Do nurses do med math

Cases in point from my practice:

Very unstable admit, direct from helicopter. I had to mix my own levophed, because there was no time to wait for the pharmacy to send it. I think BP was in the 50s/20s at the time.

Pharmacy sent me 20 ml of med in a prefilled syringe. Appropriate dose for that concentration was 10 ml. Barcode scanning only verfies that the label is accurate.

Oh, and like a PP said, peds meds (including code drugs) are often weight based. Inaccurate med math can kill a child.

I work in the ER and although our pumps are programmed with the correct rates based on you putting in the med and dose, we do have patients that need drips mixed and if pharmacy isn't there or if it's emergent, it's nurses who are mixing those drips and titrating them. It's very important that you know how to do med math!

Thanks so much for people's replies sharing why it's needed and examples of when you use med math! I think I was hoping to use "nurses don't do math" as an excuse since I'm having trouble with it, but nope, I'm going to practice until it gets better. Does anyone recommend any study aids for learning this?

You wil get it, I promise. Now, the med math questions are the be only ones I can count on for the test!!!

You wil get it, I promise. Now, the med math questions are the be only ones I can count on for the test!!!

Thanks! I decided to just do dosage calculations and no "scenarios" even though I thought "Oh I got this already" I did more. That actually helped when I went back to my book with the problems that added in the patient info and other things! My brain went right to what I'm supposed to pick out of all that. It felt good :)

I work in the NICU. I check everything. We've caught pharmacy mistakes before because the wrong amount was in the syringe. The more checks the better. Pharmacy is a great resource, but that doesn't mean you should administer meds blindly.

I got a 100 on kaplan dosages (it was basic but still had scenerios!) and a 98 on my class exam on pills to IV infusions and drip rate! I made a mistake with the calculator, typed the wrong number. But I'm feeling good!

I had to sacrifice some pathos studying but cramming it today.

We do a lot of math in the ed, especially with peds. Not uncommon to have the ed doc, the peds hospitalist & the rn doing calculations simultaneously to make sure we come up with the correct dose.

Even if you use eMAR and scan meds you still do med math. What about when you're administering controlled substances from the pyxis? You need to figure out how much to draw up when you need to give 1.5 mg of ativan and you have a 2 mg/mL vial.

I don't know about other facilities, but the pharmacy profiles the ordered medication in the Pyxis along with the ordered dose. So when you go to pull it, it'll say "pull X vials". For example, for a 60mg dose of SoluMedrol, you'd select the 40mg SoluMedrol and it'd say "remove 2 vials". Then when you scan the med, it'll say "60mg = 1.5 mL". In your Ativan example, it'd say "1.5 mg = 0.75 mL".

I don't know about other facilities, but the pharmacy profiles the ordered medication in the Pyxis along with the ordered dose. So when you go to pull it, it'll say "pull X vials". For example, for a 60mg dose of SoluMedrol, you'd select the 40mg SoluMedrol and it'd say "remove 2 vials". Then when you scan the med, it'll say "60mg = 1.5 mL". In your Ativan example, it'd say "1.5 mg = 0.75 mL".

Sure, our pharmacy would do that too but sometimes meds come in more than 1 possible concentration and the one the pharmacy assigned would be empty. We had morphine 2 mg/mL, 5 mg/mL and 10 mg/mL in the pyxis. If the pharmacy had selected 2 mg/mL and your ordered dose was 1 mg, the eMAR would tell you to give 0.5 mL. If the 2 mg/mL drawer was empty and you had to pull the 5 mg/mL or 10 mg/mL, you better know how to do your own med math, lest you overdose your patient by giving him 0.5 mL of 10 mg/mL, 5x his ordered dose.