Dosage Cal

Decimal Dosages in Healthcare

  • Understanding decimal placements is crucial in healthcare for dosages and measurements.

    • Incorrect decimal placement can lead to serious medication errors, including underdosing or overdosing.

    • Example given:

    • 0.125 mg (example one) vs. 3.125 mg (example two).

    • These decimal distinctions could cause significant misinterpretations.

Writing Decimals

  • Proper notation of decimals is emphasized:

    • Ensure accurate decimal writing to avoid confusion.

  • Adding and subtracting decimals:

    • Place decimals in aligned columns.

    • Perform operations from right to left.

    • Safety alert: Zeros can be used for alignment but should not be included in the final answer.

Rounding Decimals

  • Rounding rules vary depending on used equipment (like syringes):

    • Carry figures to appropriate decimal places as instructed.

    • Rounding to the nearest tenth is introduced:

    • If the hundredths place is 5 or greater, increase the tenths place by 1.

      • Example: 4.15 → 4.2.

    • If the hundredths place is less than 5, drop the figure.

Measurement Systems in Medication Administration

Household System

  • Equivalents and specific rules regarding household systems that relate to medication:

    • One pint = 16 fluid ounces (fl oz)

    • One quart = 32 fluid ounces or 2 pints.

  • Understanding abbreviations: weight is denoted as "gr" (grain).

    • Avoid confusion between grain (gr) and milligram (mg).

  • Important conversions to memorize for ease:

    • 1 gram (g) = 15 grains (gr)

    • 1 gram = 60 or 65 milligrams (mg).

Volume Conversions

  • One ounce = 30 milliliters (ml).

    • Medicine cups generally have a 1-ounce capacity.

  • Remember the household system is less precise:

    • Capacities of glasses/utensils can vary unless calibrated.

    • Examples of common measurement equivalents:

    • 1 teaspoon (tsp) = 5 ml.

    • 1 tablespoon (tbsp) = 15 ml.

    • 1 measuring cup = 8 oz.

Apothecary Measurements

  • These are similar measures to household systems, but caution is necessary.

  • Minimum unit of measure is a drop.

  • Delivery devices should be calibrated for accurate medication doses.

Intravenous (IV) Administration

  • IV administration has advanced, sometimes IV pumps are integrated into MRI machines to avoid patient delays.

  • Safety and precautions for IV infusions wildly utilized in emergency and non-emergency situations are discussed.

Other Medication Measurements

  • Units of medication generally pertain to specific drugs:

    • Heparin, Insulin, and Penicillin are measured in units.

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International Units and Milliequivalence

  • Understanding terms:

    • 1 milliunit = 1/1000 of a unit.

    • Milliequivalence (mEq) is crucial for dosage calculations, especially electrolytes like potassium.

  • Medication requiring careful conversion to prevent overdoses, emphasizing that underdosing can be as dangerous as overdosing.

Conversion of Measurements

Key Equivalents to Memorize

  • 1 tsp = 5 ml = 1/3 tbsp.

  • 1 tbsp = 15 ml(approx).

  • 1 oz = 30 ml.

  • 1 pint = 16 oz or 500 ml.

  • 1 quart = 32 oz or 1000 ml.

  • 1 measuring cup = 8 oz = 240 ml.

  • 1 pound = 16 oz or 450 grams.

Additional Metrics

  • 2.2 pounds = 1 kg = 1000 grams.

  • 1 inch = 2.5 cm.

Conversion Process

  • Conversion terminology includes moving decimals:

    • From larger to smaller units, moving to the right.

    • From smaller to larger units, moving to the left.

Dimensional Analysis

  • Utilizing dimensional analysis involves:

    • Writing conversion factors in fraction formats where desired units are in the numerator.

    • Understand and follow correct mathematical principles to yield appropriate equivalencies and answers.

Medication Intake and Output Monitoring

  • Intake and Output (I&O) is essential in monitoring patient fluid balance:

    • I&O must include all intake liquids or any outputs.

    • IV fluids, urine output, vomiting, and other liquid losses are recorded.

  • Measurement recording:

    • Convert all fluid ounce intake to milliliters.

    • Total intake should equal output for balanced measurement and monitoring.

Medication Orders

Essential Components

  • Key components of a medication order require:

    • Client’s name, date & time, medication name, dosage, route, frequency, prescriber’s signature.

  • Knowledge about common medication types and their administration times is essential for safe practice:

    • Standing Orders: Routine, e.g., "Ampicillin 1 gm IV q6h for 4 doses."

    • PRN Orders: Given as needed, e.g., "Tylenol 600 mg PO q4h PRN for temp > 101°."

    • Stat Orders: Immediate administration, e.g., "Adivan 2 mg IM stat."

    • One-time Orders: E.g., "Tdap 0.5 ml IM once."

Special Considerations for Medication Orders

  • Ensure notation of 'hold' in the order for certain conditions (e.g., hold if BP <100).

  • Emphasize clear routes and abbreviations to prevent errors.

  • Highest alert medications require double-checking by a second nurse to confirm dosage before administration.

Safety Protocols in Medication Administration

  • Emphasize caution with high-alert medications such as anticoagulants, potassium, and insulin, stressing verification before administration given the serious consequences of errors.