Math and Dosage Calculations For Healthcare Professionals 5Th Edition PDF Full Chapter PDF

MATH AND DOSAGE CALCULATIONS
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[ BRIEF CONTENTS
Preface xiv
Acknowledgments xxii
Pretest xxxi
UNIT 1 Performing Basic Math
CHAPTER 1 Fractions 2
C H A P T E R 2 Decimals 37
C H A P T E R 3 Relationships of Quantities: Percents, Ratios,
and Proportions 56
UNIT 2 Using Systems of Measurement
C H A P T E R 4 Metric System 84
C H A P T E R 5 Other Systems of Measurement 95
C H A P T E R 6 Converting Units 104
C H A P T E R 7 Temperature and Time 116
UNIT 3 Identifying Information Needed for Dosage
Calculations
C H A P T E R 8 Equipment for Dosage Measurement 126
C H A P T E R 9 Interpreting Medication Orders 159
C H A P T E R 10 Interpreting Medication Labels and
Package Inserts 186
C H A P T E R 11 Safe Medication Administration 221
UNIT 4 Calculating Dosages
C H A P T E R 12 Methods of Dosage Calculations 252
C H A P T E R 13 Oral Dosages 291
C H A P T E R 14 Parenteral Dosages 334
C H A P T E R 15 Intravenous Calculations 413
Copyright © 2016 by McGraw-Hill Education
UNIT 5 Performing Advanced Dosage Calculations

C H A P T E R 16 Calculations for Special Populations 460
C H A P T E R 17 Critical IV Calculations 497
UNIT 6 Performing, Dispensing, and Compounding
Calculations
C H A P T E R 18 Amount to Dispense and Days’ Supply 540
C H A P T E R 19 Calculations for Compounding 563
Comprehensive Evaluation CE-1
Glossary G-1
Credits CR-1
Index I-1
vii
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[ CONTENTS
Preface xiv 1.6 Adding Fractions 18

Acknowledgments xxii 1.7 Subtracting Fractions 21
Pretest xxxi 1.8 Multiplying Fractions 24
1.9 Dividing Fractions 29
Unit 1: Performing Chapter 1 Summary 32
Basic Math Homework Assignment 34

Chapter 1 Review 35
CHAPTER 1: FRACTIONS 2
1.1 Fractions and Mixed Numbers 2 CHAPTER 2: DECIMALS 37
Common Fractions 2 2.1 Writing and Comparing
Mixed Numbers 3 Decimals 37
1.2 Equivalent Fractions 7 Writing Decimals 37
1.3 Reducing Fractions 11 Comparing Decimals 39
1.4 Finding Common 2.2 Rounding Decimals 41

Denominators 13 2.3 Converting Fractions into
1.5 Comparing Fractions 16 Decimals 42
2.4 Converting Decimals into
Fractions 44
2.5 Adding and Subtracting
Decimals 45
2.6 Multiplying Decimals 47
2.7 Dividing Decimals 49
Chapter 2 Summary 51
Homework Assignment 53
Chapter 2 Review 54
CHAPTER 3: RELATIONSHIPS Copyright © 2016 by McGraw-Hill Education

OF QUANTITIES: PERCENTS,
RATIOS, AND
PROPORTIONS 56
3.1 Percents 56
Converting Values to and from a Percent 57
3.2 Ratios 60
Converting Values to and from a Ratio 61
3.3 Proportions 67
Writing Proportions 67
viii
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3.4 Using Proportions to Solve for CHAPTER 6: CONVERTING

an Unknown Quantity 69 UNITS 104
Means and Extremes 69 6.1 Writing Conversion Factors
Cross-Multiplying 73 from Equivalent Measures 104
Chapter 3 Summary 78 6.2 Converting Units 107

Chapter 3 Review 80
Chapter 6 Review 114
Unit One Assessment 82
CHAPTER 7: TEMPERATURE
Unit 2: Using Systems AND TIME 116
of Measurement 7.1 Converting Temperature 116
7.2 Converting Time 118
CHAPTER 4: METRIC
SYSTEM 84 Chapter 7 Summary 121
4.1 Metric System 84 Homework Assignment 122

Metric Notation 85
Unit Two Assessment 124
4.2 Converting Within the Metric
System 88
Chapter 4 Review 94
CHAPTER 5: OTHER
SYSTEMS OF
MEASUREMENT 95
5.1 Apothecary System 95
Units of Measure 95
Apothecary Notation 96
5.2 Household System 98
Units of Measure 98
Household Notation 98
5.3 Equivalent Measures 99
Milliequivalents and Units 101
Contents ix
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Unit 3: Identifying
Information
Needed for Dosage CHAPTER 9: INTERPRETING
Calculations MEDICATION ORDERS 159
9.1 Medical Abbreviations 159
CHAPTER 8: EQUIPMENT
FOR DOSAGE Roman Numerals 161
MEASUREMENT 126 9.2 Components of a
8.1 Enteral Medication Medication Order 163
Administration Devices 126 9.3 Prescription/Medication
Medicine Cups 127 Order 166
Droppers 128 9.4 Medication Administration

Records 171
Calibrated Spoons 128
Oral Syringes 128
Other Equipment for Enteral Medications 130
8.2 Parenteral Medication
Administration Devices 133
CHAPTER 10: INTERPRETING
Standard Syringes 134 MEDICATION LABELS AND
Prefilled Syringes 135 PACKAGE INSERTS 186
Insulin Syringes 135 10.1 Information on Medication
Labels 186
Tuberculin Syringes 137
Drug Name 187
Syringes for Established Intravenous
Lines 137 Form of the Drug 189
Large-Capacity Syringes 138 Dosage Strength 189
Ampules, Vials, and Cartridges 139 Combination Drugs 189

Preparing the Syringe 140 Total Number or Volume in Container 189
Needle Gauge and Length 141 Route of Administration 191
8.3 Other Medication Administration Warnings 193
Forms and Equipment 146 Storage Information 194
Drops, Sprays, and Mists 146 Manufacturing Information 194
Inhalants 146 Information About Reconstituting Drugs 195
Vaginal and Rectal Medications 147 10.2 Label Information Related to
Topical Medications 147 Medication Routes 200
Transdermal Systems 147 Oral Medications 200
Chapter 8 Summary 149 Parenteral Medications 202
x Contents
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Medications Administered by 12.2 Methods of Dosage

Other Routes 204 Calculation 261
10.3 Package Inserts 209 Chapter 12 Summary 279
Chapter 10 Summary 213 Homework Assignment 281
Homework Assignment 215 Chapter 12 Review 284
CHAPTER 13: ORAL
CHAPTER 11: SAFE DOSAGES 291
MEDICATION 13.1 Solid Oral Medications 291
ADMINISTRATION 221 Calculating Dosages for Solid Oral
11.1 Verbal Orders 222 Medications 292
11.2 Safe Medication Order Crushing Tablets or Opening Capsules 301
Transcription 224 13.2 Liquid Oral Medications 308
11.3 Error-Prone Abbreviations Chapter 13 Summary 323
and Symbols 227
11.4 The Three Checks of Medication
Administration 231 Chapter 13 Review 326
11.5 The Rights of Medication
Administration 232 CHAPTER 14: PARENTERAL
11.6 Observation 237 DOSAGES 334
11.7 Patient Teaching 238 14.1 Calculating Parenteral Dosages
in Solution 335
Medication Reference Materials 238
Syringe Sizes 335
14.2 Medications Expressed in
Homework Assignment 242 Percent or Ratio Format 350
Chapter 11 Review 243 14.3 Preparing Parenteral Medications
Unit Three Assessment 248 for Administration 361
14.4 Other Parenteral Administration

Forms 373
Unit 4: Calculating 14.5 Insulin 374
Dosages Timing of Action 375
CHAPTER 12: METHODS Insulin Labels 376
OF DOSAGE Insulin Syringes 377
CALCULATIONS 252
Insulin Combinations 380
12.1 Information Needed to
Perform Dosage Calculations 252 14.6 Heparin 388
Gathering the Information 252 Subcutaneous Heparin Dosages 390
Converting the Dosage Ordered 252 Chapter 14 Summary 393
Contents xi
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Unit 5: Performing
Advanced Dosage
CHAPTER 15: INTRAVENOUS Calculations
CALCULATIONS 413 CHAPTER 16: CALCULATIONS
15.1 IV Solutions 414 FOR SPECIAL POPULATIONS
IV Labels 414 460
IV Concentrations 415 16.1 Factors that Impact Dosing
and Medication
Compatibility 417 Administration 460
15.2 IV Equipment 419 Pharmacokinetics—How Drugs Are
The Primary Line 419 Used by the Body 461
Secondary Lines (Piggyback) 420 Pediatric Patients 463
Regulating Intravenous Infusions 420 Geriatric Patients 463
Peripheral and Central IV Therapy 422 16.2 Dosages Based on Body
Weight 467
15.3 Calculating Flow Rates 425
Ensuring Safe Dosages 471
Adjusting Flow Rates 428
16.3 Dosages Based on Body
15.4 Infusion Time and Volume 433 Surface Area (BSA) 483
Calculating Infusion Time 433 Calculating a Patient’s BSA 483
Calculating Infusion Volume 435 Chapter 16 Summary 489
15.5 Intermittent IV Infusions 438 Homework Assignment 490
Secondary Lines (Piggyback) 438 Chapter 16 Review 493
Intermittent Peripheral Infusion Devices 438
Preparing and Calculating Intermittent
Infusions 438 CHAPTER 17: CRITICAL IV
CALCULATIONS 497
17.1 Daily Maintenance Fluid
Homework Assignment 450 Needs (DMFN) 498
Chapter 15 Review 451 17.2 Dosages Based on Ideal
Unit Four Assessment 454 Weight 502
xii Contents
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17.3 Hourly Flow Rates for Chapter 18 Summary 552

Dosage per Time Infusions 506
Dosage per Hour 506
Dosage per Minute 511
17.4 Safe Heparin Dosages 513 CHAPTER 19: CALCULATIONS
Weight-Based Bolus Dose Calculations 514 FOR COMPOUNDING 563
Determining the Hourly Dose 517 19.1 Liquid Compounds 563
17.5 IV Flow Rates Based on 19.2 Solid and Semisolid

Body Weight per Time 519 Compounds 569
17.6 IV Flow Rate Adjustments and 19.3 Diluting a Stock Product 575
Titrated Medications 524 19.4 Specific Gravity 580
Titrated Medications 525 Chapter 19 Summary 584
Chapter 17 Summary 530 Homework Assignment 585
Homework Assignment 532 Chapter 19 Review 587
Chapter 17 Review 534 Unit Six Assessment 589
Unit Five Assessment 537 Comprehensive Evaluation CE-1
Glossary G-1
Unit 6: Performing, Credits CR-1
Dispensing, and Index I-1
Compounding
Calculations
CHAPTER 18: AMOUNT
TO DISPENSE AND DAYS’
SUPPLY 540
18.1 Calculating the Amount to

Dispense 540
18.2 Calculating the Days’
Supply 549
Contents xiii
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[ PREFACE
We’ve got you covered—from basic math skills to critical dosage calculations . . . from the
print textbook to the digital supplements!
Welcome to the fifth edition of Math and Dosage Calculations for Healthcare Professionals
(M&DC)! This product introduces students to the concepts and skills they will need to move
forward within their chosen health profession or nursing curriculum. Students will need
dynamic tools and multiple resources to ensure success and this product provides everything
they need!
Here’s what you and your students can expect from the new edition of M&DC:
• Reorganized content within chapters and units to allow for flexibility of utilizing the
product across various healthcare and nursing curricula.
• Simplified dosage calculation steps and examples, and consistency throughout
explanations.
• Continued comprehensive coverage of three methods of dosage calculation—proportion,
formula, and dimensional analysis—to adapt to various learning styles.
• Updated learning outcomes based on the revised Bloom’s taxonomy that serve as the
framework for each chapter and are emphasized throughout the product assets to tie the
concepts together.
• Tabular end-of-chapter summaries that are tied to the learning outcomes, along with
page references—these reinforce key points for review.
• Comprehensive digital support with ALEKS Prep for Math & Dosage and Connect.
• Focus on the application of mathematics and accuracy of dosage calculations—the essential
knowledge needed to prevent medication errors.
Here’s How Your Colleagues Have Described

the New Edition of M&DC:
“Math and Dosage Calculations is a well-written and current text with just the right amount of
rigor and relevance.
This text covers all of the concepts required for medical assisting and nursing students
in detail and with clarity and ease of use. Additionally, the use of three methods of dosage
calculations and examples in each chapter provides students with the opportunities to work
with the method they prefer. Real-life examples are given and students are required to extract
information using critical thinking skills, rather than just completing exercises. Overall, this

is an excellent product and I would highly recommend it to any medical program for the
instruction of dosage calculation and administration of medications.”
Amy Ensign
Baker College – Clinton Township
“Wow! This text is more than I expected. I am truly thrilled in all that it offers to me and my
students.”
Amanda Davis-Smith
Jefferson Community College – Louisville
“This is a very good book on the breakdown of dosage and calculations as it pertains to MAs
and their future outcomes. I like the book as it is separate from pharmacology itself yet it is
still a portion that could be added to the pharmacology course. Students will comprehend
the math and calculations portions much better than what they are currently using.”
Kathy Gaeng
Vatterott College
xiv
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“Very easy to follow and teach, and it provides students with multiple opportunities to
master the skills needed to administer and calculate medications accurately.”
Lynnae Lockett
Bryant and Stratton College
“Excellent chapter layout and design. Easy to understand. Accurate. Good depth of informa-
tion for our student population. Content that would be easy to build into Blackboard. Easy
to understand while being appropriately challenging. I plan to recommend this to my math
for health adjuncts.”
Shawn Russell
University of Alaska – Fairbanks
Organization of Math and Dosage Calculations for

Healthcare Professionals, Fifth Edition
M&DC is divided into 6 units:
UNIT COVERAGE
1: Performing Basic Math Chapters 1–3 focus on a review of basic math skills
needed to perform dosage calculations.
2: Using Systems of Measurement Chapters 4–7 focus on measurements used in dosage

calculations and drug administration.
3: Identifying Information Needed Chapters 8–11 focus on equipment, interpreting

for Dosage Calculations medication orders and labels, and safe medication
administration.
4: Calculating Dosages Chapters 12–15 focus on basic dosage calculations,

including three methods: proportion method,
dimensional analysis, and formula method. These
chapters include calculation methods and provide
specific information for calculating oral, parenteral,
and basic intravenous dosages.
5: Performing Advanced Dosage Chapters 16–17 focus on advanced clinical

Calculations calculations including special population calculations
and critical IV calculations.
6: Performing Dispensing and Chapters 18–19 focus on amount to dispense,

Compounding Calculations estimated day’s supply, compounding, and alligation.
New to the Fifth Edition!

Of the many improvements made to the fifth edition, key enhancements include:
1 Chapters arranged into logical units of study for better organization and flexibility
1 Changed titles to match the reorganized content for flexibility across healthcare and
nursing curricula
1 Icons throughout the first seven chapters to correlate chapter content to the ALEKS
assessment system
1 Updated Pretest that covers all of the learning outcomes in Chapters 1–7
1 Updated Comprehensive Evaluation that covers all of the learning outcomes in
Chapters 8–19
Preface xv
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1 Adherence to Institute for Safe Medication Practices (ISMP) error prevention guidelines
1 Procedure Checklists that provide easy-to-follow, step-by-step instruction for common
calculations
1 Increased consistency among dosage calculation steps throughout the chapters
1 Real and rendered labels that provide realistic practice of all types of calculations
1 New algorithmic practice problems within Connect content
Chapter-by-chapter highlights include:
1 Chapters 1–5: Content has been updated to provide clearer explanations of basic con-
cepts and to explain ISMP number and unit formatting rules.
1 Chapter 6: New Procedure Checklists were added to clarify the steps for writing conver-
sion factors. The proportion method was separated into two distinct procedures: one for
using fractions and one for using ratios.
1 Chapter 7: The discussion of 12-hour and 24-hour time has been updated and clarified
using consistent terminology.
1 Chapter 8: Information was added regarding dropper standardization, calibration
marks on syringes for IV lines, and clogged enteral tubes. The discussion of oral syringe
safety was updated for accuracy, and information about other medication administra-
tion forms—such as drops, sprays, mists, inhalants, vaginal and rectal medications,
topical medications, and transdermal systems—was moved to this chapter from former
Chapter 14.
1 Chapter 9: Information about prescriptions has been moved into this chapter from for-
mer Chapter 11.
1 Chapter 10: New information was added regarding package inserts, including updated
FDA regulations and when it is most necessary to consult the package insert.
1 Chapter 11: Information about common look-alike and sound-alike medications and
error-prone abbreviations was updated to reflect the latest ISMP guidelines. The new
chapter emphasizes the importance of follow-up to ensure that authorized prescrib-
ers who give verbal orders provide an electronic or written signature. In addition,
the information about the rights of medication administration was revised to empha-
size the importance of following the procedures, rather than just memorizing the
rights.
1 Chapter 12: The rules in this chapter were revised to improve clarity, and Procedure
Checklists were added to provide step-by-step guidance for dosage calculations. In
Rule 12-2, Step A was changed from “Convert” to “Gather Information and Convert.”
1 Chapter 13: Repetitive content was replaced by a Learning Link that refers back to
Chapter 12; both text and examples were revised to improve clarity.
1 Chapter 14: Content was revised and reorganized to include calculations for subcu-
taneous administration of the high-alert medications heparin and insulin, as well as
calculations for other parenteral forms. This chapter now includes calculations for
all types of parenteral calculations, except IV. The discussion of methods of injection

was revised and clarified, and a new figure was added to identify the various meth-
ods. A new Critical Thinking on the Job was added for insulin types, and the table
in former Chapter 18 about timing of insulin action was updated and moved to this
chapter.
1 Chapter 15: Rules 15-6 and 15-7 pertaining to calculating flow rates were revised and
simplified; a section was added about adjusting flow rates in mL/h; the photo showing
primary and secondary solutions (Figure 15-8) was updated for clarity.
xvi Preface
boo13806_fm_i-xxxiv.indd xvi 4/9/15 9:25 PM

1 Chapter 16: Procedure Checklists were added for rules that require step-by-step calcula-
tions. The key term for the third process in pharmacokinetics was changed from biotrans-
formation to metabolism to conform with the often-used acronym ADME.
1 Chapter 17: Information about calculating safe heparin IV dosages and performing
heparin protocol calculations was merged in this chapter. Information about daily
maintenance fluid needs (DMFN) was moved to this chapter. Step-by-step procedure
checklists were added for calculating flow rates using DMFN, for determining safe dos-
age based on a patient’s ideal weight, and for finding IV flow rate based on weight per
time.
1 Chapter 18: This completely new chapter was added to provide content for entry-level
pharmacy technicians, including instructions for calculating the amount of medication
to dispense and for calculating the days’ supply of a medication.
1 Chapter 19: Content from former Chapter 16 and Appendix A: Alligation Method
were included in this new chapter targeted for entry-level pharmacy technicians.
The chapter includes compounding calculations to determine quantities needed to
make liquid, solid, or semisolid compounds, as well as to dilute stock products. In
addition, the chapter includes new content to explain calculations using specific
gravity.
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ALEKS® (www.aleks.com)
Math and Dosage Calculations for Healthcare Professionals also offers the integra-
tion of an ALEKS (Assessment and LEarning in Knowledge Spaces) “Prep Course”
(see the three pages immediately before the beginning of Unit 1). Topics covered and remedi-
ated in ALEKS are noted by marginal icons throughout the first seven chapters.
ALEKS is a dynamic online learning system for mathematics education, available over the
Web 24/7. ALEKS assesses students knowledge, and then guides them to the material that
they are most ready to learn. With a variety of reports, Textbook Integration Plus, quizzes, and
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• ALEKS uses artificial intelligence to determine exactly what each student knows and is
ready to learn. ALEKS remediates student gaps and provides highly efficient learning
and improved learning outcomes.
• ALEKS is a comprehensive curriculum that aligns with syllabi or specified textbooks.
Used in conjunction with McGraw-Hill texts, it also provides students with links to text-
specific videos, multimedia tutorials, and textbook pages.
• Textbook Integration Plus allows ALEKS to align automatically with syllabi or speci-
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ADDITIONAL INSTRUCTOR RESOURCES

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ments, competency correlations, sample syllabi, and more.
• PowerPoint Presentations for each chapter, containing teaching notes correlated to
learning outcomes. Each presentation seeks to reinforce key concepts and provide an
additional visual aid for students.
• Test Bank and answer key for use in class assessment. The comprehensive test bank
includes a variety of question types, with each question linked directly to a learning out-
come from the text. Questions are also tagged with relevant topic, Bloom’s taxonomy
level, difficulty level, and competencies, where applicable. The test bank is available in
Connect; and the EZ Test version is also available.
xx Preface
boo13806_fm_i-xxxiv.indd xx 4/9/15 9:25 PM

• Conversion Guide with a chapter-by-chapter breakdown of how the content has been
revised between editions. The guide is helpful whether you are a first-time adopter or
are currently using M&DC and moving to the new edition.
• Instructor Asset Map to help you find the teaching material you need with a click of the
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find instructor notes, PowerPoint slides, and even test bank suggestions with ease! The
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in a multitude of learning applications.
All of these helpful materials can be found within your Connect course under the Instructor
Resources.
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boo13806_fm_i-xxxiv.indd xxi 4/9/15 9:25 PM

[ ACKNOWLEDGMENTS
Suggestions have been received from faculty and students throughout the country. This is vital feedback that is
relied on with each edition. Each person who has offered comments and suggestions has our thanks.
The efforts of many people are needed to develop and improve a product. Among these people are the
reviewers and consultants who point out areas of concern, cite areas of strength, and make recommendations for
change. In this regard, the reviewers listed below provided feedback that was enormously helpful in preparing
the fifth edition of M&DC.
Book Reviews
Over 100 instructors reviewed the fourth edition and the fifth edition manuscript, providing valuable feedback
that directly affected the development of the fifth edition.
Fifth Edition Reviewers and Accuracy Checkers Ilene Borze—RN, MS, Gateway Community College
Annette Baer—CMA, Ridley-Lowell School of Business Elicia S. Collins—BSN, MSN, Atlanta Technical College
William Butler—MHA Amy Ensign—CMA, RMA, Baker College
Kevin Chakos—National College Rhonda Evans—AND, BSN, MSN, Central Carolina
Amanda Davis-Smith—Jefferson Community Community College
College—Louisville Timothy Feltmeyer—MS, Erie Business Center
Amy Ensign—CMA (AAMA), RMA (AMT), Baker Thomas Fridley—CPhT, Sanford Brown Institute
College—Clinton Township Margaret Gingrich—Harrisburg Area Community
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College Sheldon Guenther—BS, DC, Kansas City Kansas
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Park Betty Hassler—RMA, AS, National College
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Alaska—Fairbanks
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Technology Elizabeth Laurenz—CMA, LPN, MBA, National
College
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College—Charlotte
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Deborah Zenzal—RN, BSN, AAPC, RMA Penn Foster
College Ralph C. Lucki—MA, CRT, RRT, EMT-P, West Virginia
Northern Community College
Previous Edition Reviewers:
Sheri Lee Martin—RN, BSN, LMT, BLS, Central
Karen Amsden—RN, BSN, MSHA, Jefferson College Georgia Technical College
Michele B. Bach—MS, BA, Kansas City Kansas Belva J. Matherly—CPhT, National College
Community College
xxii
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Keith A. Monosky—PhD, MPM, EMT-P, Central Technical Editing/Accuracy

Washington University
Linda W. Moore—BA, Georgia Military College
Checking
Anne F. Mullenniex—BA, MA, Ph. C, Skagit Valley Kristin Brandemuehl—Washtenaw Community College
College Kevin Chakos—National College
Donna M. Olafson—MA, Kansas City Community Rhonda Johns—Baker College-Allen Park
College Teresa Twomey—Goodwin College
Gail P. Orr—MA, RMA, National College Sherrell Williams—Everest Institute
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Ramona Gail Rice—BS, MS, Ph.D, Georgia Military
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College
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Community College
LearnSmart Subject Matter
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Health Sciences Experts
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Kristin M. Spencer—AAS, BHS, MBA, Baker College Tammy Vannatter—Baker College
George W. Strothmann Jr.—CPhT, Sanford Brown Danielle Wilken—Goodwin College
Institute
Jue-Ling Tai—MS, Danville Community College
Joseph A. Tinervia—CPhT, MBA, Tulsa Job Corps Acknowledgments from the
Center/Tulsa Community College
Authors
Debra J. Tymcio—RT, RMA, National College
We would like to thank the many individuals who
Scott David Vaillancourt—Master Certified Novell
helped develop, critique, and shape our textbook and
Instructor, Certified Cisco Academy Instructor,
ancillary package. Suggestions have been received
Microsoft Certified Trainer, Ultimate Medical
from faculty and students throughout the country.
Academy
This is vital feedback that we rely on for content
Jane K. Walker—BBA, MSN, PhD, Walters State and product development. Each person who has
Community College offered comments, suggestions, and assistance has
Olma L. Weaver—LVN, Coastal Bend College-Beeville our thanks. We also want to thank the extraordinary
Campus efforts of individuals at McGraw-Hill, although we
Janet M. Westhoff—Mott Community College have had lots of hurdles, you have made all of this
come together. A special thank you to Jody James for
Denise York—BSN, MS, Med, Columbus State her enduring assistance through the entire process.
Community College
xxiii
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[ GUIDED TOUR
Chapter Opener
9
Interpreting
The chapter opener sets the stage for what will be learned in the Medication Orders
chapter. You must motivate yourself everyday!
Learning Outcomes are written to reflect the revised version M ATTHEW S TASIOR
CHAPTER
of Bloom’s Taxonomy and to establish the key points the student LEARNING OUTCOMES
KEY TERMS
should focus on in the chapter. In addition, major chapter heads When you have completed Chapter 9, you will be able to:
9.1 Interpret common medical abbreviations.
Authorized prescriber (AP)
Electronic medication
administration record (eMAR)
9.2 Identify components of a medication order.
are structured to reflect the Learning Outcomes and are numbered 9.3
9.4
Differentiate information on prescriptions and other medication
orders.
Recognize the components of a medication order on the medication
Frequency
Medication administration
record (MAR)
accordingly. administration record (MAR). Medication order

Prescription
Route
Key terms are first introduced in the chapter opener so the

student can see them all in one place. INTRODUCTION To correctly calculate a medication dose, first you must be able to read
and understand the medication or drug order. To do this, you must learn common medical
abbreviations. You must also recognize the components of a medication order, including
prescriptions. You must be motivated to read and interpret medication orders with accu-
racy to prevent errors and perform your job effectively.
9.1 Medical Abbreviations
Rules and Examples To promote efficiency, authorized prescribers (APs) often use abbreviations on medication
orders. APs are licensed healthcare professionals that have the authority to write medication
orders, also called prescriptions. Table 9-1 provides a list of commonly used medical abbre-
viations that pertain to medication administration. Table 9-1 is organized by abbreviation
type, including general abbreviations, medication form abbreviations, and abbreviations that
Rules state important formulas and facts for completing calculations. pertain to route and frequency of medication administration. The medication route refers to
the path by which a drug is brought into the body. For example, oral route indicates that the
medication enters the body through the mouth, and the rectal route means via the rectum.
Frequency of medication administration refers to the time(s) of day and how often a medica-
The Examples that follow illustrate these rules. tion is to be given.

Memorize these abbreviations and have available a complete list of those accepted at your
facility. Approved abbreviations vary among facilities. Abbreviations may be written in either
uppercase or lowercase letters and with or without punctuation marks. APs may also put a line
over general and frequency abbreviations, such as a, ac, c, p, and s, when the abbreviations are
lowercase. You may also notice slight differences in the way that the abbreviations are spelled.
159
boo13806_ch09_159-185.indd 159 3/5/15 7:57 PM
RULE 2-1 To write a decimal number:
1. Write the whole-number part to the left of the decimal point.
2. Write the decimal fraction part to the right of the decimal point. Decimal fractions are equivalent RULE 13-1 Always question and verify any calculation that indicates you should give a portion of a tablet when the
to fractions that have denominators of 10, 100, 1,000, and so forth. tablet is not scored.
3. Use zero as a placeholder to the right of the decimal point just as you use zero for whole • Do not administer _12 of an unscored tablet.
numbers. The decimal number 1.203 represents 1 ones, 2 tenths, 0 hundredths, and
• Do not administer _13 or _14 of a tablet scored for division in two.
3 thousandths.
Example 1
Decimal Description Mixed Number
12.5 Twelve and five tenths 5

12___
10
206.34 Two hundred six and thirty-four 34
206____
hundredths 100
Procedure Checklists PROCEDURE To find the flow rate based on weight per time:
CHECKLIST
Procedure Checklists provide easy-to-follow, step-by- 17-3
1. Convert pounds to kilograms, if needed.
2. Convert the unit of measure of the dose on hand to the same unit of measure as the dose
step guidelines for performing dosage calculations. ordered, if needed.
3. Calculate the desired dose:
ordered dose × weight in kg = desired dose
unit of measurement/kg/h × kg = unit of measurement/h = D

4. Convert unit of measurement of the desired dose, if needed.
5. Calculate the flow rate in mL/h.
Methods of Dosage Calculations PROPORTION METHOD
Three methods of dosage calculation are included; EXAMPLE 1 The order is to give the patient 15 mg codeine PO now. You have 30 mg scored tablets available.
proportion, formula, and dimensional analysis. The

boo13806_ch02_037-055.indd 38 3/5/15 6:36 PM
STEP A: GATHER INFORMATION AND CONVERT
The dosage ordered is 15 mg. The dose on hand H is 30 mg, and the dosage unit Q is 1 tablet. Because
methods are color-coded so you can easily find the the dosage ordered and the dose on hand have the same units, no conversion is needed and the dos-
age ordered is the desired dose D.
method of problem solving that best fits your learning STEP B: CALCULATE
Follow Procedure Checklist 12-1.
style or has been specified by your instructor. 1. Set up the proportion.
H = __
__ D or _____________ Desired dose
Dose on hand = ____________________
Q A Dosage unit Amount to administer
30 mg
_______ 15 mg
= ______
1 tablet A
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boo13806_fm_i-xxxiv.indd xxiv 4/9/15 9:25 PM

DIMENSIONAL ANALYSIS
2. Cancel units.
Recall from the chapter “Converting Units” that the dimensional analysis (DA) method is
40 mg
_______ 80 mg similar to the proportion method, but starts with the unknown value x standing alone on
= ______
1 tablet A one side of the equation.
3. Cross-multiply and solve for the unknown.
40 × A = 1 tablet × 80 Procedure Checklist 6-5
80
A = 1 tablet × ___ Converting by Dimensional Analysis
40
A = 2 tablets 1. Write a conversion factor with the units you are converting to in the numerator and
the units you are converting from in the denominator. The units you are converting to
STEP C: THINK! . . . IS IT REASONABLE?
are the units of the dose on hand. The units you are converting from are the units of the dosage
80 is twice 40 so this dose requires twice 1 tablet. The calculated dosage does not call for more than
3 tablets, so this answer seems reasonable.
ordered.
2. Write an equation with the unknown value x on one side and the quantity being
EXAMPLE 3 Refer to Figures 13-3 and 13-4.
converted multiplied by the conversion factor on the other side. The unknown value x is
the desired dose (D). The quantity being converted is the dosage ordered (O).
3. Cancel units.
The dose on hand H is 250 mg, and the dosage unit Q is 1 tablet. Because the dosage ordered and the
dose on hand are in different units, you need to convert the dosage ordered to milligrams. 4. Solve the equation.
Convert the dosage ordered to the same unit of measurement as the dose on hand to obtain the
desired dose (D) of 0.5 g. EXAMPLE 1 The dosage ordered is 0.2 mg once a day.
1. Set up the proportion, recalling that 1 g = 1,000 mg and you are converting to mg. The dosage strength is 100 mcg per tablet.
1,000 mg _____
_________ x
=
1g 0.5 g Find the desired dose.
2. Cancel units. The drug is measured in milligrams on the drug order and in micrograms on the drug label. The units
1,000 mg _____
_________ x for the desired dose must match the units of the dose on hand. We must determine how many micro-
=
1g 0.5 g
grams is equivalent to 0.2 mg.
3. Cross-multiply and solve for the unknown.
1 × x = 0.5 × 1,000 mg
Follow the steps of Procedure Checklist 6-5.
x = 500 mg 1. Write a conversion factor with mcg in the numerator and mg in the denominator. Mcg is the
units of the dose on hand, which is what you are converting to. Mg is the units of the dosage
1,000 mcg
ordered and what you are converting from. Our conversion factor is _________.
1 mg
2. Write the equation with the unknown value D on one side and the quantity being converted,
Medication Sheet 1,000 mcg
6/5/14 © COPYRIGHT 2000

FORM # SP222
which is the dosage ordered, multiplied by the conversion factor _________.
MEDICATIONS HOUR 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 mg
1,000 mcg
Depakote ER 0.5g D = 0.2 mg × _________
PO daily 1 mg
3. Cancel units
1,000 mcg
D = 0.2 mg × _________
1 mg
4. Solve the equation.
Figure 13-3 Medication ordered.
FORMULA METHOD
CHAPTER 13 Oral Dosages 295
EXAMPLE 1 The order is to give the patient 15 mg codeine PO now. You have 30 mg scored tablets available.

The dosage ordered is 15 mg, the dose on hand is 30 mg, and the dosage unit is scored tablets.
boo13806_ch13_291-333.indd 295 3/4/15 9:41 PM boo13806_ch12_251-290.indd 256 The drug is ordered in milligrams, which is the same unit of measure as that for the dose on hand. No 3/5/15 4:21 PM
conversion is needed.
STEP B: CALCULATE
Follow Procedure Checklist 12-3.
1. Determine the components of the formula method and fill in the formula.
D = 15 mg
Q = 1 tablet
H = 30 mg
Learning Aids D×Q=A

__
H
15 mg
______
Learning Links refer students to an earlier chapter for 30 mg
× 1 tablet = A
a quick review when concepts are repeated. 2. Cancel units.

15 mg
______ × 1 tablet = A
30 mg
3. Solve for the unknown.

1 × 1 tablet = A
__
2
1 tablet
A = 0.5 tablet = __
2
Because 15 mg is one-half of 30 mg, _12 tablet is a reasonable answer since the tablets are scored.
EXAMPLE 2 The order is Inderal® 80 mg PO qid. You have 40 mg tablets available.

The dosage ordered is 80 mg, the dose on hand is 40 mg, and the dosage unit is tablets. The drug is
LEARNING LINK Recall the components of a medication order addressed in the

chapter “Interpreting Medication Orders”: name of patient, patient’s date of birth, date
and time the order is written, drug name, drug dose, route, time and/or frequency of
medication administration, and signature of authorized prescriber (AP).
PATIENT EDUCATION Patient Education boxes teach

students about clear and accu-
Healthcare workers often educate patients about the proper way to take drugs at rate communication with their
home. This responsibility may be the duty of the pharmacy technician, the nurse, or
the certified medical assistant. If you are authorized to provide patient education, patients.
you should take the following steps:
boo13806_ch13_291-333.indd 299 3/4/15 9:41 PM
1. Ensure there is no language barrier. If a language barrier exists, obtain a health-

care interpreter.
2. Be sure the patient or caretaker can read and understand the label. Some
patients cannot see the fine print on labels. Others do not have the necessary
literacy skills.
3. Ask the patient about drug allergies and any medications that he or she may
be taking. Check the label or the package insert for drug interactions. Also
boo13806_fm_i-xxxiv.indd xxv 4/9/15 9:25 PM

Error Alert! boxes point out ERROR ALERT!

common errors to students so
they can focus on avoiding them Consider the Age and Health Needs of Your Patient When You !
CAU
T
N
and doing correct calculations
IO
UTIO
Administer a Drug
N! CA
instead. Suppose the drug order reads Biaxin® 250 mg po b.i.d. Biaxin®, an antibiotic, is
CA
available in 250 mg tablets and as an oral suspension with a reconstituted dosage
UT
strength of 125 mg/5 mL. (An oral suspension is a liquid that contains solid particles ION!
of medication. You shake the medication before administering it, suspending the
particles.)
It may seem logical to fill the order with one tablet. Yet the age or health of the
patient may make a liquid the better choice, especially for children or patients who
have difficulty swallowing. If you see a situation in which another form of a drug
may work better, consult the physician or pharmacist about changing the form of
the drug.
Critical Thinking on the Job CRITICAL THINKING ON THE JOB

boxes contain real-world scenar-
ios that help students apply math The Importance of the Right Drug
and dosage calculations to the boo13806_ch10_186-220.indd 197A patient is brought to the hospital with a severe thumb laceration. The attending physi- 2/27/15 6:45 PM
cian verbally orders lidocaine 1% solution 2 mL as a local anesthetic. The healthcare

healthcare profession. Students professional picks up a vial labeled lidocaine 1% with epinephrine and draws up 2 mL.
must read the scenarios and then He then says, “This is lidocaine 1% solution 2 mL,” but neither mentions the epinephrine
nor shows the physician the label.
answer critical thinking ques- A while later, the patient expresses concern about continuing numbness in his thumb.
tions to determine what they After locating the vial, the staff member realized that the patient received epinephrine, a
vasoconstricting drug, in addition to the lidocaine. The patient is reassured that feeling
would do to solve the scenario will return to his thumb, although not quite as quickly as was first anticipated.
presented.
Think! . . . Is It Reasonable? What could have been done to prevent the
patient from losing feeling in his thumb?
Review and Practice FORMULA METHOD
Review and Practice exercises follow every section EXAMPLE 1

Find the flow rate in drops per minute that is equal to 75 mL/h when you are using 20 gtt/mL
macrodrip tubing.
in each chapter, giving students an immediate STEP A: GATHER INFORMATION AND CONVERT
F = 75 mL/h
opportunity to apply new concepts. C = 20 gtt/mL
No conversion is necessary.
STEP B: CALCULATE
Substituting into the formula gives:
F×C
f = _________
60 min/h
[ REVIEW AND PRACTICE

75 mL/h × 20 gtt/mL
f = ____________________
Cancel units.
60 min/h
75 mL/h × 20 gtt/mL
f = ____________________
60 min/h
14.6 Heparin Solve the equation.
boo13806_ch11_221-250.indd 233 2/24/15 4:31 PM

For Exercises 1–3, use Figures 14-29 to 14-34 to determine the appropriate volume bottle and dosage strength for f = 25 gtt/min
the intended purpose.
1. Heparin 7,500 units subcut If the flow rate is 75 mL/h and you need to determine the rate in minutes, you can divide by
2. Heparin 2,500 units subcut 60 min/h, which equals 1.25 mL/min. Then you multiply by the drop factor of 20 gtt/mL, which
equals 25 gtt/min. The answer 25 gtt/min is reasonable.
3. Heparin 10,000 units subcut
For Exercises 4–8, using any one of the described methods, calculate the volume of heparin to be administered.
4. Ordered: Heparin 5,000 units subcut CHAPTER 15 Intravenous Calculations 427
On hand: 5,000 USP units/1 mL
5. Ordered: Heparin 7,500 units subcut
On hand: 10,000 USP units/1 mL
On hand: Heparin 10,000 USP units/1 mL
A three-step solution process has been included for
boo13806_ch15_413-458.indd 427 3/13/15 4:30 PM

the dosage calculation problems—Gather Infor-
8. Ordered: Heparin 2,500 units subcut mation and Convert, Calculate, and “Think! . . . Is
It Reasonable?” This process is used throughout
the book to encourage critical thinking skills.
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boo13806_fm_i-xxxiv.indd xxvi 4/9/15 9:25 PM

End-of-Chapter Resources
End-of-chapter summaries are tied to the learning outcomes and reinforce key points for the students to
review. Page numbers are included for easy reference.
Homework Assignments provide at least one of every type of problem introduced in the chapter.
Answers are not provided in the back of the book so that instructors can assign these as an introduction, a
review, or even a chapter quiz.
The Chapter Review section offers additional exercises for reinforcement of the chapter content. It falls
into these categories: Check Up, Critical Thinking Applications, Case Study, and Internet Activities.
Unit Assessments are presented at the end of each of the 6 units. In each chapter, all of the calculations
have been grouped together to allow students the opportunity to practice a specific skill. In the “real
world,” however, students will be faced with a variety of situations in which they will need to use each of
these skills at various times throughout the day. This assessment requires students to use skills practiced
in each of the chapters in the unit. If they have trouble with some of these calculations, it will help them to
identify areas where more practice is needed. If they do well, they can move forward with the confidence
that they are prepared for the next unit.
[ CHAPTER 14 SUMMARY [ HOMEWORK ASSIGNMENT
Answer the following questions.

LEARNING OUTCOME KEY POINTS 1. What is the correct syringe to select if the amount to be injected is 0.75 mL? (LO 14.1)
14.1 Calculate dosages Parenteral medication is in solution 2. If the dosage to be administered is 1.75 mL, what syringe would you select and to what amount would
the dosage be rounded? (LO 14.1)
of parenteral medication Find the dosage strength
in solution and select 3. List the maximum volume for an IM injection for the following patients: an adult, an adult deltoid, a child
Use the ABCs of dosage calculations 6–12 years old. (LO 14.1)
a syringe based on the
dosage calculation. A. Gather information and convert to like units of measurement 4. If the order for a subcutaneous injection results in an amount of 2.2 mL, what action should be taken
Pages 335–350 before any administration? (LO 14.1)
B. Calculate using the proportion method, dimensional analysis, or
formula method (see Chapter 12 for discussion of each method) 5. What type of injection is usually less than 0.1 mL? (LO 14.1)
C. Think! . . . [about your answer, determine] Is It Reasonable? 6. List three common diluents used when reconstituting powdered medications. (LO 14.3)
[following Rules 14-1 to 14-3] 7. Ordered: Acetylcysteine 800 mg via nebulizer q6h
On hand: Acetylcysteine 10% solution
Rule 14-1 Select the proper syringe
8. Ordered: Thorazine® 50 mg q6h pr as needed
If volume to administer is greater than or equal to 1 mL, use a
On hand: Thorazine® 25 mg and 100-mg suppositories
3 mL syringe
9. Ordered: Nitro-Dur® 0.3 mg/h top
If volume to administer is less than 1 mL, but greater than or equal to
On hand: Nitro-Dur® 0.1 mg/h and 0.2 mg/h transdermal patches
0.5 mL and calculates evenly to the hundredths, use a 1 mL tuberculin
syringe or a 3 mL syringe Use the identified drug labels to answer the following questions.
If the volume to administer is less than 0.5 mL, round to the hun- 10. Refer to Label A. What is the storage information
dredths and use a 1 mL tuberculin syringe. For amounts less than on the label? (LO 14.3)
NDC 0073-3811-09 1300
0.5 mL, use a 0.5 mL tuberculin syringe, if available. 11. If the order is for 75 mg IM, what amount
would be administered? What syringe should THIAMINE
Rule 14-2 Correctly round the amount of an injection to administer
be used? (LO 14.1) HYDROCHLORIDE
Round volumes greater than 1 mL to the nearest tenth (3 mL syringe PROTECT FROM LIGHT
is calibrated in tenths)
100 mg/mL
Round volumes less than 1 mL to the nearest hundredth (tuberculin 2 mL Multiple Use Vial
syringe is calibrated in hundredths) For I.M or I.V. Use.
Rule 14-3 Do not exceed maximum volume for an injection in a Total Care Pharmaceuticals
single site. 24 Nowhere Street
Anytown, USA 12345-6789
Intramuscular (IM) injections:
– Adult, excluding deltoid 3 mL 000000A
– Adult deltoid (arm) 1 mL LOT/EXP
– Child 6–12 years 2 mL

– Child 0–5 years 1 mL
– Premature infant 0.5 mL
Subcutaneous (Subcut) injections: 1 mL
6 0073-3811-09 0
A
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[ CHAPTER 14 REVIEW [ UNIT THREE ASSESSMENT

For examples 1 and 2, rewrite the medication order, interpreting the abbreviations.
CHECK UP
1. Montelukast 10 mg tab i po q evening
For Exercises 1–10, find the amount to administer, then mark the syringe. (LO 14.1, 14.2)
2. Morphine sulfate 10 mg supp pr q4h prn pain
1. Ordered: INFeD® (iron dextran) 100 mg IM daily
On hand: INFeD® 50 mg/mL
For Examples 3 and 4, identify which component of the medication order is missing.
3.
Paul Mayor, DOB 8/27/53
3mL
21/2
2
11/2
1
1/
2
5/4/2014 Paroxetine 25 mg po
T. Holmes, MD
2. Ordered: Haloperidol decanoate 60 mg IM stat

On hand: Haloperidol decanoate 50 mg/mL 4.
Carolyn Flynn, DOB 2/28/80
9/14/2014 Rifaximin po TID for 3 days.

3mL
21/2
2
11/2
1
1/
Y.Xong, MD
2
5. Which medications will be administered at 9:00 a.m. on 6/2, according to the following MAR?
3. Ordered: Loxitane® 30 mg IM bid

On hand: Loxitane® 50 mg/mL
Robert Reams, DOB 4/12/48 Allergies : iodine Room 412
Order Time 6/1 6/2 6/3 6/4 6/5 6/6 6/7
Rosuvastatin 10 mg 0900 GF
ML
1.0
.9
.8
.7
.6
.5
.4
.3
.2
.1
PO daily
Cefuroxime Sodium 0900 GF
2100 SS
4. Ordered: Epogen® 1,400 units subcut three times per week 500 mg IV q12h
On hand: Epogen® 2,000 units/mL
Phenytoin 100 mg 0800 GF
1400 GF
Po TID
2200 SS
ML
1.0
.9
.8
.7
.6
.5
.4
.3
.2
.1
6. 30 milliliters (mL) equals how many cubic centimeters?

7. An order calls for 2 teaspoons of a liquid oral medication. The only available medicine cup is calibrated in
mL. How many mL will you pour into the medicine cup?
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boo13806_fm_i-xxxiv.indd xxvii 4/9/15 9:26 PM

What is ALEKS?
Assessment and Learning in Knowledge Spaces, • Subtracting a one-digit number from a two-digit
or ALEKS, is a Web-based, artificially intelligent number
assessment and learning system. ALEKS uses adaptive • Subtraction without borrowing
questioning to quickly and accurately determine • Subtraction with borrowing
exactly what you know and don’t know and then • Adding or subtracting 10, 100, or 1,000
instructs you on the topics you are most ready to learn. • Subtraction with multiple regrouping steps
As you work through a course, ALEKS periodically • Subtraction and regrouping with zeros
reassesses your understanding to ensure that topics
learned are also retained. ALEKS courses are very Multiplying and Dividing Whole Numbers
complete in their topic coverage. If you show a high (16 topics)
level of mastery of an ALEKS course, odds are you
• One-digit multiplication
will be successful in the actual course you are taking.
• Multiplication by 10, 100, and 1,000
For Booth & Whaley, Math and Dosage
Calculations for Healthcare Professionals, a “prep” • Multiplication without carry
course has been developed to coincide with the first • Multiplication with carry
seven chapters of basic math, measurement, and • Introduction to multiplication of large numbers
conversion in the text so that you can refresh your • Multiplication with trailing zeros: Problem type 1
memory as well as brush up on the math skills needed • Multiplication with trailing zeros: Problem type 2
for dosage calculation.
• Multiplication of large numbers
Your instructor can decide to include ALEKS for
everyone, or you can also decide to purchase it on • Division facts
your own. See your instructor for information about • Division without carry
what is provided for your course. • Division with carry
This course covers the topics shown below. • Division with trailing zeros: Problem type 1
• Division with trailing zeros: Problem type 2
Prep for Math and Dosage • Division involving quotients with intermediate zeros
Whole Numbers (36 topics) • Quotient and remainder: Problem type 1

• Quotient and remainder: Problem type 2
Place Value (2 topics)
• Whole number place value: Problem type 1 Rounding (2 topics)
• Numeral translation: Problem type 1 • Rounding to tens or hundreds
• Rounding to thousands, ten thousands, or hun-
Adding and Subtracting Whole Numbers dred thousands
(11 topics)
Factors and Divisibility Rules (5 topics)
• Adding a two-digit number and a one-digit num-
ber with carry • Divisibility rules for 2, 5, and 10
• Addition without carry • Divisibility rules for 3 and 9
• Addition with carry • Prime numbers
• Addition with carry to the hundreds place • Greatest common factor of two numbers
• Addition of large numbers • Least common multiple of two numbers
boo13806_fm_i-xxxiv.indd xxviii 4/9/15 9:26 PM

Fractions and Mixed Numbers (32 topics) • Mixed number multiplication: Problem type 1
• Mixed number multiplication: Problem type 2
Equivalent Fractions (5 topics)
• Mixed number division
• Introduction to fractions
• Understanding equivalent fractions Decimals (23 topics)
• Equivalent fractions Decimal Place Value (6 topics)
• Introduction to simplifying a fraction
• Writing a decimal and a fraction for a shaded
• Simplifying a fraction region
Mixed Numbers (3 topics) • Decimal place value: Tenths and hundredths
• Decimal place value: Hundreds to ten thousandths
• Writing a mixed number and an improper fraction
• Rounding decimals
for a shaded region
• Introduction to ordering decimals
• Writing an improper fraction as a mixed number
• Ordering decimals
• Writing a mixed number as an improper fraction
Ordering and Plotting Fractions (5 topics) Converting between Decimals and

Fractions (7 topics)
• Ordering fractions with the same denominator
• Converting a decimal to a fraction: Basic
• Ordering fractions with the same numerator
• Converting a decimal to a proper fraction in sim-
• Using a common denominator to order fractions
plest form: Advanced
• Fractional position on a number line
• Converting a fraction with a denominator of 10,
• Plotting fractions on a number line 100, or 1,000 to a decimal
Adding and Subtracting Fractions and • Converting a fraction to a terminating decimal
Mixed Numbers (8 topics) • Converting a fraction to a repeating decimal
• Converting a decimal to a mixed number
• Addition or subtraction of fractions with the same
• Converting a mixed number to a decimal
denominator
• Addition or subtraction of unit fractions Adding and Subtracting Decimals (3 topics)
• Introduction to addition or subtraction of fractions
• Addition of aligned decimals
with different denominators
• Decimal addition with three numbers
• Addition or subtraction of fractions with different
denominators • Subtraction of aligned decimals
• Addition or subtraction of mixed numbers with the Multiplying and Dividing Decimals (7 topics)
same denominator
• Addition of mixed numbers with the same denomi- • Multiplication of a decimal by a power of 10
nator and carry • Multiplication of a decimal by a whole number
• Subtraction of mixed numbers with the same • Decimal multiplication: Problem type 1
denominator and borrowing • Division of a decimal by a power of 10
• Addition or subtraction of mixed numbers with • Division of a decimal by a whole number

different denominators • Division of a decimal by a two-digit decimal
• Word problem with powers of 10
Multiplying and Dividing Fractions and
Mixed Numbers (11 topics) Percents, Ratios, and Proportions (7 topics)
• Product of a unit fraction and a whole number Percents (4 topics)
• Product of a fraction and a whole number: Problem • Finding the percentage of a grid that is shaded
type 1 • Converting between percentages and decimals
• Introduction to fraction multiplication • Converting a percentage to a fraction in simplest form
• Fraction multiplication • Converting a fraction to a percentage: Denominator
• The reciprocal of a number of 20, 25, or 50
• Division involving a whole number and a fraction
• Fraction division Ratios (1 topic)
• Complex fraction without variables: Problem type 1 • Writing a ratio as a percentage
boo13806_fm_i-xxxiv.indd xxix 4/9/15 9:26 PM

Proportions (2 topics)
• Writing a ratio proportion as a fraction proportion
• Finding the missing value in a proportion
Measurements and Conversions (6 topics)

Metric System (4 topics)
• Metric distance conversion with whole number
values
• Metric mass or capacity conversion with whole
number values
• Metric distance conversion with decimal values
• Metric conversion with decimal values: Two-step
problem
Converting Units (1 topic)

• Converting units
Temperature (1 topic)
• Converting between temperatures in Fahrenheit
and Celsius
You can test-drive ALEKS yourself at:
http://www.aleks.com/free_trial/consumer
If your instructor has provided you with information
and access cards, you’ll want to log in at www.aleks
.com as soon as possible and begin.
Click “Free Trial” in the “HIGHER EDUCATION”
box.
If you’re looking to purchase ALEKS on your
own, go to “Independent Use” on the top of the
home screen, from there select “Students” in the left
hand side menu item, and then click on the “Getting
Started” tab: http://www.aleks.com/independent/
students/getting_started
Then, click on the “Buy ALEKS Now” to begin to

purchase the Prep for Math and Dosage. Be sure to
choose Higher Education/Math for the Market, and
Prep for Math and Dosage as the course.
boo13806_fm_i-xxxiv.indd xxx 4/9/15 9:26 PM

[ PRETEST
The following test covers basic mathematical concepts that you will need to understand in
order to calculate dosages. This test will help you determine which concepts you need to
review before continuing. You should already be able to perform basic operations—addition,
subtraction, multiplication, and division—with whole numbers. The test covers fractions,
decimals, percents, ratios, and proportions.
Take 2 hours to answer the following 75 questions. Review the questions you answered
incorrectly to learn more about any basic math weaknesses. Then, as needed, review that
content in Chapters 1 through 3. Each question (or group of questions) has an “LO” listed
to indicate the learning outcome addressed by the question. If you need to review, these LO
indicators will help you find the appropriate material in the text.
14 to a mixed number. (LO 1.1)

1. Convert ___
3
7 to an improper fraction. (LO 1.1)
2. Convert 3__
8
8
__
3. Convert to a mixed number. (LO 1.1)
5
3 to an improper fraction. (LO 1.1)
4. Convert 2__
4
Find the missing numerator in the following proportions. (LO 1.2, 3.4)
x
2 = ___
5. __
7 21
x
1 = ___
6. 1__
8 16
7. Reduce ____40 to lowest terms. (LO 1.3)
100
8. Which fraction has the greater value, __ 3 or __
2 ? (LO 1.5)
8 6
9. Reduce 48
___ and rewrite the answer as a mixed number. (LO 1.1, 1.3)
10
10. Which number has a greater value, 3__ 1 or 3__
1 ? (LO 1.5)
3 4
Calculate the following. Reduce fractions to lowest terms and rewrite fractions greater than 1
as mixed numbers. (LO 1.1, 1.2, 1.3, 1.4, 1.6, 1.7, 1.8, 1.9)
11. __ 3
4 + __ 12. 1__ 5
1 + __ 13. ___ 1
7 - __ 1 - 2__
14. 8__ 1
5 8 3 7 10 4 4 3
3 × __
15. __ 1 16. 3__ 3
1 × 4__ 2 ÷ __
17. __ 4 5
1 ÷ 2__
18. 5__
5 9 5 8 3 5 4 8
1 + __
19. __ 1 3 - __
20. 2__ 3 21. 7__ 3
1 × __ 1
__
22. 3 ÷ 2
4 3 8 4 2 4 3
23. Which number has the lesser value, 1.01 or 1.009? (LO 2.1)
24. Round 14.42 to the nearest whole number. (LO 2.2)
25. Round 6.05 to the nearest tenth. (LO 2.2)
26. Round 19.197 to the nearest hundredth. (LO 2.2)
xxxi
boo13806_fm_i-xxxiv.indd xxxi 4/9/15 9:26 PM

4 to a decimal number. If necessary, round to the nearest tenth. (LO 2.3)

27. Convert 3__
5
28. Convert 0.045 to a fraction or a mixed number. Reduce to lowest terms. (LO 2.4)
29. Which number has a greater value, 1.015 or 1.0105?

1 to a decimal number.
30. Convert 7__
8
31. Round 3.08 to the nearest whole number.
32. Convert 3.6 to a fraction or mixed number. Reduce to lowest terms.
Calculate the following. (LO 2.5, 2.6, 2.7)
33. 7.289 + 8.011 34. 0.012 + 0.9 + 4.2
35. 19.1 - 4.4 36. 100.03 - 0.6
37. 0.07 × 3.2 38. 0.4 ÷ 0.02
39. 6 - 1.025 40. 1.4 × 1.5
41. 1.05 ÷ 2
42. Convert 0.8% to a decimal number. (LO 3.1)
43. Convert 0.99 to a percent. (LO 3.1)
44. Convert 260% to a fraction or mixed number. (LO 3.1)

1 to a percent. (LO 2.3, 3.1)
45. Convert 1__
8
46. Convert 7 : 12 to a fraction. Reduce to lowest terms. (LO 3.2)
10 to a ratio. Reduce to lowest terms. (LO 3.2)
47. Convert ___
50
48. Convert 1 : 12 to a decimal. Round to the nearest hundredth, if necessary. (LO 3.2)
49. Convert 0.4 to a ratio. Reduce to lowest terms. (LO 3.2)
50. Convert 3 : 8 to a percent. Round to the nearest percent, if necessary. (LO 3.1)
51. Convert 0.5% to a ratio. Reduce to lowest terms. (LO 3.2)
52. Convert 8:3 to a mixed number. (LO 3.2)

53. Convert 0.15 to a ratio. Reduce to lowest terms. (LO 3.2)
54. Convert 1.05 to a percent. (LO 3.1)
55. Convert 1.5% to a fraction. Reduce to lowest terms. (LO 3.1)
Find the missing value in the following proportions. (LO 3.4)
56. 8 : 16 = x : 8 5 = ___
57. __ x
9 27
58. 8 : 12 = x : 9 59. __ x
2 = ___
7 28
8
x = ___
60. __
4 32
xxxii Pretest
boo13806_fm_i-xxxiv.indd xxxii 4/9/15 9:26 PM

61. A healthcare professional is instructed to give a patient 1_12 teaspoons of cough syrup
4 times a day. How many teaspoons of cough syrup will be given each day? (LO 3.4)
62. A healthcare professional tries to keep the equivalent of 12 bottles of a medication on

hand. The hospital’s first floor has 1_12 bottles, the second floor has 1_34 bottles, the third
floor has 3_14 bottles, and the supply closet has 3 bottles. Is there enough medication on
hand? If not, how much should be ordered? (LO 1.6)
63. A bottle contains 75 milliliters (mL) of a liquid medication. Since the bottle was
opened, one patient has received 3 doses of 2.5 mL. A second patient has received
4 doses of 2.2 mL. How much medication remains in the bottle? (LO 2.5, 2.6)
64. A tablet contains 0.125 milligram (mg) of medication. A patient receives 3 tablets a
day for 5 days. How many milligrams of medication does the patient receive over the
5 days? (LO 2.6)
65. An IV bag contained 1,000 mL of a liquid. The liquid was administered to a patient,
and after 3 hours, 400 mL remain in the bag. How much IV fluid did the patient
receive each hour? (LO 3.4)
66. The patient is taking 0.5 mg of medication 4 times a day. How many milligrams would
the patient receive after 1_12 days? (LO 2.6, 3.4)
67. The patient took 0.88 microgram (mcg) every morning and 1.2 mcg each evening for
4 days. What was the total amount of medication taken? (LO 2.5, 2.6)
68. Write a ratio that represents that 500 mL of solution contains 5 mg of drug. Reduce to
lowest terms. (LO 3.3)
69. Write a ratio that represents that every tablet in a bottle contains 25 mg of drug.
Reduce to lowest terms. (LO 3.3)
70. Write a ratio that represents that 3 mL of solution contains 125 mg of drug. Reduce to
lowest terms. (LO 3.4)
71. A patient takes 5 mL of a medication twice a day. How long will 120 mL last? (LO 3.4)
72. Write a ratio that represents 2 mg of drug in 1 mL of a liquid. Reduce to lowest terms.
(LO 3.2)
73. If a patient has to take 2 tablets a day for 10 days, how many tablets will he need to fill
his prescription? (LO 3.4)
74. If each 5 mL of a solution contains 15 mg of medication, how many mL of solution will

a patient need to take to get 60 mg of medication? (LO 3.4)
75. If a solution has 80 mg of medication in 500 mL, how much solution is needed to get
40 mg of medication? (LO 3.4)
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no related content on Scribd:
Saturday and Sunday, Nov. 15th and 16th, the army started in a
south-easterly direction in three columns, with the exception of a
small force, which bore off towards Culpepper, to mislead and cause
the enemy to think we were going to advance in that direction. The
Thirty-third broke camp early on Sunday, and marching sixteen
miles, encamped in a beautiful grove near Catlett’s Station. The men
were in fine spirits, and moved rapidly over the good roads, inspired
with the hope that they were now going to Richmond without fail.
The first day’s march presented nothing worthy of interest, unless
it was the worn-out and ruined plantations which were seen on every
side. Upon halting at one we found the mansion, situated back from
the road, entirely deserted. Windows, doors, and everything of a
combustible nature, had disappeared from the once splendid
dwelling. Near by were a number of rude log huts, occupied by
negroes. A bevy of children sallied out to inspect us as we rode up,
betraying all that eager curiosity peculiar to the African race. They,
together with a few helpless old men and women, were the sole
occupants of the place. From them we learned that it belonged to a
second cousin of John Randolph of Roanoke, who had died a few
weeks before, and was buried beneath a tall oak in front of the
mansion. The widow had gone to Fredericksburg, taking with her
what effects she could.
Monday morning the reveille was sounded very early, and by six
o’clock the Regiment was on its way. The march lay through a
country more barren and desolate, if possible, than that north of
Warrenton, presenting the worst features of a slave region.
“Snatching” and “jayhawking” continued to be the order of the day,
as when in the Loudon Valley. “How are you, Stuart?” “I believe this
horse came from Pennsylvania;” “This is a Maryland pig;” were
among the oft repeated responses made to the rebel farmers, who
expostulated with the boys for making way with their animals. Very
little satisfaction could be obtained from the “invaders.” War the
Virginians wanted, and war they should now have to their hearts’
content. After a march of fourteen miles, we bivouacked near the
mouth of Acquia Creek.
A Virginia Sowing Machine.
Tuesday we proceeded about fourteen miles further, and

encamped near Stafford Court House, between the Potomac and
Rappahannock rivers, about ten miles from the latter.
The right and centre Divisions had now arrived in the vicinity of
Falmouth, but no pontoons greeted the eye of Gen. Burnside. The
Washington authorities had neglected to forward these essentials for
crossing the river, and the rapid and successful marching had been
to no purpose. In a day or two more the enemy would be on hand,
fortifying the Fredericksburg Heights, and resisting our passage.
How great must have been the Commanding General’s
disappointment and anger at this phase of affairs! All his plans foiled;
the whole campaign a failure; simply because some one had
“forgotten to give the order” for forwarding a few pontoons.
The Second, Third, Fifth and Ninth Corps encamped near the
river. The Sixth remained near Stafford Court House, and the First,
pushing on to Brooks’ Station, was stretched along the
Fredericksburg and Acquia railroad, upon which repairs were
immediately commenced. Generals Franklin and Smith, who were
boon companions, and nearly always together, located their
headquarters in a grove close by the village of Stafford, which
presented a scene of utter ruin. Dwellings, formerly occupied by the
better class, were deserted, and the surrounding negro huts
consumed, timber by timber, in the camp fires of the Union soldiers.
Our troops had occupied the place during the previous spring. The
once neat Court House stood by the road side, a striking monument
to treason and rebellion. Deprived of its white picket fence, stripped
of window blinds, benches and doors, walls defaced by various
hieroglyphics, the judge’s bench a target for the expectorating
Yankee, the circular enclosure for the jury besmeared with mud, and
valuable documents lying about the floor; it was indeed a sad picture
of what an infatuated people will bring upon themselves. In one
corner of the yard stood a House of Records, in which had been filed
all the important documents belonging to the county for a century.
But they now lay scattered upon the floor around the steps, and in
the door yard, to the depth of fifteen inches or more. It is impossible
to estimate the inconvenience and loss which will follow this
wholesale destruction of deeds, claims, mortgages, &c.
Warwick Court-House, near Youngs’ Mills, Virginia.
The jail, across the way from the Court House, where many a poor
fugitive had doubtless languished in chains for striking out for
freedom, was converted into a guard-house. Peeping through the
iron grates of the windows, were to be seen the bilious
countenances of several culprits, who, may be, were atoning for
having invaded a hen roost or bagged an unsuspecting pig.
Colonel Taylor’s men took up position on a woody crest, and
immediately commenced felling trees, pitching tents, building camp
fires, and making themselves comfortable generally. The constant
ringing of numerous axes and crashing of falling trees all around us,
recalled memories of other days, and it was difficult to realize that we
were not in a western log clearing. Indeed, the army of “invaders”
have accomplished for Virginia what her indolent population have
failed to do, cleared up the woodlands, and let the sunlight into many
a hitherto cheerless and unhealthy spot.
The boys, as if prescient of coming delay and ease, soon began to
construct elaborate log huts, which afforded a much more
comfortable shelter than the thin, airy tents. Foraging parties scoured
the surrounding country daily, and returned at night loaded down
with eatables of every description. What confederate money (of
which we had an abundance) would not buy, was “confiscated.”
These expeditions were greatly enjoyed by those participating in
them. Roving through woods and fields, from one farm house to
another, they made numerous acquaintances, and learned
everything of interest pertaining to the locality.
On one occasion a party halted at an obscure hovel for a drink of
water. On entering we found the only occupant to be a
superannuated negress, who, as she expressed it, having become
“too old a critter to do nothing, had been turned out here to die.”
Further conversation disclosed the fact that she had belonged to
James Ashby, a brother of the deceased famous General of that
name. She related much that was of interest concerning the Ashby
family. There were three brothers of them—James, Turner and
Richard (commonly known as Dick)—raised in the vicinity of Front
Royal, and all now in their graves. James, who was her master,
moved to this vicinity when a young man, acquired a large estate,
and died February, 1861. Turner, the General, who, when a young
man, was admired by every one for his manly bearing, and in later
years for his chivalric deeds, was killed at the battle of Cross-Keys.
Dick, the remaining and youngest brother, was shot in a skirmish,
just prior to the last battle of Bull Run.
After the death of her master, the younger slaves were sent South
and sold. “Though I hab raised,” she said, “nineteen children to
manhood (eleven sons among the number), all of whom hab been
torn away from me, and hab worked hard all my life for massa, his
heirs wouldn’t let me stay in the house, but sent me here, with a little
hog and hominy, to die alone.” Three times she had herself hoed the
little patch of corn in front of the hut, and gathered and husked it. On
our inquiring if she was “Union,” she replied, “I’se partial to Yankees,
but some of dem is mighty rogues. Dem ar low class people among
dem steal all my things. Two came along last week and showed me
twenty-five cents for some hoe-cake, which I gib dem, and bless you
child, when dey come to pay, felt in all de pockets and couldn’t find
de money; but, God bless you chil’ren, dey knew all de time where it
was. But de Southrons are just as bad.”
She recounted, with tears in her eyes, the manner in which her
youngest son was dragged away. He had been sick for some time,
but when word came that the Union forces were advancing, they tied
his legs, and placing him in a cart, drove off towards Richmond; but
he never reached there, having died in the streets of Olean. We left
“Aunt Sophie,” more convinced than ever that the cruelties and
wrongs which grow out of slavery have not been overdrawn.
CHAPTER XXV.
Completion of the Potomac Creek Bridge.—An interesting relic of Virginia
Aristocracy.—General Burnside determines to cross the river.—March of the
Sixth Corps.—White-Oak Church.
During the first few days the rations were drawn from Acquia
Landing with teams, but heavy rains coming on, the wheeling
became terrible. Pioneers were accordingly set to work building
corduroy roads, and in a week’s time constructed seven miles of
them.
On the 28th the bridge over the Potomac Creek, ninety feet in
length, was completed, and the cars immediately commenced
running, bringing up plenty of supplies of every description. This
structure, in addition to numerous other works, had been destroyed
during the preceding August, when General Burnside abandoned the
region. They had now all to be rebuilt.
The time passed here much in the same manner as in Maryland,
the Regiment being employed on picket duty, slashing timber, &c.,
&c. Occasionally the officers rode over to the front, and viewed
General Headquarters, Fredericksburg, and the river scenery, which
is very attractive. Our own and the rebel pickets were scattered
along the banks of the Rappahannock, almost within speaking
distance of each other, and frequently indulged in conversation. “You
have lost your best man,” shouted out a grey-back, one afternoon;
“Burnside is played out. We don’t care a —— for him.” A Ninth New
Hampshire boy replied by asking him where they had stolen their
blue overcoats. “We took them off the dead Yankees at Antietam.
Why didn’t you take ours?” “Because they walked off so fast,” was
the ready reply. Another wanted to know if we had any Bull Run boys
with us. “Have you any South Mountain or Antietam boys with you?”
retorted one of our pickets. These interviews, which generally
partook of a profane character, were afterwards forbidden. The
enemy continued to augment their forces daily, throwing up new
earthworks every night to the right or left of the city. Their operations
were plainly visible from the balloon and signal stations.
Nearly opposite the road to the camp of the Thirty-third was an
interesting relic of the old-time Aristocracy, concerning which the
present race of Virginians boast so much, and possess so little.
Standing remote and alone in the centre of a dense wood, was an
antiquated house of worship, reminding one of the old heathen
temples hidden in the recesses of some deep forest, whither the
followers after unknown gods were wont to repair for worship, or to
consult the oracles. On every side are venerable trees, overtowering
its not unpretentious steeple. The structure is built of brick (probably
brought from England), in the form of a cross, semi-gothic, with
entrances on three sides, and was erected in the year 1794. On
entering, the first object which attracts the attention, is the variously
carved pulpit, about twenty-five feet from the floor, with a winding
stair-case leading to it. Beneath are seats for the attendants, who, in
accordance with the custom of the old English Episcopacy, waited
upon the rector. The floor is of stone, a large cross of granite lying in
the centre, where the broad aisles intersect. To the left of this is a
square enclosure for the vestrymen, whose names are written on the
north wall of the building. The reader, if acquainted with Virginia
pedigrees, will recognize in them some of the oldest, and most
honored names of the State—Thomas Fitzhugh, John Lee, Peter
Hodgman, Moor Doniphan, John Mercer, Henry Tyler, William
Mountjoy, John Fitzhugh, and John Peyton. On the south wall are
four large tablets, containing Scriptural quotations. Directly beneath
is a broad flag-stone, on which is engraved, with letters of gold: “In
memory of the House of Moncure.” This smacks of royalty. Parallel
to it lies a tomb-stone, “Sacred to the memory of William Robison,
the fourth son of H. and E. Moncure, of Windsor Forest; born the
27th of January, 1806, and died 13th of April, 1828, of a pulmonary
disease brought on by exposure to the cold climate of Philadelphia,
where he had gone to prepare himself for the practice of medicine.
Possessed of a mind strong and vigorous, and of a firmness of spirit
a stranger to fear, he died manifesting that nobleness of soul which
characterized him while living, the brightest promise of his parents,
and the fondest hopes of their afflicted family.”
Led, doubtless, by the expectation of discovering buried valuables,
some one had removed the stone from its original position, and
excavated the earth beneath. Close by the entrance on the north
side, are three enclosed graves, where sleep those of another
generation. The brown, moss-covered tombstones appear in strong
contrast to a plain pine board at the head of a fresh made grave
alongside, and bearing the inscription: “Henry Basler, Co. H, 118th
Pennsylvania Volunteers.”
One evening considerable alarm was occasioned by the
appearance of numerous camp fires in the rear, the supposition
being that the enemy had turned the right of our lines, and were
pushing for Acquia Landing. Inquiry, however, soon ascertained that
they proceeded from General Sickles’ Division, which was on the
march from the vicinity of Fairfax to join the Second Corps.
Nearly four weeks had now elapsed since the army arrived at the
new base of operations. The rainy season was approaching, and
whatever was done, must be done quickly. Owing to the difficulty our
scouts and spies experienced in crossing the river, but very little
reliable information could be obtained of the enemy’s forces. They
were variously estimated at from sixty to one hundred and twenty-
five thousand men. A long extended line of fortifications appeared on
the first crest of hills, but whether these constituted their only
earthworks, or a new Torres Vedras existed beyond, was a matter of
uncertainty.
It was, however, definitely ascertained that Jackson had arrived
from the Shenandoah Valley, and that Lee had posted his troops up
and down the river for a distance of twenty miles, to obstruct our
crossing.
After consulting with his Division and Corps Commanders,
General Burnside decided upon throwing his entire army across at
some given point, and hurling it quickly upon the necessarily weak
line, pierce, and break it, before the rebel General could concentrate
his forces. Skinner’s Neck, about twelve miles below the city, was
the point first chosen for crossing. But he afterwards decided to
cross at Fredericksburg, because, as he has since informed us, he
“felt satisfied that they did not expect us to cross here, but down
below. In the next place, I felt satisfied that this was the place to fight
the most decisive battle; because, if we could divide their forces by
piercing their lines at one or two points, separating their left from
their right, then a vigorous attack by the whole army would succeed
in breaking their army in pieces. The enemy had cut a road along the
rear of the line of heights, by means of which they connected the two
wings of their army, and avoided a long detour around, through a
bad country. I wanted to get possession of that road.”
As an initiatory step to active operations, he commenced a series
of feints down the river as far as Port Conway, twenty miles below.
Among other ruses, a long train of empty wagons was sent down the
river road, in plain view of the enemy, and returned by an obscure
route. Wednesday evening, December 3rd, the Left Grand Division
received marching orders, with instructions to proceed in a southerly
course, as if intending to strike and cross the river several miles
below Fredericksburg.
Colonel Taylor had just moved his command to a new spot, higher
up the side of the woody crest on which it was encamped, and the
men were busily employed in erecting log-huts when the orders
came. Instead, however, of occasioning any dissatisfaction, they
were received with joy, and the men began, with alacrity,
preparations for resuming the “on to Richmond.” Strange as it may
seem, soldiers dread the privations and dangers of an active
campaign less than the idleness and ennui of camp; and, contrary as
it may be to the opinion generally entertained, there is much less
sickness on the march than when the troops are encamped. The
excitement consequent upon seeing new sights, and participating in
new scenes, dispels those camp ills, real or imaginary, so common
among soldiers during a period of inactivity.
By eleven o’clock the next morning, everything was got in
readiness, and the Regiment took its place in the advancing column,
which extended for miles, and was headed by Generals Franklin and
Smith. Proceeding about eight miles, through Stafford Village, on the
cross-road intersecting the Falmouth and Acquia Turnpike, the
troops bivouacked for the night close by Potomac Creek bridge.
On the following day a snow storm set in, which, together with the
rain, imparted a decidedly gloomy and sombre aspect to the
surroundings. The soldiers protected themselves as best they could
with their frail tents, stirring out but little. The march was resumed
Saturday morning at eight o’clock, and reaching White-Oak Church,
an insignificant building, in which Stephen A. Douglass delivered an
address during his last political tour, the Corps turned straight to the
left, towards Belle Plain, and proceeding about a mile, encamped in
the fields and woods adjoining the road. Here it remained until the
following Thursday, about six miles from Fredericksburg, and two in
the rear of Burnside’s Headquarters. The Thirty-third occupied a
small grove, together with the 20th, 49th, 77th New York and 7th
Maine. The First Corps soon after came up and took position near
the Sixth. Various inquiries concerning the roads and distances to
Port Conway were made of the inhabitants, who, with hardly an
exception, were rebels, in order to create the impression that we
were going to move down the river. This, together with other similar
ruses, succeeded admirably, for, as we afterwards learned, General
Lee sent down the whole of Jackson’s force to Port Royal, opposite
Port Conway, to resist our crossing.
Meanwhile preparations were actively going on in front. Additional
pontoons had been brought from Washington, and the Engineers’
Brigade made ready their trains. The Second, Third, Fifth and Ninth
Corps, composing the right and centre Grand Divisions, were placed
under marching orders, though not moving from their camps.
CHAPTER XXVI.
Laying of the Bridges.—A solemn scene.—Bombardment of Fredericksburg.—
Gallantry of the Seventh Michigan and other Regiments.—Crossing of the
left Grand Division.
At length everything was in readiness, and during Wednesday

evening, December 11th, the advance movement was begun. All
night long, the rumbling of artillery could be heard, as numerous
batteries moved to the Rappahannock and were planted along the
bank. One after another, the long, phantom-like pontoons descended
the hillsides, and were unloaded near the points designated for
crossings. Four bridges were to be thrown, the first a few yards
above the Lacey House, which fronts the main street of the city, the
second several hundred yards below, and the third and fourth about
a mile still further down the river. The right and centre Grand
Divisions were to cross on the first two, and the left on the remaining
two. General Burnside designed to have all the artillery in position by
eleven o’clock, the pontoons thrown by two A. M., and a large force
across by sunrise. Owing, however, to numerous delays, none of the
boats were launched before four o’clock.
The writer stood at the upper crossing. It was a most solemn
scene, those brave Engineers (50th New York) pushing their
pontoons out upon the ice, and fearlessly moving them around in the
water, to their proper positions. Any moment might terminate their
existence. They were upon the very threshold of eternity. Pacing
along the opposite bank, or grouped around the picket fires, were to
be seen the rebel sentinels, almost within pistol-shot. Occasionally
they would stop a moment to view our operations, then resume their
beat as unconcernedly as if nothing unusual was transpiring. The
bridge was headed directly for one of their fires.
Nearly one quarter of it was completed without interruption, when,
suddenly, as the Court House clock struck five, two signal guns
boomed away in the distance, and were immediately followed by a
sharp volley of musketry. Lieutenant-Colonel Bull, two captains and
several men fell dead; others tumbled headlong into the water and
sank to the bottom, or were rescued by their brave comrades and
brought bleeding and dripping to the shore. We were not unprepared
for this. Before the enemy had time to re-load, our artillery planted on
the bluffs overhead, and infantry drawn up along the river’s bank,
returned a heavy fire upon the buildings in which the sharpshooters
were secreted.
Boom, boom, went the cannon, crack, crack, went the rifle, for one
long hour, until the silence of the rebels terminated the duel, and the
pontoniers resumed operations. But they had hardly reached the
outermost boat, and turned their backs to place an additional one in
position, before another murderous fire was poured in upon them,
and the fierce duel was renewed. After another hour’s delay firing
ceased, and again the builders stepped forward, but were again
compelled to fall back. New batteries now opened rapidly upon the
buildings, but failed to dislodge the sharpshooters, who, crouching
down in their hiding places, fired upon the pontoniers as often as
they ventured from the shore. About ten o’clock General Burnside
appeared and gave the order, “Concentrate the fire of all your guns
upon the place, and batter it down.” One hundred and forty-three,
cannon of various calibre, from 10-pound Parrots to 4½ inch siege
guns, were immediately trained upon the doomed city, and for fifty
minutes rained down a perfect tempest of solid shot, shell and
canister. Through the mist and dense clouds of smoke, bright fires
appeared bursting forth in different parts of the town, and adding to
the terrible grandeur of the spectacle.
When the cannonading ceased and the smoke cleared away, the
destructiveness of our fire was apparent. Whole rows of buildings
along the river side were rent and riven, as if by the thunderbolts of
heaven—roofs gone, doors and windows smashed to atoms, and
great hideous gaps through the walls; shade trees shorn of their
limbs or twisted from their trunks; fences stripped of their pickets by
canister, or lying flat on the ground; streets furrowed with solid shot,
and strewn with household effects; elegant up-town residences in
flames; we had literally swept the city with the besom of destruction.
It did not seem possible that any animate thing could have
survived this bombardment; and there were in fact no signs of life
visible; but no sooner had the engineers again resumed operations,
than they were greeted with a fresh shower of bullets. How the
sharpshooters had managed to live through all that fire and smoke,
was to us almost a miracle. Yet they were alive, and as plucky as
ever, and our gunners returned to their work.
General Burnside now almost despaired of effecting a crossing.
Nothing but some brilliant coup-de-main would accomplish it. He
accordingly decided upon sending a body of men over in boats, who
should rush suddenly upon the concealed foe, and hunt them from
their holes. The Seventh Michigan and Nineteenth Massachusetts
were designated for this purpose. The gallant fellows never flinched
from the duty assigned them, but taking their places in the pontoons,
pushed bravely out into the stream, regardless of the rapid volleys of
musketry which were poured into them. In a moment they had
gained the opposite shore, and fearlessly sweeping up the bank,
dashed into the houses, and shot, bayoneted or captured the small
force which had occasioned us so much trouble and delay. A
hundred dark, swarthy Alabamians and Mississippians were brought
back, amidst the wildest cheers of the spectators who had witnessed
the heroic act.
Fredericksburg was now ours, and no further trouble was
experienced in laying the bridge. The second was completed in a
similar manner; about ninety men belonging to Colonel Fairchild’s
New York Regiment being taken over in boats, and returning with
110 rebels. Owing to the fact of there being no buildings to screen
them, the enemy could offer but little resistance to the engineers at
the lower crossings, and they were completed much earlier in the
day.
The pontoons now being thrown, the right and centre Grand
Divisions moved down in columns to cross, halting around Falmouth
Station. The left, which had marched from White-Oak Church early in
the morning, was massed during the day on the plain below. For
some reason, General Burnside decided to cross but a small force
that night, and the Sixth Corps drew back from the plain, and
bivouacked in the adjoining woods. Leaving the vast army—
“A multitude like which the populous North

Poured never from its frozen loins”—
sleeping along the banks of the river and in the groves beyond, let us
briefly survey the scene of its operations during the four days which
followed.
Directly in the rear of Fredericksburg is a plain, about one quarter
of a mile wide, extending back to a low range of hills, along the crest
of which was the enemy’s first line of works. At the foot of and
running parallel with this range, is a massive stone wall, behind
which infantry were posted. In the rear of the first is another and
much higher chain of hills, extending down the river for several
miles. Along the top of these woody heights ran the road, referred to
by General Burnside, connecting the rebel right with the rebel left,
which rested immediately back of the city.
Crossing Hazel Creek, a small stream skirting the lower part of the
place and emptying into the Rappahannock, the ground becomes
very level, stretching out into a broad plateau, and traversed by the
Bowling Green turnpike, running half a mile back from the river, and
the Fredericksburg and Richmond railroad still further back. The
Bernard House was located on the bank, about one mile and a half
below the city. Three-fourths of a mile lower down, the Massaponax
Creek flows into the Rappahannock. This plain, bounded on the
north by Hazel Creek, east by the Rappahannock, west by a chain of
hills, and south by the Massaponax, was the theatre of General
Franklin’s operations. While he advanced and occupied some point
in these hills, Sumner and Hooker were to storm the batteries in the
rear of Fredericksburg. Our narrative will be confined mainly to the
left Grand Division.
Long before daylight Friday morning, it commenced crossing, and
by ten o’clock was all over. As fast as the various commands
reached the opposite shore, they debouched upon the plain,
spreading out like a fan, prepared to sweep down the enemy before
them. The Thirty-third passed over the bridge about 7½ o’clock. An
hour and a half later the Sixth Corps was drawn up in line of battle,
facing to the west. The First Corps joined on further to the left.
Skirmishers were deployed, and feeling their way cautiously forward,
encountered those of the enemy near the Bowling Green road. The
first man wounded was John S. Havens, of Company H, Thirty-third,
which was in the front. After a few moments the rebels fell back,
leaving us in possession of the road. Owing to the dense fog which
prevailed, it was deemed best not to fight the battle that day, and our
troops moved no further forward. About 2½ o’clock in the afternoon,
the enemy opened some masked guns from the heights on our
batteries facing in that direction, which, immediately limbering up,
moved several yards further to the front and returned the fire. The
artillery duel was kept up for some time, resulting in but little loss to
us.
General Burnside rode down from the right at sunset, and was
received with vociferous cheering by the Regiments as he galloped
rapidly by. Officers and men had alike admired the courage which led
him to boldly cross the river and endeavor to clear up the mystery
which enshrouded the enemy; and now that the rebels had
apparently retreated, leaving a mere shell of an army to oppose us,
their admiration for their chief knew no bounds.
CHAPTER XXVII.
BATTLE OF FREDERICKSBURG,
FOUGHT SATURDAY, DECEMBER 13TH.
Battle-field of the Left Grand Division.
Franklin’s troops slept upon their arms that night, little dreaming of
the fierce conflict of the morrow. At an early hour Saturday morning,
it became evident that the enemy, instead of having fallen back,
were concentrating their forces, with the design of giving us battle.
The sun rose clear in the heavens, though the mist and fog of a late
Indian summer enveloped the plain. The air was mild and balmy as
on a September day, and the fifty thousand men whom the reveille
woke from their slumbers began to prepare for action, and were
soon marshalled in “battle’s magnificently stern array.”
They were arranged as follows: The Sixth Corps, under General
Smith, on the right, composed of three Divisions, viz: General
Newton’s on the extreme right and rear, resting near the bridges;
General Brooks’ in the centre, and General Howe’s on the left. The
First Army Corps, General Reynolds, extended still further to the left,
drawn up in the following order: General Gibbon’s Division on the
right, connecting with General Howe’s; General Meade’s, centre; and
General Doubleday’s, left, facing to the southward, and resting
nearly on the river. The Thirty-third was posted in the first of the
three lines of battle, to support a battery. General Jackson
commanded the rebels in front of us. At an early hour the Thirteenth
Massachusetts and Pennsylvania Bucktails, among other
Regiments, were deployed in front, as skirmishers, between whom
and the enemy’s skirmishers considerable firing ensued. General
Vinton, now commander of the Brigade, venturing too far in front,
was shot through the groin, and conveyed back to the Bernard
House, which had been appropriated for the Division Hospital. Col.
Taylor took command until the arrival of Gen. Neill, formerly of the
Twenty-third Pennsylvania. As soon as the heavy mist cleared away,
Capt. Hall’s Second Maine Battery, planted at the right of Gibbon’s
Division, opened upon the enemy. Artillery firing now became
general along the whole line. Heavy siege guns in our rear, the First
Maryland and First Massachusetts Batteries, and Battery D, Fifth
Artillery, on the right; Captain Ransom’s and Captain Walker’s in
front, and Harris’ Independent on the left, kept up a terrific fire on the
rebels. Orders now came to advance, and about nine o’clock,
Gibbon’s and Meade’s Divisions commenced moving slowly forward,
thereby almost straightening our lines, which were previously
arranged somewhat in the form of a crescent. Considerable
resistance was met with, but the forces continued to move forward,
until at mid-day the line of battle was half a mile in advance of where
it had been in the morning.
But now came the reserve fire of the enemy, with terrific force.
Shot and shell were poured into our men from all along the heights,
which, curving around in the shape of a horse-shoe, exposed them
to an enfilading fire. The rebel infantry likewise appeared, and fired
rapidly. Still Meade and Gibbon continued to press on, and as the
enemy gave way, cheer after cheer rent the air from our troops.
General Meade now led his Division on a charge, and pressing on
the edge of the crest, skilfully penetrated an opening in the enemy’s
lines and captured several hundred prisoners, belonging to the Sixty-
first Georgia and Thirty-first North Carolina Regiments. Owing,
however, to the lack of reinforcements, he was eventually compelled
to fall back. While the fight was progressing at this point, Jackson
sent down a heavy column, near the Massaponax, to turn our left,
but it was handsomely repulsed and driven back by Doubleday.
Very heavy firing now raged along the line. Dense clouds of smoke
hid friend and foe from view, and the heavy roar of artillery and
musketry shook the ground as with an earthquake. The bloody
carnival was at its height, “and wild uproar and desolation reigned”
supreme. Mortals could not long endure such a conflict, and after
forty minutes’ duration, it was followed by a temporary lull, the
combatants resting from their labors through sheer exhaustion. The
rising smoke disclosed the field strewn with the dead and wounded,
lying thick as autumnal leaves. The lull, however, was of short
duration. Again “stiffening the sinews and summoning up the blood,”
the warriors rushed forward over the mangled forms of their
comrades, and the conflict raged with fury. One of Gibbon’s
Brigades, gallantly charging over the plain, dashed right up to the
mouths of the frowning cannon, and storming the enemy’s
breastworks, captured two hundred prisoners. Once more the air
resounded with cheers, cheers which, alas! were many a noble
fellow’s death-cry. But unable to withstand the galling fire, the troops,
like those of Meade before them, were compelled to relinquish their
hold on the crest, and fall back, with decimated ranks.
Reinforcements now arrived, consisting of Sickles’ and Birney’s
Divisions from Hooker’s command, and were sent to the support of
Meade. Newton’s Division was also transferred from the extreme
right of the line to the right of the First Corps, and became engaged.
General Franklin was seated, most of the time, in a little grove, which
he had made his temporary headquarters, watching the progress of
the battle, and delivering orders to the Aid-de-Camps, who were
constantly arriving and departing. Occasionally mounting his horse,
he rode up and down the lines, regardless of the missiles of death,
anxiously peering in the direction of the woody crest, to discover if
possible some weak spot in the enemy’s lines. Generals Smith and
Reynolds were with him frequently.
About one o’clock, the young and gallant General Bayard, of the
cavalry, was fatally wounded. He had just seated himself under a
tree by General Franklin, when a ball striking a few yards in front,
ricocheted, and passed through his thigh, inflicting a fearful wound.
He was immediately conveyed to the hospital, and died a few hours
afterwards. As he was lying on the couch, the Chaplain of the Harris
Light Cavalry approached, and inquiring if he desired him to write
anything for him, “By-and-by,” he replied. Then turning to Surgeon
Hackley, he asked if he should be able to live forty-eight hours. A
negative answer being given, he further inquired if he should die
easy. He was to have been married in a few days.
Meanwhile Generals Howe’s and Brooks’ Divisions were exposed
to an enfilading fire from the enemy’s artillery. The Thirty-third still
supported a battery. Instead of being posted some distance to the
rear, Colonel Taylor was ordered close up to the guns, and the men
lay almost beneath the caissons. Shot and shell were whizzing,
screaming, crashing, and moaning all around them, but they
manfully maintained their position, receiving the fire directed upon
the artillerists. Towards noon a 64-pounder opened from the hill
directly back of Fredericksburg. The first shell struck a few feet in
front of the Regiment, the second fell directly in their midst, plunging
into the ground to the depth of three feet or more. The enemy had
obtained a most perfect range, and would have inflicted a great loss
of life, had not the monster gun, very fortunately for us, exploded on
the third discharge. The guns which the Thirty-third supported were
repeatedly hit by the enemy, whose batteries could be distinctly seen
glistening in the edge of the woods a mile distant.
One round shot struck the wheel of a caisson, smashing it to
atoms, and prostrating the “powder boy,” who was taking ammunition

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MATH AND DOSAGE CALCULATIONS

FOR HEALTHCARE PROFESSIONALS

Dosage Calculations Made Incredibly Easy! (Incredibly

(eTextbook PDF) for Medical Dosage Calculations: A

Dosage Calculations: A Multi Method Approach 2nd

Henke’s Med Math: Dosage Calculation, Preparation, and

Handbook of Informatics for Nurses & Healthcare

Electrocardiography for healthcare professionals 4th

Pharmaceutical Calculations 5th Edition, (Ebook PDF)

Understanding Pharmacology for Health Professionals 5th

UNIT 5 Performing Advanced Dosage Calculations

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Preface xiv 1.6 Adding Fractions 18

Unit 1: Performing Chapter 1 Summary 32

Basic Math Homework Assignment 34

1.2 Equivalent Fractions 7 Writing Decimals 37

1.3 Reducing Fractions 11 Comparing Decimals 39

1.4 Finding Common 2.2 Rounding Decimals 41

CHAPTER 3: RELATIONSHIPS Copyright © 2016 by McGraw-Hill Education

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3.4 Using Proportions to Solve for CHAPTER 6: CONVERTING

Chapter 3 Summary 78 6.2 Converting Units 107

4.1 Metric System 84 Homework Assignment 122

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Homework Assignment 151

Droppers 128 9.4 Medication Administration

Copyright © 2016 by McGraw-Hill Education

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Medications Administered by 12.2 Methods of Dosage

14.4 Other Parenteral Administration

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Homework Assignment 395

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17.3 Hourly Flow Rates for Chapter 18 Summary 552

17.5 IV Flow Rates Based on 19.2 Solid and Semisolid

18.1 Calculating the Amount to

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Here’s How Your Colleagues Have Described

Copyright © 2016 by McGraw-Hill Education

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Organization of Math and Dosage Calculations for

2: Using Systems of Measurement Chapters 4–7 focus on measurements used in dosage

3: Identifying Information Needed Chapters 8–11 focus on equipment, interpreting

4: Calculating Dosages Chapters 12–15 focus on basic dosage calculations,

5: Performing Advanced Dosage Chapters 16–17 focus on advanced clinical

6: Performing Dispensing and Chapters 18–19 focus on amount to dispense,

New to the Fifth Edition!

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Copyright © 2016 by McGraw-Hill Education

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McGraw-Hill Connect for Math & Dosage Calcu-

eCollege—and much more.

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Blackboard, the web-based course management sys-

At-a-glance analysis on your class’s progress: Connect Insight

Connect Insight™ is the first and only analyt-

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Create a textbook organized the way you teach: McGraw-Hill Create