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Acknowledgments
Special thanks to:

• Wolters Kluwer editors: Sherry Dickinson, Matt Hauber
• Sister Grace Henke
• Lynn Farmer: Photography
• Ginger Pyron: Editor
• Pharmaceutical companies for supplying labels
• Faith community at Oakhurst Baptist Church for their support and prayers
• Colleagues at Herzing University
• Valerie, Andrew, and Chelsea for their love
• “Unofficial” proofreaders:
Alina-Sarai Gal-Chis
Jocylyn Lundy
Michelle Sugden
Orpha Gehman
Milly Rodriquez
Diane Skwisz
Maritza Cantarero
Ose Martinez
vi
Buchholz9781496302847-fm.indd 6 07/07/15 10:20 AM

Contents
CHAPT E R Arithmetic Needed for Dosage 1

1 Multiplying Whole Numbers 2
Dividing Whole Numbers 2
Fractions 3
Decimals 9
Percents 15
Fractions, Ratio, and Proportion 18
Proficiency Test 1 Arithmetic 21
Answers to Self-Tests 22
CH APT E R Metric and Household Systems of Measurement 31

2 Metric System 32
Household System 39
Liquid Measures 40
Other Conversions 41
Proficiency Test 1 Exercises in Equivalents and Mixed Conversions 44
CH APT E R Drug Abbreviations, Labels, and Packaging 47

3 Interpreting the Language of Prescriptions 47
Time of Administration of Drugs 48
Routes of Administration 52
Metric and SI Abbreviations 54
Household Abbreviations 55
Terms and Abbreviations for Drug Preparations 55
Drug Labels 57
Drug Packaging 59
vii

viii Contents
Equipment to Measure Doses 68

Proficiency Test 1 Abbreviations/Military Time 72
Proficiency Test 2 Reading Prescriptions/Interpreting Written Prescriptions 73
Proficiency Test 3 Labels and Packaging 75
CH AP TER Calculation of Oral Medications—Solids and Liquids 81

4 Oral Solids 82
Converting Order and Supply to the Same Weight Measure 91
Clearing Decimals 93
Special Types of Oral Solid Orders 97
Oral Liquids 98
Special Types of Oral Liquid Orders 107
Oral Solid and Liquid Problems Without Written
Calculations/“Common Sense” Calculations 107
Proficiency Test 1 Calculation of Oral Doses 113
CH AP TER Liquids for Injection 139

5 Syringes and Rounding 139
Special Types of Problems in Injections From a Liquid 153
Injections From Powders 160
Distinctive Features of Injections From Powders 162
Where to Find Information About Reconstitution of Powders 163
Insulin Injections 172
Proficiency Test 1 Calculations of Liquid Injections 187
Proficiency Test 2 Calculations of Liquid Injections
and Injections From Powders 190
Proficiency Test 3 Calculations of Liquid Injections 193
Proficiency Test 4 Mental Drill in Liquids-for-Injection Problems 194
CH AP TER Calculation of Basic IV Drip Rates 213

6 Types of IV Fluids 213
Calculating Basic IV Drip Rates 216
Adding Medications to IVs 224

Contents ix
Medications for Intermittent IV Administration 226

Ambulatory Infusion Device 230
Enteral Nutrition 231
Proficiency Test 1 Basic IV Problems 239
CH APT E R Special Types of IV C

alculations 255
7 Amount of Drug in a Solution 256
Medications Ordered in units/hour or mg/hour 256
Medications Ordered in mcg/minute, mcg/kg/minute,
or milliunits/minute—Calculation of Rate 268
Body Surface Nomogram 276
Patient-Controlled Analgesia 279
Heparin and Insulin Protocols 281
Proficiency Test 1 Special IV Calculations 289
CH APT E R Dosage Problems for Infants and Children 315

8 Dosage Based on mg/kg 316
Administering IV Medications 334
General Guidelines for Continuous IV Medications 347
Proficiency Test 1 Infants and Children Dosage Problems 354
CH APT E R Information Basic to Administering Drugs 367

9 Drug Knowledge 367
Pharmacokinetics 372
Legal Considerations 376
Ethical Principles in Drug Administration 380
Proficiency Test 1 Basic Drug Information 385
CH APT E R Administration Procedures 391

10 Three Checks and Six Rights 391
Standard Precautions Applied to Administration of Medications 400
Routes of Administration 403
Special Considerations 431

x Contents
Proficiency Test 1—Part A, Administration Procedures 437

Proficiency Test 1—Part B, Administration Procedures 441
Appendix A: Proficiency Test Answers 445
Appendix B: Putting It Together Answers 504
Glossary 523
Index 529

1
CHAPTER
Arithmetic Needed
for Dosage
TOPICS COVERED
1. Multiplication and division of whole numbers, fractions, and decimals
2. Addition and subtraction of fractions
3. Reading decimals
4. Changing decimals to fractions
5. Addition, subtraction, multiplication, and division of decimals
6. Clearing and rounding of decimals
7. Percents
8. Solving ratio and proportion
When a medication order differs from the fixed amount at which a drug is supplied, you must calculate
the dose needed. Calculation requires knowledge of the systems of dosage measurements (see Chapter 2)
and the ability to solve arithmetic. This chapter covers the common arithmetic functions needed for the
safe administration of drugs.
Examples that use basic arithmetic functions include problems in dosage calculations such as:
45.5 mL water + 34.75 mL juice = total intake
administer 1.5 mg of a drug; if you have 0.75 mg on hand, how much more of the drug do you need?
administer 3 tablets; if each tablet is 1.5 mg, what is the total dose?
administer 7.5 mg of a drug; if you have 1.25 mg tablets on hand, how many tablets need to be given?
on hand are two ophthalmic solutions: 0.05% and 0.02%. Which solution is strongest?
Beginning students invariably express anxiety that they will miscalculate a dose and cause harm.
lthough everyone is capable of error, no one has to cause an error. The surest way to prevent a mistake is
A
to exercise care in performing basic arithmetic operations and practice basic arithmetic calculations.
For students who believe their arithmetic skills are already satisfactory, this chapter contains self-
tests and a proficiency exam. Once you pass the proficiency exam, you can move on to other chapters
in the book.
Students with math anxiety and those with deficiencies in performing arithmetic will want to work
through this chapter. Examples demonstrate how to perform calculations; the self-tests provide practice
and drill. FINE POINTS boxes explain details about the calculation. After you’ve mastered the content,
take the proficiency exam to verify your readiness to move on.
Since calculators are readily available, why go through all the arithmetic? For one thing, using a cal-
culator still requires that you to know what numbers and functions to enter. In clinical situations you may
encounter some problems that require a calculator’s help, but it’s good to know how to make calculations
Buchholz9781496302847-ch001.indd 1 07/07/15 7:30 PM

2 Henke’s Med-Math: Dosage Calculation, Preparation & Administration
on your own. Solving the arithmetic problems yourself helps you think logically about the amount ordered
and the relative dose needed. And when you can mentally calculate dosage, you increase your speed and
efficiency in preparing medications. Work out the problems in this chapter with and without a calculator.
Multiplying Whole Numbers

If you need a review, study a multiplication table for the numbers 1 through 12, which can be found in a
basic math book or on the internet. (Search for “multiplication table.” One site is http://www.mathisfun.com/
tables). Then do the self-tests, aiming for 100% accuracy.
SELF-TEST 1 Multiplication
Write the answers to these problems. Answers are given at the end of the chapter; aim for 100%.
1. 2 × 6 = 10. 8 × 9 = 19. 4 × 9 =
2. 9 × 7 = 11. 3 × 5 = 20. 3 × 8 =
3. 4 × 8 = 12. 6 × 7 = 21. 12 × 11 =
4. 5 × 9 = 13. 4 × 6 = 22. 9 × 5 =
5. 12 × 9 = 14. 9 × 6 = 23. 9 × 9 =
6. 8 × 3 = 15. 8 × 8 = 24. 7 × 5 =
7. 11 × 10 = 16. 7 × 8 = 25. 12 × 10 =
8. 2 × 7 = 17. 2 × 9 =
9. 8 × 6 = 18. 8 × 11 =
Dividing Whole Numbers

Review division if necessary, using a division table which can be found in a basic math book or on the
internet. Again, aim for 100% accuracy on the self-test.
SELF-TEST 2 Division
Write the answers to the following problems. Answers are given at the end of the chapter.
1. 63 ÷ 7 = 10. 18 ÷ 3 = 19. 36 ÷ 6 =
2. 24 ÷ 6 = 11. 72 ÷ 8 = 20. 18 ÷ 9 =
3. 36 ÷ 12 = 12. 48 ÷ 8 = 21. 21 ÷ 3 =
4. 42 ÷ 6 = 13. 28 ÷ 7 = 22. 48 ÷ 4 =
5. 35 ÷ 5 = 14. 21 ÷ 7 = 23. 144 ÷ 12 =
6. 96 ÷ 12 = 15. 24 ÷ 8 = 24. 56 ÷ 8 =
7. 12 ÷ 3 = 16. 84 ÷ 12 = 25. 60 ÷ 5 =
8. 27 ÷ 9 = 17. 81 ÷ 9 =
9. 49 ÷ 7 = 18. 32 ÷ 8 =

C HAPTE R 1 Arithmetic Needed for Dosage 3
Fractions
A fraction is a portion of a whole number. The top number in a fraction is called the numerator, and
the bottom number is called the denominator. The line between the numerator and the denominator is
a division sign. Therefore, you can read the fraction 14 as “one divided by four.”
EXAMPLE 1 → numerator
4 → denominator
Types of Fractions
In a proper fraction, the numerator is smaller than the denominator.
EXAMPLE 2
5 (Read as “two fifths.”)
In an improper fraction, the numerator is larger than the denominator.
EXAMPLE 5
2
(Read as “five halves.”)
A mixed number has a whole number plus a fraction.
EXAMPLE
1 23 (Read as “one and two thirds.”)
In a complex or common fraction, both the numerator and the denominator are already fractions.
EXAMPLE 1
2
(Read as “one half divided by one fourth.”)
1
4
RULE REDUCING FRACTIONS

Find the largest number that can be divided evenly into the numerator and the denominator.
EXAMPLE EXAMPLE 1:
Reduce 4
12
1
4 1
12
= 3
3
EXAMPLE 2:
Reduce 7
49
FINE POINTS
1 Check to see if the denominator is evenly
7 1
49
= 7 divisible by the numerator. In this exam-
7 ple, the number 7 can be evenly divided
into 49.

Sometimes fractions are more difficult to reduce because the answer is not obvious.
EXAMPLE EXAMPLE 1:
56
Reduce 96 FINE POINTS
1
56 8 ×7 7 In Example 1, note both the numerator
96
= 8 × 12
= 12 and denominator can be evenly divided
1
by 8. In Example 2 both can be evenly
divided by 9.
EXAMPLE 2:
54
Reduce 99
1
54 9×6 6
99
= 9 × 11
= 11
1
When you need to reduce a very large fraction, it may be difficult to determine the largest number that
will divide evenly into both the numerator and the denominator. You may have to reduce the fraction sev-
eral times.
EXAMPLE EXAMPLE 1:
189
Reduce 216 FINE POINTS
63 Prime numbers cannot be reduced any
189 63
Try to divide both by 3 216
= 72 further. Examples are 2, 3, 5, 7, and 11.
72
When reducing, if the last number is even
1
63 9×7 7 or a zero, try 2.
Then use multiples 72
= 9×8
= 8
1 If the last number is a zero or 5, try 5.
If the last number is odd, try 3, 7, or 11.
EXAMPLE 2:
27
Reduce 135
9 1
Try to divide both by 3 27 9 1
135
= 45
= 5
45 5
Then divide by 9.
SELF-TEST 3 Reducing Fractions
Reduce these fractions to their lowest terms. Answers are given at the end of the chapter.
16 8
1. 24 6. 48
36 12
2. 216 7. 30
18 68
3. 96 8. 136
70 55
4. 490 9. 121
18 15
5. 81 10. 60

Adding Fractions
If you need to add two fractions that have the same denominator, first add the two numerators; write that
sum over the denominator and, if necessary, reduce.
1
5
+ 35 = 4
5
If the two fractions have different denominators, the process takes two steps. First convert each frac-
tion, multiplying both of its numbers by their lowest common denominator. After you’ve converted both
fractions, add their two numerators together. If necessary, reduce.
3 32 2
+ += =
5 53 3
3
5
+ 23 35=(( 35×× 33(( ××)) 33=)) 15
=9 15
=9 35= 35
3 ( × 3 )2 ( 2× 95( ×
= )=5=)3510
5 ( × 3 )3 ( 3×15 = 10
= 2= 2
5( × ) 5 ) 15 15 3 3
2 ( × 5 )9 91010 10219 19
= +==3 = or or1 1541 154
3 ( × 5 )15 1+51515 15 15 15
9 10 19
+ = 15 or 1 154
15 15
Subtracting Fractions
To subtract two fractions that have the same denominator, first subtract their numerators and then write
the difference over the denominator. Reduce if necessary.
27
32
− 18
32
= 9
32
= 1
2
If the two fractions have different denominators, first convert each fraction using the lowest common
denominator (just as you did in the adding example above). Then subtract the numerators, and reduce
again if necessary.
7 72 2
− −= =
8 83 3
7 7 ( 7× (3 ×) 3 ) 21 21 7
8
− 23 8=( 8× (3 ×) 3=) 24 = 24
= 8= 7
8
7 ( × 3 )2 ( 2×21
= 8(8( ××)) 88==)) 8716
8 ( × 3 )3 ( 3×24 = 16
= 2=
24 24 3
2
3
2 ( × 8 )21 216 2
= −12416
3 ( × 8 )24 24 −=16 = =5 5
24 243 24 24
21 16 5
24
− 24 = 24
SELF-TEST 4 Adding and Subtracting Fractions
Add and subtract these fractions. Answers are given at the end of the chapter.
15 5
1. 3
7 + 2
7 = 6. 16
− 16 =
3 1 3 2
2. 5
+ 5
= 7. 7 − 7 =
2 1 3 2
3. 4
+ 4
= 8. 5
− 15 =
11 7
4. 2
3
+ 1
6
= 9. 15
− 10 =
1 1 8 5
5. 2
+ 3
= 10. 9
− 12 =

Multiplying Fractions
There are two ways to multiply fractions. Use whichever method is more comfortable for you.
First Way
Multiply the numerators across. Multiply denominators across. Reduce the answer to its lowest terms.
EXAMPLE 2 3 2×3 6
7 ×2 4 =3 7 × 24 ×=3 28 6
× =
726 × 3 4 1 67 × 4 =
2 3 22 × 33 28
7 × 4 =77×× 44 =6 28 =
7 × 423 ×× 32281 3
2 3 21 ×23×283 6= 6 14 ×32×==
1= 2 614 3
76 × 4 3=×672×74 3=34×28 =
7 × 41 28= 14
282 3 ×2
14
= 14 28 == 14 =1
3 ×362×62 14 31
28
26 2 × 22121×263×14
3 33××=
× = =3 =1 28 =
7 =47 4 7 ×28 7 =× 4
14 × 2 1 1414 × 21
28 4 28 14
11
26 6 3=3 ×322××23 3 63
728× =414=14
28 = = 14
×72× 42 14 28
1
11
6 3× 2 3
= 14 × 2 = 14
Second28Way (When You 1
Are Multiplying Several Fractions)
First, reduce each fraction by dividing its numerator evenly into its denominator. Multiply the remaining
numerators across. Multiply the remaining denominators across. Check to see if further reductions are
possible. In Example 1, because of several fractions, you can use any numerator to divide into any of the
denominators.
EXAMPLE EXAMPLE 1: 1 1 1
3 7 5 3 7 5 1
14
× 10 × 12 = 14
× 10
× 12
= 16 FINE POINTS
1 1 12 2 4
2 3 3 7 2 × 53 63 7 5 1 The denominators are
× × = ×
714 4 10 7 ×12 4
= 28
14
× 10
× 12
= 16 14 ÷ 7 = 2
2 2 4 being divided by the
1 1 1 1 10 ÷ 5 = 2
3 7 5 236 3 73 × 22 ×53 3 61 numerators to reduce.
× 10 × 12 = 728××=410= × = = 28
14 14 14 ×72×124 14 16 12 ÷ 3 = 4
2 2 11 4
6 3× 2 3
28
= 14 × 2 = 14
If you’re multiplying
1 mixed numbers, you first need to change each of them into an improper fraction.
The process: For each fraction, multiply the whole number by the denominator; then add that total to the
numerator.
EXAMPLE12: 2
3 4
1 12 × 46 = 2
× 6 = 22 =1
1 2 1 2
2 3 1 2 × 34 36 4 2
7 × =
1 ×
4 27 × 46
= 28
2
× 6
= 2 =1
1 1 2 1 2
26 4 3 33× 22 × 43 3 26
1 12 × × = = × 4 =14 28
728 61 41422×72× 6=
= 2
=1
2 3 3 14 211× 232 6
1 12 × 46 76 ×2 4×3=6× 72=× 42 =
= = 128
3
28
=
1 2
14 × 12
= 14
6 3 × 21 3
28
= 14 × 2 = 14
1 EXAMPLE 3: 4
20
4
5
× 6 23 =4
5
× 3
= 16
3
4 1
2×3 20
2
7 × 43 45= ×7 6× 423 = 46
28
5
× 3
= 16
3
1 4 1
× 627623×==43 345=××722××3=
4 203 3 16
5 = 63
28 14 × 2 4 14 28
1 11
6 3× 2 3
28
= 14 × 2 = 14
1

SELF-TEST 5 Multiplying Fractions
Multiply these fractions. Reduce if necessary. Answers are given at the end of the chapter.
5 3 2
1. 1
6
× 4
5
× 2
= 5. 3 4 × 10 3 = 9. 5 81 × 8 16 × 1
7 =
11 1 2
2. 4
× 3
= 6.
7 2
× 14 = 10. 12
× 4
× 3
=
15 2 20
3. 1 12 × 4 23 = 7. 9
2
× 3
2
=
9
4. 1
× 15
= 8. 6 14 × 7 19 × 5
=
5 45
Dividing Fractions
To divide two fractions, first invert the fraction that is after the division sign, then change the division sign
to a multiplication sign. Reduce to lowest number.
EXAMPLE EXAMPLE 1:
2
150
1
75
1
÷ 150 = 1
× 1
=2 FINE POINTS
75
1
2 Complex fractions such as
1 1 1 150
75
÷ 150 = × 1
=2
75 1
2 1
150 4 1 3
1 1
÷ 150 = 1
× =2 are read as ÷
75 75 1 3 4 8
1 8
The vertical arrangement acts just like a

EXAMPLE 2:
division sign.
1 2
8
4
3 = 1
4
÷ 83 = 1
4
× 3
= 2
3
8 1
1 2
8
4
3 = 1
4
÷ 83 = 1
4
× 3
= 2
3
8 1
1 2
8
4
3 = 1
4
÷ 83 = 1
4
× 3
= 2
3
8 1
1 2
8
4
3 = 1
4
÷ 83 = 1
4
× 3
= 2
3
8 1
EXAMPLE 3:
3
115 6
2 = 65 ÷ 23 = 5
× 3
2
= 9
5
or 1 45
3 1
3
115 6
2 = 65 ÷ 23 = 5
× 3
2
= 9
5
or 1 45
3 1
3
115 6
2 = 65 ÷ 23 = 5
× 3
2
= 9
5
or 1 45
3 1
3
115 6
2 = 65 ÷ 23 = 5
× 3
2
= 9
5
or 1 45
3 1

SELF-TEST 6 Dividing Fractions
Divide these fractions. Answers are given at the end of the chapter.
1 1 7 7
1. 75
÷ 150 = 5. 25
÷ 75 = 9. 5
÷ 1
=
8 3
1
2. 1
8
÷ 1
4
= 6. 2
÷ 14 = 10. 5 12 ÷ 1
=
4
3. 2 23 ÷ 1
2
= 7. 3
4
÷ 83 =
7
4. 75 ÷ 12 12 = 8. 1
60
÷ 10 =
Changing Fractions to Decimals

To change a fraction into a decimal, begin by dividing the numerator by the denominator. Remember that
the line between the numerator and the denominator is a division sign, so 14 can be read as 1 ÷ 4.
In a division problem, each number has a name. The number that’s being divided (your fraction’s
numerator) is the dividend; the one that does the dividing (your fraction’s denominator) is the divisor:
and the answer is the quotient.
40. ← quotient
divisor → 16 640. ← dividend
64
)
0
1
1. Look at the fraction 4
1 ← numerator = dividend
4 ← denominator = divisor
2. Write
41 )
3. Some people find it easier to simply extend the fraction’s straight line to the right, then strike out
the numerator and place that same number down into the “box.”
1 1
=
4
4 1 )
4. Once you’ve set up the structure for your division problem, place a decimal point immediately after
the dividend. Put another decimal point on the quotient line (above), lining up that point exactly
with the decimal point below.
By placing your decimal points carefully, you can avoid serious dosage errors.
1 . ← quotient
)
4 1. ← dividend
FINE POINTS
If the answer does not have a whole
5. Complete the division. number, place a zero before the decimal
1 .25 = 0.25 point: .25 is incorrect; 0.25 is correct.
)
4 1.00
8
This is called a leading zero.
The number of places to carry out the
20 decimal will vary depending on the drug
20 and equipment used. For these exercises,
0 when possible, carry answers to the
thousandths place (three decimal places).

EXAMPLE EXAMPLE 1:
5 5 0.312
=
)
16 = 0.312
16 5.000
4 8
20
16
40
32
8
EXAMPLE 2:
640 640 80. FINE POINTS

)
8
= = 80
8 640. In the answer for Example 2, note the
space between 8 and the decimal point.
When such a space occurs, fill it with a
zero to complete your answer.
EXAMPLE 3:
1 1 0.013
=
)
75 = 0.013
75 1.000
75
250
225
25
SELF-TEST 7 Converting Fractions to Decimals
Divide these fractions to produce decimals. Answers are given at the end of the chapter. Carry
decimal point to three decimal places if necessary. (Do not use rounding rules yet!)
1 1
1. 6
5. 8 9. 5
8
6 1 1
2. 8
6. 7 10. 5
4 1
3. 5
7. 3
9 11
4. 40 8. 12
Decimals
Most medication orders are written in the metric system, which uses decimals.
Reading Decimals and Converting Decimals to Fractions

Start by counting how many places come after the decimal point. One space after the decimal point is the
tenths place. Two spaces is the hundredths place. Three places is the thousandths place, and so on. When
you read the decimal aloud, it sounds like you’re reading a fraction:
0.1 is read as “one tenth” ( 101 ) .

0.01 is read as “one hundredth” ( 1001 ) .

0.001 is read as “one thousandth” ( 1000
1 .
)
Always read the number by its name first, then count off the decimal places. If a whole number precedes
the decimal, read it just as you normally would.
Since decimals are parts of a whole number, you can write them as fractions:
( 100 )
EXAMPLE 56
0.56 = “fifty-six hundredths”
FINE POINTS
0.2 = “two tenths” ( 102 )
Notice the use of the “leading zero.”
0.194 = “one hundred ninety-four This is a zero used before a decimal point
thousandths” 194 ( 1000 ) when writing only a decimal number.
This leading zero is used in dosage
0.31 = “thirty-one hundredths” ( 100
31
) calculations to reduce errors in writing
decimals.
1.6 = “one and six tenths” (1 10
6
)
17.354 = “seventeen and three hundred
fifty-four thousandths” (17 1000
354 .
)
SELF-TEST 8 Reading Decimals
Write these decimals in longhand and as fractions. Do not reduce. Answers are given at the end of
the chapter.
1. 0.25 ________________________________________________________________________
2. 0.004 _______________________________________________________________________
3. 1.7 _________________________________________________________________________
4. 0.5 _________________________________________________________________________
5. 0.334 _______________________________________________________________________
6. 136.75 ______________________________________________________________________
7. 0.1 _________________________________________________________________________
8. 0.15 ________________________________________________________________________
9. 2.25 ________________________________________________________________________
10. 10.325 ______________________________________________________________________
Addition and Subtraction of Decimals

To add decimals, stack them vertically, making sure that all decimal points line up exactly. Starting at the
far right of the stack, add each vertical column of numbers. In your answer, be sure your decimal point
lines up exactly with the points above it.
EXAMPLE 1:
0.8
+ 0.6
1.4

EXAMPLE 2:
10.30
+ 3.28
13.58
To subtract decimals, stack your two decimals as you did for addition, lining up the decimal points as
before. Starting at the far right of the stack, subtract the numbers; again, make sure that the decimal point
in your answer aligns with those above it.
EXAMPLE 1:
2 9 10
13 − 12.54 = 13 .0 0
− 12.54
0.46
EXAMPLE 2:
4 16
14.56 − 0.47 = 14 .56
− 0.47
14.09
SELF-TEST 9 Addition and Subtraction of Decimals
Add and subtract these decimals. Answers are given at the end of the chapter.
1. 0.9 + 0.5 = 6. 98.6 − 66.5 =

2. 5 + 2.999 = 7. 0.45 − 0.38 =
3. 10.56 + 357.5 = 8. 1.724 − 0.684 =
4. 2 + 3.05 + 0.06 = 9. 7.066 − 0.2 =
5. 15 + 0.19 + 21 = 10. 78.56 − 5.77 =
Multiplying Decimals
Line up the numbers on the right. Do not align the decimal points. Starting on the right, multiply each
digit in the top number by each digit in the bottom number, just as you would with whole numbers. Add
the products. Place the decimal point in the answer by starting at the right and moving the point the same
number of places equal to the sum of the decimal places in
both numbers multiplied, count the number of places that
you totaled earlier. If you end up with any blank spaces, fill FINE POINTS
each one with a zero.
Avoid the “trailing zero.” There should
EXAMPLE 1: be no zeroes used to the right of the
decimal point. The use of the trailing zero
2.6 × 0.03 = 2.6 (1 decimal place)
often leads to errors in writing decimals.
× 0.03 ( 2 decimaal places)
0.078 (3 decimal places from the right)
EXAMPLE 2:
FINE POINTS
200 × 0.03 = 200 ( no decimal place)
0.03 ( 2 decimaal places) A quick “double-check” to determine
6.00 ( 2 decimal places from the right) decimal places is to count the number
or of decimal places in each number that is
6 being multiplied. The answer should have
the same number of decimal places.

Dividing Decimals
A reminder: The number being divided is called the dividend; the number doing the dividing is called the
divisor; and the answer is called the quotient.
0.312 → quotient
)
divisor →16 5.000 → dividend
Note: As soon as you write your dividend, place a decimal point immediately after it. Then place another
decimal point directly above it, on the quotient line.
.
)
EXAMPLE 13
16 16 130
Divide.
EXAMPLE 0.812
)
16 13.000
12 8
20
16
40
32
8
Clearing the Divisor of Decimal Points

Before dividing one decimal by another, clear the divisor of decimal points. To do this, move the decimal
point to the far right. Move the decimal point in the dividend the same number of places and, directly
above it, insert another decimal point in the quotient.
EXAMPLE EXAMPLE 1:
) )
0.2 0.004 = 0.: 2 0 .: 0 04
0.02
Hence, 2 00.04)
EXAMPLE 2:
1.262 FINE POINTS
) )
4 .: 3 5.: 4 27 becomes 43. 54.270
43
When you’re dividing, the answer may
not come out even. The dosage calcula-
11 2 tion problems give directions on how
86 many places to carry out your answer.
2 67 In Example 2, the answer is carried out
2 58 to three decimal places.
90
86
4

SELF-TEST 10 Multiplication and Division of Decimals
Do these problems in division of decimals. The answers are given at the end of this chapter. If neces-
sary, carry the answer to three places (unless the answer comes out “even”). (Do not use rounding
rules yet!)
1. 3.14 × 0.02 = 5. 54 × 7.41 =

9. 1.3 40 )
2. 100 × 0.4 = 6. 7.8 140) )
10. 7 18.61
3. 2.76 × 0.004 = )
7. 6 140
4. 6.3 × 7.6 = 8. 0.025 10 )
Rounding Off Decimals

How do you determine the number of places to carry out division? This question seems to continually
confuse students (and teachers sometimes!). The answer depends on the way the drug is dispensed and
the equipment needed to administer the drug. Some tablets can be broken into halves or fourths. Some
liquids are prepared in units of measurement: tenths, hundredths, or thousandths. Some syringes are
marked to the nearest tenth, hundredth, or thousandth place. Intravenous rates are usually rounded to
the nearest whole number or sometimes tenth place. Sometimes, determining when to round is depen-
dent on the clinical setting you work in. Pediatric settings often use dosages in tenths, hundredths, and
thousandths, while in adult settings, often the answer is rounded to the nearest whole number. As you
become familiar with dosage, you’ll learn how far to round off your answers. To practice, first review
the general rule for rounding off decimals.
RULE ROUNDING OFF DECIMALS

To round off a decimal, you simply drop the final number. Exception: If the final number is 5 or higher,
drop it and then increase the adjacent number by 1.
EXAMPLE 0.864 becomes 0.86

1.55 becomes 1.6
0.33 becomes 0.3
4.562 becomes 4.56
2.38 becomes 2.4
To obtain an answer that’s rounded off to the nearest tenth, look at the number in the hundredth place and
follow the above rule for rounding off.

0.667 becomes 0.7
1.46 becomes 1.5

If you want an answer that’s rounded off to the nearest hundredth, look at the number in the thousandth
place and f ollow the above rule for rounding off.

0.148 becomes 0.15
2.375 becomes 2.38
And if you want an answer that’s rounded off to the nearest thousandth, look at the number in the
ten-thousandth place and follow the same rules.

0.0024 becomes 0.002
4.5555 becomes 4.556
SELF-TEST 11 Rounding Decimals
Round off these decimals as indicated. Answers are given at the end of the chapter.
Nearest Tenth Nearest Hundredth Nearest Thousandth
1. 0.25 = ______________ 6. 1.268 = ______________ 11. 1.3254 = ______________
2. 1.84 = ______________ 7. 0.751 = ______________ 12. 0.0025 = ______________
3. 3.27 = ______________ 8. 0.677 = ______________ 13. 0.4521 = ______________
4. 0.05 = ______________ 9. 4.539 = ______________ 14. 0.7259 = ______________
5. 0.63 = ______________ 10. 1.222 = ______________ 15. 0.3482 = ______________
Comparing the Value of Decimals

Understanding which decimal is larger or smaller can help you solve dosage problems. Example: “Will I
need more than one tablet or less than one tablet?”
RULE DETERMINING THE VALUE OF DECIMALS

The decimal with the higher number in the tenth place has the greater value.
EXAMPLE Compare 0.25 with 0.5.

Since 5 is higher than 2, the greater of these two decimals is 0.5.
SELF-TEST 12 Value of Decimals
In each pair, underline the decimal with the greater value. Answers are given at the end of the chapter.
1. 0.125 and 0.25 5. 0.825 and 0.44 9. 0.3 and 0.225

2. 0.04 and 0.1 6. 0.9 and 0.5 10. 0.5 and 0.455
3. 0.5 and 0.125 7. 0.25 and 0.4
4. 0.1 and 0.2 8. 0.7 and 0.35

Percents
Percent means “parts per hundred.” Percent is a fraction, containing a variable numerator and a denomina-
tor that’s always 100. You can write a percent as a fraction, a ratio, or a decimal. (To write a ratio, use two
numbers separated by a colon. Example: 1:100. Read this ratio as “one is to a hundred.”)
5
Percent written as a fraction: 5% = 100
Percent written as a ratio: 5% = 5:100 FINE POINTS
Percent written as a decimal: 5% = 0.05 These represent the same number:

5% = 5:100 = 5/100 = 0.05
Whole numbers, fractions, and decimals may all be
written as percents.
EXAMPLE Whole number: 4% (four percent)

Decimal: 0.2% (two tenths percent)
Fraction: 14 % (one fourth percent)
Percents That Are Whole Numbers

EXAMPLE EXAMPLE 1:
Change to a fraction.
4 1
4% = 100 = 25
EXAMPLE 2:
Change to a decimal.
4 .04
)
4% = = 0.04
100 4.00
Percents That Are Decimals

These may be changed in three ways:
By moving the decimal point two places to the left
0.2% = 00
L . 2 = 0.002
OR By keeping the decimal, placing the number over 100, and then dividing
0.2 0.002
)
0.2% = = 0.002
100 0.200

OR B y turning it into a complex fraction. If you’re using this method, remember to invert the number
after the division sign and then multiply. A whole number always has a denominator of 1.
2 2
1010
0.02.%
2% = =100100= =
2
10 2 2 100
0.2% = 100 = ÷ ÷ 100= =
1010 1 1
2
2
0.210
% ÷= 10010 2 2 1 1
1 =
100
2 2
=1010× ×100100= =1000
1000
1 1
2
× 100
÷ 1 2
= 1000 2 2
10 100 1 = =1500
1000 500
1000
1
2 1
× 21 = 1000 25050
1
0 0
10 100
1000
= 500
50120
1
= 500
Percents That Are Fractions
1000
500
EXAMPLE EXAMPLE 1: EXAMPLE 2:
1 1
1
4
% = 4
100
= 14 ÷ 100
1
= 1
4
1
× 100 = 1
400
1
2
% = 2
100
= 12 ÷ 100
1
= 12 × 100
1
= 1
200
1 1
1
4
%= 4
100
= 1
4
÷ 100
1
= 1
4
1
× 100 = 1
400
1
2
%= 2
100
= 12 ÷ 100
1
= 12 × 100
1
= 1
200
1 1
1
4
% = 4
100
= 1
4
÷ 100
1
= 1
4
1
× 100 = 1
400
1
2
2
% = 100 = 1
2
÷ 100
1
= 12 × 100
1
= 1
200
1 1
1
4
%= 4
100
= 1
4
÷ 100
1
= 1
4
1
× 100 = 1
400
1
2
%= 2
100
= 12 ÷ 100
1
= 12 × 100
1
= 1
200
1 1
1
4
% = 4
100
= 1
4
÷ 100
1
= 1
4
1
× 100 = 1
400
1
2
% = 2
100
= 12 ÷ 100
1
= 12 × 100
1
= 1
200
ALTERNATIVE WAY. Because 12 = 0.5 , 12 % could also be written as 0.5%. If you follow the rule of clearing
a percent by moving the decimal point two places to the left, you get 00.5% = 0.005. Note that 0.005 is
:
5 1 . You could also write 0.5
1000
= 200 100
SELF-TEST 13 Conversion of Percents
Change these percents to both a fraction and a decimal. Reduce if necessary. Answers are given at
the end of the chapter.
1. 10% ____________ ____________ 1

9. 10 % ____________ ____________
2. 0.9% ____________ ____________
10. 2 12 % ____________ ____________
1
3. % ____________ ____________
5 11. 33% ____________ ____________
4. 0.01% ____________ ____________
12. 50% ____________ ____________
2
5. % ____________ ____________
3 13. 1 14 % ____________ ____________
6. 0.45% ____________ ____________
14. 75% ____________ ____________
7. 20% ____________ ____________
15. 25% ____________ ____________
8. 0.4% ____________ ____________

Fractions, ratios, and decimals also can be converted to percents. Again, remember that percent means
“parts of a hundred.”
Fractions Converted to Percents

If the denominator is 100, simply write the numerator as a percent:
5
100
= 5%
If the denominator is not 100, you must convert the fraction, using 100 as the denominator. In this ex-
ample, multiply the numerator and denominator, using 20 as the lowest common denominator:
3 60
5
= 100
= 60%
Ratios Converted to Percents

If the second number in the ratio is 100, simply write the first number as a percent:
1:100 = 1%
If the second number in the ratio is not 100, you must convert the ratio, using 100 as the denominator.
In this example, multiply the numerator and denominator, using 20 as the lowest common denominator:
4:5 = 80:100 = 80%
Decimals Converted to Percents

Move the decimal point two places to the right and then write the percent sign:
0.1 = 0.10 = 10%
0 +
0.05 = 0.05 = 5% 0 +
SELF-TEST 14 Fractions, Ratios, and Decimals
Change these percents to a fraction, ratio, and a decimal. Answers are given at the end of the chapter.
Do not reduce.
Fraction Ratio Decimal

1. 32% = ______________________ ______________________ ______________________
2. 8.5% = ______________________ ______________________ ______________________
3. 125% = ______________________ ______________________ ______________________
4. 64% = ______________________ ______________________ ______________________
5. 11.25% = _____________________ ______________________ ______________________
Now change these fractions, ratios, and decimals to a percent.
6. 7
10
= 9. 0.56 =
10. 3 =
7. 2:5 =
8. 0.08 =

Fractions, Ratio, and Proportion

Fractions show how the part (numerator) relates to the whole (denominator). Ratio indicates the relation-
ship between two numbers. In this book, ratios are written as two numbers separated by a colon (1:10).
Read this ratio as “one is to ten.” Proportion indicates a relationship between two ratios or two fractions.
EXAMPLE 2 10
8
= 40
(Read the proportion like this: “two is to eight as ten is to forty.”)
5:30 : : 6:36 (Read as “five is to thirty as six is to thirty-six.”)
Proportions written with two ratios and the double colon can also be written as
fractions. Thus, 5:30 : : 6:36 becomes
5 6
30 = 36
Solving Proportions With an Unknown

When one of the numbers in a proportion is unknown, the letter x substitutes for that missing number.
By following three steps, you can determine the value of x in a proportion.
Step 1. Cross-multiply.
Step 2. Clear x.
Step 3. Reduce.
Here’s how the three steps work.
Proportions Expressed as Two Fractions

Suppose you want to solve this proportion:
1 x
0.125
= 0.25
Step 1. Cross-multiply the numerators and denominators.

1 Zz x
=
0.125Xx 0.25
0.125 x = 0.25
Step 2. Clear x by dividing both sides of the equation with the number that precedes x.
0.25
x= 0.125
Step 3. Reduce the number.

2.
0 .125
: 0 . )
250
: .
x=2

EXAMPLE 45 = 3
180 x
45 x = 540
x = 540
45
x = 12
Proportions Expressed as Two Ratios

Suppose you start with this proportion:
4 : 3.2 : : 7 : x
Step 1. Cross-multiply the two outside numbers (called extremes) and the two inside numbers
(called means).
4 : (9 3.2 : : 7 : x
(9
4x = 22.4
Step 2. Clear x by dividing both sides of the equation with the number that precedes x.
22.4
x= 4
Step 3. Reduce the number.

5.6
)
4 22.4
x = 5.6
EXAMPLE
11 : 121 : : 3 : x
(9
11x = 363
33.
)
11 363.
33
33
33
x = 33
SELF-TEST 15 Solving Proportions
Solve these proportions. Answers are given at the end of the chapter.
120 16 81 x 0.25 x
1. 4.2
= x 5. 3
= 15
9. 500
= 1000
2. 750 : 250 : : x : 5 6. 0.125 : 0.5 : : x : 10 10. x : 20 : : 2.5 : 100
1 x
3. 14
140
= 22
x 7. 50
= 40
4. 2 : 5 : : x : 10 8. x : 12 : : 9 : 24
19.indd 19 08/07/15 9:44 AM

Ratio and Proportion in Dosage: An Introduction

When the amount of drug prescribed by a physician or healthcare provider differs from the supply, you
can solve the dosage problem with proportion, using either two ratios or two fractions.
EXAMPLE Order: 0.5 mg of a drug

Supply: A liquid labeled 0.125 mg per 4 mL
You know that the liquid comes as 0.125 mg in 4 mL. And you know that the amount you want is
0.5 mg. You don’t know, however, what amount of liquid is needed to equal 0.5 mg. So, you need one
more piece of information: the unknown, or x.
You can set up and solve this arithmetic operation as a proportion, using either two fractions or two
ratios. Notice that both methods eventually become the same calculation.
Two Fractions Two Ratios
0.5 Zz x
X=x
0.125 4
0.125 x = 2 0.5 0(9 .125 x 4
(9
↓ 0.125 x = 2
↓
0.125 x 2
=
0.125 0.125 0.125 x 2
=
↓ 0.125 0.125
↓
2 2
x= x=
0.125 0.125
↓ ↓
x= 2 16. x= 2 16.
0 .125
: )
2 . 000
: . 0 .125
: 2 .)000
: .
1 25 1 25
750 750
750 750
x = 16
So far, you’ve learned two ways to solve dosage calculation problems: the ratio method (i.e., the
p roportion of two ratios) and the proportion method (i.e., the proportion of two fractions). Chapter 4
introduces the simpler formula method, which is derived from ratio and proportion. Also, Chapter 4
explains another less complicated way: the dimensional analysis method. Throughout the book, self-test
and proficiency test problems illustrate solutions reached by all four methods of calculation.

PROFICIENCY TEST 1 Arithmetic
Name: ___________________________________________________________________________
These arithmetic operations are needed to calculate doses. Reduce if necessary. See Appendix A for
answers. Your instructor can provide other practice tests if necessary.
A. Multiply
0.56
a) 647 b) 8
× 12
c)
× 38 9 32 × 0.17
B. Divide. If necessary, round to two decimal places.

a) 82 793 ) b) 5 14 ÷ 7
4 )
c) 0.015 0.3
C. Add and reduce
a) 7 8 b) 3 2 c) 0.825 + 0.1
15 + 15 +
8 5
D. Subtract and reduce
11 7 8 4
a) 15
− 10 b) 15
− 15 c) 1.56 – 0.2
E. Change to a decimal. If necessary, round to two decimal places (unless the answer comes
out “even”).
1 3
a) 18
b) 8
F. Change to a fraction and reduce to lowest terms.
a) 0.35 b) 0.08
G. In each set, which number has the greater value?
a) __________ 0.4 and 0.162
b) __________ 0.76 and 0.8
c) __________ 0.5 and 0.83
d) __________ 0.3 and 0.25
H. Reduce these fractions to their lowest terms as decimals. Round to two decimal places.
20 7 6
a) 12 b) 84 c) 13
I. Round off these decimals as indicated.
a) nearest tenth 5.349 _____________________
b) nearest hundredth 0.6284 ____________________
c) nearest thousandth 0.9244 ____________________
J. Change these percents to a fraction, ratio, and decimal.
1
a) 3
% b) 0.8%
K. Change these fractions, ratios, and decimals to a percent.
a) 7 b) 1 : 10 c) 0.008
100
L. Solve these proportions.
32 4 0.4 x
a) 128
= x b) 8 : 72 : : 5 : x c) 0.12
= 8 (nearest whole number)

Answers
Self-Test 1 Multiplication
1. 12 5. 108 9. 48 13. 24 17. 18 20. 24 23. 81
2. 63 6. 24 10. 72 14. 54 18. 88 21. 132 24. 35
3. 32 7. 110 11. 15 15. 64 19. 36 22. 45 25. 120
4. 45 8. 14 12. 42 16. 56
Self-Test 2 Division
1. 9 5. 7 9. 7 13. 4 17. 9 20. 2 23. 12
2. 4 6. 8 10. 6 14. 3 18. 4 21. 7 24. 7
3. 3 7. 4 11. 9 15. 3 19. 6 22. 12 25. 12
4. 7 8. 3 12. 6 16. 7
Self-Test 3 Reducing Fractions

16 4 2
1. 24
= 6
= 3
(Divide by 4, then 2.) 7. 12
30
= 6
15
= 2
5 (Divide by 2, then 3.)
16 2
Alternatively: 24
= 3
(Divide by 8.) Alternatively:
12
30
= 2
5 (Divide by 6.)
36 6 1
2. 216
= 36
= 6
(Divide by 6, then 6.) 68
8. 136 = 34
= 1
(Divide by 2, then 34.)
68 2
18 9 3
3. 96
= 48 = 16 (Divide by 2, then 3.) 55
9. 121 = 5
(Divide by 11.)
11
70 7
4. = 49 = 17 (Divide by 10, then 7.)
490 10. 15
60
= 1
4
(Divide by 15.)
18
5. 81
= 92 (Divide by 9.)
15 3 1
8 Alternatively: = 12 = (Divide by 5, then 3.)
6. 48
= 16 (Divide by 8.) 60 4
Self-Test 4 Adding and Subtracting Fractions

5 1 1 3 2 5
1. 7
5. 2
+ 3
= 6
+ 6
= 6 9. 11
− 7 = 30
15 10
22 21
− 30 1
= 30
4 8
2. 5 6. 10
16
or 5
8
10. − 5 = 32
9 12 36
− 15
36
= 17
36
3 1
3. 4
7. 7
(2 × 2) 1 4 1 5 (3 × 3) 2 9 2 7
4. + 6
= 6
+ 6
= 6 8. − 15 = 15
− 15 = 15
3 5
6 15
Self-Test 5 Multiplying Fractions (Two Ways to Solve)

First Way Second Way
1
2 1 1
1 4 5 2
1. 1
6
× 45 × 52 = 20
60
= 1
3
1.
6
×
5
×
2
=
6
= 13
3 1 1 3
2 2 1
4 3 12 2 4 3 2
2. 15
× = 2 30
= 2. 15 × 2 = 5
5
5 5 1
(Divide by 6.)
(continued)

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Henke’s Med Math: Dosage Calculation,

Preparation, and Administration 8th

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

MATH AND DOSAGE CALCULATIONS FOR HEALTHCARE

Linux Administration: A Beginner's Guide 8th Edition

Linux Administration: A Beginner's Guide. 8th Edition

Chance, Calculation and Life Thierry Gaudin

Understanding Food: Principles and Preparation 6th

(Original PDF) Making Math Meaningful, 3rd Edition

Introduction to 80×86 Assembly Language and Computer

Special thanks to:

Buchholz9781496302847-fm.indd 6 07/07/15 10:20 AM

CHAPT E R Arithmetic Needed for Dosage 1

CH APT E R Metric and Household Systems of Measurement 31

CH APT E R Drug Abbreviations, Labels, and Packaging 47

Buchholz9781496302847-fm.indd 7 07/07/15 10:20 AM

Equipment to Measure Doses 68

CH AP TER Calculation of Oral Medications—Solids and Liquids 81

CH AP TER Liquids for Injection 139

CH AP TER Calculation of Basic IV Drip Rates 213

Buchholz9781496302847-fm.indd 8 07/07/15 10:20 AM

Medications for Intermittent IV Administration 226

CH APT E R Special Types of IV C

CH APT E R Dosage Problems for Infants and Children 315

CH APT E R Information Basic to Administering Drugs 367

CH APT E R Administration Procedures 391

Buchholz9781496302847-fm.indd 9 07/07/15 10:20 AM

Proficiency Test 1—Part A, Administration Procedures 437

Appendix A: Proficiency Test Answers 445

Appendix B: Putting It Together Answers 504

Buchholz9781496302847-fm.indd 10 07/07/15 10:20 AM

Buchholz9781496302847-ch001.indd 1 07/07/15 7:30 PM

Multiplying Whole Numbers

Dividing Whole Numbers

Buchholz9781496302847-ch001.indd 2 07/07/15 7:31 PM

In an improper fraction, the numerator is larger than the denominator.

A mixed number has a whole number plus a fraction.

RULE REDUCING FRACTIONS

Buchholz9781496302847-ch001.indd 3 07/07/15 7:31 PM

SELF-TEST 3 Reducing Fractions

Buchholz9781496302847-ch001.indd 4 07/07/15 7:31 PM

SELF-TEST 4 Adding and Subtracting Fractions

Buchholz9781496302847-ch001.indd 5 07/07/15 7:31 PM

Buchholz9781496302847-ch001.indd 6 07/07/15 7:31 PM

SELF-TEST 5 Multiplying Fractions

The vertical arrangement acts just like a

Buchholz9781496302847-ch001.indd 7 07/07/15 7:31 PM

SELF-TEST 6 Dividing Fractions

Changing Fractions to Decimals

Buchholz9781496302847-ch001.indd 8 25/07/15 12:32 PM

640 640 80. FINE POINTS

SELF-TEST 7 Converting Fractions to Decimals

Reading Decimals and Converting Decimals to Fractions

Buchholz9781496302847-ch001.indd 9 07/07/15 7:32 PM

0.01 is read as “one hundredth” ( 1001 ) .

SELF-TEST 8 Reading Decimals

Addition and Subtraction of Decimals

Buchholz9781496302847-ch001.indd 10 07/07/15 7:32 PM

SELF-TEST 9 Addition and Subtraction of Decimals

1. 10% 1

B. Divide. If necessary, round to two decimal places.