DOSAGE

CALCULATION
AND
MEDICATION
ADMINISTRATION
ROBIN CALVERT MSN, RN
 OBJECTIVES
Upon completion of this learning module, the student will be able to:
• Calculate for a missing term (X) using ratio and proportions.
• Calculate medication dosages using the formula method.
• Calculate the number of tablets or capsules to administer.
• Calculate the volume to administer for medications in a solution.
• Calculate dosages using dimensional analysis.
• Calculate infusion time in hours and minutes
 COMMON CONVERSIONS &
ABBREVIATIONS
• 1,000 mcg = 1 mg • gtt = drop
• 1,000 mg = 1 g
• Tsp = teaspoon
• 1,000 g = 1 kg
• 1, 000 ml = 1 L • Tbsp = tablespoon
• 2.2 lbs = 1 kg • oz = ounce
• 1 oz = 30 ml • IM = intramuscular
• gr1 = 60mg
• IV = intravenous
• 1 tsp = 5 ml
• 1 tbsp = 15 ml • IVP = intravenous push
• IVPB = intravenous piggyback
• G = gram • PO = oral (by mouth)
• mcg = microgram • BID = twice a day
• mg = milligram
• TID = three times a day
• L = liter
• ml = milliliter
• gr = grain
 DROP FACTOR

• The drop factor always appears on package of IV tubing

• Microdrop: 60 gtt/mL
• Macrodrop: check manufacturer’s packaging
• 10 gtt/mL
• 15 gtt/mL
• 20 gtt/mL
 PROPORTIONS
The left side of the equation represents the known quantities and the right
side of the equation represents the desired dose and the amount to be
given.

(Known) (Unknown)

H = dose on hand
Q = quantity
D = desired dose
X = unknown
 PROPORTIONS

(Known) (Unknown)

Steps:
1. Determine the dose on hand.
2. Determine the dose ordered.
 Convert to like measurements before going to step 3, if necessary
3. Cross multiply and drop units of measurement.
4. Solve for x.
 PROPORTIONS: EXAMPLE 1
• Ordered: 25mg diphenydramine PO

• On hand: 50mg/5mL

• How many mL will the nurse administer?

 FORMULA METHOD
• The formula method is a quick way to solve dosage calculations.
• Always use critical thinking checks to make sure that your answer is
logical.
• Sometimes it will be necessary to convert between systems (use
equivalents) before calculating the dosage.

H = dose on hand
Q = quantity
D = desired dose
X = unknown
 FORMULA METHOD
Steps:
1. Determine the dose desired (D).
2. Determine the dose on hand (H).
3. Determine the unit or quantity of the medication that contains the
dose on hand (Q).
4. Solve for the amount to give (X).

H = dose on hand
Q = quantity
D = desired dose
X = unknown
 FORMULA METHOD: EXAMPLE
• Ordered: Vancomycin 250mg IV
• On hand: Vancomycin 500mg/100mL
• How many mL will the nurse administer?
 DIMENSIONAL ANALYSIS
• All necessary steps can be done using one equation.

• The idea is to set up the equation so that all unnecessary units of

measure are cancelled out, leaving only the unit of measure needed to
arrive at the correct dosage.
 DIMENSIONAL ANALYSIS
Steps to dimensional analysis:
1. Determine the dose desired (D).
2. Determine the dose on hand (H).
3. Determine the unit or quantity of the medication that contains the
dose on hand (Q).
4. Put above items in an equation, solving for amount to be
administered (X).
• Multiply across, then divide numerator by denominator.
5. Only units to be administered should remain. Other units should
cancel out.
 DIMENSIONAL ANALYSIS:
EXAMPLE

• Ordered: furosemide 40mg PO daily

• On hand: 20mg tablets

• How many tablets will the nurse administer?

 CALCULATING INFUSION TIME IN
HOURS AND MINUTES
• A simple one-step ratio (division) is all that is needed when total
volume is known and milliliters per hour have been ordered.

NOTE: When the number of hours includes additional minutes, you need
to round to the nearest tenth. Then multiply the part of an hour by 60 min
to get the exact number of minutes.
 CALCULATING INFUSION TIME IN
HOURS AND MINUTES: EXAMPLE
• The MD has ordered 500ml of a fluid to run at a rate of 80ml/hr. How
long will the IV infusion run? Express your answer in hours and
minutes.
 HEPARIN PROTOCOLS
• Heparin protocols contain 3 steps:
• Bolus
• Continuous infusion
• Re-bolus and/or infusion rate adjustment

Calculating the bolus dose:

Remember, you cannot give part of a unit, so you must round up or down,
using rounding rules.
 HEPARIN PROTOCOLS: EXAMPLE
A client weighs 160lb. Continuous Heparin IV infusion is ordered with a
Heparin bolus of 60mg/kg, then initiate the drip at 14 units/kg/hr.
Calculate the bolus dose to administer:

Note: If you were to calculate the kg, round to 72.73, then multiply that
by the 60 units/kg, you will get 4363.8, which still rounds to 4364 units,
because you cannot give part of a unit!
 CALCULATING DROPS PER
MINUTE

To calculate drops per minute (gtt/min), you need three pieces of

information:
• The total volume to be infused in milliliters
• The drop factor of the tubing you will use
• The total time for the infusion in minutes or hours
 CALCULATING DRIP RATE OR
DROPS PER MINUTE: EXAMPLE

The MD ordered 500 mL of 0.9% NS to run over 6 hr. Using an IV set

with a drop factor of 20 gtt/mL, calculate the drops per minute (gtt/min).
 EXAMPLE 1
The MD has ordered 75mg of a medication. The medication is supplied
as 125mg/1mL. How many ML will the nurse administer?

1. Set up the equation using the proportion method:

2. Set up the equation using the formula method:
3. Set up the equation using dimensional analysis:
 EXAMPLE 2
The MD has ordered 1500 mg of a medication. The label reads
500mg/5mL. How many ml will the nurse administer?

1. Set up the equation using the proportion method:

2. Set up the equation using the formula method:
3. Set up the equation using dimensional analysis:
 EXAMPLE 3
The MD ordered 2g of a medication in 100ml NS to infuse over 15
minutes. Using an IV set with a drop factor of 60gtt/ml, calculate the drip
rate in gtt/min.

1. Set up the equation using the proportion method:

2. Set up the equation using the formula method:
3. Set up the equation using dimensional analysis:
 EXAMPLE 4
An IV of 250 mL is to infuse at 80 mL/hr. Calculate the infusion time.

1. Set up the equation using the formula method:

2. Set up the equation using dimensional analysis:
 EXAMPLE 5
A client weighs 210 lb. Continuous Heparin IV infusion is ordered with a
Heparin bolus of 30mg/kg, then initiate the drip at 14 units/kg/hr.
Calculate the bolus dose to administer:
 CHECK YOUR MATH: EXAMPLE 1
The MD has ordered 75mg of a medication. The medication is supplied
as 125mg/1ml. How many ML will the nurse administer?
• Set up the equation using the proportion method:

• Set up the equation using the formula method:

• Set up the equation using dimensional analysis:

 CHECK YOUR MATH: EXAMPLE 2
The MD has ordered 1500 mg of a medication. The label reads
500mg/5mL. How many ml will the nurse administer?
• Set up the equation using the proportion method:

• Set up the equation using the formula method:

• Set up the equation using dimensional analysis:

 CHECK YOUR MATH: EXAMPLE 3
The MD ordered 2g of a medication in 100ml NS to infuse over 15
minutes. Using an IV set with a drop factor of 60gtt/mL, calculate the drip
rate in gtt/min.

• Set up the equation using the formula method:

• Set up the equation using dimensional analysis:

 CHECK YOUR MATH: EXAMPLE 4
An IV of 250 mL is to infuse at 80 mL/hr. Calculate the infusion time.

• Set up the equation using the formula method:

• Set up the equation using dimensional analysis:

 CHECK YOUR MATH: EXAMPLE 5
A client weighs 210 lb. Continuous Heparin IV infusion is ordered with a
Heparin bolus of 30mg/kg, then initiate the drip at 14 units/kg/hr. Calculate the
bolus dose to administer:

Note: If you were to calculate the kg, round to 95.45, then multiply that by the 30
units/kg, you will get 2863.5, which still rounds to 2864 units, because you
cannot give part of a unit!