Dosage cal.

Fredablyee

DosageCalculationPracticeWorkbook1.pdf

Home >Nursing homework help >Dosage cal.

Dosage Calculation Practice Packet

Oral Meds……………………..….2-7

Syringes and Needles………8-11

Parenteral……………………..12-20

Insulin…………………………...21-25

Powdered………………….…..26-35

Use the information provided to answer questions 1 through 5.

1. How many mL of erythromycin ethylsuccinate will the nurse administer?

2. The nurse receives a bottle of Amoxicillin and Clavulanate Potassium for Oral Suspension from the pharmacy. What is the total amount of water the nurse will add to reconstitute the Amoxicillin and Clavulanate Potassium for Oral Suspension?

3. What is the total amount (mL) of Amoxicillin and Clavulanate Potassium for Oral Suspension in the bottle after reconstitution?

4. The reconstituted medication must be shaken each time before the administration of a dose. ❏ Yes ❏ No 5. MD orders: Amoxicillin and Clavulanate Potassium for Oral Suspension 600 mg/42.9 mg 2 tsp PO bid.

To administer the medication, the nurse needs to clarify the dosage strength. ❏ Yes ❏ No

D e v e l o p i n g C o m p e t e n c y

Electronic Medical Record

Provider

Order

DateM. Physician, MD

Erythromycin ethylsuccinate oral suspension 0.12 gram

q.AM

2-08-xx

Name

MR #

R. Patient

701256

Age

Allergies

NKDA

Gender

Room

F DOB 11-30-xx

117

Provider Orders Pharmacy sends: Erythromycin ethylsuccinate oral suspension 400 mg per 5 mL.

Directions for mixing: 1. Tap bottle until all powder flows freely.

Add 170 mL of WATER IN TWO PARTS. 2. Add approximately 2/3 of the water for

reconstitution. Shake vigorously. 3. Add remaining water. Shake vigorously.

Keep tightly closed. Shake well before using. Store reconstituted suspension under refrigeration. Discard unused suspension after 10 days.

2496_Ch09_149-178 26/08/16 3:35 PM Page 173

DeCastillo, S. L. M., & Werner-McCullough, M. (2016). Calculating drug dosages : a patient-safe approach to nursing and math. Retrieved from http://ebookcentral.proquest.com Created from ras on 2018-11-04 10:30:48.

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

Oral Medications Practice

6. MD orders: Ceftin Oral Suspension 375 mg PO bid. Pharmacy sends: Ceftin Oral Suspension 125 mg/5 mL How many tsp will the nurse give? The most appropriate measuring device to administer this dose is the: a. medicine cup. b. 5 mL oral syringe. c. 10 mL oral syringe.

7. MD orders: Nitrostat 0.6 mg SL now. Pharmacy sends: Nitrostat 0.3 mg tablets How many tablet(s) will the nurse give? To properly administered the ordered dose, the nurse will: a. give the tablet(s) orally with water. b. place the tablet(s) between the gum and the cheek. c. place the tablet(s) under the tongue.

8. MD orders: Naprosyn SR 500 mg PO q.12h prn migraine headache. Pharmacy sends: Naprosyn SR 250 tablets How many tablet(s) will the nurse give? Which of the following best describes the appropriate administration of this drug? The tablet: a. may be chewed. b. active ingredient is released slowly. c. is placed under the tongue.

9. After reconstituting the fluconazole oral suspension, the nurse will include which of the following on the drug label? (Select all that apply.)

a. Total amount of reconstituted drug b. Dosage strength of the drug c. Time of reconstitution d. Nurse’s initials e. Date of reconstitution

10. Cefdinir for Oral Suspension 250 mg is ordered. Pharmacy sends the following drug. Which of the following applies to the administration of this ordered dose? (Select all that apply.)

a. One tsp will be administered. b. The bottle needs to be shaken well. c. 2.5 mL will be administered. d. 2 mL will be administered. e. It is for enteral use only.

In the following questions, calculate the ordered dose using the method of your choice.

2496_Ch09_149-178 26/08/16 3:35 PM Page 174

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

11. Albuterol sulfate syrup 1 mg is ordered. Pharmacy sends the following drug with a dropper calibrated at the 0.5 mL and 1 mL markings. Which of the following apply to the administration of this ordered dose? (Select all that apply.)

a. 1 mL will be administered. b. The medicine cup can also be used to measure this dose. c. The drug needs to be reconstituted. d. A conversion is not necessary. e. It is for enteral use only.

12. Use the PrednisoLONE Oral Solution drug label to answer the following questions.

How many mL of PrednisoLONE Oral Solution will the nurse administer to the patient q.AM? How many mL of PrednisoLONE Oral Solution will the nurse administer to the patient q.PM?

13. Use the Fluconazole for Oral Suspension drug label to determine the amount of water the nurse will add for recon- stitution of the drug.

Which of the following best describes the action of the nurse who is preparing to administer the 0900 dose of Fluconazole for Oral Suspension on 5/23/xx? (Select all that apply.) a. The nurse may store the drug in the refrigerator. b. The nurse may use this reconstituted drug. c. The nurse needs to reconstitute a new bottle of fluconazole.

Electronic Medical Record

Provider

Order

DateM. Physician, MD

Prednisolone oral solution 15 mg q.AM

Prednisolone oral solution 7.5 mg q.PM

5-09-xx

Name

MR #

U. Patient

560321

Age

Allergies

Penicillin

Gender

Room

F DOB 2-26-xx

405

Provider Orders

05/10/xx 2100 SA. RN

FOR ORAL USE ONLY Usual Dosage: See package insert for full prescribing information. Store dry powder at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature]. Store reconstituted suspension between 25°C (77°F) and 2°C (36°F) and discard unused portion after 2 weeks. Protect from freezing. SHAKE WELL BEFORE EACH USE. DISCARD UNUSED PORTION AFTER TWO WEEKS.

2496_Ch09_149-178 26/08/16 3:35 PM Page 175

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

14. Use the Lanoxin drug label to calculate the ordered dose: Lanoxin tablet 0.125 mg PO qAM. How many tablet(s) will the nurse administer?

15. Use the provider’s orders and Calcitriol label to determine the ordered dose. How many Calcitriol capsule(s) will the nurse administer to the patient?

16. The medication order is for Coreg 6.25 mg PO q.12h. The nurse finds the following drugs in the patient’s medica- tion drawer.

For the morning dose, the nurse is correct in: a. administering one tablet of the 6.25 mg dose. b. administering one-half tablet of the 12.5 mg dose.

Electronic Medical Record

Provider

Order

DateM. Physician, MD

Calcitriol capsule 0.5 mcg PO daily

3-16-xx

Name

MR #

D. Patient

034671

Age

Allergies

NKDA

Gender

Room

F DOB 4-17-xx

302

Provider Orders

2496_Ch09_149-178 26/08/16 3:35 PM Page 176

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

17. The medication order is for metformin 0.5 g PO q.AM. The nurse finds the following drugs in the patient’s medication drawer.

The nurse is most correct in: a. administering two tablets of the 1.25 mg/250 mg dose. b. administering one tablet of the 2.5 mg/500 mg dose. c. calling the pharmacist.

18. Penicillin V Potassium oral solution 100 mg PO q.6h is ordered. How many mL will the nurse administer to the patient?

19. Ceftin oral suspension 250 mg is ordered q.8h. On May 16, the nurse is preparing to give the 5:00 p.m. dose and finds the patient’s medication in the refrigerator.

Which action by the nurse is most appropriate? a. Administer 5 mL. b. Discard expired bottle. c. Clarifying the drug with the pharmacist.

05/06/xx 0900 LM. RN

2496_Ch09_149-178 26/08/16 3:35 PM Page 177

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

20. Vibramycin syrup 150 mg PO is ordered. How many tsp will the nurse instruct the patient to take?

2496_Ch09_149-178 26/08/16 3:35 PM Page 178

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

For questions 1 through 8, read the dose of medication measured in the syringes.

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

½ 1 1½ 2 2½ 3 m L

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

½ 1 1½ 2 2½ 3 m L

1 2 3 4 5 6 7 8 9 1 0

m L

D e v e l o p i n g C o m p e t e n c y

2496_Ch10_179-193 25/08/16 4:38 PM Page 190

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

Syringes and Needles Practice

For questions 9 through 16, fill in the syringe with the dose indicated.

9. 0.68 mL

10. 0.5 mL

11. 1.8 mL

12. 2.2 mL

13. 0.33 mL

14. 3.2 mL

1 2 3 4 5 m L

¼ ½ 1 o z¾

5 1 0

2 0

2 5

1 5

3 0

m L

¼ ½ 1

1 ¼

1 ½

1 ¾ o z¾

5 1 0

2 0

2 5

3 0

3 5

4 0

4 5

1 5

5 0

m L

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

½ 1 1½ 2 2½ 3 m L

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

1 2 3 4 5 m L

2496_Ch10_179-193 25/08/16 4:38 PM Page 191

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

16. 6.8 mL

For questions 17 through 20, use the physician’s order on the electronic medical record and the medication label to determine the amount to administer to the patient. Fill in the syringe with the correct amount.

17.

18.

15. 18 mL

¼ ½ ¾ o z

5 1 0

1 5

2 0

m L

1 2 3 4 5 6 7 8 9 1 0

m L

Electronic Medical Record

Provider

Order

DateM. Physician, MD

Digoxin 150 mcg IV now.

4-08-xx

Name

MR #

J. Patient

12345

Age

Allergies

NKDA

Gender

Room

F DOB 3-10-xx

317-B

Provider Orders

½ 1 1½ 2 2½ 3 m L

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

Electronic Medical Record

Provider

Order

DateM. Physician, MD

Lorazepam 0.2 mg IV on call to surgery.

3-01-xx

Name

MR #

L. Patient

12587

Age

Allergies

NKDA

Gender

Room

M DOB 7-19-xx

320-A

Provider Orders

2496_Ch10_179-193 25/08/16 4:38 PM Page 192

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

19.

20.

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

Electronic Medical Record

Date Time 19007-08-xx

MAR

Time

Scheduled Medications

Drug name Dose Route Freq.

1900 Robinul 150 mcg IV one time dose

Adm.

Name

MR #

Z. Patient

12345

Age

Allergies

NKDA

Gender

Room

M DOB 1-21-xx

207-B

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

Electronic Medical Record

Provider

Order

DateT. Physician, MD

Enalaprilat 312.5 mcg IV q.6h.

1-10-xx

Name

MR #

B. Patient

12345

Age

Allergies

Sulfa

Gender

Room

M DOB 7-23-xx

1330-A

Provider Orders

2496_Ch10_179-193 25/08/16 4:38 PM Page 193

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

1. The order is for phenytoin sodium 80 mg IV now. The following medication is available from the pharmacy. How many mL will the nurse give?

2. The physician orders Granisetron HCl 150 mcg IV now. The nurse has the following vial of medication and the following syringe available. How many mL will the nurse give?

Fill in the syringe with the amount ordered.

½ 1 1½ 2 2½ 3 m L

2496_Ch11_194-225 25/08/16 4:40 PM Page 217

DeCastillo, Sandra Luz Martinez, and Maryanne Werner-McCullough. Calculating Drug Dosages : A Patient-Safe Approach to Nursing and Math, F. A. Davis Company, 2016. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/ras/detail.action?docID=4732552. Created from ras on 2018-11-04 10:39:51.

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

Parenteral Dosage Calculation Practice

3. The patient is due for a dose of glycopyrrolate 100 mcg IM. The nurse has the following vial of the medication. How many mL will the nurse give?

The nurse can draw up the dose in which of the following syringes? a. 1 mL syringe b. 3 mL syringe

4. The patient is to receive mesna 210 mg IV now. The pharmacy sends the following vial of mesna, and the nurse has the following syringes available. How many mL will the nurse give?

Fill in the appropriate syringe with the ordered dose.

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

½ 1 1½ 2 2½ 3 m L

2496_Ch11_194-225 25/08/16 4:40 PM Page 218

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

5. The nurse is preparing a 135 mg IV dose of PACLitaxel. The pharmacy sends the following drug and the nurse has a 1 mL, 3 mL, 5 mL, 10 mL, and 30 mL syringe available to use to withdraw the medication from the vial.

Which of the following applies to the administration of this ordered dose? (Select all that apply.) a. A conversion is not necessary. b. 2.25 mL will be administered. c. All but the 1 mL syringe can be used to measure the ordered dose. d. The nurse should write date, time, initials, and beyond-use date on the vial

after withdrawing the dose.

6. The patient is to receive HYDROmorphone 1.5 mg subcut q.4h prn pain. The following medication is available from the pharmacy. How many mL will the nurse give?

Fill in the appropriate syringe with the amount ordered.

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

½ 1 1½ 2 2½ 3 m L

2496_Ch11_194-225 25/08/16 4:40 PM Page 219

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

7. The physician orders adenosine 4.5 mg IV STAT. The nurse has available the following prefilled syringe of adenosine:

How many mL will the nurse discard from the prefilled syringe? How many mL will the nurse administer?

8. The patient is to receive Clindamycin 0.225 g IV q.6h. The nurse has the following vial of Clindamycin. How many mL will the nurse give? Write the appropriate information on the drug label.

9. The patient complains of incisional pain. The nurse has the following order in the electronic medical record, and the following vial of morphine is available. The nurse checks the medication record and notes that it is time for another pain injection. How many mL will the nurse prepare for the patient?

Electronic Medical Record

Provider

Order

DateM. Physician, MD

Morphine sulfate 6 mg IV q.3h prn incisional pain.

4-08-xx

Name

MR #

F. Patient

12345

Age

Allergies

NKDA

Gender

Room

F DOB 2-10-xx

227-B

Provider Orders

2496_Ch11_194-225 25/08/16 4:40 PM Page 220

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

10. The nurse is preparing to administer 0800 medications using the patient’s electronic medication administration record. The following vial is in the medication drawer. How many mL will the nurse administer to the patient?

Fill in the syringe with the amount ordered.

11. The nurse is preparing to administer the 0900 medications to the postoperative patient. The electronic medication administration record lists the scheduled medications, and the following medications are in the patient’s medication drawer:

The nurse draws up 2 mL of ondansetron, 0.7 mL of heparin, and 0.2 mL of morphine, and labels the three vials with the date, time, the nurse’s initials, and the beyond-use date. Has the nurse calculated the doses and labeled the vials correctly?

Electronic Medical Record

Date Time 080011-08-xx

MAR

Time

Scheduled Medications

Drug name Dose Route Freq.

0800 Metoclopramide 2.5 mg IV a.c. breakfast

Adm.

Name

MR #

B. Patient

87313

Age

Allergies

NKDA

Gender

Room

M DOB 11-21-xx

507-B

½ 1 1½ 2 2½ 3 m L

Electronic Medical Record

Date Time 09007-02-xx

MAR

Time

Scheduled Medications

Drug name Dose Route Freq.

0900 Ondansetron 4 mg IV q.4h.

0900 Morphine 3 mg IV q.3h.

0900 Heparin 3,500units subcut daily

Adm.

Name

MR #

H. Patient

94376

Age

Allergies

NKDA

Gender

Room

M DOB 3-29-xx

941-A

2496_Ch11_194-225 25/08/16 4:40 PM Page 221

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

12. The patient is to have diltiazem 0.012 g IV. The following vial is available. How many mL will the nurse draw up into the syringe?

Fill in the syringe with the ordered amount.

13. The order is for adenosine and the pharmacy sends a disposable syringe of the medication.

How many mL will the nurse administer? How many mL will the nurse discard from the prefilled syringe?

14. The physician orders DAUNOrubicin 0.04 g IV daily for 3 days. The pharmacy sends the following drug and the nurse has a 1 mL, 3 mL, 5 mL, and 10 mL syringe available to use to withdraw the medication from the vial.

Which of the following applies to the administration of this ordered dose? (Select all that apply.) a. A conversion is needed. b. Two dosage strengths are listed on the vial. c. 2 mL will be administered. d. The 10 mL syringe is the best choice to measure the ordered dose.

½ 1 1½ 2 2½ 3 m L

Electronic Medical Record

Provider

Order

DateM. Physician, MD

Adenosine 3 mg IV now.

4-08-xx

Name

MR #

C. Patient

56792

Age

Allergies

NKDA

Gender

Room

F DOB 8-22-xx

227-B

Provider Orders

2496_Ch11_194-225 25/08/16 4:40 PM Page 222

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

15. The nurse is preparing to administer a dose of pain medication to the patient. The following electronic medica- tion administration record and medication vial is available. How many mL will the nurse administer to the patient?

Fill in the syringe with the amount ordered.

16. The order is for HYDROmorphone 1.5 mg subcut q.4h. The following vial is available. How many mL will the nurse administer to the patient?

17. The following is the physician’s order and available medication:

How many mL will the nurse administer? How many mL will the nurse discard from the prefilled syringe?

Electronic Medical Record

Date Time 150012-08-xx

MAR

Time

PRN Medications

Drug name Dose Route Freq.

Meperidine 12.5 mg IM q.4h.

Adm.

Name

MR #

K. Patient

18833

Age

Allergies

NKDA

Gender

Room

F DOB 1-21-xx

57-2

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

Electronic Medical Record

Provider

Order

DateM. Physician, MD

Amiodarone 0.15 g IV now.

4-08-xx

Name

MR #

W. Patient

12345

Age

Allergies

NKDA

Gender

Room

M DOB 12-06-xx

1274

Provider Orders

2496_Ch11_194-225 25/08/16 4:40 PM Page 223

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

Which of the following applies to the administration of this ordered dose? (Select all that apply.) a. The nurse has a choice of dosage strengths to use in the calculation. b. There are two possible routes for this medication. c. 0.45 mL of lorazepam will be drawn up into the syringe and given directly into the vein. d. Once opened, the vial can be stored in the refrigerator and used again.

19. The physician orders metoclopramide 8 mg IM now. The nurse has the following vial of metoclopramide. How many mL will the nurse administer?

Fill in the appropriate syringe with the ordered amount.

18. The physician orders LORazepam 1,800 mcg IV BID. The pharmacy sends the following drug:

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

½ 1 1½ 2 2½ 3 m L

2496_Ch11_194-225 25/08/16 4:40 PM Page 224

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

0 .1

0 .2

0 .3

0 .4

0 .5

0 .6

0 .7

0 .8

0 .9

1 .0

m L

Electronic Medical Record

Provider

Order

DateM. Physician, MD

Granisetron 85 mcg IV 30 minutes prior to chemotherapy.

4-08-xx

Name

MR #

I. Patient

34872

Age

Allergies

NKDA

Gender

Room

F DOB 7-03-xx

1025

Provider Orders

20. The following medication is on the electronic medical record. The nurse withdraws the medication from the automated medication dispensing drawer. How many mL will the nurse administer?

Fill in the syringe with the ordered amount.

2496_Ch11_194-225 25/08/16 4:40 PM Page 225

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

Circle “Correct” or “Incorrect” for the following 10 questions. For problems with incorrect answers, provide a rationale to support your answer.

1. In administering insulin, the nurse will use the 100 units/mL listed on the drug label to calculate the dose. Correct Incorrect Rationale:

2. U-100 on the insulin label refers to the insulin concentration. Correct Incorrect Rationale:

3. The physician orders Humalog 6 units subcut now. The nurse has a vial of Novolog insulin. The nurse may use Novolog insulin to administer the 6 units of insulin. Correct Incorrect Rationale:

4. Humulin 70/30 insulin may be mixed with a rapid-acting insulin in the same syringe. Correct Incorrect Rationale:

5. The nurse selects the 100 unit insulin syringe to combine 7 units of Humulin R and 23 units of Humulin N. Correct Incorrect Rationale:

D e v e l o p i n g C o m p e t e n c y

2496_Ch13_253-274 25/08/16 4:42 PM Page 266

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

Insulin Dosage Calculation Practice

6. Levemir is a synthetic insulin. Correct Incorrect

Rationale: 7. 25 units of insulin have been drawn into the insulin syringe.

Correct Incorrect

Rationale: 8. 13 units of insulin have been drawn into the insulin syringe.

Correct Incorrect

Rationale: 9. 35 units of insulin have been drawn into the insulin syringe.

Correct Incorrect

Rationale: 10. 42 units of insulin have been drawn into the insulin syringe.

Correct Incorrect

Rationale:

5 10 15 2 0

2 5

3 0

3 5

4 0

4 5

5 0

U N

IT S

5 10 15 2 0

2 5

3 0

U N

IT S

5 10 15 2 0

2 5

3 0

3 5

4 0

4 5

5 0

U N

IT S

10 2 0

3 0

4 0

5 0

6 0

7 0

8 0

9 0

10 0

5 15 2 5

3 5

4 5

5 5

6 5

7 5

8 5

9 5

U N

IT S

2496_Ch13_253-274 25/08/16 4:42 PM Page 267

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

Shade in the ordered number of units of insulin in the appropriate syringe for following five questions.

11.

12.

13.

5 10 15 2 0

2 5

3 0

3 5

4 0

4 5

5 0

U N

IT S

10 2 0

3 0

4 0

5 0

6 0

7 0

8 0

9 0

10 0

U N

IT S

Electronic Medical Record

Date Time 07204-12-xx

MAR

Time

Scheduled Medications

Drug name Dose Route Freq.

0730 Humulin N 13 units subcut q.AM

Humulin R 5 units subcut q.AM

Adm.

Name

MR #

V. Patient

67533

Age

Allergies

NKDA

Gender

Room

M DOB 4-12-xx

412

5 10 15 2 0

2 5

3 0

3 5

4 0

4 5

5 0

U N

IT S

10 2 0

3 0

4 0

5 0

6 0

7 0

8 0

9 0

10 0

U N

IT S

Electronic Medical Record

Date Time 08001-22-xx

MAR

Time

Scheduled Medications

Drug name Dose Route Freq.

0800 Novolog 10 units subcut q.AM

Adm.

Name

MR #

M. Patient

93658

Age

Allergies

NKDA

Gender

Room

F DOB 11-01-xx

106

5 10 15 2 0

2 5

3 0

3 5

4 0

4 5

5 0

U N

IT S

5 10 15 2 0

2 5

3 0

U N

IT S

Electronic Medical Record

Date Time 08006-02-xx

MAR

Time

Scheduled Medications

Drug name Dose Route Freq.

0800 Humulin 70/30 15 units subcut q.AM

Adm.

Name

MR #

C. Patient

035786

Age

Allergies

NKDA

Gender

Room

F DOB 3-17-xx

235

2496_Ch13_253-274 25/08/16 4:42 PM Page 268

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

14.

15.

5 10 15 2 0

2 5

3 0

U N

IT S

10 2 0

3 0

4 0

5 0

6 0

7 0

8 0

9 0

10 0

U N

IT S

Electronic Medical Record

Date Time 072010-03-xx

MAR

Time

Scheduled Medications

Drug name Dose Route Freq.

0730 Humulin N 27 units subcut q.AM

Adm.

Name

MR #

A. Patient

28653

Age

Allergies

NKDA

Gender

Room

M DOB 6-20-xx

317

5 10 15 2 0

2 5

3 0

U N

IT S

10 2 0

3 0

4 0

5 0

6 0

7 0

8 0

9 0

10 0

U N

IT S

Electronic Medical Record

Date Time 07202-28-xx

MAR

Time

Scheduled Medications

Drug name Dose Route Freq.

0730 Humulin N 21 units subcut q.AM

Humulin R 7 units subcut q.AM

Adm.

Name

MR #

S. Patient

15490

Age

Allergies

NKDA

Gender

Room

M DOB 7-15-xx

601

2496_Ch13_253-274 25/08/16 4:42 PM Page 269

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

1. The physician orders cefepime 1 g IV q.12h. The nurse has the following vial of cefepime and the package insert for the drug.

Amount of diluent:

Dosage strength:

Administer:

UNIT F

D e v e l o p i n g C o m p e t e n c y

Use the drug labels or package inserts to answer the questions.

Table 14: Preparation of Solutions of Cefepime for Injection

Excerpt from package insert for Cefepime

Single-Dose Vials for Intravenous/ Intramuscular Administration

cefepime vial content

1 g (IV) 10 11.3 100

1 g (IM) 2.4 3.6 280

2 g (IV) 10 12.5 160

Approximate Cefepime

Concentration (mg/mL)

Amount of Diluent to be added (mL)

Approximate Available Volume (mL)

2496_Ch12_226-252 25/08/16 4:41 PM Page 242

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

Powdered Dosage Calculation Practice

2. The physician orders Vancomycin 0.4 g IV q.8h. The following vial of powdered vancomycin is available.

What type of diluent is used? What is the dosage strength of the mixed medication? Once the pharmacy has recon- stituted the medication, how long will it retain its potency?

Type of diluent:

Dosage strength:

Potency:

2496_Ch12_226-252 25/08/16 4:41 PM Page 243

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

3. The cefTAZIDime vial is reconstituted at 0900 on 2/12/xx and stored in the refrigerator. What is the expiration time and date for the reconstituted medication?

4. The physician orders cefepime 0.75 g IV q.12h. The nurse has the following vial of cefepime and the package insert for the drug.

Amount of diluent:

Dosage strength: Administer:

Table 14: Preparation of Solutions of Cefepime for Injection

Excerpt from package insert for Cefepime

Single-Dose Vials for Intravenous/ Intramuscular Administration

cefepime vial content

1 g (IV) 10 11.3 100

1 g (IM) 2.4 3.6 280

2 g (IV) 10 12.5 160

Approximate Cefepime

Concentration (mg/mL)

Amount of Diluent to be Added (mL)

Approximate Available Volume (mL)

2496_Ch12_226-252 25/08/16 4:41 PM Page 244

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

5. The physician orders cefUROXime 500 mg IV q.8hr the nurse has the following vial of cefUROXime and the pack- age insert for the drug.

Amount of diluent: Dosage strength: Administer:

6. The nurse has the following vial of Solu-Medrol.

Once the Act-O-Vial is activated, what is the dosage strength of the medication? If the nurse finds a partial dose of the reconstituted medication stored in the patient’s medication drawer, what should the nurse do?

7. The physician orders nafcillin 400 mg IM q.6h for the patient. The pharmacy sends the following vial of nafcillin with a package insert.

Identify the amount of diluent to add to the vial.

How many mL will the nurse administer to the patient?

Table 3: Preparation of Solution and Suspension

Excerpt from package insert for Cefuroxime

Strength

750 mg Vial 3.0 (IM) Total* 220

750 mg Vial 8.3 (IV) Total 90

1.5 gram Vial 16.0 (IV) Total 90

750 mg Infusion Pack 100 (IV) --- 7.5

1.5 gram Infusion Pack 100 (IV) --- 15

Approximate Cefuroxime

Concentration (mg/mL)

Amount of Diluent to be Added (mL)

Volume to be Withdrawn

DIRECTIONS FOR USE

For Intramuscular Use Reconstitute with Sterile Water for Injection, USP, 0.9% Sodium Chloride Injection, USP or Bacteriostatic Water for Injection, USP (with benzyl alcohol or parabens); add 3.4 mL to the 1 g vial for 4 mL resulting solution; 6.6 mL to the 2 g vial for 8 mL resulting solution. All reconstituted vials have a concentration of 250 mg per mL....

For Direct Intravenous Use The required amount of drug should be diluted in 15 to 30 mL of Sterile Water for Injection, USP or Sodium Chloride Injection, USP and injected over a 5- 10- minute period...

Excerpt from Nafcillin package insert

2496_Ch12_226-252 25/08/16 4:41 PM Page 245

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

Amount of diluent: Dosage strength: Administer:

9. The nurse uses 0.9% Sodium Chloride Solution to reconstitute a vial of cefTRIAXone for IV use on 5/14/xx and administers a dose to the patient. If the reconstituted medication is stored under refrigeration, when is the last date when the medication can be used for another dose?

8. The order is for Fortaz 350 mg IV q.12h. The following vial and package insert are in the patient’s medication drawer:

Ceftriaxone for injection intramuscular solutions remain stable (loss of potency less than 10%) for the following time periods.

Excerpt from cefTRIAXone package insert

*Data available for 10 to 40 mg/mL concentrations in this diluent in PVC containers only.

Diluent

Sterile Water for Injection

0.9% Sodium Chloride Solution

100

250,350

2 days

24 hours

10 days

3 days

100

250,350

2 days

24 hours

10 days

3 days

100

250,350

2 days

24 hours

10 days

3 days 5% Dextrose Solution

Bacteriostatic Water + 0.9% Benzyl Alcohol

100

250,350

24 hours

10 days

3 days

100

250,350

24 hours

10 days

3 days 1% Lidocaine Solution (without epinephrine)

Refrigerated (4°C)

Concentration mg/mL Room Temp.

(25°C)

Storage

Diluent

Sterile Water 2 days 10 days

0.9% Sodium Chloride Solution 2 days 10 days

5% Dextrose Solution 2 days 10 days

10% Dextrose Solution 2 days 10 days

5% Dextrose + 0.9% Sodium Chloride Solution* 2 days Incompatible

5% Dextrose + 0.45% Sodium Chloride Solution 2 days Incompatible

Refrigerated (4°C)

Room Temp. (25°C)

Storage

Ceftriaxone for injection intravenous solutions, at concentrations of 10, 20 and 40 mg/mL, remain stable (loss of potency less than 10%) for the following time periods stored in glass or PVC containers:

Table 5: Preparation of Solutions of FORTAZ

Excerpt from Fortaz package insert

Size

Intramuscular 500-mg vial 1.5 1.8 280 1-gram vial 3.0 3.6 280

Intravenous 500-mg vial 5.3 5.7* 100 1-gram vial 10.0 10.8† 100 2-gram vial 10.0 11.5‡ 170

Pharmacy bulk package 6-gram vial 26 30 200

Approximate Ceftazidime

Concentration (mg/mL)

Amount of Diluent to be Added (mL)

Approximate Available Volume

(mL)

2496_Ch12_226-252 25/08/16 4:41 PM Page 246

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

10. The physician orders penicillin G potassium 400,000 units q.6h. IM. The nurse has the following vial of penicillin G potassium.

Identify the amount of diluent to add to the vial to make the most concentrated medication.

Dosage strength:

Administer: 11. The order is for Ampicillin 400 mg IM now. The following vial is in the patient’s medication drawer:

Amount of diluent:

Administer:

2496_Ch12_226-252 25/08/16 4:41 PM Page 247

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

12. The physician orders Gemcitabine 760 mg IV weekly for 7 weeks for the patient with pancreatic cancer. The pharmacy sends four vials of Gemcitabine and a package insert.

What amount and type of diluent needs to be added to each vial for reconstitution? What is the resulting dosage strength of the reconstituted medication? How many mL will the nurse administer to the patient each week?

Amount and type of diluent:

Dosage strength:

Administer:

Stable until: 13. The following instructions are on a label of powdered medication: “Add 12 mL, 6 mL, or 3 mL of diluent to

provide 250 mg, 500 mg, or 1 g per mL, respectively.” The nurse adds 6 mL of diluent to the vial. What is the dosage strength of the reconstituted medication? How many mL will the nurse administer to give a 750 mg dose?

Dosage strength:

Administer: 14. The nurse finds a Mix-O-Vial of Solu-Cortef in the patient’s medication cabinet.

If the nurse follows the directions for mixing, what is the resulting dosage strength? If the physician orders Solu-Cortef 80 mg IV, how many mL will the nurse administer?

Dosage strength:

Administer:

2.7 Preparation for Intravenous Infusion Administration Reconstitute the vials with 0.9% Sodium Chloride Injection without preservatives.

Add 5 mL to the 200-mg vial or 25 mL to the 1-g vial. These dilutions each yield a Gemcitabine for Injection, USP concentration of 38 mg/mL. Complete withdrawal of the vial contents will provide 200 mg or 1 g of Gemcitabine for Injection, USP. Prior to administration the appropriate amount of drug must be diluted with 0.9% Sodium Chloride Injection. Final concentrations may be as low as 0.1 mg/mL.

Reconstituted Gemcitabine for Injection, USP is a clear, colorless to light straw-colored solution. Inspect visually prior to administration and discard for particulate matter or discoloration. Gemcitabine for Injection, USP solutions are stable for 24 hours at controlled room temperature of 20° to 25°C (68° to 77°F). Do not refrigerate as crystallization can occur.

Excerpt from Gemcitabine package insert.

ACT-O-VIAL® System (Single-Dose Vial) in four strengths: 100 mg

ACT-O-VIAL Each 2 mL contains

(when mixed):

Hydrocortisone sodium succinate

Excerpt from Solu-Cortef package insert

equiv. to 100 mg

Hydrocortisone 0.8 mgMonobasic sodium

phosphate anhydrous Dibasic sodium phosphate dried 8.73 mg

2496_Ch12_226-252 25/08/16 4:41 PM Page 248

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

15. The nurse has an order to administer Zinacef 1.5 g IV q.6h. The pharmacy sends the following vial of Zinacef.

The nurse follows the directions for reconstitution of the powdered medication. How long will the reconstituted medication remain stable?

16. The order is for CefTAZidime 500 mg IV q.8h. The following vial is in the patient’s medication drawer.

What is the dosage strength of the reconstituted medication? How many mL will the nurse administer to the patient? What are the storage directions for the reconstituted medication?

Dosage strength:

Administer:

Storage directions:

Store between 15° and 30°C (59° and 86°F). Protect from light. To prepare IV solution, add 16.0 mL of Sterile Water for Injection. Shake until dissolved and withdraw com- pletely for injection. After constitution, the solution main- tains potency for 24 hours at room temperature or 48 hours under refrig- eration (5°C). Color changes in solu- tion do not affect potency.

Table 5: Preparation of Solutions of Ceftazidime for Injection

Excerpt from cefTAZidime package insert

Size

Intramuscular 1 gram vial 3 3.6 280

Intravenous 1 gram vial 10 10.8* 100 2 gram vial 10 11.5** 170

Approximate Ceftazidime

Concentration (mg/mL)

Amount of Diluent to be Added (mL)

Approximate Available Volume

(mL)

2496_Ch12_226-252 25/08/16 4:41 PM Page 249

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

17. The physician orders penicillin G potassium 1,200,000 units q.6h. IV. The nurse has the following vial of penicillin G potassium.

Identify the amount of diluent to add to the vial to make the most dilute medication.

Dosage strength:

Administer:

Storage Instructions: 18. The physician orders 450 mg cefazolin IM now. The following medication is available from the pharmacy:

Amount of diluent:

Volume of displacement:

Administer:

2496_Ch12_226-252 25/08/16 4:41 PM Page 250

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

19. The nurse is preparing to administer IV cefOXItin using the patient’s electronic medication administration record. The following vial is in the medication drawer, along with the package insert.

The nurse adds 10 mL of diluent to the powder in the vial.

Dosage strength:

Administer:

Table 3: Preparation of Solution for Intravenous Administration

PREPARATION OF SOLUTION Table 3 is provided for convenience in constituting Cefoxitin for Injection for intravenous administration.

Excerpt from cefOXitin package insert

++Shake to dissolve and let stand until clear.

Strength

1 gram Vial 10 10.5 95

2 gram Vial 10 or 20 11.1 or 21 180 or 95

Approximate Average Concentration

(mg/mL) Amount of Diluent

to be Added (mL)++

Approximate Withdrawable Volume (mL)

Electronic Medical Record

Provider

Order

DateM. Physician, MD

1. Cefoxitin 1.8 g IV q.8h.

4-08-xx

Name

MR #

F. Patient

12345

Age

Allergies

NKDA

Gender

Room

F DOB 2-10-xx

227-B

Provider Orders

2496_Ch12_226-252 25/08/16 4:41 PM Page 251

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

20. The nurse is preparing to administer 1600 medications using the patient’s electronic medication administration record. The pharmacy sends the following vial of powdered medication, along with the package insert.

Amount of diluent:

Dosage strength:

Administer:

Ceftriaxone Excerpt from package insert

Excerpt from cefTRIAXone package insert

Directions for Use

Vial Dosage Size Amt. of diluent to be added

500 mg 4.8 mL

1 g 9.6 mL

2 g 19.2 mL

Electronic Medical Record

Date Time 16007-08-xx

MAR

Time

Scheduled Medications

Drug name Dose Route Freq.

1600 Ceftriaxone 1 g IV daily

Adm.

Name

MR #

Z. Patient

12345

Age

Allergies

NKDA

Gender

Room

M DOB 1-21-xx

207-B

Intravenous Administration Ceftriaxone should be administered intravenously by infusion over a period of 30 minutes. Concentrations between 10 mg/mL and 40 mg/mL are recommended; however, lower concentrations may be used if desired. Reconstitute vials with an appropriate IV diluent (see COMPATIBILITY AND STABILITY).

After reconstitution, each 1 mL of solution contains approximately 100 mg equivalent of ceftriaxone. Withdraw entire contents and dilute to the desired concentration with the appropriate IV diluent (sterile water for injection; 0.9% sodium chloride solution).

2496_Ch12_226-252 25/08/16 4:41 PM Page 252

C op

yr ig

ht ©

2 01

6. F

. A . D

av is

C om

pa ny

. A ll

rig ht

s re

se rv

ed .

Dosage Calculation Practice Packet
Combined

Faculty Guide_Oral Meds Practice (Chapter 9)
Faculty Guide_Syringes and Neeldes Quiz (Chapter 10)
Faculty Guide_Parenteral Quiz (Chapter11)
Faculty Guide_Insulin Quiz (Chapter 13)
Faculty Guide_Powdered Quiz (Chapter 12)