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The Nurse, The Math, The Meds - E-Book

The Nurse, The Math, The Meds - E-Book

Joyce L. Mulholland | Susan Turner

(2014)

Additional Information

Book Details

Abstract

Use the simplicity of the dimensional analysis method to minimize drug calculation errors! The Nurse, The Math, The Meds, 3rd Edition helps you overcome any math anxiety you may have by clearly explaining how to use the dimensional analysis method. It shows how to analyze practice problems, find the reasonable answer, and then evaluate it. But first, it lets you refresh your math skills with a review of essential math. Written by noted nursing educator Joyce Mulholland, this book offers over 1,400 questions for plenty of practice in mastering math concepts and learning dosage calculations.


Table of Contents

Section Title Page Action Price
Front cover Cover
Evolve ifc1
Dimensional analysis style examples i
Standard abbreviations for medications ii
Front matter iii
The nurse, the math, the meds drug calculations using dimensional analysis iii
Copyright iv
Dedication v
Content and math reviewers vi
To the student vii
To the instructor xi
Ancillaries xii
Acknowledgments xiii
Table of contents xv
Part I Math review 1
Math self-assessment 2
Introduction 2
Symbols (explanation on p. 7) 2
Whole numbers (explanation on p. 8) 2
Products, factors, common factors and multiples (explanation on pp. 11-12) 2
Squares, square roots, and powers of 10 (explanation on pp. 13-15) 3
Fractions (explanation on pp. 24-35) 3
Decimals (explanation on pp. 17-23) 4
Percent (explanation on pp. 35-38) 4
Answer keys 5
Math self-assessment (p. 2) 5
1 Math review 6
Objectives 6
Introduction 6
Directions 6
Essential math vocabulary and concepts 7
Whole numbers 8
Multiplying and dividing whole numbers by the number 1 8
Implied decimal points and trailing zeros 9
Dividing a number or fraction by itself 9
Sum 10
Product 11
Factor 11
Common factors 11
Common factors other than 1 11
Multiple 12
Factors versus multiples 12
Multiplier 12
Divisor, dividend, quotient, and remainder 12
Square 13
Square root 13
Bases and exponents 15
Read or say 15
Powers of 10 calculations 15
Multiplying and dividing by 10, 100, and 1000 16
Decimal fractions 17
Reading numbers and decimals 18
Decimal point spatial placement 19
Writing decimals as fractions 19
Decimals: Which is larger? 20
Rounding decimals 21
Adding and subtracting decimals 22
Multiplying decimals 22
Dividing decimals 23
Division of decimals when the divisor is a whole number 23
Division of decimals when divisor contains decimals 23
Fractions 24
Alternative fraction forms 25
Mixed fractions 25
Improper fractions 25
Converting mixed and improper fractions 25
Converting an improper fraction to a mixed fraction 26
Reducing fractions 27
Common (same) denominator 28
Lowest common denominator 28
Finding the lowest common denominator 28
Equivalent fractions 29
Comparing fractions 30
Adding and subtracting fractions 30
Denominators the same 31
Denominators not the same 31
Mixed fraction subtraction and borrowing 31
Multiplying fractions 33
Cancellation and multiplication of fractions 33
Canceling when the numerators and denominators are the same 33
Canceling when the numerators and denominators are not the same but have common factors 34
Division of fractions 35
Percentages 35
Changing a fraction to a percentage 36
Changing a percentage to a fraction 36
Changing a decimal to a percentage 37
Changing a percentage to a decimal 37
Calculating the percentage of a whole number 38
Constants 39
Finding unit values and totals 39
Finding the total value 39
Equations 40
Estimated completion time: 41
Answers on:  41
Directions: 41
Estimated completion time: 43
Answers on:  43
Directions: 43
CHAPTER 1 Answer key 45
Rapid practice 1-1 (p. 7) 45
Rapid practice 1-2 (p. 8) 45
Rapid practice 1-3 (p. 10) 45
Rapid practice 1-4 (p. 10) 45
Rapid practice 1-5 (p. 12) 45
Rapid practice 1-6 (p. 13) 45
Rapid practice 1-7 (p. 14) 45
Rapid practice 1-8 (p. 14) 45
Rapid practice 1-9 (p. 16) 46
Rapid practice 1-10 (p. 17) 46
Rapid practice 1-11 (p. 19) 46
Rapid practice 1-12 (p. 20) 46
Rapid practice 1-13 (p. 20) 46
Rapid practice 1-14 (p. 20) 46
Rapid practice 1-15 (p. 21) 46
Rapid practice 1-16 (p. 22) 46
Rapid practice 1-17 (p. 24) 46
Rapid practice 1-18 (p. 26) 46
Rapid practice 1-19 (p. 27) 46
Rapid practice 1-20 (p. 29) 46
Rapid practice 1-21 (p. 29) 46
Rapid practice 1-22 (p. 30) 46
Rapid practice 1-23 (p. 31) 46
Rapid practice 1-24 (p. 32) 47
Rapid practice 1-25 (p. 33) 47
Rapid practice 1-26 (p. 34) 47
Rapid practice 1-27 (p. 35) 47
Rapid practice 1-28 (p. 36) 47
Rapid practice 1-29 (p. 37) 47
Rapid practice 1-30 (p. 38) 48
Rapid practice 1-31 (p. 40) 48
Chapter 1 multiple-choice review (p. 41) 48
Chapter 1 final practice (p. 43) 48
Suggestions for further reading 49
2 Dimensional analysis method 50
Objectives 50
Introduction 50
Three required elements of all dimensional analysis equations 51
Setup of a basic equation using the dimensional analysis method 51
Conversion factor review 54
Conversions for dimensional analysis calculations 56
Problems that call for more than one conversion factor 60
Estimated completion time: 63
Answers on:  63
Directions: 63
Estimated completion time: 65
Answers on:  65
Directions: 65
CHAPTER 2 Answer key 68
Rapid practice 2-1 (p. 55) 68
Rapid practice 2-2 (p. 56) 68
Rapid practice 2-3 (p. 57) 68
Rapid practice 2-4 (p. 59) 68
Rapid practice 2-5 (p. 60) 68
Rapid practice 2-6 (p. 62) 68
Chapter 2 multiple-choice review (p. 63) 68
Chapter 2 final practice (p. 65) 68
Suggestions for further reading 69
Part II Metric system and medication calculations 71
3 Metric units and conversions 72
Objectives 72
Introduction 72
Metric measurements: Base units 73
Metric units number line 74
Metric prefixes 74
Writing metric units correctly 75
Equivalent metric measurements of weight (mass) 78
Equivalent metric measurements of volume 80
Equivalent metric measurements of length 80
Metric equivalents 83
Converting milligrams to grams and grams to milligrams 83
Verifying metric equivalents by moving decimals 84
Examining micrograms 86
Milliequivalents (mEq) 87
Other medication measurement systems 88
Household measurements 88
Apothecary system 88
Household and metric liquid measuring containers 89
Converting pounds to kilograms 90
Key points about the measurement systems 91
Estimated completion time: 92
Answers on:  92
Directions: 92
Estimated completion time: 93
Answers on:  93
CHAPTER 3 Answer key 96
Rapid practice 3-1 (p. 75) 96
Rapid practice 3-2 (p. 76) 96
Rapid practice 3-3 (p. 77) 96
Rapid practice 3-4 (p. 77) 96
Rapid practice 3-5 (p. 78) 96
Rapid practice 3-6 (p. 79) 96
Rapid practice 3-7 (p. 82) 96
Rapid practice 3-8 (p. 84) 96
Rapid practice 3-9 (p. 85) 96
Rapid practice 3-10 (p. 86) 96
Rapid practice 3-11 (p. 86) 96
Rapid practice 3-12 (p. 87) 97
Rapid practice 3-13 (p. 87) 97
Rapid practice 3-14 (p. 90) 97
Chapter 3 multiple-choice review (p. 92) 97
Chapter 3 final practice (p. 93) 97
Suggestions for further reading 97
4 Patient records, medication orders, and medication labels 98
Objectives 98
Introduction 98
Medication storage and security 101
Medication forms and packaging 102
Solid medication forms 102
Liquid medication forms 105
Medication routes 107
Frequency and times of medication administration 109
The 24-hour clock 117
Medication orders 119
Complete medication orders 119
Sample physician’s order sheet 119
Directions:  119
Interpreting medication orders and medication labels 120
Calculating dose based on label and order information 126
Orders for two or more medications to be combined 130
Telephone and verbal orders 130
Examples of orders that must be clarified 130
Medication administration records 133
The seven rights of medication administration 137
Estimated completion time: 140
Answers on:  140
Direction: 140
Directions: 141
Estimated completion time: 145
Answers on:  145
Directions: 145
Directions: 146
CHAPTER 4 Answer key 146
Rapid practice 4-1 (p. 104) 146
Rapid practice 4-2 (p. 105) 146
Rapid practice 4-3 (p. 106) 147
Rapid practice 4-4 (p. 108) 147
Rapid practice 4-5 (p. 114) 147
Rapid practice 4-6 (p. 115) 147
Rapid practice 4-7 (p. 116) 147
Rapid practice 4-8 (p. 116) 147
Rapid practice 4-9 (p. 118) 147
Rapid practice 4-10 (p. 124) 147
Rapid practice 4-11 (p. 127) 147
Rapid practice 4-12 (p. 132) 148
Rapid practice 4-13 (p. 136) 148
Rapid practice 4-14 (p. 139) 148
Chapter 4 multiple-choice review (p. 140) 148
Chapter 4 final practice (p. 145) 148
Suggestions for further reading 149
Part III Reconstituted medications 151
5 Oral medications 152
Objectives 152
Introduction 152
Metric conversions by moving decimal places 156
Estimating liquid dose medication orders 161
Estimating liquid doses 161
Misinterpretation 162
Rounding numbers to simplify estimations of a liquid dose 162
Setting up DA-style equations 163
When ordered dose and available unit concentration match 163
When the ordered units do not match the available units 164
Usual unit doses 165
Equipment for administering oral liquid doses 168
Selecting the implement for oral liquid medications 168
Measuring liquids 168
Measuring oral milliliter doses that call for more or less than the calibrated lines on the cup 168
Oral syringes 169
Oral syringes versus injectable syringes 170
Safe dose ranges (SDRs) 176
Calculating safe dose ranges (SDRs) 176
SDR with simple ranges 177
SDR with divided doses 177
Safe and unsafe orders 178
SDR with range based on weight 178
Estimated completion time: 187
Answers on:  187
Directions: 187
Estimated completion time: 188
Answers on:  188
Directions: 188
CHAPTER 5 Answer key 194
Rapid practice 5-1 (p. 153) 201
Rapid practice 5-2 (p. 153) 201
Rapid practice 5-3 (p. 156) 201
Rapid practice 5-4 (p. 157) 201
Rapid practice 5-5 (p. 157) 201
Rapid practice 5-6 (p. 159) 201
Rapid practice 5-7 (p. 162) 201
Rapid practice 5-8 (p. 165) 201
Rapid practice 5-9 (p. 172) 201
Rapid practice 5-10 (p. 172) 201
Rapid practice 5-11 (p. 173) 201
Rapid practice 5-12 (p. 179) 201
Rapid practice 5-13 (p. 180) 201
Rapid practice 5-14 (p. 182) 201
Chapter 5 multiple-choice review (p. 187) 201
Chapter 5 final practice (p. 188) 201
Suggestions for further reading 201
6 Syringes for injection 202
Objectives 202
Introduction 202
Syringe sizes 203
20-mL, 10-mL, 5-mL, 3-mL, and 1-mL syringes 203
Insulin syringes 204
Parts of the syringe 205
Total capacity and lowest measurable dose 205
Where to measure the dose on syringes 206
Examining the calculated doses for correct syringe selection 209
Prefilled injectable syringes 211
Prefilled medication cartridges for injection 212
Needle sizes 213
Basics of needle selection 213
Safety syringes 215
Safety issues and disposal of sharps 216
Recommended fluid volume for selected sites 221
Estimated completion time: 222
Answers on:  222
Directions: 222
Estimated completion time: 223
Answers on:  223
Directions: 223
CHAPTER 6 Answer key 226
Rapid practice 6-1 (p. 206) 226
Rapid practice 6-2 (p. 207) 226
Rapid practice 6-3 (p. 208) 226
Rapid practice 6-4 (p. 210) 226
Rapid practice 6-5 (p. 210) 226
Rapid practice 6-6 (p. 216) 226
Rapid practice 6-7 (p. 218) 227
Rapid practice 6-8 (p. 219) 227
Rapid practice 6-9 (p. 220) 227
Chapter 6 multiple-choice review (p. 222) 227
Chapter 6 final practice (p. 223) 227
Suggestions for further reading 229
7 Reconstitution of medications 230
Objectives 230
Introduction 230
Reconstituted medications 231
Interpreting orders and reading labels for reconstituted medications 231
Reading labels  231
Marking the label for reconstituted medications 232
Expired reconstituted drugs 233
Reconstituted parenteral drugs 240
Diluents 240
Selecting the appropriate unit dose concentration based on dilution directions when more than one dilution is offered  240
Reconstituted drug prefilled containers 243
Liquid concentrates: Diluting liquids 248
Inactive ingredients used for dilutions 249
Converting dilution ratios to fractions and percentages 249
Using a DA equation to calculate the amount of concentrate 250
Estimated completion time: 251
Answers on:  251
Directions: 251
Estimated completion time: 252
Answers on:  252
Directions: 252
CHAPTER 7 Answer key 256
Rapid practice 7-1 (p. 233) 256
Rapid practice 7-2 (p. 236) 257
Rapid practice 7-3 (p. 242) 257
Rapid practice 7-4 (p. 244) 258
Rapid practice 7-5 (p. 250) 258
Chapter 7 multiple-choice review (p. 251) 258
Chapter 7 final practice (p. 252) 259
Suggested references 260
Part IV Parenteral medications 261
8 Injectable medications 262
Objectives 262
Introduction 262
Intradermal injections 263
Subcutaneous injections 263
Intramuscular injections 264
Administering injections 265
Parenteral mixes 273
Mixing two medications in one syringe 274
Calculating the dose for a parenteral mix 274
Medicines supplied in units 279
Estimated completion time: 279
Answers on:  279
Directions: 279
Estimated completion time: 281
Answers on:  281
Directions: 281
CHAPTER 8 Answer key 288
Rapid practice 8-1 (p. 266) 288
Rapid practice 8-2 (p. 270) 289
Rapid practice 8-3 (p. 274) 289
Chapter 8 multiple-choice review (p. 279) 290
Chapter 8 final practice (p. 281) 290
Suggestions for further reading 292
9 Basic intravenous calculations 293
Objectives 293
Introduction 293
Overview of intravenous therapy 295
Purpose of intravenous solutions 295
Maintenance intravenous flow rates 296
Basic intravenous equipment 296
Types of intravenous solutions 297
Tonicity of intravenous solutions 297
Intravenous solution volume 298
Intravenous solution orders for milliliters per hour 299
Determining infusion durations 299
Calculating simple milliliter per hour (mL per hr) orders 300
Electronic infusion pumps 301
Gravity infusions 303
Intravenous administration sets 303
Infusion administration sets for gravity infusions 304
Calculating flow rates for gravity infusions 305
Calculation of gravity infusion rates 306
Estimating drops per minute for a drop factor of 60 308
Counting drops per minute 310
Intravenous piggyback solutions 312
Flow rates for IVPB infusions 313
Simplified piggyback calculations for milliliter-per-hour settings 313
IVPB flow rates (drops per minute) 315
Regulating and positioning gravity infusion devices 317
Flow rate errors 319
Monitoring the flow rate on infusion devices 319
Timed tapes 319
Drops per minute to milliliters per hour 322
Electronic infusion pump alarms 323
“Volume to be infused” alarm 323
“To keep open” flow rates 328
Calculating grams of solute 328
Calculating total grams of solute in a solution 328
A word about potassium chloride 330
Intravenous intermittent solution delivery systems 330
Volume-control device (calibrated burette chamber) 332
Intravenous push medications (direct) 333
Syringe pump 333
Patient-controlled analgesia (PCA) pump  333
Blood administration 334
Estimated completion time: 336
Answers on:  336
Directions: 336
Estimated completion time: 337
Answers on:  337
Directions: 337
CHAPTER 9 Answer key 339
Rapid practice 9-1 (p. 300) 339
Rapid practice 9-2 (p. 307) 339
Rapid practice 9-3 (p. 309) 340
Rapid practice 9-4 (p. 311) 340
Rapid practice 9-5 (p. 312) 341
Rapid practice 9-6 (p. 314) 341
Rapid practice 9-7 (p. 316) 341
Rapid practice 9-8 (p. 318) 342
Rapid practice 9-9 (p. 318) 342
Rapid practice 9-10 (p. 322) 343
Rapid practice 9-11 (p. 324) 343
Rapid practice 9-12 (p. 324) 343
Rapid practice 9-13 (p.327) 344
Rapid practice 9-14 (p. 329) 344
Chapter 9 multiple-choice review (p. 336) 344
Chapter 9 final practice (p. 337) 344
Suggestions for further reading 345
10 Advanced intravenous calculations 347
Objectives 347
Introduction 347
Advanced intravenous calculations 349
Using conversion factors 350
Calculating flow rates 350
Flow rates requiring two conversion factors 352
Flow rates for weight-based doses 354
Total dose for weight-based orders 355
Flow rate in milliliters per hour (mL per hr) for weight-based orders 355
Equipment for intravenous solutions containing medications 358
Calculating milligrams per milliliter (mg per mL) 361
Calculating the dose of an infusing solution 361
Intravenous solution and medications 363
Intravenous push medications 364
IV push administration 365
Method 1: Milliliters per minute 365
Method 2: Seconds per calibration line on a syringe 366
Hyperalimentation: Parenteral nutrition 371
Estimated completion time: 374
Answers on:  374
Directions: 374
Estimated completion time: 375
Answers on:  375
Directions: 375
CHAPTER 10 Answer key 381
Rapid practice 10-1 (p. 349) 381
Rapid practice 10-2 (p. 351) 382
Rapid practice 10-3 (p. 353) 382
Rapid practice 10-4 (p. 357) 382
Rapid practice 10-5 (p. 359) 383
Rapid practice 10-6 (p. 362) 383
Rapid practice 10-7 (p. 367) 384
Chapter 10 multiple-choice review (p. 374) 384
Chapter 10 final practice (p. 375) 385
Suggestions for further reading 386
Part V Common high-alert medications 387
11 Antidiabetic medications 388
Objectives 388
Introduction 388
Oral and injectable non-insulin antidiabetic medications 390
Parenteral antidiabetic medications: Insulin products 392
Insulin labels 394
Short- and rapid-acting insulins 395
Intermediate-acting insulins 398
Short- and intermediate-acting insulins: Insulin fixed-combination mixes 399
Long-acting insulins 400
Steps to prepare doses for insulin syringes 401
Matching insulin concentration and syringes 402
Reading units on insulin syringes 402
Even- and odd-numbered scales on insulin syringes 403
Lo-dose syringes 404
Sites for insulin injection 406
Sliding-scale insulin 407
Mixing insulins: Short fast-acting and slower-acting intermediate mixes 412
Fixed premixed intermediate- and short-acting combination insulins 412
When the mix must be prepared by the nurse 414
Technique for preparing insulin mixes 414
Intravenous insulin infusions 419
Insulin administration devices 421
Prefilled pens 422
Insulin pumps 423
Estimated completion time: 424
Answers on:  424
Directions: 424
Estimated completion time: 425
Answers on:  425
Directions: 425
CHAPTER 11 Answer key 429
Rapid practice 11-1 (p. 397) 429
Rapid practice 11-2 (p. 399) 429
Rapid practice 11-3 (p. 401) 429
Rapid practice 11-4 (p. 405) 429
Rapid practice 11-5 (p. 408) 429
Rapid practice 11-6 (p. 410) 429
Rapid practice 11-7 (p. 416) 429
Rapid practice 11-8 (p. 420) 430
Rapid practice 11-9 (p. 421) 430
Chapter 11 multiple-choice review (p. 424) 430
Chapter 11 final practice (p. 425) 430
Suggestions for further reading 431
12 Anticoagulant medications 432
Objectives 432
Introduction 432
Injectable anticoagulants 440
Heparin flushes (low-dose concentrations) 440
Heparin for subcutaneous and intravenous administration 442
Heparin concentrations used for intravenous infusions 443
Calculating heparin flow rates 446
Determine mL per hour 446
Determine units per hour 446
Estimated completion time: 452
Answers on:  452
Directions: 452
Estimated completion time: 453
Answers on:  453
Directions: 453
CHAPTER 12 Answer key 456
Rapid practice 12-1 (p. 436) 456
Rapid practice 12-2 (p. 437) 456
Rapid practice 12-3 (p. 444) 456
Rapid practice 12-4 (p. 447) 456
Rapid practice 12-5 (p. 449) 457
Chapter 12 multiple-choice review (p. 452) 457
Chapter 12 final practice (p. 453) 457
Suggestions for further reading 458
Part VI Medications for infants and children 459
13 Pediatric medications 460
Objectives 460
Introduction 460
Comparing adult and pediatric medication doses and schedules 461
Calculating kilograms from pounds and ounces 463
Calculating safe dose range (SDR) 465
Body surface area (BSA) 467
Calculating milligrams per square meter (mg per m2) 468
Medication administration equipment 470
Injection sites 475
Safe injection volumes 476
Fluid requirements 480
Intravenous injections 481
Using a volume-control device 481
Using volume-control chambers to protect patients from fluid and drug overload 482
Using a volume-control device to administer intravenous medication  483
Flushing a volume-control device 483
Calculating for a volume-control device 484
Syringe pump infusers 486
Review of infusion rate calculations 486
Comparing safe dose range and order 487
Estimated completion time: 490
Answers on:  490
Directions: 490
Estimated completion time: 492
Answers on:  492
Directions: 492
CHAPTER 13 Answer key 498
Rapid practice 13-1 (p. 462) 498
Rapid practice 13-2 (p. 464) 498
Rapid practice 13-3 (p. 466) 498
Rapid practice 13-4 (p. 469) 499
Rapid practice 13-5 (p. 472) 499
Rapid practice 13-6 (p. 477) 500
Rapid practice 13-7 (p. 485) 501
Rapid practice 13-8 (p. 487) 501
Chapter 13 multiple-choice review (p. 490) 502
Chapter 13 final practice (p. 492) 502
Suggestions for further reading 503
Comprehensive final practice 504
Estimated completion time: 504
Answers on  504
Directions: 504
Answer key 522
Comprehensive final practice: Chapters 1-13 (p. 504) 522
Appendix A The joint commission do not use list 526
Appendix B Institute for safe medication practices list of high alert medications 527
Appendix C 5-minute sample verbal communication hand-off report 528
Appendix D Sample medication administration errors and potential clinical outcomes 530
Appendix E Apothecary system and household measurements 532
Index 533
A 533
B 533
C 533
D 533
E 534
F 534
G 534
H 535
I 535
K 536
L 536
M 536
N 537
O 537
P 537
Q 537
R 537
S 538
T 538
U 538
V 538
W 539
Z 539
End sheets ibc1