Drug Calc. on the Job

lvnandmomx3 · Mar 28, 2008

I used drug calculations in clinicals, most you can do in your head( dr order 650mg tylenol, you have 325mg tabs, how many do you give). But there were a few that I had work out on paper. Like giving morphine IM, I had to figure out how many ml's to give the pt. of course since I was a student I had the instructor right there beside me. My current job as an LVN give meds but they are in pre divided packages, so I do not have to fugure dosages out.

Medic2RN, BSN, RN, EMT-P · Mar 28, 2008

Most medications are sent from pharmacy and already calculated for us.

However, simple calculations are usually done for PRN meds and for stat orders such as dopamine, nitro, dobutamine, etc. drips. You still need to know how to calculate everything in case you're in a pinch.

loriangel14, RN · Mar 28, 2008

I haven't run into anything I couldn't do in my head. If I am not sure I ask a coworker to check my math. I had to draw up 3 mg of morphine today and it was in a 300mg/5ml vial, that's about as tough as it gets(usually) where i work.

Beachgirl1212 · Mar 28, 2008

I understand that we need to be able to handle situations as you have all spoke of......I was just wondering if the Nursing Programs might be going a little over the top with some of the scenarios. I understand the need to know this stuff.I was just wondering what was a practical application. Thanks

OC_An Khe · Mar 28, 2008

No they're not over the top with the calculations. If you understand how to do the calculations, and know how to actually do them, it has been my expirience that you prevent and pick up errors easier. This leads you to safer administrations of drugs.

HM2VikingRN, RN · Mar 28, 2008

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

*ac* · Mar 28, 2008

If I have to calculate how many ml's to give, I jot it down and do it on a calculator. If there's any doubt in my mind, I get another nurse to check it - no one minds doing this.

I only do the very simplest, simplest things in my head. I just don't trust myself.

In school, they make you do a lot of drip rates. I've never had to do that on the job. The pharmacy tells you how many minutes to run the IV med for, you set the pump and the pump figures out the drip rate.

Granny B · Mar 28, 2008

:typing 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.:nuke:

bluesnurse · Mar 29, 2008

Would somebody be able to tell me how this happens in the real world of Nursing after you have a job.
I just got accepted into a Nursing Program that will start in the Fall. Our first class is Pharm in all it's glory including Drug Calculations.
My question is this.....After you have your license and you are out there working.....what do you guys actually use to do you Drug Calcs ? Do you do it by hand, computer or some sort of Drug Conversion system that the hospital has set up ? :heartbeat
Thanks ........

It depends where you work! Yes, in the hospital you have lots of backup. You can always call pharmacy and check with other nurses, and a lot of calculations become routine once you get experience with them and can program the IV pumps.

BUT ... that may not be the case. If you're in an OP clinic, or home care, or a rural area that doesn't have the greatest equipment, you may well have to do your own calculations.

I'm very good at math, but I work in outpatient cardiology, and I use a calculator and write out the calculations when I have to give IV meds in the office. It can be weeks or months between times when a pt needs IV lasix, adenosine for SVT, or a dobutamine stress echo. You DO need to be able to do calcs without relying on a computer or pharmacist. You never know when it might be necessary!

That said -- I do not understand WHY pharmacology is offered in the very first semester of nursing programs. It was the same when I was in school. It's just way too much information to absorb when you haven't had any clinical experience at all. It makes a lot more sense when it's put into context.

It would be nice if there were a way to ease into pharm, maybe with an overview and basic math refresher in the beginning and a more in-depth course in the second or third year. But then, I never did think nursing school made a whole lot of sense compared to the Real World. :banghead:

not now, RN · Mar 29, 2008

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 · Mar 29, 2008

:typing 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.:nuke:

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. :confused: :nurse: :nurse: