Unit Conversions

* Mass
mcg→mg→g→kg (÷ by 1,000) mcg←mg←g←kg (x by 1,000) EX: Convert 5,000mcg to mg mcg→ mg →g →kg
0) 5,000mcg ÷ 1,000= 5mg
* Weight
lb→kg (÷ by 2.2) lb←kg (x by 2.2) EX: Convert 74.8lb to kg 74.8lb ÷ 2.2 = 34kg
* Volume
mcL→ mL→ L→ KL (÷ by 1,000) mcL← mL← L← KL (x by 1,000) EX: Convert 0.003L to mcL mcL← mL←
by 1,000) Convert L to mL then mL to mcL 0.003L X 1,000=3mL 3mL X 1,000=3,000mcL
* Time
min→ hr (÷ by 60) min← hr (x by 60) EX: Convert 5 hours to minutes min← hr (x by 60) 5hr
X60=300min
Dosage Calculations
Mass for mass questions
* Given an amount of mass per tablet, how many tablets do you require? Formula:
Ordered --------------- = tablets required Have
Example: Lopressor, 25mg by mouth, is ordered. Lopressor is available as 50mg ta
blets. How many tablets would the nurse give? 25mg --------------- = 0.5 tablets
50mg
Mass/Liquid for Liquid questions
*Given an amount of mass per liquid, how much liquid do you require? Formula: Or
dered --------------- X volume Per Have= liquid required (mL) Have
Example: Dilantin, 0.1g by mouth , is ordered to be given through a nasogastric
tube. Dilantin is available as 30mg/5mL. How much would the nurse give? 1. Conve
rt 0.1g to mg mcg←mg←g←kg (x by 1,000) 0.1g X 1,000=100mg 2. Plug numbers into formula
100mg --------------- X 5mL = 16.7mL 30mg
Parenteral Dosage of Drugs
*Given an amount of mass per liquid, how much liquid do you require for injectio
n? Formula: Apply the same steps used for the calculation of oral dosages. Order
ed --------------- X volume Per Have= liquid required (mL) Have
Example: Ordered: Lasix 40mg IV push now. Available: 80mg in 1mL 40mg ---------
X 1mL=0.5mL 80mg *Rule: The maximum dosage volume to be administered per IM inje
ction site: 1. Average 150lb adult = 3mL (maximum for deltoid is 2mL) 2. Childre
n 6 to 12 years = 2mL 3. Children birth to 5 years = 1mL *Rule: As you calculate
Parenteral dosages: 1. If the amount is greater than 1mL, round the amount to b
e given to the tenths (ex: 1.3mL). Measure it in a 3mL syringe. 2. If the amount
is less than 1mL, round the amount to be given to hundredths (ex: 0.65mL). Meas
ure it in a 1mL syringe. 3. Amounts of 0.5 to 1mL, calculated in tenths (ex: 0.6
mL), can be measured in either a 1mL or 3mL syringe.
Important IV Terms and Abbreviations
*IV Terms: gtts- drops Drop Factor- Number of drops per volume of IV fluid. Meas
ured in gtts/mL Drop factor is stated on the IV tubing package. Macrodrop factor
s- 10, 15, or 20 gtt/mL Microdrop factor- 60 gtt/mL Flow Rate- Measure of the fl
ow of liquid from an IV. Usually measured in gtts/min or in mL/hr. gtts/min- is
used for manually regulating an IV. mL/hr- is used when utilizing an electronic
IV regulator. Tonicity or Osmolarity- blood or serum concentration. Usually meas
ured in milliOsmols per liter, or mOsm/L. *The osmolarity of a manufactured solu
tion is detailed on the printed label. Look for the mOsm/L under the solution na
me. Normal Average Tonicity for all ages is 280-320 mOsm/L Hypotonic (<250 mOsm/
L)- lower tonicity or osmolarity than blood and other body serums. Solvent excee
ds solute - used to dilute excess serum electrolyte, as in hyperglycemia. Isoton
ic (250-375 mOsm/L)- the same tonicity or osmolarity as blood and other body ser
ums. Solvent and solutes are balanced - used to expand volume and maintain norma
l tonicity. Hypertonic (>375 mOsm/L)- higher tonicity or osmolarity than blood a
nd other body serums. Solutes exceed solvent - used to correct electrolyte imbal
ances, as in loss from excess vomiting and diarrhea.
Primary IV- used when administering primary IV fluids. Tubing includes a drip ch
amber, one or more injection ports, and a roller clamp. Can be regulated
manually using the roller clamp or by placing the tubing in a electronic infusio
n pump. Secondary IV- used when giving medications. Secondary tubing is shorter
and also contains a drip chamber and roller clamp. It is “piggybacked” into the prim
ary line. This gives access to the primary IV catheter with having to start anot
her IV. *IVPB is hung higher than primary IV to allow the secondary set of medic
ation to infuse first. *Major complications associated with IV therapy: Phlebiti
s-vein becomes irritated, red, or painful (warm and cordlike vein). Infiltration
-IV catheter becomes dislodged from the vein and IV fluid escapes into subcutane
ous tissue (cool and puffy skin). Infection Solution strength- expressed as a pe
rcent (%) indicates the number of g per 100mL. *The abbreviation letters indicat
e the solution components, and the numbers indicate the solution strength or con
centration of the components. D- Dextrose W- Water S- Saline NS- Normal Saline (
0.9% NaCl) Examples: D5W= dextrose 5% in water D5LR= dextrose 5% in Lactated Rin
ger’s D5NS 1,000 mL IV q.8.h.= administer 1,000 mL 5% dextrose in normal saline in
travenously every 8 hours. D5 ¼ NS= 5% dextrose in 0.225% saline solution NaCl- So
dium Chloride RL- Ringer’s Lactate LR- Lactated Ringer’s
Calculating Components Of IV Solutions When Expressed As A Percent %
*Given a volume of IV fluid and a dosage expressed in %, what is the mass of the
particular dosage? *Remember that % indicates g per 100mL. Formula: Concentrati
on % --------------------------- X volume (mL)= Dosage amount (g) 100mL
Example 1: Calculate the amount of dextrose in 1000mL D5W. 5 ------------- X 100
0mL= 50g 100mL Example 2: Calculate the amount of Sodium Chloride in 2000mL NS.
*Recall that NS is 0.9% NaCl (Sodium Chloride) 0.9 ----------- X 2000mL= 18g 100
mL Example 3: Order: D5 ¼ NS 500mL IV q.6h Calculate the amount of dextrose and so
dium chloride in 500mL. D5= Dextrose 5% (5g of dextrose per 100mL) 5g ----------
- X 500mL= 25g of Dextrose 100mL ¼ NS= 0.225%NaCl (0.225g NaCl per 100mL) *Recall
that NS is 0.9% NaCl; therefore ¼ NS is ¼ X 0.9% = 0.225% NaCl 0.225g ----------- X
500mL= 1.125g of NaCl 100mL 500mL D5 ¼ NS contains 25g of dextrose and 1.125g sodi
um chloride.
Calculating Flow Rates For Electronic Regulators in mL/h
* Given a certain amount of liquid and a time period, what is the necessary IV
flow rate in mL/hr? Formula: Volume (mL) --------------------------- = Flow Rate
(mL/hr) Time (hr)
Example 1: Infuse 250mL over the next 120 minutes by infusion pump. First, conve
rt 120 minutes to hours min→ hr (÷ by 60) 120÷ 60=2hr Next, plug in to formula 250mL -
---------- = 125mL/hr 2hr Example 2: D5W 250mL IV over the next 2hr by infusion
pump 250mL ----------- = 125mL/hr 2hr
If the infusion time is less than 1 hour
Formula: Volume (mL) ---------------------------X 60min/h = Flow Rate (mL/hr) Ti
me (min)
Example: Ampicillin 500mg IV in 50mL D5 ½NS in 30min by controller 50mL ----------
---X 60min/h = 100mL/hr 30 min
Calculating Flow Rates For Manually Regulated IVs in gtt/min
* Given a certain amount of liquid, a time period, and a drop factor (gtts/mL),
what is the necessary IV flow rate in gtts/min? * It is impossible to give a pat
ient a fraction of a drop, so round up or down to the nearest whole number. Form
ula: Volume (mL) --------------------- X Drop factor (gtts/mL) = Flow Rate (gtts
/min) Time (min) The drop factor is stated on the IV tubing package. ** Typical
values of gtts/min are in the range of 20 to 100 gtts/min. Example 1: Calculate
the IV flow rate for 1200mL of NS to be infused in 6 hours. The infusion set is
calibrated for a drop factor of 15 gtts/mL. First convert 6 hours to minutes Min←
hr (x by 60) 6hr x 60 = 360min Next, plug numbers into formula 1200mL ----------
----------- X 15 gtts/mL = 50 gtts/min 360min Example 2: Calculate the IV flow r
ate for 200mL of 0.9% NaCl IV over 120 minutes. Infusion set has a drop factor o
f 20 gtts/mL. 200mL --------------------- X 20 gtts/mL = 33 gtts/min 120min
Calculating IV Push Drugs And Safe Infusion Times
* Dosage calculations for IV push injections are the same as calculations for IM
injections. Formula: Example: Order: Ativan 3mg IV push 20 min preoperatively Su
pply: Ativan 4mg/mL with drug literature guidelines of IV infusion not to exceed
2mg/min. How much Ativan should you prepare? 3mg --------------- X 1mL= 0.75mL
4mg What is a safe infusion time? Formula: Ordered ------------- X Quantity of t
ime to infuse supply dose= infusion time Have 3mg --------------- X 1min= 3/2 mi
n =1½ min 2mg Safe infusion time = 0.75mL over 1½ min. Ordered --------------- X vol
ume Per Have= liquid required (mL) Have
Calculating IV Infusion Time When mL Is Known
* The nurse needs to know how long a volume of fluid in the IV bag at the curren
t flow rate will last, i.e.., When will a new bag need to be hung? Formula: Volu
me (mL) -------------------------- = Total hours Flow rate (mL/hr)
Example: The nurse makes rounds and notes that the current IV bag contains appro
ximately 450 mL. The IV flow rate is 150 ml/hr. How long will it be before the n
urse must hang a new bag? 450mL ---------------- = 3hr 150mL/hr