I learned this formula in 12th grade chemistry.

It works almost ALL of the time for me, as long as I set it up correctly. You answer should always end with the units (mg, ml, units, etc.) that you are looking for. Next, remember that units above and below the line will cancel each other out. Just practice and it will start to make sense. Here is my secret formula! 1. Set up your equation. This may take some time to learn, but once you do, it will become simple 2. Cancel all units that you see on both the bottom AND the top of the equation. Note that if the unit measure is only present once on the top, you can only mark it out once on the bottom, and vice versa. 3. Now the only math step! Multiply all the numbers on the top, then multiply all the numbers on the bottom. Now divide the top number by the bottom number and WALA you have your answer. Dont worry, it is easier than it sounds. Ready? Here is your formula:

Lets Jump Right In

1. The doctor orders 5mg of Robitussin PO daily. Your medication bottle from the pharmacy states 1mg/2ml of Robitussin. There are 30ml in the bottle. How many do you give?

Try again!
2. You need to give 40meq of KCL PO x1. You have little cups that state KCL 20meq/5ml. How many mL do you give:

Last example!
3. You need to give 10,000 units of swish and spit Nystatin q6h. You have 5,000units/2ml packages of Nystatin. What to do?

If you are having trouble grasping this concept dont worry. Most people struggle with it in the beginning. It will just make sense to you one day, at least that is what happened to me. After practicing and practicing, I just had a lightbulb moment one day. Now nursing math is simple to me. Learn this formula before moving on because it is your base and you MUST understand calculating liquid medication before moving on to IV drip calculations. For example: Lets say you have to give 80mg of IV lasix STAT x1 so that your patient, who is gasping for air and starting to panic more and more by the second, can get some relief from her flash pulmonary edema that just came on. This is not the time to realize you cannot do calculations! Luckily for you, you came here, memorized this formula, and helped save your patient. Bravo! Let's get started. If you already learned how to calculate liquid PO medications you are already done. Yep, that's right, the formula is exactly the same.

Example 1
Life Saving time! Using the scenario from above, your patient is in respiratory distress. The doctor looks at you and yells (yeah get used to that) "give 80mg IV lasix stat!" The code cart has 10ml vials of lasix. Each vial says 10mg/1ml of lasix. What do you give, and remember do it quickly!

Example 2

You are starting a heparin gtt. You have calculated that you need to give a 4200 unit bolus of heparin from your protocol orders. You have a 10ml vial of heparin that states the concentration as 1000units/1ml. How much is your bolus in ml?

Last Example
Warning! This one of those multi-step IV dosage calculations. you will need a conversion table for metric units of measure. The order states to give 2 grams of magnesium sulfate. You have a bag of fluid that states 1000mg magnesium sulfate per 100ml of normal saline. How many ml do you give AND how many bags will you be giving?

As you can see sometimes your dosage calculations will require a little more work. Always go back to the 3 basic steps if you get confused!

1. Setup the Equation 2. Mark out like units of measurement and 3. Multiply Then Divide Make sure you are very comfortable working with multi-step dosage calculations. You will do a lot of these in the real world.

Brush up on Your Drug Calculation Skills

HOME Who am I? Interesting Articles Helpful Hints & Links Publication Guidelines Advertising Info Contacting Me

by Louise Diehl, RN, MSN, ND, CCRN, ACNS-BC, NP-C Nurse Practitioner - Owner Doctor of Naturopathy Lehigh Valley Wellness Center

Visit me at work at

Lehigh Valley Wellness Center

Many nurses are weak with drug calculations of all sorts. This article will help to review the major concepts related to drug calculations, help walk you through a few exercises, and provide a few exercises you can perform on your own to check your skills. There are many reference books available to review basic math skills, if you find that you have difficulty with even the basic conversion exercises.

Common Conversions:
1 Liter = 1000 Milliliters 1 Gram = 1000 Milligrams 1 Milligram = 1000 Micrograms

1 Kilogram = 2.2 pounds

Methods of Calculation
Any of the following three methods can be used to perform drug calculations. Please review all three methods and select the one that works for you. It is important to practice the method that you prefer to become proficient in calculating drug dosages. Remember: Before doing the calculation, convert units of measurement to one system. I. Basic Formula: Frequently used to calculate drug dosages. D (Desired dose) H (Dose on hand) V (Vehicle-tablet or liquid) D x V = Amount to Give H D = dose ordered or desired dose H = dose on container label or dose on hand V = form and amount in which drug comes (tablet, capsule, liquid) Example: Order-Dilantin 50 mg p.o. TID Drug available-Dilantin 125 mg/5ml D=50 mg H=125 mg V=5 ml

50 250 x5= = 2 ml 125 125 II. Ratio & Proportion: Oldest method used in calculating dosage. Known H : V :: Desired D : X

Means Extremes III. Left side are known quantities

IV. V.

Right side is desired dose and amount to give Multiply the means and the extremes HX = DV X= DV H

Example: Order-Keflex 1 gm p.o. BID Drug available-Keflex 250 mg per capsule VIII. IX. X. D=1 gm (note: need to convert to milligrams) 1 gm = 1000 mg H=250 mg V=1 capsule 250 : XI. 1 :: 1000 : X

250X = 1000 X= 1000 250

XIII.

XII. X = 4 capsules Fractional Equation H D = V X

XIV.

Cross multiply and solve for X. H D = V X HX = DV X= DV H

Example: Order - Digoxin 0.25 mg p.o. QD Drug Available - 0.125 mg per tablet D=0.25 mg H=0.125 mg 0.125 0.25 = 1 X XX. 0.125X = 0.25 V=1 tablet

X=

0.25 0.125

XXII.

XXI. X = 2 tablets Intravenous Flow Rate Calculation (two methods) Two Step Step 1 - Amount of fluid divided by hours to administer = ml/hr ml/hr x gtts/ml(IV set) Step 2 = gtts/min 60 min One Step amount of fluid x drops/milliliter (IV set) hours to administer x minutes/hour (60) Example: 1000 ml over 8 hrs IV set = 15 gtts/ml Two Step Step 1 Step 2 1000 = 125 8

125 x 15 = 31.25 (31 gtts/min) 60 One Step 1000 x 15 15,000 = = 31.25 (31gtts/min) 8 hrs x 60 480 XXIII. How to Calculate Continuous Infusions A. mg/min (For example - Lidocaine, Pronestyl) Solution cc x 60 min/hr x mg/min = cc/hr Drug mg Drug mg x cc/hr = mg/hr Solution cc x 60 min/hr

Rule of Thumb
Lidocaine, Pronestyl 2 gms/250 cc D5W

1 mg = 7 cc/hr 2 mg = 15 cc/hr 3 mg = 22 cc/hr 4 mg = 30 cc/hr D. mcg/min (For example - Nitroglycerin) Solution cc x 60 min/hr x mcg/min = cc/hr Drug mcg Drug mcg x cc/hr = mcg/hr Solution cc x 60 min/hr

Rule of Thumb
NTG 100 mg/250 cc 1 cc/hr = 6.6 mcg/min NTG 50 mg/250 cc 1 cc/hr = 3.3 mcg/min G. mcg/kg/min (For example - Dopamine, Dobutamine, Nipride, etc.) 1. To calculate cc/hr (gtts/min) Solution cc x 60 min/hr x kg x mcg/kg/min = cc/hr Drug mcg Example: Dopamine 400 mg/250 cc D5W to start at 5 mcg/kg/min. Patients weight is 190 lbs. 250 cc 400,000 mcg x 60 min x 86.4 x 5 mcg/kg/min = 16.2 cc/hr

4. To calculate mcg/kg/min Drug mcg/ x cc/hr = mcg/kg/min Solution cc x 60 min/hr x kg Example: Nipride 100 mg/250 cc D5W was ordered to decrease your patients blood

pressure. The patients weight is 143 lbs, and the IV pump is set at 25 cc/hr. How many mcg/kg/min of Nipride is the patient receiving? 100,000 mcg x 25 cc/hr 2,500,000 = 250 cc x 60 min x 65 975,000 kg = 2.5 mcg/kg/min

A. How to calculate mcg/kg/min if you know the rate of the infusion Dosage (in mcg/cc/min) x rate on pump Patients weight in kg B. For example: 400mg of Dopamine in 250 cc D5W 1600 mcg/cc = 60 min/hr = 26.6 mcg/cc/min = mcg/kg/min

C. 26.6 is the dosage concentration for Dopamine in mcg/cc/min based on having 400 mg in 250 cc of IV fluid. You need this to calculate this dosage concentration first for all drug calculations. Once you do this step, you can do anything! D. NOW DO THE REST! E. If you have a 75 kg patient for example... 26.6 mcg/cc/min x 10 cc on pump = 3.54 mcg/kg/min Patientss weight in kg (75 kg) = 3.5 mcg/kg/min (rounded down) F. How to calculate drips in cc per hour when you know the mcg/kg/min that is ordered or desired mcg/kg/min x patients weight in = rate on

kg dosage concentration in mcg/cc/min

pump

G. For example: H. 400 mg Dopamine in 250 cc D5W = 26.6 mcg/cc/min 3.5 mcg/kg/min x 75 kg = 9.86 cc 26.6 mcg/cc/min = 10 cc rounded up I. ALWAYS WORK THE EQUATION BACKWARDS AGAIN TO DOUBLE CHECK YOUR MATH! J. For example: 10 cc x 26.6 mcg/cc/min = 3.5 mcg/kg/min 75 Kg Dosage (in mcg/cc/min) x rate on pump Patients weight in kg = mcg/kg/min

L. For example: M. 400mg of Dopamine in 250 cc D5W = 1600 mcg/cc 60 min/hr = 26.6 mcg/cc/min N. 26.6 is the dosage concentration for Dopamine in mcg/cc/min based on having 400 mg in 250 cc of IV fluid. You need this to calculate this dosage concentration first for all drug calculations. Once you do this step, you can do anything! O. NOW DO THE REST!! P. If you have a 75 kg patient for example 26.6 mcg/cc/min x 10 cc on pump Patientss weight in kg (75 kg) = 3.54 mcg/kg/min

Now do some practice exercises to check what you learned A. Practice Problems: 1. 2.5 liters to milliliters 2. 7.5 grams to milligrams 3. 10 milligrams to micrograms

4. 500 milligrams to grams 5. 7500 micrograms to milligrams 6. 2800 milliliters to liters 7. 165 pounds to kilograms 8. 80 kilograms to pounds B. Practice Problems: Use the method you have chosen to calculate the amount to give. 1. Order-Dexamethasone 1 mg Drug available-Dexamethasone 0.5 mg per tablet 2. Order-Tagamet 0.6 gm Drug available-Tagamet 300 mg per tablet 3. Order-Phenobarbital 60 mg Drug available-Phenobarbital 15 mg per tablet 4. Order-Ampicillin 0.5 gm Drug available-Ampicillin 250 mg per 5 ml 5. Order-Dicloxacillin 125 mg Drug Available-Dicloxacillin 62.5 mg per 5 ml 6. Order-Medrol 75 mg IM Drug Available-Medrol 125 mg per 2 ml 7. Order-Lidocaine 1 mg per kg Patients weight is 152 pounds 8. Order- 520 mg of a medication in a 24 hour period. The drug is ordered every 6 hours. How many milligrams will be given for each dose? C. Practice Problems: IV set 15 gtts/ml 1. Order-1000 ml over 6 hrs 2. Order-500 ml over 4 hrs 3. Order-100 ml over 20 min. IV set 10 gtts/ml IV set 15 gtts/ml D. Practice Problems: 1. Dopamine 400 mg in 250 cc D5W to infuse at 5 mcg/kg/min. The patients weight is 200 pounds. How many cc/hour would this be on an infusion pump? 2. A Dopamine drip (400mg in 250 cc of IV fluid) is infusing on your 80 kg patient at 20

3.

4.

5.

6.

cc/hour. How many mcg/kg/min are infusing for this patient? A Nitroglycerin drip is ordered for your patient to control his chest pain. The concentration is 100 mg in 250 cc D5W. The order is to begin the infusion at 20 mcg/min. What is the rate you would begin the infusion on the infusion pump? A Nitroglycerin drip (100mg in 250 cc D5W) is infusing on your patient at 28 cc/hour on the infusion pump. How many mcg/min is your patient receiving? A procainamide drip is ordered (2gms in 250 cc D5W) to infuse at 4 mg/min. The patient weighs 165 pounds. Calculate the drip rate in cc/hour for which the infusion pump will be set at. A Lidocaine drip is infusion on your 90 kg patient at 22 cc/hour. The Lidocaine concentration is 2 grams in 250 cc of D5W. How many mg/min is your patient receiving?

Summary
Many nurses have difficulty with drug calculations. Mostly because they dont enjoy or understand math. Practicing drug calculations will help nurses develop stronger and more confident math skills. Many drugs require some type of calculation prior to administration. The drug calculations range in complexity from requiring a simple conversion calculation to a more complex calculation for drugs administered by mcg/kg/min. Regardless of the drug to be administered, careful and accurate calculations are important to help prevent medication errors. Many nurses become overwhelmed when performing the drug calculations, when they require multiple steps or involve life-threatening drugs. The main principle is to remain focused on what you are doing and try to not let outside distractions cause you to make a error in calculations. It is always a good idea to have another nurse double check your calculations. Sometimes nurses have difficulty calculating dosages on drugs that are potentially life threatening. This is often because they become focused on the actual drug and the possible consequences of an error in calculation. The best way to prevent this is to remember

that the drug calculations are performed the same way regardless of what the drug is. For example, whether the infusion is a big bag of vitamins or a life threatening vasoactive cardiac drug, the calculation is done exactly the same way. Many facilities use monitors to calculate the infusion rates, by plugging the numbers in the computer or monitor with a keypad and getting the exact infusion titration chart specifically for that patient. If you use this method for beginning your infusions and titrating the infusion rates, be very careful that you have entered the correct data to obtain the chart. Many errors take place because erroneous data is first entered and not identified. The nurses then titrate the drugs or administer the drugs based on an incorrect chart. A method to help prevent errors with this type of system is to have another nurse double check the data and the chart, or to do a hand calculation for comparison. The use of computers for drug calculations also causes nurses to get rusty in their abilities to perform drug calculations. It is suggested that the nurse perform the hand calculations from time to time, to maintain her/his math skills.

Answers to Practice Problems

A. Practice Problems 1. 2500 mL 2. 7500 mg 3. 10,000 mcg 4. 0.5 gm 5. 7.5 mg 6. 2.8 L 7. 75 kg 8. 176 lbs B. Practice Problems 1. 2 tablets 2. 2 tablets 3. 4 tablets 4. 10 mL 5. 10 mL 6. 1.2 mL 7. 69 kg = 69 mg 8. 130 mg for 4 doses C. Practice Problems

1. 41.6 (42) 2. 20.8 (21) 3. 75 D. Practice Problems 1. 17 cc/hr 2. 6.65 mcg/kg/min 3. 3 cc 4. 186.5 mcg/min 5. 30 cc/hr 6. 3 mg/min

Unit conversions
Many calculations require different volumes or weights to be converted into the same unit or value. To convert larger units to smaller the larger is multiplied:
Kilograms (kg) to grams (g) = kg x 1,000; Grams to milligrams (mg) = g x 1,000; Milligrams to micrograms (mcg) = mg x 1,000; Micrograms to nanograms (ng) = mcg x 1,000; Litres (L) to millilitres (ml) = L x 1,000.

To convert smaller units to larger the smaller is divided:

Grams to kilograms = g/1,000; Milligrams to grams = mg/1,000; Micrograms to milligrams = mcg/1,000; Nanograms to micrograms = ng/1,000; Millilitres to litres = ml/1000.

Large infusion rates

To administer fluid volumes over a specified time a gravitational flow administration set may be used, which requires the infusion rate to be administered as drops per minute. To calculate this the number of drops per ml for the specific set must be ascertained - this is usually identified on its packaging. Generally, crystalloid administration sets operate at 20 drops per millilitre (d/ml) and blood (large-bore) sets operate at 15d/ml.
TO CALCULATE THE INFUSION RATE IN DROPS PER MINUTE THE FOLLOWING FORMULA IS APPLIED (FIG 1): Vol required / Duration (hr) x Set value (d/ml) / Minutes (60)

Fluid infusions are often administered via volumetric pumps, many of which run in a millilitre per hour (ml/hr) rate.
TO CALCULATE ML/HR THE FOLLOWING FORMULA IS APPLIED (FIG 2): Volume to be infused / Duration of infusion

Nurses must ensure they have received specific training in the use of the particular infusion device before operating it.

Required drug volume from stock strength

This is a common calculation as many prescribed doses are smaller than the available preparation. In some drugs the stock concentration may depend on the volume of diluent. This is often the case in reconstituting antibiotics.
THE FOLLOWING FORMULA IS APPLIED (FIG 3): Amount required / Stock strength x Stock volume Or more simply What you want / What you have got x Volume

Calculating weight-related doses

Occasionally, and particularly in paediatrics, drugs are prescribed based on the patients body weight. The prescription may be expressed as millilitres per kilogram (ml/kg) or milligrams per kilogram (mg/kg).
THE FOLLOWING FORMULA IS APPLIED (FIG 4): Prescribed volume x Body weight or Prescribed dose x Body weight

Concentrations (mg/ml) from solutions

Some drugs are presented in a percentage concentration (for example, lidocaine, calcium chloride and dextrose in solution). The expression refers to grams per 100ml, so a one per cent solution would be 1g per 100ml and a 50 per cent solution would be 50g per 100ml. The volume always remains constant (Fig 5).

Concentrations from weight to volume ratios

Some drugs are expressed as a weight to volume ratio (such as adrenaline and noradrenaline). These could be expressed as 1:1,000 or 1:10,000. The expression is similar to a percentage except that the weight remains constant (1g) and the volume differs. The volume is in millilitres. Therefore:
Adrenaline 1:10,000 = 1g in 10,000ml; Noradrenaline 1:1,000 = 1g in 1,000ml.

Once a mg/ml concentration has been calculated, further formulae such as dose or stock strength x volume may be necessary to calculate the volume required (Fig 6).
PROFESSIONAL RESPONSIBILITIES All nurses who administer medication must have undertaken a programme of education and demonstrated competence under supervision. The practitioner is responsible for ensuring that her or his practice is compliant with NMC guidelines. The practitioner should also ensure that she or he is familiar with local trust policies.

How to calculate IV flow rates:

Intravenous fluid must be given at a specific rate, neither too fast nor too slow. The specific rate may be measured as ml/hour, L/hour or drops/min. To control or adjust the flow rate only drops per minute are used. The burette contains a needle or plastic dropper which gives the number of drops per ml (the drop factor). A number of different drop factors are available (determined by the length and diameter of the needle). Common drop factors are: 10 drops/ml (blood set), 15 drops / ml (regular set), 60 drops / ml (microdrop). To measure the rate we must know: (a) the number of drops (b) time in minutes. The formula for working out flow rates is:
volume (ml) X drop factor (gtts / ml) = gtts / min --------------------------------------------(flow rate) time (min)

Example: 1500 ml IV Saline is ordered over 12 hours. Using a drop factor of 15 drops / ml, how many drops per minute need to be delivered?
1500 (ml) X 15 (gttss / ml) --------------------------------------------------- = 31 gtts / minute 12 x 60 (gives us total minutes)

calculate IV rate using calibrated tubing

nursing calculators search site map

x = hours x = minutes x = milliliters/hour x volume calibration gtt/min gtt/15sec

Reset
N/A

Formulas TO CALCULATE RATE USING MINUTES

volume x calibration minutes
= gtt/min

TO CALCULATE RATE USING HOURS

volume x calibration hours x 60

= gtt/min

Examples 1) Give a 50cc IVPB over 30 minutes using IV tubing with a calibration of 10. How many drops per minute should this IVPB be set for? See the example below. select "x = minutes" x = 30 volume = 50 calibration = 10 Actual formula:
50 x 10 30
= 16.7 or 17 gtt/min

2) Using IV tubing alone (calibrated at 60), prepare an IV to infuse 1 liter over 8 hours. How many drops per minute should the IV be set for? See the example below. select "x = hours" x=8

volume = 1000 calibration = 60 Actual formula:

1000ml x 60 8 x 60
= 125 gtt/min

Note, when using microdrip tubing (calibration = 60), the drip rate will be the same as mL/hr. This will save you the time of calculating the drip rate if asked to give the rate in mL/hr. 3) The doctor orders an IV to infuse at 125cc/hr. Calculate the flow rate using 10 drop/min IV tubing. select "x = milliters/hour" x = 125 calibration = 10 Actual formula:
125cc x 10 = 20.8 or 21 gtt/min 60

Note You may be wondering why a second answer is displayed in the calculator. The first answer displays the number of drops per minute. The second answer displays how many drops fall in 15 seconds. Sometimes the IV rate is set by counting for 15 seconds instead of a full minute.

Volume/Time - IV Drop Rate Questions

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? Measurement used when IV is regulated manually. Because it is not possible to give a patient a fraction of a drop, it is typical to round answers for these problems up or down to the nearest whole number. Formula:
Volume (mL) Time (min)

x Drop Factor (gtts/mL) = Y (Flow Rate in gtts/min)

Example: Calculate the IV flow rate for 1200 mL of NS to be infused in 6 hours. The infusion set is calibrated for a drop factor of 15 gtts/mL.

Volume (mL) Time (min)

x Drop Factor (gtts/mL) = Y (Flow Rate in gtts/min)

Convert 6 hours to minutes.

min hr ( x by 60 ) 6 hr x 60 = 360 min x 15 gtts/mL = 50 gtts/min

1200 mL 360 min

Example: Calculate the IV flow rate for 200 mL of 0.9% NaCl IV over 120 minutes. Infusion set has drop factor of 20 gtts/mL.
Volume (mL) Time (min) 200 mL

x Drop Factor (gtts/mL) = Y (Flow Rate in gtts/min)

x 20 gtts/mL = 33 gtts/min
120 min

The following is an overview of key IV concepts which are useful for dosage calculation problems.

Important IV Terms

gtts: drops Drop Factor: Number of drops per volume of IV fluid. Varies depending on the tubing used. Usually measured in gtts/mL. Flow Rate: Measure of the flow of liquid from an IV. Usually measured in gtts/minute (how many drops are released every

minute) or in mL/hour (how many mL flow through each hour). gtts/minute is used for manually regulating an IV while mL/hour is used when utilizing an electronic IV regulator.

Important IV Abbreviations

D: Dextrose W: Water S: Saline NS: Normal Saline (0.9% NaCl) RL or LR: Lactated Ringer's

Example: D5W = 5% Dextrose in Water Example: D5 NS = 5% dextrose in 0.225% saline solution

Dosage By Weight Questions

Given the weight of a patient and a dosage specified in terms of weight, calculate the necessary dosage. These problems are a type of pediatric dosage calculations. Formula: Weight in Kg * Dosage Per Kg = Y (Required Dosage) Example: A doctor orders 200 mg of Rocephin to be taken by a 15.4 lbinfant every 8 hours. The medication label shows that 75-150 mg/kg per day is the appropriate dosage range. Is this doctor's order within the desired range? Weight in Kg * Dosage Per Kg = Y (Required Dosage)

Convert 15.4 lb to kg.

lb kg ( by 2.2 ) 15.4 lb 2.2 = 7 kg 7 kg * 75 mg/kg = 525 mg (Minimum Desired Dosage) 7 kg * 150 mg/kg = 1,050 mg (Maximum Desired Dosage)

24 hours in one day and the medication is ordered every 8 hours.

24 hrs / 8 hrs = 3 times per day doctor ordered medication

200 * 3 = 600 mg ordered per day 600 mg is within the desired range of 525-1,050 mg Yes doctor has ordered a dosage within the desired range. Example: Solumedrol 1.5 mg/kg is ordered for a child weighing 74.8 lb. Solumedrol is available as 125 mg / 2mL. How many mL must the nurse administer? Weight in Kg * Dosage Per Kg = Y (Required Dosage) Convert 74.8 lb to kg.

lb kg ( by 2.2 ) 74.8 lb 2.2 = 34 kg 34 kg * 1.5 mg/kg = 51 mg

This is now an ordinary Mass/Liquid For Liquid Question. 51 mg is ordered and the medication is available as 125 mg / 2 mL.
Ordered Have 51 mg

x Volume Per Have = Y (Liquid Required) x 2 mL = 0.82 mL

125 mg

Unit Conversion
Mass:

mcg mg g kg mcg mg g kg lb kg ( by 2.2 ) ( x by 2.2 )

( by 1,000 ) ( x by 1,000 )

lb kg Volume:

mcL mL L kL mcL mL L kL Time:

( by 1,000 ) ( x by 1,000 )

min hr min hr

( by 60 ) ( x by 60 )

Example: Convert 5,000 mcg to mg.

mcg mg g kg ( by 1,000 ) 5,000 mcg 1,000 = 5 mg

Example: Convert 44 lb to kg.

lb kg ( by 2.2 ) 44 lb 2.2 = 20 kg

Example: Convert 0.003 L to mcL.

mcL mL L kL

( x by 1,000 )

0.003 L x 1,000 = 3 mL 3 mL x 1,000 = 3,000 mcL

Example: Convert 5 hours to minutes.

min hr ( x by 60 ) 5 hr x 60 = 300 min

IV Drip Rate Calculations

We all know that the "titrate to effect" works oh so well in the field when treating patients, right? Truth is we may get by with it - but, we could do ourselves and our patients some good by reviewing, practicing and using theses important formulas for IV infusions.

Let's get started with some review

Here are the BIG 3 formulas for calculating IV drips
To calculate an IV drip rate based on the volume of fluid to be infused over time.
Volume to be infused in cc X Drop factor of IV set Drops per minute = Time in minutes

To calculate an IV drip rate for a medication that is administered based on a specified dosage to be infused per minute
Dosage per minute to be administered X Drop factor (60) Drops per minute = Concentration of medication per ml

Hint: Make sure the unit measurement of the concentration and the dosage are the same.(e.g. both in milligrams) To calculate an IV drip rate for a medication that is administered based on a specified dosage per kilogram of body weight per minute
Drops per minute Desired dosage per minute X Weight in Kg X Drop factor of IV

set Concentration of medication per ml

Hint: Make sure the unit measurement of the concentration and the dosage are the same.(e.g. both in milligrams)

Other handy items to review

Convert pounds to kilograms: Divide pounds by 2.2
1 gram = 1000 milligrams 1 milligram = 1000 micrograms

Calculating and counting drops

When was the last time you have counted the drops on your patients IV? Thanks to the marvels of infusion pump technology, for many of us, it may have been a while and to some of our new colleagues, perhaps none of them have actually counted drops. Why bother with such unimportant matter? Is it really necessary to know how to calculate and count drops on an IV infusion? In many clinical settings, it may not be important at all because of the smart pump technology. And for patient safety, it is best practice to use infusion pumps because gravity drip rates are not accurate and precise. But what happens in a situation when pumps fail and/or in an emergency situation when the IV tubing has to be removed from the pump and even in a setting where infusion pumps are not available?

A nursing colleague recently admitted to me that she has forgotten how to count drops and struggled to remember how to calculate when she volunteered in a medical mission in Haiti. Luckily she said, it was just hydration fluids and patients were not critically ill.

Another nurse colleague said she has never counted drops as a student nurse and now as a new RN struggled when she had to help evacuate patients out of the building during an emergency and the IV pump battery failed on a patient who was on TPN.

In a small rural physicians office, the staff was not aware that IV tubings have different drop factors and although they knew they had to count drops, they didnt realize they were using the incorrect drop factor.

Another nurse told me that she doesnt count drops because she uses a dial-a-flow.

If you are in a situation where you need to infuse by gravity drip, remember the following steps:

Identify the drop factor of the IV administration set (tubing) you are using. You can find this information on the label of the tubing package. Macrodrip sets are either 10, 15 or 20 drops to deliver 1 ml of fluid.

Use this formula to calculate gravity flow rates:

Drops/min:

ml/hr divided by 60 min/hr x drop factor

Examples:

A. IV fluid of 1000ml to infuse for 8 hours using tubing with drop factor of 15.

1000ml for 8 hours = 125ml/hr. 125ml/hr divided by 60 min/hr = 2.08ml/min 2.08ml/min X 15 drop factor = 31.2 drops/min

B. IV fluid of 1000ml to infuse for 8 hours using tubing with drop factor of 10.

1000ml for 8 hours = 125ml/hr. 125ml/hr divided by 60 min/hr = 2.08ml/min 2.08ml/min X 10 drop factor = 20.8 drops/min

C. IV fluid of 1000ml to infuse for 8 hours using tubing with drop factor of 20.

1000ml for 8 hours = 125ml/hr. 125ml/hr divided by 60 min/hr = 2.08ml/min 2.08ml/min X 20 drop factor = 41.6 drops/min

Regardless of what flow control device is used, remember that the flow control devices should be considered an enhancement to patient care and doesnt replace the nurses responsibility to monitor the infusion of the prescribed therapy. Oh, by the way, in case you have forgotten, when infusing by gravity, you do need to count the drops/minute for a full minute and adjust the flow using the roller clamp till you have regulated to the desired rate. If you are enticed to use flow regulators (like dial-a-flow), remember, those are still gravity drip infusions and you will need to count the drip rate even if you set the dial to the correct number to ensure accuracy. Have fun counting drops.youre going to make this guy happy!!!

Fahrenheit and Celsius Conversion Formulas

Fahrenheit to Celsius:

Celsius to Fahrenheit:

Temperature Scales
The degree Fahrenheit (F) is a unit of temperature named for the german physicist Gabriel Fahrenheit (1686 - 1736). In the Fahrenheit scale of temperature the freezing point of water is 32 degrees and the boiling point is 212 degrees placing the boiling and melting points of water 180 degrees apart. Zero degrees Fahrenheit indicates the lowest temperature Fahrenheit could obtain by a mixture of ice and salt. The degree Celsius (C) is a unit of temperature named for the Swedish astronomer Anders Celsius (1701-1744) who first proposed it. The Celsius temperature scale was designed so that the freezing point of water is 0 degrees and the boiling point is 100 degrees at standard atmospheric pressure. Since there are one hundred steps between these two reference points the original term for this system was Centigrade (100 parts).

Examples
How many degrees Celsius are 68 degrees Fahrenheit? Replace Fahrenheit with 68 and solve for Celsius: C = (68 - 32) * 5/9 C = 36 * 5/9 C = 20 20 C = 68 F Replace F by 68 in C = (F - 32) * 5/9 Simplify

At what temperature are Celsius and Fahrenheit temperatures equal? Replace both temperatures with "T" in one of the equations above and solve for T: T = T * 9/5 + 32 T - 32 = T * 9/5 -32 = T * 4/5 -160 = T * 4 Subtract 32 from both sides Subtract T from both sides (Note that T * 9/5 is the same as T + T * 4/5) Multiply both sides by 5 Divide both sides by 4

-40 = T -40 C = -40 F

Although there are many online temperature converters, it's always helpful to have a knowledge of the actual formula for the conversions. C is Celsius F is Farenheit C = 5/9 (F-32 F = 9/5 (C+32 Let's try converting 68 degrees Farenheit to celsius 5/9(68-32) Step 1: 68 less 32 is 36 Step 2: 5 divided by 9 is 0.5555555555555 Step 3: multiply the repeating decimal by 36 Step 4: your solution is 20 Now, convert 20 degrees Celsius to Farenheit to check your work. 9/5C +32 Step 1: 9 divided by 5 is 1.8 Step 2: 1.8 multiplied by 20 is 36 Step 3: 36 plus 32 = 68

Added by Bill Frederickson on September 27, 2000 at 14:08:40: These are common temperature formulas. Fahrenheit To Centigrade: 5/9 * (Fahrenheit - 32); note: .55555 = 5/9 Centigrade To Fahrenheit: (1.8 * Centigrade) + 32; note: 1.8 = 9/5 Centigrade To Kelvin: Centigrade + 273; Kelvin To Centigrade: Kelvin - 273;

Fahrenheit To Kelvin: (5/9 * (Fahrenheit - 32) + 273 ); note: .55555 = 5/9 Kelvin To Fahrenheit: ((Kelvin - 273) * 1.8 ) + 32; note: 1.8 = 9/5