Whether administering medications or hanging IV drips, nurses must accurately perform dosage calculations. Some excellent online resources are listed here, to help the struggling nursing student.
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A new-grad orientee was to give an I.V. heparin drip to one of her patients. She calculated the I.V. rate incorrectly. The orientee asked the charge nurse to counter-check her drug calculation. The charge nurse was too busy to do an independent drug calculation and just looked at the orientee's drug calculation and said something like, "It looks o.k. to me." This was a sentinel event and it was very scary to say the least. I am very thankful that it did not happen in our unit.
I do drug calculations to keep my mind sharp and also not to forget the formulas, but I also quickly log on to a web site that has drug calculations to verify my math. I'm sure in many U.S. hospitals, independent counter-checkings are required for drug calculations of critical medications and also in programming I.V. pumps with critical meds.
At the risk of being repetitive: Just remember to do INDEPENDENT drug calculation and INDEPENDENT counter-check, or do INDEPENDENT programming and INDEPENDENT counter-checking of already programmed I.V. pump for a critical medication, whatever the case may be.
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Thank you so much for those math resources. I am wondering why as a prerequisite to nursing in the state of California that Intermediate Algebra is the requirement. I have been through almost 2 years of math for nursing and not "once" has anything been taught to me regarding calculations of dosages etc.
In some states, the nursing school requirements are specific to nursing and I think this is the answer. When my husband went to get his MBA he took Business Math. Why are nurses not being taught math for nursing exclusively?? My math skills are not so great but taking College Algebra, Trigonometry or Calculus is not going to fix this. Graphing a hyperbola and functions doesn't teach me a thing about IV drips and so on.
State Boards of Nursing need to look in to this and change the curriculum so that we have nurses that are capable to performing these duties accurately.
Thanks Again!
Thank you for the Math resources. This is my first semester teaching a LPN Clinical. My students just took the first of 8 dosage calculation quizzes in clinical. Using Dimensional Analysis is part of the quizzes. Most students did well, but there are a few that had problems. I will pass the resources along to them all.
sallypz/MoxieMe
Vicki,
May I ask a somewhat related question?
I have no problems with calculations. I maintained a 100 avg in all my calculation courses.
My question is - -
I have a patient on D5W, let's say. It is not hanging on a pump and the dial on the tubing is set to 60 as the orders are for D5W @ 60cc/hr.
I go in 1 hour later to hang IVPB Cefepime. Order: 100ml over 30 mins. The drop factor ion the secondary tubing is 15gtt. I spike, prime, connect and hang the bag. Lower the primary bag.
I don't touch the dial on the primary tubing (leave the dial set to 60cc/hr) and I go ahead and open the roller clamp on my secondary tubing and count my drips to get 50 drops per minute.
This way the Cefpime runs at 50 gtt/min and when the bag is empty my primary will run at 60cc/hr.
IS THIS CORRECT? My school focused so much on the calculating art and not so much on the actual IV-hanging part! MANY THANKS.
Whether administering medications or hanging iv drips, nurses must accurately perform dosage calculations. this is a critical factor for patient safety, as a patient's life may depend on it.
Nursing math requires a working knowledge of ratio-proportion and/or dimensional analysis. most of these type calculations are at the 6th or 7th grade level, involving addition, subtraction, multiplication, division, and decimals/ fractions. memorizing the most common conversion factors and knowing how to use them (such as converting kilograms to pounds or centimeters to inches) is essential. instructor specifications for rounding (whether to the tenth or hundredths) should be carefully clarified by the student prior to taking any dosage calculation examination.
Free internet nursing math resources
Free dosage calculation study ware from Delmar publishing (interactive - great study tool!)
Conversion factors (centimeters to inches, etc.)
Manuel's web nursing calculators - you can use this handy tool to double check your own calculations.
Dimensional analysis
Medication math for the nursing student - uses dimensional analysis
Dosage help - a very useful tutorial for practicing dosage calculations
Dosage Help - Practice Questions
Calculators including dosage given, clinical and conversion calculators
Calculating Safe Medication Dose Ranges: Learning Practice Activities
About VickyRN, MSN, DNP, RN
VickyRN, PhD, RN, is a certified nurse educator (NLN) and certified gerontology nurse (ANCC). Her research interests include: the special health and social needs of the vulnerable older adult population; registered nurse staffing and resident outcomes in intermediate care nursing facilities; and, innovations in avoiding institutionalization of frail elderly clients by providing long-term care services and supports in the community. She is a Professor in a large baccalaureate nursing program in North Carolina.
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