Henke’s Med-Math: Dosage Calculation, Preparation & Administration

520 Pages·2011·13.52 MB·English

by  Susan Buchholz

LWBK942-FM.qxd 6/25/11 8:45 AM Page x
LWBK940-FM_pi-x_Buchholz 9/5/11 7:38 PM Page i
Title
Henke’s
Med-Math
Dosage Calculation,
Preparation & Administration
Seventh Edition
Susan Buchholz, RN, MSN
Associate Professor
Georgia Perimeter College
Clarkston, Georgia
LWBK940-FM_pi-x_Buchholz 9/5/11 7:38 PM Page ii
Acquisitions Editor:Hilarie Surrena
Product Manager:Annette Ferran
Editorial Assistant:Jacalyn Clay
Design Coordinator:Holly McLaughlin
Illustration Coordinator:Brett MacNaughton
Manufacturing Coordinator:Karin Duffield
Prepress Vendor:Aptara, Inc.
7th edition
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Copyright © 2009 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Copyright © 2006, 2003, 1999
by Lippincott Williams & Wilkins. Copyright © 1995, 1991 by J.B. Lippincott Company. All rights reserved.
This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by
any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information
storage and retrieval system without written permission from the copyright owner, except for brief quotations
embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of
their official duties as U.S. government employees are not covered by the above-mentioned copyright. To
request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market
Street, Philadelphia, PA 19103, via email at [email protected], or via our website at lww.com (products
and services).
9 8 7 6 5 4 3 2 1
Printed in China
Library of Congress Cataloging-in-Publication Data
Buchholz, Susan, RN.
Henke’s med-math: dosage calculation, preparation & administration /
Susan Buchholz. — 7th ed.
p. ; cm.
Med-math
Includes bibliographical references and index.
ISBN 978-1-60831-799-8 (alk. paper)
I. Henke, Grace. II. Title. III. Title: Med-math.
[DNLM: 1. Pharmaceutical Preparations–administration &
dosage–Nurses’ Instruction. 2. Pharmaceutical
Preparations–administration & dosage–Programmed Instruction. 3. Drug
Dosage Calculations–Nurses’ Instruction. 4. Drug Dosage
Calculations–Programmed Instruction. QV 18.2]
615.1(cid:2)401513–dc23
2011033646
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted
practices. However, the author, editors, and publisher are not responsible for errors or omissions or for any
consequences from application of the information in this book and make no warranty, expressed or implied,
with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this
information in a particular situation remains the professional responsibility of the practitioner; the clinical
treatments described and recommended may not be considered absolute and universal recommendations.
The author, editors, and publisher have exerted every effort to ensure that drug selection and dosage set
forth in this text are in accordance with the current recommendations and practice at the time of publication.
However, in view of ongoing research, changes in government regulations, and the constant flow of informa-
tion relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug
for any change in indications and dosage and for added warnings and precautions. This is particularly impor-
tant when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA)
clearance for limited use in restricted research settings. It is the responsibility of the healthcare provider to
ascertain the FDA status of each drug or device planned for use in his or her clinical practice.
LWW.com
LWBK940-FM_pi-x_Buchholz 9/5/11 7:38 PM Page iii
Acknowledgments
and Dedication
Contributors:
Sonique Sailsman,RN, MSN, CCRN, CPN (Chapter 8)
Dedication:
This edition is dedicated to Andrew and Chelsea. You continue to bring joy and laughter to my life.
Special Thanks to:
Laura Lacey-Bordeaux andLynn Farmer:Photography
Sister Grace Henke:Original text and format
Hilarie Surrena, Annette Ferran, Tonya Koch:Editorial assistance, expertise, and support
Stephanie Hill, Jana Mills, Scott McAuleyof DeKalb Medical Center: Assistance with medication labels and
information
Pharmaceutical companies:Medication labels
Laporsha Baker, Irene Deitel, Yvonne Durrant,Edison State College students, Damien Herrera,Annette
Kersting, Fran Kamp, Nancy Krug, Kathy McGettigan, Tammy Smyth, Eva Williams: Proofreading and
editorial assistance
Valerie:Bringing love to my life
Bri:Taking care of me and my Uncle Joe
iii
LWBK940-FM_pi-x_Buchholz 9/5/11 7:38 PM Page iv
Reviewers
Joyce Azzaline, APRN-BC, DHSc Mary J. McCoy, RN, MSN
Associate Professor of Nursing Assistant Professor of Nursing
Trinity Christian College University of Indianapolis
Palos Heights, Illinois Indianapolis, Indiana
Dorothy Craig, MSN, RN Karen Noss, RN, MSN, OCN
Professor of Nursing Associate Professor
Luzerne County Community College Luzerne County Community College
Nanticoke, PA Nanticoke, Pennsylvania
Wendy J. G. DuFour, RN, MN, CCRN Connie Peterson
Associate Professor of Nursing Associate Professor
Los Angeles Valley College Concordia College
Valley Glen, California Moorhead, Minnesota
Connie Evenson, RN, MSN, CNE Linda Pruitt, RN, MS
University of South Dakota Program Director
Sioux Falls, South Dakota Eastern Shore Community College
Melfa, Virginia
Tammyra Ford
Jefferson State Community College Wendy Robinson, MS, RN, FNP-BC
Birmingham, Alabama Vice President for Academic Affairs
Helene Fuld College of Nursing
Tammy Fralicker New York, NY
Associate Dean of Nursing
Olney Central College Karen A. Vercellino, MSN, RN-BC
Olney, Illinois Assistant Professor of Nursing
Richland Community College
Peggy Imus Decatur, Illinois
Minnesota State Community & Technical College
Moorhead, Minnestora Janet Walsh, RN, MSN, MA
Professor/Nursing Program Coordinator
Jeri Jaquis, MSN, RN, ANP-BC St. Louis Community College
Assistant Professor St. Louis, Missouri
University of Texas Medical Branch
Galveston, Texas Carol Webb, RN, MN, BSN, FPNP
Associate Professor
Brenda Johnson Division of Nursing
West Texas A&M University The University of West Alabama
Canyon, Texas Livingston, Alabama
iv
LWBK940-FM_pi-x_Buchholz 9/5/11 7:38 PM Page v
Preface
Learning math can be summed up in one simple phrase:
Practice makes perfect
There are many ways to learn math. There are several ways to calculate dosages. Ultimately, the more you prac-
tice, the better you get.
I have tried to make this the focus of this book. Whether you are a beginning nursing student or one who is
confident in math abilities, or an experienced nurse or healthcare professional, I encourage you take advantage of
the self-tests and proficiency tests in this text. Each chapter will walk you through the various methods of calcula-
tion and then give you an opportunity to practice. Each chapter stands alone, so you may work ahead at your own
pace.
The text is organized as such:
Chapter 1:Arithmetic needed to calculate doses Chapter 6: IV drip calculations
Chapter 2:Systems of measurement Chapter 7: Advanced IV drip calculations
Chapter 3:Drug abbreviations, labels and packaging Chapter 8:Pediatric medication calculations
Chapter 4:Oral medication calculations Chapter 9: Medication administration information
Chapter 5:Liquid injection calculations Chapter 10: Medication administration procedures
Key Features
(cid:129) Clinical dosage problems
(cid:129) Easy-to-learn formulas
(cid:129) Step-by-step approach in solving methods
(cid:129) Demonstration of four methods of calculation (formula, proportion expressed as two ratios, proportion
expressed as two fractions, dimensional analysis)
(cid:129) Self-tests in each chapter with answers at the end of the chapter
(cid:129) Proficiency tests in each chapter with answers in Appendix A
(cid:129) Simple to complex organization of the text
(cid:129) Joint Commission-approved abbreviations
(cid:129) Test Your Clinical Savvy—“what if” situations that stimulate critical thinking
(cid:129) Glossary with definitions and common abbreviations
(cid:129) Putting It Together—case studies with application of dosage calculations and critical thinking questions with
suggested answers in Appendix B
(cid:129) Handy quick reference plastic card with common conversions and formulas
v
LWBK940-FM_pi-x_Buchholz 9/5/11 7:38 PM Page vi
vi Preface
New to This Edition
(cid:129) The four calculation methods are presented side by side for each problem.
(cid:129) Drug labels and drug names have been updated.
(cid:129) The chapters have been reorganized to bring similar material together and to introduce calculation problems
earlier in the text.
(cid:129) Research Points have been added. These are a summary of journal articles that highlight evidence-based
practice concerning dosage calculations, medication administration, and safe practice.
Resources and aids for students and faculty are provided on thePoint at:
(cid:129) thepoint.lww.com/Buchholz7e
Please send any comments and suggestions to me, as I appreciate any feedback and “proofreading” that will help
make each edition better. I hope that this book helps anyone involved in calculating correct and safe medication
dosages.
Susan Buchholz, RN, MSN
Decatur, Georgia
[email protected]
LWBK940-FM_pi-x_Buchholz 9/5/11 7:38 PM Page vii
Contents
R
PTE 1 Arithmetic Needed for Dosage 1
A
H
C
Multiplying Whole Numbers 2
Dividing Whole Numbers 2
Fractions 3
Decimals 9
Percents 14
Fractions, Ratio, and Proportion 17
Proficiency Test 1 Arithmetic 20
Answers to Self-Tests 21
PTER 2 Metric, Apothecary, and Household Systems
A
H
C of Measurement 31
Metric System 31
Apothecary System 39
Household System 41
Liquid Measures 41
Other Conversions 43
Proficiency Test 1 Exercises in Equivalents and Mixed Conversions 46
Answers to Self-Tests 47
PTER 3 Drug Abbreviations, Labels, and Packaging 49
A
H
C
Interpreting the Language of Prescriptions 49
Time of Administration of Drugs 49
Routes of Administration 53
Metric and SI Abbreviations 55
Apothecary Abbreviations 56
Household Abbreviations 56
Terms and Abbreviations for Drug Preparations 57
Drug Labels 58
Drug Packaging 61
vii
LWBK940-FM_pi-x_Buchholz 9/5/11 7:38 PM Page viii
viii Contents
Equipment to Measure Doses 69
Proficiency Test 1 Abbreviations/Military Time 74
Proficiency Test 2 Reading Prescriptions/Interpreting Written Prescriptions 75
Proficiency Test 3 Labels and Packaging 77
Answers to Self-Tests 81
PTER 4 Calculation of Oral Medications—Solids and Liquids 83
A
H
C
Oral Solids 84
Converting Order and Supply to the Same Weight Measure 89
Clearing Decimals When Using the Formula Method 90
Special Types of Oral Solid Orders 93
Oral Liquids 94
Special Types of Oral Liquid Orders 100
Oral Solid and Liquid Problems Without
Written Calculations/“Common Sense” Calculations 100
Research Point 102
Putting It Together 102
Proficiency Test 1 Calculation of Oral Doses 104
Proficiency Test 2 Calculation of Oral Doses 106
Proficiency Test 3 Calculation of Oral Doses 108
Answers to Self-Tests 109
PTER 5 Liquids for Injection 131
A
H
C
Syringes and Rounding 131
Special Types of Problems in Injections From a Liquid 141
Injections From Powders 148
Distinctive Features of Injections From Powders 150
Where to Find Information About Reconstitution of Powders 151
Insulin Injections 160
Research Point 170
Critical Thinking Test Your Clinical Savvy 170
Putting It Together 171
Proficiency Test 1 Calculations of Liquid Injections 173
Proficiency Test 2 Calculations of Liquid
Injections and Injections From Powders 176
Proficiency Test 3 Calculations of Liquid Injections 179
Proficiency Test 4 Mental Drill in
Liquids-for-Injection Problems 180
Answers to Self-Tests 181