdrop factor- 60 gtt/mL
Flow Rate- Measure of the flow of liquid from an IV.
Usually measured in gtts/min or in mL/hr.
gtts/min- is used for manually regulating an IV.
mL/hr- is used when utilizing an electronic IV regulator.
Tonicity or Osmolarity- blood or serum concentration. Usually measured in
milliOsmols per liter, or mOsm/L. *The osmolarity of a manufactured solution is
detailed on the printed label. Look for the mOsm/L under the solution name.
Normal Average Tonicity for all ages is 280-320 mOsm/L
Hypotonic (<250 mOsm/L)- lower tonicity or osmolarity than blood and other
body serums. Solvent exceeds solute - used to dilute excess serum electrolyte,
as in hyperglycemia.
Isotonic (250-375 mOsm/L)- the same tonicity or osmolarity as blood and other
body serums. Solvent and solutes are balanced - used to expand volume and
maintain normal tonicity.
Hypertonic (>375 mOsm/L)- higher tonicity or osmolarity than blood and other
body serums. Solutes exceed solvent - used to correct electrolyte imbalances, as
in loss from excess vomiting and diarrhea.

Primary IV- used when administering primary IV fluids. Tubing includes a drip
chamber, one or more injection ports, and a roller clamp. Can be regulated
manually using the roller clamp or by placing the tubing in a electronic infusion
pump.
Secondary IV- used when giving medications. Secondary tubing is shorter and
also contains a drip chamber and roller clamp. It is “piggybacked” into the
primary line. This gives access to the primary IV catheter with having to start
another IV. *IVPB is hung higher than primary IV to allow the secondary set of
medication to infuse first.
*Major complications associated with IV therapy:
Phlebitis-vein becomes irritated, red, or painful (warm and cordlike vein).
Infiltration-IV catheter becomes dislodged from the vein and IV fluid escapes
into subcutaneous tissue (cool and puffy skin).
Infection
Solution strength- expressed as a percent (%) indicates the number of g per
100mL. *The abbreviation letters indicate the solution components, and the
numbers indicate the solution strength or concentration of the components.

D- Dextrose NaCl- Sodium Chloride


W- Water RL- Ringer’s Lactate
S- Saline LR- Lactated Ringer’s
NS- Normal Saline (0.9% NaCl)
Examples:
D5W= dextrose 5% in water
D5LR= dextrose 5% in Lactated Ringer’s
D5NS 1,000 mL IV q.8.h.= administer 1,000 mL 5% dextrose in normal saline
intravenously every 8 hours.
D5 ¼ NS= 5% dextrose in 0.225% saline solution

Calculating Components Of IV Solutions When Expressed As A


Percent %
*Given a volume of IV fluid and a dosage expressed in %, what is the mass of
the particular dosage?
*Remember that % indicates g per 100mL.
Formula: Concentration %
--------------------------- X volume (mL)= Dosage amount (g)
100mL

Example 1:
Calculate the amount of dextrose in 1000mL D5W.
5
------------- X 1000mL= 50g
100mL

Example 2:
Calculate the amount of Sodium Chloride in 2000mL NS.
*Recall that NS is 0.9% NaCl (Sodium Chloride)
0.9
----------- X 2000mL= 18g
100mL

Example 3:
Order: D5 ¼ NS 500mL IV q.6h
Calculate the amount of dextrose and sodium chloride in 500mL.
D5= Dextrose 5% (5g of dextrose per 100mL)
5g
----------- X 500mL= 25g of Dextrose
100mL

¼ NS= 0.225%NaCl (0.225g NaCl per 100mL)


*Recall that NS is 0.9% NaCl; therefore ¼ NS is ¼ X 0.9% = 0.225% NaCl
0.225g
----------- X 500mL= 1.125g of NaCl
100mL

500mL D5 ¼ NS contains 25g of dextrose and 1.125g sodium chloride.

Calculating Flow Rates For Electronic Regulators in mL/h


* Given a certain amount of liquid and a time period, what is the necessary IV
flow rate in mL/hr?
Formula: Volume (mL)
--------------------------- = Flow Rate (mL/hr)
Time (hr)

Example 1:
Infuse 250mL over the next 120 minutes by infusion pump.
First, convert 120 minutes to hours
min→ hr (÷ by 60)

120÷ 60=2hr
Next, plug in to formula
250mL
----------- = 125mL/hr
2hr

Example 2:
D5W 250mL IV over the next 2hr by infusion pump
250mL
----------- = 125mL/hr
2hr

If the infusion time is less than 1 hour


Formula: Volume (mL)
---------------------------X 60min/h = Flow Rate (mL/hr)
Time (min)

Example: Ampicillin 500mg IV in 50mL D5 ½NS in 30min by controller


50mL
-------------X 60min/h = 100mL/hr
30 min

Calculating Flow Rates For Manually Regulated IVs in gtt/min


* Given a certain amount of liquid, a time period, and a drop factor (gtts/mL),
what is the necessary IV flow rate in gtts/min?
* It is impossible to give a patient a fraction of a drop, so round up or down to the
nearest whole number.

Formula: Volume (mL)


--------------------- X Drop factor (gtts/mL) = Flow Rate (gtts/min)
Time (min)
The drop factor is stated on the IV tubing package.
** Typical values of gtts/min are in the range of 20 to 100 gtts/min.

Example 1:
Calculate the IV flow rate for 1200mL of NS to be infused in 6 hours. The
infusion set is calibrated for a drop factor of 15 gtts/mL.
First convert 6 hours to minutes
Min← hr (x by 60)
6hr x 60 = 360min
Next, plug numbers into formula
1200mL
--------------------- X 15 gtts/mL = 50 gtts/min
360min

Example 2:
Calculate the IV flow rate for 200mL of 0.9% NaCl IV over 120 minutes. Infusion
set has a drop factor of 20 gtts/mL.
200mL
--------------------- X 20 gtts/mL = 33 gtts/min
120min

Calculating IV Push Drugs And Safe Infusion Times


* Dosage calculations for IV push injections are the same as calculations for IM
injections.
Formula: Ordered
--------------- X volume Per Have= liquid required (mL)
Have
Example:
Order: Ativan 3mg IV push 20 min preoperatively
Supply: Ativan 4mg/mL with drug literature guidelines of IV infusion not to
exceed 2mg/min.
How much Ativan should you prepare?
3mg
--------------- X 1mL= 0.75mL
4mg

What is a safe infusion time?


Formula: Ordered
------------- X Quantity of time to infuse supply dose= infusion time
Have

3mg
--------------- X 1min= 3/2 min =1½ min
2mg

Safe infusion time = 0.75mL over 1½ min.

Calculating IV Infusion Time When mL Is Known


* The nurse needs to know how long a volume of fluid in the IV bag at the current
flow rate will last, i.e.., When will a new bag need to be hung?
Formula: Volume (mL)
-------------------------- = Total hours
Flow rate (mL/hr)

Example:
The nurse makes rounds and notes that the current IV bag contains
approximately 450 mL. The IV flow rate is 150 ml/hr. How long will it be
before the nurse must hang a new bag?
450mL
---------------- = 3hr
150mL/hr

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