Dosage Calc Mid-Term
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| When do you round decimals? | Calculate one decimal place passed desired position; if 4 or less no adjustment; if 5 or more, round up
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| Do you round up decimal positions when administering oral medication or injections? | NO. May cause overdose
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| Why do you always add a 0 before a decimal if the value is less than 1? | Draws attention to the decimal and avoids two potentially critical errors: missing the decimal or mistaking it for a number “1.”
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| Divisor | Number you are dividing by
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| Dividend | Number being divided
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| Percent (%) means.. | Per hundred
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| What is a Ratio? | Comparison of two quantities
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| Two ways to express a Ratio | As a fraction
With a colon
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| How does the Ratio 2 : 3 read? | 2 to 3
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| What is a Proportion? | A statement that shows the relationship between two different ratios
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| Adverse Drug Event (ADE) | A medication-related occurrence that causes harm to a patient
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| Drug Concentration (strength) | The ratio of medication amount to a specific amount of liquid or solid ( amount of drug, 50 milligrams) per tablet or metric-calibrated teaspoon, or the amount of drug in the total quantity or weight supplied ( 1 gram per 500-milliliter container)
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| Food and Drug Administration (FDA) | The federal agency responsible for ensuring the safety, efficacy, and security of drugs, biological products such as vaccines, medical devices, and more. FDA approves medications for specific uses and sale in the United States.
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| Generic Drug | Drug product that is comparable to a brand-name drug product in dosage form, strength, route of administration, quality and performance characteristics, and intended use.
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| High Alert Medication | Medication identified by ISMP as capable of causing significant harm to patients if used in error. The red flag icon is placed next to high-alert medications in the text as a visual reminder to help the reader become familiar with some of these drugs.
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| Institute for Safe Medication Practices (ISMP) | A nonprofit, voluntary agency dedicated to educating the health care community and consumers about safe medication practices
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| Patent | A license giving the original manufacturer exclusive rights to manufacture the approved new product for a period of about 20 years from the time the patent was filed. When the patent expires, other companies may manufacture a generic copy of the product
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| Sentinel Event | an unexpected occurrence involving death or serious physical or psychological injury or the risk thereof. Serious injury specifically includes the loss of limb or function.
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| Unit Dose Packaging | Non-reusable packaged and labeled single serving of drug dose ordered for the patient; usually used in health care institutions. May contain more than one unit of the drug, depending on the order (e.g., 2 tablets per serving).
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| The Joint Commission | A national nonprofit, independent agency that provides accreditation and certification to health care organizations, with an emphasis on high standards and patient safety, including medication administration safety
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| Usual Dose | The average dose ordered for the desired therapeutic effect for the target population (e.g., usual dose for children age 5 to 12 years: 1 teaspoon at bedtime for itching). Seen on manufacturers’ prepared labels
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| Seven Patient Rights | Right Patient
Right Drug
Right Dose
Right Time
Right Route
Right Documentation
Right to Refuse
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| Minimum number of patient identifiers to be used when determining Right Patient | Minimum of TWO patient identifiers
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| Name some patient identifiers | Patients name
Assigned ID number (wristband)
Telephone Number
Other person specific identifiers
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| What can not be used as patient identifiers? | Bed number
Room Number
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| What do you do when a patient refuses medication of is unable to tolerate the route ordered? | Document patients reason and include an assessment of patients mental status
Contact prescriber
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| Accurate and timely reporting and documentation in the patient medication record, as well as other records, is _________ | Essential for patient safety
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| The nurse who prepares and administers the medication offers the last step in administration _________ | Safeguards to the patient.
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| Medication form can affect _________. | Rate of absorption
Route of administration
Distribution through body
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| Medication forms | Solids
Liquids
Inhalants
Suppositories
Skin Patched
Others
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| Compress powder drugs | Plain tablet
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| Tablet with a dividing line | Scored tablet
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| What is the ONLY kind of tablet that can be cut? | Scored tablet
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| Oval shaped tablets | Caplet
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| Tablets with coating to permit them to dissolve in the small intestine instead of the stomach, where it might cause gastric irritation | Enteric Coated tablet
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| Soluble case—usually gelatin—that holds liquid or dry particles of the drug; can be hard or soft (softgels), in one piece or two pieces | Capsule
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| Forms of Delayed Release (DR) | ER - Extended Release
SR - Slow Release
CR - Controlled Release
LA - Long Acting
EL - Extra Long Acting
CD - Controlled Dose
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| DS | Double Strength
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| ES | Extra Strength
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| Loose or molded drug substance usually to be dissolved in liquid or nonessential food | Powders/granules
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| Never crush or cut Delayed Release or Enteric Coated medications | It will accelerate their release into the body
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| Solid particles suspended in liquid that must be mixed well before administration | Aqueous Suspension
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| Sweetened alcohol and water solutions | Elixir
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| Fats or oils suspended in a solution by an emulsifier | Emulsion
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| Syrups or derived form of active drugs | Extract
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| Concentrated alcoholic liquid extracts of plants or vegetables | Fluid Extract
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| Mixture in solids are fully dissolved | Solution
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| How to measure a liquid using a metric-calibrated cup? | On level surface at eye level
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| Routes of Medication Administration | Parenteral (Injectable)
Nonparenteral (All other routes that are not injectable)
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| Parenteral routes | Intradermal (ID) - between dermis and epidermis
Intramuscular (IM) - into muscle
Intravenous (IV) - into vein
Subcutaneous (Subcut) - injected in hypodermis
Epidural - into the space between vertebral wall/dura mater
Intrathecal - into spinal fluid
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| Nonparenteral routes | Oral (PO) - swallowed by mouth
Sublingual (SL) - dissolved under tongue
Buccal (bucc) - dissolved in cheek
Topical (top) - applied to skin
Transdermal (skin) - for systemic effects (skin patches)
Nasogastric (NG) - nose to stomach
Inhalants
Others
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| Most medications are ordered for which routes? | Oral (PO)
Intravenous (IV)
Intramuscular (IM)
Subcutaneous (Subcut)
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| When patient is discharged from the hospital, you should? | Teach correct use and/or application of drug
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| Copies of original brand name drugs after their patent has expired | Generic drugs
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| What are the only differences permitted by the FDA between original and generic drug? | Inactive ingredients
Size
Shape
Color
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| What is included on drug labels? | Brand/Trade name (may have)
Generic name (must have)
National Drug Code
Manufacturer name
Drug concentration (dose)
Form (tablet,etc)
Bar Code
Total quantity
Administration route
Expiration Date
Lot number
Directions/Warning
Special storage
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| Medication order can be: | Handwritten
Faxed
Entered in computer
Verbal?
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| Medication orders must have: | Date/Time
Patient name
Medication name
Dosage
Form
Route
Frequency (dose schedule)
Prescribers signature
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| A report that is confidential regarding a medication related incident | Medication Incident Report
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| Medication Reconciliation | A measure to reduce the high rate of medication errors upon transfers, admissions, and discharges
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| How many times should drug dose, label, and drug order be checked prior to administration? | 3
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| How many times difference is between a (g) and mg; mg and mcg? | 1000 times
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| 5 mL | 1 teaspoon
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| 15 mL | 1 Tablespoon
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| 30 mL | 1 ounce
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| 240 mL | 1 measuring cup (1 glass)
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| 1 L | 1.06 qt
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| Pupil size: 1-2mm; possible strong reaction to light or opioid use | Pinpoint pupil
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| Dilated pupil | 10 mm
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| 1 kg | 2.2 lb
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| 10 cm | 2.5 in
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| 1 m | 39 in
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| 1 pint | 16 oz
540 mL
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| 1 gallon | 4 quarts
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| 1 quart | 960 mL
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| Milliequivalent (mEq) | The number of grams of solute dissolved in 1 mL of solution. Typically, electrolytes are measured in mEq (potassium, sodium, chlorides)
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| Milliequivalent per 1 L | 1/1000 of gram of substance dissolved in 1 L
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| Milliequivalent per 1 mL | 1/1000 of a gram of substance dissolved in 1 mL
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| Controlled Drug Schedules | Schedule I
Schedule II
Schedule III
Schedule IV
Schedule V
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| Highest potential for abuse and no medical use (heroin) | Schedule I
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| High potential for abuse and have medical use with severe restrictions; potential for severe dependence (morphine, hydrocodone, amphetamines) | Schedule II
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| Potential for abuse and moderate dependence (codeine products, testosterone) | Schedule III
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| Lower potential for abuse than schedule I, II, III; limited dependence lower than schedule III (Valium, Ambien) | Schedule IV
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| Lower potential for abuse than schedule IV; Limited dependence relative to schedule IV (cough syrups with codeine) | Schedule V
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| A set of graduations on a scale to indicate values | Calibration
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| Viscosity | fluid resistance
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| “under the skin,” a “hypodermic” is an injection that delivers medication under the skin to the intradermal, subcutaneous, muscular, and intravenous layers. | Hypodermic
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| A standardized means of measure used to quantify selected products with biological activity such as vitamins, vaccines, blood products, and hormones, including insulin. | Units
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| Syringe selection depends on: | Volume of medication to be administered
Calibrations on syringe
Route to be administered
Viscosity of medication (thicker the med, larger the syringe barrel needed)
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| Syringe parts: | Plunger
Rubber stopper
Barrel
Tip (Hub)
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| Needle parts: | Hub
Shaft
Bevel
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| Needle selection criteria: | Patient size
Location to be administered
Skin condition
Muscle development
Type and viscosity of medication
Equipment available
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| How should the patient be when giving injections? | Seated or lying down to prevent injury
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