,Metric Equivalents
Weight
Gram (g) Milligram (mg) Microgram (mcg) Length (meter)
1 1000 1,000,000 1 m 5 1000 mm
0.5 500 500,000 1 m 5 100 cm (centimeter)
0.3 300 300,000 1 cm 5 10 mm (millimeter)
0.1 100 100,000
0.06 60 60,000
0.015 15 15,000
0.0006 0.6 600
0.00003 0.03 30
Pound to Kilogram Conversion
2.2 lb 5 1 kg
Household to Metric Length Equivalent Volume
1 inch 5 2.54 cm 1 L (liter) 5 1000 mL (milliliter)
39.37 inches 5 1 m
Temperature Conversions: Celsius (C) and Fahrenheit (F)
0º C (freezing) 5 32º F 100º C (boiling) 5 212º F 37º C 5 98.6º F
To convert Fahrenheit to Celsius: To convert Celsius to Fahrenheit:
1. Subtract 32 1. Multiply by 1.8
2. Divide by 1.8 2. Add 32
Comparison of the 12-Hour Clock and the 24-Hour Clock
12-hr 24-hr 12-hr 24-hr 1200
1100 0100
Clock Clock Clock Clock
12
11 1
Midnight 2400 Noon 1200 1000 0200
12:00 AM 12:00 PM 10 2
1:00 AM 0100 1:00 PM 1300 0900 9 AM 3 0300
2:00 AM 0200 2:00 PM 1400
8 4
3:00 AM 0300 3:00 PM 1500 0800 7 5 0400
6
4:00 AM 0400 4:00 PM 1600 0700 0500
0600
5:00 AM 0500 5:00 PM 1700 2400
2300 1300
6:00 AM 0600 6:00 PM 1800 12
11 1
2200 1400
7:00 AM 0700 7:00 PM 1900 10 2
8:00 AM 0800 8:00 PM 2000 2100 9 PM 3 1500
9:00 AM 0900 9:00 PM 2100 8 4
2000 7 5 1600
10:00 AM 1000 10:00 PM 2200
6
11:00 AM 1100 11:00 PM 2300 1900 1700
1800
,YOU’VE JUST PURCHASED
MORE THAN
A TEXTBOOK!
Evolve Student Resources for Mulholland/Turner:
The Nurse, The Math, The Meds: Drug Calculations Using
Dimensional Analysis, third edition, include the following:
• Dimensional Analysis Companion, version 3
A completely updated, interactive
student tutorial that includes an
extensive menu of various topic
areas within drug calculations such
as oral, parenteral, pediatric, and
intravenous calculations to name
a few. It includes animations and
interactive exercises in which students
can fill in syringes to answer problems.
Covering the dimensional analysis method,
this companion contains over 500 practice
problems, including a comprehensive post-test and additional
content information. Case studies have been added in this version.
Activate the complete learning experience that comes with each
textbook purchase by registering at
http://evolve.elsevier.com/Mulholland/themath/
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,Dimensional Analysis Style Examples
Ordered: Medication Y, 1 g PO daily
Available: 500 mg per tablet
How many tablets will you give?
Conversion factor needed: 1000 mg 5 1 g
Estimate: Will give 2 tablets (500 mg 3 2 5 1000 mg 5 1 g)
2
tablet 1 tablet 1000 mg 1 g
5 3 3 5 2 tablets per dose
dose 500 mg 1 g dose
Evaluation: The equation is balanced. Only tablets remain.
Ordered: Medication Y, 30 mg PO daily
Available: 20 mg per 5 mL
How many mL will you give?
Estimate: Will give more than 5 mL but less than 10 mL
3
mL 5 mL 30 mg
5 3 5 7.5 mL per dose
dose 20 mg dose
2
Evaluation: The equation is balanced. Only mL remain.
Ordered: 1000 mL q8h
Available: IV administration set: Drop factor (DF) 5 10 drops per mL
At how many drops per minute will the flow rate be set?
1 125
drops 10 drops 1000 mL 1 hr
5 3 3
minute 1 mL 8 hr 60 minutes
1 6
5 21.83, rounded to 21 drops per minute
Evaluation: The equation is balanced. Only drops per minute remain.
Ordered: IV antibiotic to infuse in 30 minutes 4 times daily
Available: 50 mL of IV antibiotic
At how many mL per hour will the flow rate be set?
Conversion factor needed: 60 minutes 5 1 hour
Estimate: 100 mL rate in 60 minutes will deliver 50 mL in 30 minutes
2
mL 50 mL 60 minutes
5 3 5 100 mL per hour
hr 30 minutes 1 hr
1
Evaluation: The equation is balanced. Only mL per hour remain.
,Standard Abbreviations for Medications
Abbreviation Meaning Abbreviation Meaning
a or a before ml or mL milliliter
aa or aa of each NKA no known allergies
ac before meals NKDA no known drug allergies
ad lib as desired, freely NPO nothing by mouth
ADE adverse drug event NS normal saline
A.M., a.m., AM, am in the morning, before noon oz ounce
amp ampule OTC over the counter
aq water p after
bid twice a day pc after meals
BSA body surface area PCA patient-controlled analgesia
C Celsius per through, by (route)
c with per each (math term)
cap or caps capsule PO, po, per os by mouth
CD* controlled dose P.M., p.m., PM, pm afternoon, evening
comp compound prn as needed, when necessary
CR* controlled release q each, every
dil. dilute qh or q1h every hour
DR* delayed release qid four times daily
DS* double strength q2h, q4h, etc. every 2 hours, every 4 hours, etc.
elix elixir qs as much as needed; quantity suf-
E-R* extended release ficient
ext external, extract rep. repeat
F Fahrenheit Rx give, treatment, prescription
fl. or fld fluid s without
g gram SL, subl sublingual (under the tongue)
gtt drop sol. or soln. solution
h or hr hour SR* slow, sustained release
ID intradermal(ly) stat. immediately, at once
IM intramuscular(ly) subcut subcutaneous(ly)
Inj injection supp suppository
IV intravenous(ly) susp. suspension
IVPB intravenous piggyback Syr syrup
kg kilogram tab tablet
KVO keep vein open tbs., Tbsp, or T tablespoon
L liter tid three times a day
LA* long acting tinct tincture
lb pound TKO to keep open
liq. liquid tsp teaspoon
m meter ung ointment
m2 square meter vag vaginal
mcg microgram XL* long acting
mEq milliequivalent XR* extended release
mg milligram
Clinical Alert: *The manufacturer acronyms that follow medication names
have caused confusion and errors. CD, CR, DR, E-R, LA, SA, SR, TR, XL, XR,
XT all refer to various timed-release forms of the drug. They cannot be used
interchangeably. Some need to be taken more than once a day, some tablets
can be cut, others cannot. Double check the order and the acronym with
a current drug reference and the patient medication history to protect the
patient from a medication type or dose error.
, JOYCE M.
MULHOLLAND,
MS, RN, ANP, MA
Nursing Education Consultant,
Tucson, Arizona
THIRD EDITION
MS Nursing, California
State University,
Long Beach, California
NURSE,
MA Education, Arizona State
University, Tempe, Arizona
BS, Fairleigh
the
Dickinson College,
Rutherford, New Jersey
MATH,
Former Captain, USAF Reserve
41st Casualty Staging Unit,
Luke AFB, Arizona
the
SUSAN J.
TURNER,
MSN, RN, FNP
Professor of Nursing
MEDS
Gavilan Community College,
Gilroy, California
Family Nurse Practitioner the
Rota-Care Free Clinic,
Gilroy, California
Family Nurse Practitioner
and Nursing Director
Indian Acres & Forest
Acres Summer Camps,
Fryeburg, Maine
FNP, State University
of New York (SUNY) DRUG CALCULATIONS using
at Stony Brook
Stony Brook, New York
DIMENSIONAL ANALYSIS
MSN, San Jose
State University,
San Jose, California
BSN, California
State University,
Bakersfield, California
, 3251 Riverport Lane
St. Louis, Missouri 63043
THE NURSE, THE MATH, THE MEDS: DRUG CALCULATIONS ISBN: 978-0-323-18711-4
USING DIMENSIONAL ANALYSIS, THIRD EDITION
Copyright © 2015 by Mosby, an imprint of Elsevier Inc.
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by
any means, electronic or mechanical, including photocopying, recording, or any information storage
and retrieval system, without permission in writing from the publisher. Details on how to seek
permission, further information about the Publisher’s permissions policies and our arrangements with
organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be
found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein. In
using such information or methods they should be mindful of their own safety and the safety of
others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the
most current information provided (i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or formula, the method and duration
of administration, and contraindications. It is the responsibility of practitioners, relying on their
own experience and knowledge of their patients, to make diagnoses, to determine dosages and the
best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors,
assume any liability for any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any methods, products,
instructions, or ideas contained in the material herein.
Library of Congress Cataloging-in-Publication Data
Mulholland, Joyce M., author.
The nurse, the math, the meds : drug calculations using dimensional analysis / Joyce M. Mulholland,
Susan J. Turner. -- Third edition.
p. ; cm.
Joyce M. Mulholland’s name appears first and only in the previous edition.
Includes bibliographical references and index.
ISBN 978-0-323-18711-4 (pbk. : alk. paper)
I. Turner, Susan J., author. II. Title.
[DNLM: 1. Drug Prescriptions--nursing--Problems and Exercises. 2. Drug Prescriptions--nursing--
Programmed Instruction. 3. Pharmaceutical Preparations--administration & dosage--Problems and
Exercises. 4. Pharmaceutical Preparations--administration & dosage--Programmed Instruction. 5. Drug
Administration Routes--Problems and Exercises. 6. Drug Administration Routes--Programmed Instruction.
7. Mathematics--Problems and Exercises. 8. Mathematics--Programmed Instruction. WY 18.2]
RS57
615’.1401513076--dc23
2014012928
Sr. Content Strategist: Yvonne Alexopoulos
Content Development Manager: Jean Sims Fornango
Sr. Content Development Specialist: Danielle M. Frazier
Publishing Services Manager: Jeff Patterson
Sr. Project Manager: Tracey Schriefer
Design Direction: Teresa McBryan
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
, To the persevering students of medication
math and its clinical relevance.
Joyce M. Mulholland
To my smart and beautiful daughters,
Sara and Amy,
you have brought joy to every day of my life.
And to my husband,
Warren,
thank you for supporting
everything I do, always.
Susan Turner
,Content and Math Reviewers
Bret Alan Barker, MSN, RN, CCRN, Jennifer Wilkes RN
PHN Oncology Nurse
Adjunct Faculty, Nursing Instructor Trauma Intensive Care Unit Nurse
Allied Health Department Santa Clara Valley Medical Center
Gavilan College San Jose, California
Gilroy, California
Laura Brigantino, RN Mulholland/Turner
Medical Surgical Floor Ancillary Writers
Hazel Hawkins Hospital PowerPoint Slides
Hollister, California Bret Alan Barker, MSN, RN, CCRN,
PHN
Mary C. Carlton, MSN, RN Adjunct Faculty, Nursing Instructor
Assistant Professor Allied Health Department
Bluegrass Community and Technical Gavilan College
College Gilroy, California
Lexington, Kentucky
Student Companion
Peggy Corrigan Rinehart, DNP, Ann Tritak, RN, EdD, MA, BSN
APRN, NNP-BC Dean and Professor, School of Nursing
Assistant Professor Saint Peter’s University
Bluegrass Community and Technical Jersey City, New Jersey
College
Lexington, Kentucky Test Bank and Case Studies
Linda Fluharty, RNC, MSN
Denise Kreismann, RN, MSN(R) Associate Professor
Associate Professor School of Health Sciences
Cape Cod Community College Nursing Program
West Barnstable, Massachusetts Ivy Tech Community College
Indianapolis, Indiana
Ann Tritak, RN, EdD, MA, BSN
Dean and Professor, School of Nursing
Saint Peter’s University
Jersey City, New Jersey
vi Copyright © 2015 by Mosby, an imprint of Elsevier Inc. All rights reserved.
, To the Student
The Nurse, The Math, The Meds: Drug Calculations Using Dimensional Analysis, third
edition has been designed not only to teach you what you need to know, but also to
save your valuable time. Here are a few time-tested tips:
1. First, take an hour or so to review and master Chapters 1 and 2. They contain
all the math and concepts of dimensional analysis you will need.
2. Set aside at least three study periods for each chapter — the first shortly after
the initial presentation and the last shortly before the next class session or
quiz. Working with a study buddy can help a lot.
3. Take the time to review the Vocabulary provided at the beginning of each
chapter. This is a very useful reference as you proceed through each chapter.
4. Try to complete a topic and quiz in one sitting.
5. Fifteen minutes spent studying medication labels in the over-the-counter drug
section of a pharmacy will be of great help to clarify information needed
about medication labels and drug measurements.
6. Be sure to estimate reasonable answers. Don’t use your calculator until you
get to very large numbers or the final chapters. The methods of solving
the problems need to be fully understood first. This gives you the ability to
perform an independent verification of the math answers. The discipline of
writing out equations and solutions will make you competent quickly and
help you avoid errors.
7. As you proceed through the text, some useful math operation shortcuts
will occur to you. They have their place, but only after you are sure you
understand what you are doing.
8. Write numbers as neatly as you can, using the metric notation guidelines.
Sloppy writing of numbers, decimals, and commas contributes to major
errors.
9. Working a vocabulary practice problem or two each day will improve your
retention.
10. Be sure to review and refresh your memory after holidays and long breaks as
well as before entering new clinical areas. And remember, think metric!
Copyright © 2015 by Mosby, an imprint of Elsevier Inc. All rights reserved. vii
