King Faisal Specialist Hospital & Research Center

Nursing Development & Saudization

NINGP – Medication Calculation

Practice Booklet

Prepared by NINGP Team:

Modified Jan 2022

 
 CALCULATION FORMULAS

Conversions

Microgram 1000 = Milligram

Milligram 1000 = Gram
Gram 1000 = Kilogram
Milliliter 1000 = Liter
Kilogram x 1000 = Gram
Gram x 1000 = Milligram
Milligram x 1000 = Microgram
Liter x 1000 = Milliliter
Milliliter x Drop Factor = Drops
Drops Drop Factor = Milliliter
Drop Factor = Number of Drops per Milliliter

Drug Calculation

Number of Tablets per dose = Required Dose

Available Dose

Patient’s dose in ml = Required Dose x Volume (ml)

Available Dose
OR
Required Dose
Drug concentration

Drug Concentration (medication unit per ml) = Amount of drug

Total volume of fluid (ml)

Drug Dose per hour = Rate (ml per hour) x Concentration

Fluid Calculation

Fluid Rate in ml per hour = Total fluid Volume (ml)

Time (hour)

Fluid Rate in Drops per minute = Fluid Volume (ml) x Drop Factor
Time (minutes)

Fluid Volume in ml = Rate in Drops per Minute x Time (Minutes)

Drop Factor

Modified Jan 2022

Medication Calculation Review

Metric System:

 Mass

÷1000 ÷1000
Microgram Milligram Gram

Example: 100 mg = 0.1 gram

X 1000 X 1000
Gram Milligram Microgram

Example: 1 gram = 1000 mg = 1000000 mcg

 Volume:

÷1000 ÷1000
Micro-Liter Milliliter Liter

Example: 100 ml = 0.1 liter

x1000 x1000
Liter Milliliter Micro-Liter

Example: 1 liter = 1000 ml = 1000 cc

Milliliter (ml) and cubic centimeter (cc) are the same and used interchangeably

Modified Jan 2022

Law of Definite Proportions

 By the Law of Definite Proportions, IF

A C
____ ____
=
B D

Then,

AxD = BxC

BxC AxD
A = __________ B = _________

D C

AxD BxC

C = _________ D = __________
B A

Required Dose
____________________________ Volume
X
Available Dose

Example: Physician ordered 12.5 mg of Captopril (Capoten) to be administered

to a patient. The nurse found that the pharmacy supplied Captopril as 50 mg
tablets. How many tablets should the patient get?

Required Dose = 12.5 mg

_____________________________ X Volume = 1 tablet = 0.25 tablet (Quarter)
Available Dose = 50 mg

Modified Jan 2022

  The other way to solve this exercise is:

1 tablet of Captopril 50 mg

? tablet of Captopril 12.5 mg

12.5 mg X 1 tablet
? = _____________________________ = 0.25 tablet

50 mg

If you could notice, 12.5 mg is the required (ordered) dose; 50 mg is the

available (stock) dose. For managing tablets, the volume will be
considered as (1) quantity.

Example: The physician ordered morphine sulfate elixir to be given to the patient
as 20 mg oral every 6 hours. The bottle of morphine reads as: Morphine Sulfate 5
mg in 2 mls. What is the amount to be given to the patient?

Required Dose = 20 mg
_____________________________ X Volume = 2 ml = 8 ml
Available Dose = 5 mg

If you follow the Law of Definite Proportions:

2 ml
5 mg of Morphine

20 mg of Morphine ? ml

20 mg X 2 ml
? = _____________________________ = 8 ml
5 mg

Modified Jan 2022

 Fluid Rate:

(VOLUME) (ml) X (DROP FACTOR) (drops per ml)

RATE (drops per minute) = _______________________________________________

TIME (minutes)

 REMEMBER TO CONVERT TIME TO MINUTES.

 REMEMBER TO CONVERT VOLUME TO ML (SAME AS CC).
 DROP FACTOR DEPENDS ON THE GIVING SET (TUBING); HOW MANY DROPS
TO FORM ONE ML.

Rate, Time Volume, Drop Factor

(VOLUME) (ml) X (DROP FACTOR) (drops per ml)

RATE (drops per minute) = _______________________________________________

TIME (minutes)

RATE (drops per minute) X TIME (minutes)

(VOLUME) (ml) = _______________________________________________

DROP FACTOR (Drops per ml)

RATE (drops per minute) X TIME (minutes)

DROP FACTOR (Drops per ml) = _______________________________________________

(VOLUME) (ml)

(VOLUME) (ml) X (DROP FACTOR) (drops per ml)

TIME (minutes) = _______________________________________________

Modified Jan 2022

 RATE (drops per
Fluid Rate minute)

Example:
The physician ordered fluids of one liter of D/W 5% to run over 8 hours. The tubing set
delivers 15 drops per ml. What is the fluid rate?

(VOLUME) (ml) X (DROP FACTOR) (drops/ml)

RATE (drops/minute) = _______________________________________________

TIME (minutes)

1000 (ml) X 15 (drops/ml)

(drops/ml)
RATE (drops/minute) = __________________________ = 31 (drops/minute)
8 X 60 (minutes)

 WHEN DROP FACTOR IS 60 DROPS/ML, THE RATE IN DROPS/MINUTE IS THE SAME

RATE AS ML/HOUR

Drug Concentration

Drug Concentration refers to the amount of medication that is present is one ml of

volume.

Example: Heparin 25,000 Units is added to 250 ml of D/W 5%. What is the concentration
of Heparin in the bag?

Total Dose in the Bag

Concentration = ___________________________

Total Volume of the Bag

(drops/ml)

25000 Units
= ___________________ = 100 Units per ml
(drops/ml)
250 ml
(drops/ml)

Modified Jan 2022

 DOSE (gram, mg, unit)

RATE (ml per hour) = ___________________________________________

CONCENTRATION (gram, mg, unit per ml)

DOSE (gram, mg, unit) = RATE (ml/hour)

X CONCENTRATION (gram, mg, unit/ml)

Example: A patient is receiving 1000 Units of Heparin per hour intravenously. The
pharmacy delivers a bag of 500 ml of NS containing 20,000 Units of Heparin.
– What is the drug concentration?
– What is the rate of infusion in ml per hour?

TOTAL DOSE 20000 Unit

_________________ ______________ = 40 Unit per ml
CONCENTRATION = =
TOTAL VOLUME 500 ml

DOES 1000 Unit/Hour

RATE = ____________________ = ___________________ 25 ml/Hour
=
CONCENTRATION 40 Unit/ml

 The other way to solve this exercise is:

Required Dose
__________________ X Volume
Available Dose

1000 Unit/Hour
__________________ X 500 ml = 25 ml/Hour
20000 Units
Modified Jan 2022
 Example: A patient’s IV fluid is ordered as: D/W 5% + 80 mmol of Potassium
Chloride per liter, running @ 100 ml per hour. How many mmol of KCl the patient
is receiving in an hour?

DOSE (gram, mg, unit) = RATE (ml/hour)

X CONCENTRATION (gram, mg, unit/ml)

= 100 (ml/hour)
X 0.08 (mmol per ml)

= 8 (mmol/ml)

Modified Jan 2022

Law of Definite Proportions
Exercise (1)
The physician ordered 6.25 mg of Captopril to be given every 12 hours. Captopril
is available as 25 mg tablets. How many tablets would you give per dose?

Exercise (2)
Digoxin 0.250 mg is ordered and the tablet is available as 125 mcg. How many
tablets would you give to the patient?

Exercise (3)
Calcium Carbonate 1.2 g is ordered and the tablet is available as 600 mg. How
many tablets would you give to the patient?

Exercise (4)
Your patient requires 12 mg of Diazepam (Valium). The medication is available
as 20 mg in 4-ml vial. How many ml would you administer?

Exercise (5)
Morphine Sulfate elixir (Intermittent Release) is ordered as 20 mg PO Q 4 hours
PRN. The label on the Morphine bottle reads: 10 mg in 4 ml. What is the amount
(ml) of Morphine you’ll give to your patient per dose?

Exercise (6)
Your patient needs 80 mg of Methylprednisolone IV. The medication is pre-
packaged as 125 mg in 2 ml. What is the volume (ml) you’d give to your patient?

Exercise (7)
The dose of Acyclovir is to be calculated according to patient’s body weight
using the standard dose of 5 mg per Kg. What would be the dose if patient’s
body weight is 65 Kg?

If Acyclovir is to be given according to the Body Surface Area (BSA) using a

standard dose of 750 mg per m² per day, to be given in 3 divided doses, what
would be the patient’s individual dose if BSA is 1.7 m²?

Exercise (8)
Acetaminophen is ordered 15 mg/kg/dose. The child weigh 18 kg.
Acetaminophen is available as 125 mg/5ml. How many ml of medication you will
give to the child?

Answers
1. 0.25 tab
2. 2 tab
3. 2 tab
4. 2.4 ml
5. 8 ml.
6. 1.28 ml
7. a) 325 mg, b) 425 mg
8. 10.8 ml

Modified Jan 2022

Calculation of Fluid Rate

Exercise (1)
You are about to start administering packed red blood cells to a patient. The
volume of the bag is 420 ml. You will administer the transfusion over 3 hours in a
giving set that delivers 15 drops per ml. What would be the infusion rate
(drops/mt)?

Exercise (2)
Total Parenteral Nutrition (TPN) is to be administered in a giving set that delivers
20 drops per ml. The TPN volume is 1200 ml and will be given continuously over a
24-hour period. What is the rate of infusion (drops/mt)?

Exercise (3)
IV fluid-bag is running at a rate of 100 ml per hour. What is the total volume that
runs over a period of 24 hours?
What is the rate in drops per minute if the tubing delivers 10 drops per ml?

Exercise (4)
An IV fluid is running at 21 drops per minute over a period of 8 hours. What is the
volume in the bag when the tubing drop factor is 20 drops per ml?

Exercise (5)
An IV fluid is running at a rate of 40 drops/mt through a microdrip infusion set. If
the drop factor of the tubing is 60 drops per ml, what is the volume (ml) of fluid
patient receives over 6 hours
Exercise (6)
IV fluid Normal saline is ordered as 3 Liters over 24 hours. How many ml /hr would
you set the infusion pump?

Answers
1. 35 drops/minute
2. 17 drops/minute
3. 2400 ml over 24 hours, 17 drops/minute
4. 504 ml
5. 240 ml
6. 125 ml/hour

Modified Jan 2022

Drug Concentration

Exercise (1)
A patient is receiving 1200 Units of Heparin per hour intravenously. The pharmacy
delivers a bag of 250 ml of 5%Dextrose containing 25,000 Units of Heparin.
a) What is the drug concentration?

b) How many ml per hour would you set the infusion pump at?

Exercise (2)
The physician ordered IV infusion of Regular Insulin 5 Units per hour. Pharmacy
supplied 100 Units of Regular Insulin in 100 ml D/W 5%. How many ml per hour
would you set the infusion pump to deliver?

Exercise (3)
An IV solution has 150 mg of Morphine in 100 ml of NS. If the patient is receiving 2
ml per hour, how many mg of Morphine is the patient receiving per hour?

Exercise (4)
Dopamine IV is ordered 5mcg/kg/mt. Patient’s weight is 70 kg. Pharmacy
supplied Dopamine 800mg in 250 ml 5% Dextrose. How many ml/hr would you set
up the infusion pump?

Exercise (5)
A patient’s IV fluid is ordered as:
D/W 5% + 80 mmol of Potassium Chloride per liter, running @ 100 ml per hour
How many mmol of Potassium Chloride the patient is receiving per hour?

Exercise (6)
A discharge order reads: Gabapentin 1 gram PO Q 8 hours. The patient’s
medication supply has Gabapentin that is placed in two containers with labels
that read respectively: Gabapentin 300 mg per capsule and Gabapentin 400
mg per capsule. What instructions are you going to give the patient upon
discharge?

Answers
1. a) 100 units/ml, b) 12 ml/hour

2. 5 ml/hour

3. 3 mg per hour

4. 6.56 ml/hour

5. 8 mmol/hour

6. Take 2 tablets of 300 mg and 1 tablet of 400 mg per dose.

Modified Jan 2022

DRUG CALCULATION PRACTICE QUESTIONS

1. A patient is to receive 1 gm Keflin IV in 100 ml D5NS over 1 hr. How many

drops/min would you give with a drip factor of 60 drops/ml?

2. A patient is to receive 600 ml over 5 hrs. How many drops/min would you give
with a drip factor of 15 drops/ml?

3. A patient is to receive 400 ml of IVF over 6 hrs. How many drops/min would you
give with a drip factor of 60 drops/ml?

4. A patient is to receive 800 ml in 6 hrs. How many ml/hr will he get?

5. A patient is to receive 2000 ml in 24 hrs. How many mls will the patient receive
in 12 hrs?

6. A patient’s IV is running at 31 drops/min. How many ml will be administered in 1

hr? In 8-hrs? The drop factor is 15 drops/ml.

7. A patient is to receive 500 mg Cefazolin IV in 100 ml D5W over 2 hrs. How many
drops/min would you give with a drip factor of 15 drops/ml?

8. A patient is to receive 2 units of packed cells (250ml/unit) over 5 hrs. How

many ml/hr will the patient receive? How many drops/min would you give with a
drip factor of 10 drops/ml?

9. A patient is to receive Heparin IV at a rate of 1000 units/hr. If the pharmacy

delivered 500 ml of D5W with 20,000 units of Heparin, how many ml/hr should the
patient receive?

10. A patient is to receive an insulin drip continuously for 24 hrs at 25 units/hr. How
many units of insulin should be added to a 1000 ml to infuse over 24 hrs? How
many ml/hr will deliver 25 units/hr?

11. You have Aminophylline 500 mg in 250 ml. The order is for Aminophylline IV at
2 mg/min. With a drop rate of 60 drops/ml, how many drops/min should the IV be
set at?

12. You must administer three 40 meq doses of potassium chloride in 2 litres of NS
over 24 hrs. The stock available is 20 meq/10 ml. What are the total ml you need
to add to the IVF? How many drops/min should infuse with a drop factor of 60
drops/ml?

13. You must administer two 20 meq doses of potassium chloride in 3 litres of NS
over 24 hrs. The stock available is 10 meq/15 ml. What are the total ml you need
to add to the IVF? How many drops/min should infuse with a drop factor of 60
drops/ml?

Modified Jan 2022

14. You must administer four 40 meq doses of potassium chloride in 3 litres of NS
over 24 hrs. The stock available is 20 meq/10 ml. What are the total ml you need
to add to the IVF? How many drops/min should infuse with a drop factor of 60
drops/ml?

15. You need to administer Gentamycin 60 mg in 75 ml NS over 30 minutes. Using

tubing with a drop factor of 60 drops/ml, how many drops/min should you set the
infusion at?

16. You need to administer Gentamycin 80 mg in 100 ml NS over 45 minutes.

Using tubing with a drop factor of 15 drops/ml, how many drops/min should you
set the infusion at?

17. You need to administer Gentamycin 80 mg in 100 ml NS over 30 minutes.

Using tubing with a drop factor of 10 drops/ml, how many drops/min should you
set the infusion at?

18. Mr. Suliman is to have Aminophylline at 25 mg/hr. You need to add 750 mg of
Aminophylline to 1000 ml D5W. The ampules available contain Aminophylline 250
mg/ml. How many total ml. should be added to the IV bag? How many ml/hr
should you set the IV to infuse at?

19. Ms. Al Sadan is to have Aminophylline at 35 mg/hr. You need to add 250 mg
of Aminophylline to 1000 ml D5W. The ampules available contain Aminophylline
250 mg/ml. How many total ml. should be added to the IV bag? How many
ml/hr should you set the IV to infuse at?

20. Mr. Nuaim is to have Aminophylline at 25 mg/hr. You need to add 500 mg of
Aminophylline to 1000 ml D5W. The ampules available contain Aminophylline 200
mg/ml. How many total ml. should be added to the IV bag? How many ml/hr
should you set the IV to infuse at?

21. The order is for Morphine 75 mg in 250 ml D5W to infuse at 2 mg/hr. How many
mg of morphine are in each ml of IVF? How many ml/hr should you set the IV to
infuse at?

22. The order is for Morphine 50 mg in 250 ml D5W to infuse at 2 mg/hr. How many
mg of morphine are in each ml of IVF? How many ml/hr should you set the IV to
infuse at?

23. The order is for Morphine 50 mg in 500 ml D5W to infuse at 2 mg/hr. How many
mg of morphine are in each ml of IVF? How many ml/hr should you set the IV to
infuse at?

24. A patient’s IVF are infusing at 75 drops/min. The IV tubing delivers 15 drops/ml.
How many mls will infuse in 1 hr? In 8 hrs?

25. A patient’s IVF are infusing at 18 drops/min. The IV tubing delivers 60 drops/ml.
How many mls will infuse in 1 hr? In 8 hrs?

Modified Jan 2022

26. You are to give 6 units of Regular and 12 units of Lente insulin. How much
insulin should you administer?

27. A patient is to receive .125 mg Digoxin IV. Digoxin is available in ampules of

.25 mg/ml. How many ml. should you administer?

28. A patient has a continuous IV Heparin infusion at 600 units/hr. The IVF from
pharmacy contain 10,000 units Heparin in 500 ml. How many ml/hr should be
administered?

29. The nurse must administer 250 ml packed red cells over 2.5 hrs. The blood set
has a drip factor of 10 drops/ml. How many ml/hr should you infuse the blood at?
How many drops/min?

30. The patient is to have Aminophylline at 75 mg/hr. You need to add 500 mg of
Aminophylline to 1000 ml D5W. The ampules available contain Aminophylline 250
mg/10 ml. How many total ml. should be added to the IV bag? In the prepared
solution, how many mg of Aminophylline are in each ml? How many ml/hr should
you set the IV to infuse at?

31. The order is for Morphine 50 mg in 250 ml D5W to infuse at 4 mg/hr. How many
mg of morphine are in each ml of IVF? How many ml/hr should you set the IV to
infuse at? How many drops/min with a drop factor of 60 drops/ml?

32. You need to administer 40 mg Solu-medrol. Solu-medrol is supplied in 125

mg/2 ml. How many ml should you administer?

33. The order is for Morphine 20 mg in 100 ml D5W to infuse at 2 mg/hr. How many
mg of morphine are in each ml of IVF? How many ml/hr should you set the IV to
infuse at?

34. A patient’s IVF are infusing at 17 drops/min. The IV tubing delivers 10 drops/ml.
How many mls will infuse in 1 hr? In 8 hrs?

35. The order is for Lasix 20 mg. Lasix is available in 40 mg tablets. How many
tablets would you give?

36. The physician orders 2,000 units Heparin SC. The available stock is 10,000
units/ml. How many mls should you give?

37. The order is for Metroclopramide 20 mg IV. Metroclopramide is available in 10

mg/1 ml. How many mls would you give?

38. The order is for 1000 ml NS to infuse over 10 hrs. Using tubing that administers
15 drops/ml, how many drops/min should the IV infuse at?

39. A patient has a continuous IV Heparin infusion at 1200 units/hr. The IVF from
pharmacy contain 30,000 units Heparin in 1000 ml. How many ml/hr should be
administered?

Modified Jan 2022

40. A patient has a continuous IV infusion at 30 mg/hr. The IVF from pharmacy
contain 500 mg in 500 ml. How many ml/hr should be administered? Using tubing
that administers 15 drops/ml, how many drops/min should the IV infuse at?

Answers to Drug Calculation Practice Questions

1. 100 drops/min
2. 30 drops /min
3. 67 drops /min
4. 133 mls/hr
5. 1000 ml
6. 124 mls in 1 hr; 992 mls in 8 hrs
7. 12 drops /min
8. 100 ml/hr; 17 drops /min
9. 25 mls/hr
10. 600 units; 41.67 ml/hr
11. 60 drops /min
12. 60 ml; 86 drops /min
13. 60 ml; 128 drops /min
14. 80 ml; 128 drops /min
15. 150 drops /min
16. 33 drops /min
17. 33 drops /min
18. 3 ml; 33.4 ml/hr
19. 1 ml; 140.14 ml/hr
20. 2.5 ml; 50.125 ml/hr
21. 0.3 mg/ml; 6.67 ml/hr
22. 0.2 mg/ml; 10 ml/hr
23. 0.1 mg/ml; 20 ml/hr
24. 300 ml in 1 hr; 2400 ml in 8 hrs
25. 18 ml in 1 hr; 144 ml in 8 hrs
26. 18 units
27. 0.5 mls
28. 30 ml/hr
29. 100 ml/hr; 17 drops /min
30. 20 ml; 0.49 mg/ml; 153 ml/hr
31. 0.2 mg/ml; 20 ml/hr; 20 drops /min
32. 0.64 ml
33. 0.2 mg/ml; 10 ml/hr
34. 102 mls in 1 hr; 816 mls in 8 hrs
35. 0.5 tablets
36. 0.2 mls
37. 2 mls
38. 25 drops /min
39. 40 mls/hr
40. 30 mls/hr; 8 drops /min

Modified Jan 2022

Modified Jan 2022