[not now]

The pharmacy usually sets everything up for us. Even if I'm pulling out of a Pyxis (sp?) it will tell me to pull one pill or multiple pills or that the dose is less than what I'm pulling so I'll have to split a pill. The MAR also will say how many ml's or tabs to give.

On top of that our new fancy pants IV pumps will calculate a rate for us automatically, we tell it what med we are running. I know longer have to use an "X factor" (or "K factor" depending on where you learned) because I enter all the info into the pump and it sets it for me down to a tenth of an ml. This is nice since I tend to doubt my math even when it's right.

[peridotgirl]

Originally Posted by Granny B

I agree that most meds come from the pharmacy ready to administer. Sometimes you will have to split a pill to give the correct dose. For the times that you have to do the calculations I always carry a small pocket calculater in my scrubs. I think the most used calc is Desired over have times volume. It has served me well. Good Luck and remember you can always ask a coworker to double check your calculations.

Wait a minute, there is a "desired over dose an hand times volume" pocket calculator out there ?? ya mean an actual calc that does that for you? and here I am using a regular calculator to figure things out... humm.. please clarify.

[Perpetual Student]

In my home care job the calculations are incredibly easy (e.g. two 325 mg tabs = 650 mg). If I were in a more difficult setting I'd use a calculator, pen and paper for the more difficult problems.

[MIA-RN]

Two of my three nursing jobs have involved using IV sets to gravity---so I tend to do a lot of math in figuring drip rates. We only had minimal training on that in school since the trend is supposed to be the pumps.
I carried a calculator for the first year on the job but now I find I can do most in my head or on paper when I am unsure.

[suanna]

It really depends on what type of unit you are working and at how big/small a facility. There have been many times when I have to calculte a dose by body weight. (give .3mcg/kg ivpb over 30min) Our pharmacy is 24/7 but I'm the one giving the med. I always make sure the pharmacy calculations are accurate before giving a drug. As for as I.V. rates- ___mcg/kg/min, our IV pumps can titrate by CCs,mg, mcg, or by weight in whatever units are ordered, but it dosen't hurt to double check. You are assuming someone else has entered the right weight, the right mix, and the right mode if you don't set up your own pump. Checking the rate by calculator is common. It gets easier as you do it more.

[nyapa]

You'd be surprised what you use maths for:

• calculating IV fluids
• calculating drugs
• calculating oral intake
• calculating urinary output, especially if you are concerned about the hourly amount

I don't use a calculator if I can help it. It is so easy to make a mistake if you hit the wrong button, or if it doesn't register. But that is my preference.

Maths is essential. You use it all the time, without thinking. That is why unis emphasize it.

[loricatus]

I don't know about anyone else; but, I have yet to use a drop factor since I graduated. In the ER, most of the fluids are to gravity and we just eyeball for the rate. If the rate has to be finely controlled (eg, peds, cardiac drips, CHF pt....) a pump is used & no drop factor is used. However, whenever I have had microdrip tubing, I have had a difficult time trying to eyeball the flow rate-don't know if that's because my aging eyes can't see the tiny drops very well or I have just gotten used to the regular tubing's flow rate.

[queenjean]

I've calculated drip rates to get an estimate--now I know how it's supposed to look if it's supposed to run over a certain time, and I don't calculate them anymore.

But I do often run something by gravity when our census is high and pumps are scarce and I have this one dumb antibiotic to run--it's not worth the trouble to find a pump.

I always double check the math on stuff like weight based meds when they initially are entered into the computer or come up from pharmacy. Once I know it's correct, it doesn't need to be rechecked unless a change is made. I've never caught a mistake on stuff that comes from pharmacy, but it makes me feel better to know it is right. Heparin we calculate and titrate on the floor, no pharmacy input, so the math has to be good, and we always double check one another (and I have caught mistakes that way).

Peridot girl, Granny B is referring to the type of calculation they do most commonly on their calculator.

[MeghanRN]

Originally Posted by HM2Viking

My philosophy is measure twice cut once.....In other words do it on paper....

1000000% agreed!

I had to give stat Ativan the other day to a seizing baby.

Order was 0.7mg. Drug was 2mg/1ml. Almost overlooked the 2mg/1ml.

In rushing, I almost gave extra.

So, nothing is that stat that you cant double check the dosage.

(at that point, I had to override our pixis to get the medication out- pharmacy had not even seen the order, otherwise it would have been worked out for me on how many ml's to give. (Not that I wouldnt have double checked it - you always should!))

So I guess to the OP- you'll learn how to do the calcuations, and above is a scenario where you would use one. Otherwise, it's pretty much all figured out by pharmacy..

[BandAidMaid]

Thanks to all of you. Your insight helps to understand what's involved.