Medication Calculations

The nurse's quick guide to drug calculations

Nurses are often intimidated by the math that occurs in everyday practice. Patient safety depends on the practitioner’s ability to calculate medications correctly and in a timely manner. This article will provide a simple and concise method for accurate computation using basic calculations

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Even with the programmable I.V. pumps commonly used in clinical settings, it is advisable for nurses to independently calculate and verify the correct dosage at least once during their shift. This frequency may increase when titrating or changing medications. Additionally, many professionals adhere to the widespread practice of verifying dosages with another registered nurse, and in some institutions, this practice is mandatory.

Understanding the therapeutic dosage required to achieve the desired effect is equally crucial as accurately calculating the drug dosage. For instance, dopamine administered at doses ranging from 3 to 5 mcg/kg/minute induces gentle dilation of the renal arteries, leading to increased urine output without affecting blood pressure. However, at higher doses (up to 20 mcg/kg/minute), dopamine is employed for blood pressure support. Familiarize yourself with the medication’s intended effects and the maximum recommended safe infusion dosage.

Nursing Responsibilities for Medication Administration

Right Patient

Prior to administering medication, it is crucial to confirm the patient's identity by asking their name and checking their identification band. Even if you are familiar with the patient, it is necessary to verify their identity to ensure accuracy.

Right Drug

The first right of drug administration involves confirming the correct name and form of the medication. It is important to be cautious of medications with similar names that can be easily confused. Mistaking medications with look-alike or sound-alike names is a common error.

Right Route

Common routes include oral, intramuscular, intravenous, topical, and subcutaneous injections. Advancements have introduced newer routes like central venous catheters, patient-controlled analgesia, epidural infusions, and intrathecal administration, adding complexity to the process.

Right Time

It is important to administer medications as prescribed, considering specific time intervals for optimal therapeutic effect. Nurses should aim to give medications within a half-hour window to avoid altering bioavailability or chemical mechanisms.

Right Dose

Medication administration errors often result from incorrect dosage, unit conversion, or substance concentration. Nurses may give the correct medication to a verified patient but at the wrong strength due to decimal misplacement, arithmetic mistakes, or unit confusion.