Medical Dosage CalculationsA Dimensional Analysis Approach

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For courses in medical dosage calculation in departments of nursing, pharmacy, pre-med, pre-dental, and other health disciplines; and for courses covering dosage calculation in other programs, such as pharmacology, pediatrics and critical care.

The complete and user-friendly guide to safe drug dosage calculation
Fully revised for current practices and medication, Medical Dosage Calculations remains the field’s most complete, user-friendly and accessible drug calculation text and workbook. Using the dimensional analysis format it pioneered, students begin with simple arithmetic, progressing to the most complex drug calculations. As they develop mathematical skills for accurate dosage calculations, they also gain a thorough professional understanding of safe drug administration. Compared with competitors, our text contains deeper, more realistic problems, incorporating actual dosages and requiring real critical thinking.

June Looby Olsen began her nursing career in Burlington, Vermont, at Bishop De Goesbriand Memorial Hospital, where she graduated from its nursing program. She obtained her BS and MS degrees in nursing from St. John’s University, New York. She was a staff nurse, as well as a nurse supervisor, and became head nurse at the Veterans Administration Hospital in Brooklyn, New York.

Her teaching career began at Staten Island Community College, and she retired as full professor emeritus from the College of Staten Island of the City University of New York. In addition to this textbook, Professor Olsen has written Fundamentals of Nursing Review and Dosage Calculation, both published by Springhouse. She was a recipient of the Mu Epsilon Leadership in Nursing award.

Anthony Giangrasso was born and raised in Maspeth, New York. He attended Rice High School on a scholarship and in his senior year was named in an annual citywide contest by the New York Journal-American newspaper as New York City’s most outstanding high school scholar-athlete. He was also awarded a full-tuition scholarship to Iona College, from which he obtained a BA in mathematics, magna cum laude, with a ranking of sixth in his graduating class.

Anthony began his teaching career as a fifth-grade teacher in Manhattan, as a member of the Christian Brothers of Ireland, and taught high school mathematics and physics in Harlem and Newark, New Jersey. He holds an MS and PhD from New York University and has taught at all levels from elementary school through graduate school. He is currently teaching at Adelphi University and LaGuardia Community College, where he was chairman of the mathematics department. He has authored nine college textbooks through twenty-five editions.

Anthony’s community service has included membership on the boards of directors of the Polish-American Museum Foundation, Catholic Adoptive Parents Association, and Family Focus Adoptive Services. He was the president of the Italian-American Faculty Association of the City University of New York and the founding chairman of the board of the Italian-American Legal Defense and Higher Education Fund, Inc. He and his wife, Susan, are proud parents of three children–Anthony, Michael, and Jennifer–and grandparents of Calvin and Jackson. He enjoys tennis and twice has been ranked #1 for his age group in the Eastern Section by the United States Tennis Association.

Dolores M. Shrimpton is Professor emerita of Nursing at Kingsborough Community College (CUNY), where she was Chairperson of the department for thirteen years. She received a diploma in nursing from Kings Country Hospital Center School of Nursing, a BS from C.W. Post College, an MA in nursing administration from New York University, and a post-Master’s certificate in nursing education from Adelphi University. She is a member of the Upsilon and Mu Upilson Chapters of Sigma Theta Tau. She has taught a wide variety of courses in practical nursing, diploma, and associate degree nursing programs. She has authored three college nursing books through seven editions.

Dolores has held many leadership positions in nursing, including Board Member, Vice-President, and President of the NYS Associate Degree Nursing Council. She was the Co-Chair of the CUNY Nursing Discipline Council, and Member of the Board of Directors and Co-President of the Brooklyn Nursing Partnership. She has served on a number of Advisory Boards of LPN, associate degree, and baccalaureate degree nursing programs. She is a recipient of the Presidential Award in Nursing Leadership from the Nurses Association of Long Island (NACLI) as well as of the Mu Upsilon award for Excellence in Nursing Education and Excellence in Nursing Leadership. The Brooklyn Nursing Partnership has also recognized her for her commitment to nursing.

Dolores lives in Brooklyn, New York, and enjoys cooking and spending time with her grandchildren, Brooke Elizabeth, Paige Dolores, Jack Paul, and their parents, Kim and Shawn. She also enjoys traveling and spending time with friends and family in Harwich Port, Cape Cod, Massachusetts.

Unit 1 Basic Calculation Skills and Introduction to Medication Administration 1
Chapter 1 Review of Arithmetic for Dosage Calculations 2
Diagnostic Test of Arithmetic 3
Changing Decimal Numbers and Whole Numbers to Fractions 5
Calculator 6
Ratios 7
Changing Fractions to Decimal Numbers 8
Rounding Decimal Numbers 10
Rounding Off 10
Rounding Down and Rounding Up 10
Adding Decimal Numbers 11
Subtracting Decimal Numbers 12
Multiplying Decimal Numbers 12
Dividing Decimal Numbers 13
Estimating Answers 14
Multiplying Fractions 15
Dividing Fractions 16
Complex Fractions 18
Addition and Subtraction of Fractions 19
Same Denominators 19
Different Denominators 20
Percentages 21
Percent of Change 23
Summary 24
Practice Sets 24
Chapter 2 Safe and Accurate Medication Administration 28
The Medication Administration Process 29
Preventing Medication Errors 29
Six Rights of Medication Administration 30
The Right Drug 30
The Right Dose 31
The Right Route and Form 32
The Right Time 36
The Right Patient 37
The Right Documentation 38
Drug Prescriptions 39
Medication Orders 42
Types of Medication Orders 43
Components of a Medication Order 43
Medication Administration Records 46
Technology in the Medication Administration Process 51
Drug Labels 53
Combination Drugs 57
Controlled Substances 58
Drug Information 58
Prescription Drug Package Inserts 59
Over-the-Counter (OTC) Labels 59
Summary 63
Practice Sets 64
Chapter 3 Dimensional Analysis 77
Introduction to Dimensional Analysis 78
The Mathematical Foundation for Dimensional Analysis 78
Changing a Single Unit of Measurement to Another Single Unit of Measurement 80
Simple (One-Step) Problems with Single Units of Measurement 80
Complex (Multi-Step) Problems with Single Units of Measurement 84
Changing One Rate to Another Rate 88
Simple (One-Step) Problems with Rates 88
Complex (Multi-Step) Problems with Rates 90
Summary 93
Practice Sets 93
Unit 2 Systems of Measurement 97
Chapter 4 The Household and Metric Systems 98
The Household System 99
Liquid Volume in the Household System 99
Weight in the Household System 100
Length in the Household System 101
Decimal-Based Systems 102
The Metric System 103
Liquid Volume in the Metric System 104
Weight in the Metric System 106
Length in the Metric System 109
Summary 110
Practice Sets 110
Chapter 5 Converting from One System of Measurement to Another 117
Equivalents of Common Units of Measurement 118
Metric-Household Conversions 119
Volume Conversions 119
Weight Conversions 121
Length Conversions 122
Summary 124
Practice Sets 124
Unit 3 Oral and Parenteral Medications 131
Chapter 6 Oral Medications 132
Simple (One-Step) Problems 133
Medication in Solid Form 133
Medication in Liquid Form 137
Medications Measured in Milliequivalents 141
Complex (Multi-Step) Problems 143
Dosages Based on the Size of the Patient 149
Dosages Based on Body Weight 149
Dosages Based on Body Surface Area (BSA) 152
BSA Formulas 152
Summary 155
Case Study 6.1 156
Practice Reading Labels 158
Practice Sets 165
Chapter 7 Syringes 175
Parts of a Syringe 176
Needles 176
Commonly Used Sizes of Hypodermic Syringes 177
Insulin 182
Insulin Syringes 182
Types of Insulin 184
Insulin Pens 186
Insulin Pumps 186
Measuring Two Types of Insulin in One Syringe 189
Premixed Insulin 191
Insulin Coverage/Sliding-Scale Calculations 192
Prefilled Syringes 192
Safety Syringes 194
Needleless Syringes 194
Dosing Errors with Syringes 195
Summary 196
Case Study 7.1 196
Practice Sets 201
Chapter 8 Solutions 214
Introduction 215
Strengths of Solutions Using Explicit Units of Measurement 215
Strengths of Solutions as Ratios, Fractions, and Percents 215
Liquid Solutes 217
Dry Solutes 219
Determining the Amount of Solute in a Given Amount of Solution 221
Determining the Amount of Solution that Contains a Given Amount of Solute 224
Irrigating Solutions, Soaks, and Oral Feedings 226
Summary 227
Case Study 8.1 228
Practice Sets 231
Chapter 9 Parenteral Medications 237
Parenteral Medications 238
Parenteral Medications Supplied as Liquids 238
Parenteral Medications Supplied in Powdered Form 245
How to Use a Mix-O-Vial 251
Heparin 253
Summary 259
Case Study 9.1 259
Practice Sets 262
Unit 4 Infusions and Pediatric Dosages 277
Chapter 10 Flow Rates and Durations of Enteral and Intravenous Infusions 278
Introduction to Enteral and Intravenous Solutions 279
Enteral Feedings 279
Intravenous Infusions 280
Intravenous Solutions 280
Gravity Systems and Pumps 283
Calculations for Infusions 285
Finding the Flow Rate on a Pump 286
Finding the Volume Infused Using a Pump 287
Finding the Duration of an Infusion Using a Pump 287
Finding the Flow Rate (Drip Rate) Using a Gravity System 288
Finding the Volume Infused Using a Gravity System 291
Finding the Duration of an IV Using a Gravity System 292
Adjusting the Flow Rate of an IV 294
Fluid Balance: Intake/Output 296
Summary 297
Case Study 10.1 297
Practice Sets 298
Chapter 11 Flow Rates and Dosage Rates for Intravenous Medications 304
Intravenous Administration of Medications 305
Intravenous Piggyback Infusions 305
Finding the Dosage Rate 306
Converting IV Dosage Rates to Flow Rates 309
Converting IV Flow Rates to Dosage Rates 311
Safe Dose Range 311
Determining Infused Volume and Duration of Infusion 312
IV Push 313
Compound Rates 316
Adding Medication to an IVPB Bag 319
Titrated Medications 323
Summary 326
Case Study 11.1 326
Practice Sets 327
Chapter 12 Pediatric Dosages 334
Pediatric Drug Dosages 335
Oral Medications 335
Parenteral Medications 336
Dosages Based on Body Size 336
Dosages Based on Body Weight 336
Dosages Based on BSA 339
Determining Safe Dosage Range 340
Intravenous Medications 343
Using a Volume-Control Chamber 344
Calculating Daily Fluid Maintenance 347
Summary 349
Case Study 12.1 350
Practice Sets 351
Comprehensive Self-Tests 360
Appendices 373
Appendix A Answer Section 374
Appendix B FDA and ISMP Lists of Look-Alike Drug Names with
Recommended Tall Man Letters 392
Appendix C Commonly Used Abbreviations 397
Appendix D Units of Measurement in Metric and Household Systems 399
Appendix E Celsius and Fahrenheit Temperature Conversions 400
Appendix F Diluting Stock Solutions 402
Appendix G Apothecary System 405
Index 410

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