Paralyzing Fear!!!

vanilla bean · Jan 18, 2015

Take a deep breath. It's going to be OK. You will get classroom instruction about what types of fluid and medication orders you will see and how to go about solving calculations. Many, including myself, have also found this site helpful for practice. Good luck, you've got this!

NurseGirl525, ASN, RN · Jan 18, 2015

You need to look at the problem and see what is relevant information and what isn't. Especially with reconstituting problems. Also, know your conversions. How mcg goes to milligrams. How many tsp are in a milliliter. It is very important to know these. I just look at the label, look at the order, cross out the non relevant information and take it one step at a time.

Esme12, ASN, BSN, RN · Jan 18, 2015

DosageHelp.com - Helping Nursing Students Learn Dosage Calculations

It will all make sense...BREATHE

Boxer Mama · Jan 18, 2015

I was really worried about the math, and it turns out that I now love the math problems because of how we were taught. I do set up every problem I have with dimensional analysis. I have to see and write everything.

Step 1: Figure out and write

ORDER: What is your order

HAVE: What do you have on hand

KNOW: Any conversions you will be using.

Step 2: Solve for what the question is asking (ml/hour, ml, teaspoons).

Step 3: Set up the problem using the numbers in step 1 to cross cancel out until you only have what you are solving for left and solve the problem.

Example: The dose to be given is 2000 mg.

The stock solution contains 1 g per 15 ml.

How many ml would you give?

ORDER: 2000 mg

HAVE: 1 g/15ml

KNOW: 1000 mg/1 g

Solve: xmL: 15 ml/1 g x 1 g/1000 mg x 2000 mg/1 = 30,000/1000 = 30 mL

I hope this did not confuse you more, but you can do an internet search on dimensional analysis that would go through the steps more thoroughly.

Good luck!

PaigeAlayne · Jan 18, 2015

Hi! I am just beginning my final semester and know how you are feeling. They seem way more daunting than they actually are. It's true that your school may provide more complex problems than mine did but as a general rule, once you figure out what the question is asking you will find a lot of extraneous information that doesn't apply to the question. Know your conversion factors, take your time, and get into a study group. You can do it. Trust me.

icuRNmaggie, BSN, RN · Jan 19, 2015

Don't freak out, just study some of the links provided above. It's basic math, mainly multiplication and division.

Review the metric system.

Know how many ml ( also called cc it's the same thing) are in a liter.

Know how many mg are in a gram.

Know how to convert pounds to kilograms.

Here's a common question to get you thinking. A one liter ( that's 1000ml) bag of IV fluid must go in over eight hours. What rate in ml per hour do you give?

Here's another common question. Digoxin comes in 0.5 mg per 1ml ampules. You need to give 0.25 mg. How many mls is that?

SopranoKris, MSN, RN, NP · Jan 19, 2015

I find that if I start with the unit I need on top of the fractions FIRST, then it's easy to cancel out the units you don't need until you arrive at your answers. I never go wrong that way.

I also highly recommend this book: Math Attack by Karen S. Champion.

It is very helpful in alleviating the fear associated with med math problems and it gives you 4 different ways you can approach a problem. You just pick the method that works best for you :) Once you get familiar with conversions & dimensional analysis, you'll find that there is really nothing to fear at all.

MurseJJ · Jan 19, 2015

I need some guidance from all you wonderful, experienced folks out there!!
I'm starting nursing school in about a week and looking at the schedule, it appears that I'll have my Dosage Calculations class 15 weeks into the program. Okay...now, the paralyzing fear...word problems, very confusing word problems. I've read the example dosaging questions from people on this site and HOLY COW!!! My head starts to do 360's and I feel like I might need a priest. :)
I need to know how to get through this class. How do I learn to solve these dosage "puzzles"? What resources can help me? I'd like to start practicing before I ever step foot in the classroom. It literally makes me queasy to think about how I'm going to do in this class.
Any suggestions, secrets, tips, advice, useful tools, etc. you'd like to share with me would be appreciated more than you'll ever know! This area is the only one that truly strickens me with fear. Help...please!!!!
New RN-FEAR of dosage calculations

Congrats on starting nursing school! Dosage calculation really isn't as bad as many think it is. I know that when I looked at sample problems here and elsewhere before starting nursing school, I thought it looked a little hard. Once you start actually learning, you'll see that the math is very basic, it just looks complicated. The great thing is that many textbooks and professors will show you at least 3 different ways to solve the same problem. If your school uses Evolve, they also show the different ways of solving one problem in the online modules. Choose the way that makes the most sense to you and stick with it.

After that, practice practice practice. Do all of the problems assigned by your professor. Do the problems in the textbook. Do any practice tests given. Then do them all over again.

As others have suggested, for now, you should become comfortable with conversions within the metric system (the most important are between the actual unit (i.e. gram) and milli, micro, and kilo, though be familiar with the rest. 1L=1000 mL. 1mg=1000 mcg (micrograms). Convert between pounds and kilograms (very important). We also saw things like 1T (tablespoon)=3t (teaspoon) and 1T=15ml.

It really seems like a lot before you get into it, but it's not that bad! You'll have lots of practice.

Good luck!

akulahawkRN, ADN, RN, EMT-P · Jan 19, 2015

now, the paralyzing fear...word problems, very confusing word problems. I've read the example dosaging questions from people on this site and HOLY COW!!! My head starts to do 360's and I feel like I might need a priest. :)

First off, you can calm down... you have no need for a nursing drug calculation exorcist. Most of the drug stuff is done using the metric system, so most of the time, it'll be very easy to do once you wrap your head around it. During school you will get instruction in how to do this stuff, so you'll be OK there. It's good to start early though.

Many of the word problems will have a LOT of distracting fluff along with info that is pertinent to the problem. The hard part is figuring out what is being asked and what you need to do with the information provided to answer the question. It's not hard once you get the hang of it!

The other posters above have provided some good advice and resources for you to try this stuff. Mostly, it'll be a lot like the typical word problems you've had to conquer in your previous math courses.

Glycerine82, LPN · Jan 19, 2015

I took a class like this last semester and the best thing I did was cross out all of the irrelevent information. I don't need to know how tall someone is if the calculation is only based on weight, etc. I would re-word the problem in the shortest logical way. That was the biggest help, for me.

Also, be comfortable with your metric conversions, so that they're second nature.

Lastly, practice until your fingers fall off and you can do the problems in your sleep!

nurseprnRN, BSN, RN · Jan 19, 2015

Do you remember the famous riddle about going to St. Ives?

"When I was going to St. Ives

I met a man with seven wives.

Every wife had seven sacks,

Every sack had seven cats,

Every cat had seven kits.

Kits, cats, sacks, wives--

How many were going to St. Ives?"

I know that as you are reading this you are starting to plan your multiplication. But before your head starts spinning and multiplying by sevens, STOP. Read the problem again. Who is going to St. Ives? I am, that's who. If I am meeting the man on the road, he and all his wives, sacks, cats, and kits, are going the other way. So the answer is ... 1.

Here's another: A plane is carrying 215 people. 72 are French, 80 are German, and 63 are Italian. The plane crashes in Switzerland. One ninth of the French, one ninth of the Italians, and one eighth of the Germans are killed. Where do they bury the survivors?

Before you go Google the map of Europe (at https://www.google.com/maps/place/Europe/@49.5,22,4z/data=!3m1!4b1!4m2!3m1!1s0x46ed8886cfadda85:0x72ef99e6b3fcf079) to refresh your memory about Switzerland being right in the middle between all three of those countries, STOP and think.

Right. Nobody buries survivors.

Last, a med calc example:

At report you hear that the night nurse hung a new IV on your patient at 0600 (6:00 am). Your patient weighs 220 pounds and is has a liter of IV of 5% dextrose in 0.9% NaCl (normal saline) with miraculocillin at 5mg/kg running at 125cc/hour. When do you hang the new bag?

OK, you're thinking now: 220lbs = 100kg, so there's 500mg in the bag. Now what?

We see people all the time who set up this huge dimensional analysis thing with all those numbers. Faculty who write test questions know this, and when they give you 4 choices for an answer they are sure to include at least 2 that you'll get when you use some of them; these are called "distractors" for a reason. But if you STOP and follow the kind suggestion of a former poster who told you to cross out things that don't matter, what you have is this: A liter went up at 125cc/hr at 0600. When will it run dry? And you will see that 1000/125 = 8, meaning it will run for 8 hours, being all gone at 1400 (2:00 pm). See? Is that so hard?