Nursing Math: cram pack

Formula sheets, the key method steps for every topic and 12 practice problems, with full solutions at the back.

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1Formulas and methods

Nursing math & unit conversions

Metric steps
1 kg = 1000 g, 1 g = 1000 mg, 1 mg = 1000 mcg, 1 L = 1000 mL
Weight and length
1 kg = 2.2 lb, 1 lb = 16 oz, 1 in = 2.54 cm, 1 ft = 12 in
Household measures
1 tsp = 5 mL, 1 tbsp = 15 mL, 1 fl oz = 30 mL, 1 cup = 8 fl oz = 240 mL
Temperature
°C = (°F − 32)·5/9, °F = °C·9/5 + 32
24-hour clock
PM hours 1–11: add 12; 12 AM = 00:xx; 12 PM = 12:xx
Dose rate
mcg/min × 60/1000 = mg/h
Laboratory factors
glucose 1 mmol/L = 18 mg/dL; creatinine 1 mg/dL = 88.4 µmol/L; Hb 1 g/dL = 10 g/L

Method

  1. Write the given quantity with its unit and the unit you want.
  2. Pick the equivalent: 1000 between kg, g, mg and mcg or L and mL; 1 kg = 2.2 lb; 1 tsp = 5 mL, 1 tbsp = 15 mL, 1 fl oz = 30 mL, 1 cup = 240 mL.
  3. Write it as a fraction so that the unwanted unit cancels; for a rate, use one fraction per unit that changes.
  4. Check the direction: a smaller unit gives a bigger number.
  5. Round only the final answer, to the precision the question names.

Dosage calculations

Dose from strength
volume = dose / strength
Weight-based dose
dose = mg/kg × body weight
Tablets
number = dose / tablet strength
Units
1 g = 1000 mg, 1 mg = 1000 mcg

Method

  1. Convert the ordered dose and the stock strength to the same unit.
  2. Use desired over have times quantity: (D/H) × Q.
  3. For weight-based doses, multiply by the weight in kg first, then divide the daily dose by the number of doses.
  4. Estimate first and check that the answer is reasonable.

IV infusion rates

Pump rate
mL/h = volume (mL)/time (h)
Drip rate
drops/min = volume (mL) × drop factor / time (min)
Infusion time
time (h) = volume (mL)/rate (mL/h)

Method

  1. Pump rate in mL/h: volume divided by time in hours.
  2. Drip rate in drops/min: volume × drop factor divided by time in minutes.
  3. For time remaining: volume left divided by the rate.
  4. Round as the question or the equipment requires.

IV fluids & fluid balance

Holliday–Segar per hour
4 mL/kg (first 10 kg) + 2 mL/kg (next 10 kg) + 1 mL/kg (each kg above 20)
Holliday–Segar per day
100 / 50 / 20 mL/kg for the same bands
Fluid balance
intake − output
Ice chips
count as half their volume
Urine output
mL/kg/h = mL / (kg × h)
Infusion time
time (h) = volume left (mL) / rate (mL/h)
Volume infused
mL = rate × time

Pediatric & critical-care dosing

Daily dose
mg/day = mg/kg/day × weight (kg)
Doses per day
number = 24 h / dosing interval (h)
Pounds to kilograms
kg = lb / 2.2
Infusion concentration
units/mL = units in bag / bag volume
Pump rate
mL/h = dose per hour / concentration
Titrated drip
mL/h = mcg/kg/min × kg × 60 / (mcg/mL)
Dose from pump rate
mcg/kg/min = mL/h × (mcg/mL) / (60 × kg)
Units
1 mg = 1000 mcg

Pharmacy calculations

Percentage strength
% w/v = g per 100 mL
Amount in a solution
g = % × mL / 100
Ratio strength
1:X = 1 g in X mL; % = 100 / X
Reconstitution
final volume = diluent + powder volume
Concentration
mg/mL = drug in vial / final volume
Alligation
parts of H = T − L, parts of L = H − T
Water or base
0%

2Practice problems

1.Nursing math & unit conversionsMedium
1234567891011127:00 PM?19:0018:0007:0020:00

Practice exercise (made-up values, not clinical guidance). A dose is charted at 7:00 PM. Which entry is the same time on the 24-hour clock? Click it.

7:00 PM
  1. 119:00
  2. 218:00
  3. 307:00
  4. 420:00
2.Nursing math & unit conversionsHard
20 mcg/min? mg/h1 h = 60 min1 mg = 1000 mcg

Practice exercise (made-up values, not clinical guidance). An infusion delivers 20 mcg/min. Express this dose rate D in mg/h.

20 mcg/min1 h = 60 min1 mg = 1000 mcg
D = mg/h
3.Dosage calculationsMedium
024681010 mL

A child weighing 16 kg is prescribed 2.5 mg/kg of a drug. The stock solution contains 20 mg/mL. Draw up the dose: what volume V do you give?

16 kg2.5 mg/kg20 mg/mL
V = mL
4.Dosage calculationsHard
00.10.20.30.40.50.60.70.80.911 mL

The prescription is 455 micrograms. The ampoule contains 0.5 mg/mL. Draw up the dose in the 1 mL syringe: what volume V do you give?

455 mcg0.5 mg/mL
V = mL
5.IV infusion ratesMedium
1500 mL10 gtt/mL4 h? gtt/min

Infuse 1500 mL over 4 hours with a giving set of 10 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.

1500 mL4 h10 gtt/mL
R = gtt/min
6.IV infusion ratesHard
50 mg500 mL3 mL/h? mcg/min

An infusion of 50 mg in 500 mL runs at 3 mL/h. How many micrograms per minute D does the patient receive?

50 mg/500 mL3 mL/h
D = mcg/min
7.IV fluids & fluid balanceMedium
IntakeOutput8-hour shiftjelly120 mLsoup150 mLwater300 mLIV infusion60 mL/h × 8 hIV antibiotic1 × 50 mLurine425 mLurine275 mLvomit150 mL

Practice exercise (made-up values, not clinical guidance). The record shows a patient's intake and output for one 8-hour shift. The patient weighs 100 kg. Find the average urine output U in mL/kg/h. Round to two decimal places.

100 kg8 hurine: 425 mLurine: 275 mLvomit: 150 mL
U = mL/kg/h
8.IV fluids & fluid balanceHard
1000 mL50 mL/hstart 12:0015:30: ? mL

Practice exercise (made-up values, not clinical guidance). A 1000 mL bag was started at 12:00 and runs by pump at 50 mL/h. How many mL V are left in the bag at 15:30?

1000 mL50 mL/h12:00 → 15:30
V = mL
9.Pediatric & critical-care dosingMedium
50 units50 mLregular insulin? mL/h1.5 units/h

Practice exercise (made-up values, not clinical guidance). An infusion contains 50 units of regular insulin in 50 mL. The order is 1.5 units/h. Find the pump rate R in mL/h. Round to one decimal place.

50 units/50 mL1.5 units/h
R = mL/h
10.Pediatric & critical-care dosingHard
250 mg250 mLdobutamine4 mL/h63 kg? mcg/kg/min

Practice exercise (made-up values, not clinical guidance). A dobutamine infusion of 250 mg in 250 mL runs at 4 mL/h. The patient weighs 63 kg. What dose D in mcg/kg/min is the patient receiving? Round to one decimal place.

250 mg/250 mL4 mL/h63 kg
D = mcg/kg/min
11.Pharmacy calculationsMedium
cefuroxime 750 mgAdd 7.2 mL sterile water.Powder volume: 0.3 mL.? mg/mL

Practice exercise (made-up values, not clinical guidance). A vial contains cefuroxime 750 mg as a powder. The practice label says to add 7.2 mL of sterile water; the powder adds 0.3 mL to the volume. What is the concentration C in mg/mL after reconstitution?

750 mg7.2 mL+0.3 mL
C = mg/mL
12.Pharmacy calculationsHard
0123455 mL

A vial holds 2000 mg of powder. You add 3.5 mL of diluent, and the powder adds 0.5 mL of volume. The prescription is 1300 mg. Draw up the dose: what volume V do you give?

2000 mg3.5 mL + 0.5 mL1300 mg
V = mL

3Solutions

1.Nursing math & unit conversions

Answer: 19:00

24-hour clock: from 1 PM onwards add 12 to the hour (3:45 PM = 15:45). Midnight to 12:59 AM is 00:00–00:59, and 12:00–12:59 PM stays 12:00–12:59. Going back, subtract 12 from hours 13–23 and add PM; hours 00 become 12 AM. Count time across midnight in two parts: up to 24:00 (00:00), then from 00:00 on.

Convert the hour

7 PM → 7 + 12 = 19

Answer

19:00

Answer

19:00
2.Nursing math & unit conversions

Answer: D = 1.2 mg/h

Dimensional analysis: write the given quantity, then multiply by conversion factors written as fractions (for example 60 min/1 h or 1 mg/1000 mcg) so that each unwanted unit appears once on top and once underneath and cancels. When only the wanted unit is left, calculate. Use the equivalents the question gives and round only the final answer.

Set up the chain

D = 20 mcg/min × (60 min/1 h) × (1 mg/1000 mcg)

Calculate

D = 20·60/1000 = 1.2 mg/h

Answer

D = 1.2 mg/h
3.Dosage calculations

Answer: V = 2 mL

Drawing up a dose: volume = (prescribed dose/stock strength) × stock volume. Convert to the same units first, then check that the volume fits the syringe and lands on one of its graduations.

Dose from body weight

D = 2.5·16 = 40 mg

Volume

V = 40/20 = 2 mL

On the syringe

On this 10 mL syringe every small line is 0.2 mL.

Answer

V = 2 mL
4.Dosage calculations

Answer: V = 0.91 mL

Drawing up a dose: volume = (prescribed dose/stock strength) × stock volume. Convert to the same units first, then check that the volume fits the syringe and lands on one of its graduations.

Same units

0.5 mg/mL = 500 mcg/mL

Volume

V = 455/500 = 0.91 mL

Answer

V = 0.91 mL
5.IV infusion rates

Answer: R = 63 gtt/min

Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.

Time in minutes

4·60 = 240 min

Drip rate

R = 1500·10/240 = 62.5 ≈ 63 gtt/min

Answer

R = 63 gtt/min

At the bedside you round to the nearest whole drop: 63 gtt/min.

6.IV infusion rates

Answer: D = 5 mcg/min

Dose-based infusions: concentration = amount of drug in the bag/bag volume. Pump rate (mL/h) = dose per hour/concentration, and dose per hour = mL/h × concentration. Convert per-minute doses to per-hour (× 60) and keep the mass units the same (1 g = 1000 mg, 1 mg = 1000 mcg).

Concentration

50000 mcg/500 mL = 100 mcg/mL

Dose per hour

3·100 = 300 mcg/h

Dose per minute

D = 300/60 = 5 mcg/min

Answer

D = 5 mcg/min
7.IV fluids & fluid balance

Answer: U = 0.88 mL/kg/h

Intake and output: intake counts everything that goes in (oral fluids, IV infusions, IV medications and flushes, tube feeds); ice chips count as half their volume. Output counts urine, drains, vomit and other losses. Balance = total intake − total output; a negative balance is a net loss. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.

Total urine

425 + 275 = 700 mL

Per kilogram per hour

U = 700/(100·8) = 0.875 ≈ 0.88 mL/kg/h

Answer

U = 0.88 mL/kg/h
8.IV fluids & fluid balance

Answer: V = 825 mL

Infusion time: time (h) = volume to infuse (mL)/rate (mL/h); use the volume still left in the bag, not the bag size. Volume infused = rate × time. Convert decimal hours to hours and minutes with the fraction × 60 (0.5 h = 30 min, not 50 min). The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.

Elapsed time

12:00 → 15:30 = 3.5 h

Volume infused

50·3.5 = 175 mL

Volume left

V = 1000 − 175 = 825 mL

Answer

V = 825 mL
9.Pediatric & critical-care dosing

Answer: R = 1.5 mL/h

Heparin and insulin infusions: concentration = units in the bag/bag volume (units/mL). Pump rate (mL/h) = units per hour/concentration, and units per hour = mL/h × concentration. For a weight-based order, units/h = units/kg/h × weight first. A bolus volume = units needed/vial strength. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.

Concentration

50/50 = 1 units/mL

Pump rate

R = 1.5/1 = 1.5 mL/h

Answer

R = 1.5 mL/h
10.Pediatric & critical-care dosing

Answer: D = 1.1 mcg/kg/min

Titrated drips: first find the concentration in mcg/mL (mg × 1000/mL). For a weight-based order, mcg/min = mcg/kg/min × weight. Then mL/h = mcg/min × 60/concentration. Working backwards, mcg/kg/min = mL/h × concentration/(60 × weight). The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.

Concentration

250 000/250 = 1000 mcg/mL

Micrograms per minute

4·1000 = 4000 mcg/h
4000/60 = 66.67 mcg/min

Per kilogram

D = 66.67/63 = 1.058 ≈ 1.1 mcg/kg/min

Answer

D = 1.1 mcg/kg/min
11.Pharmacy calculations

Answer: C = 100 mg/mL

Reconstitution: the powder takes up space, so the final volume is the diluent plus the powder volume. Concentration = drug in the vial/final volume, and the volume to give = dose/concentration. On a multi-strength label, use the concentration that belongs to the amount of diluent you actually added. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.

Final volume

7.2 + 0.3 = 7.5 mL

Concentration

C = 750/7.5 = 100 mg/mL

Answer

C = 100 mg/mL
12.Pharmacy calculations

Answer: V = 2.6 mL

Strength to volume: turn the strength into mg per mL first. A w/v percentage is grams per 100 mL, so x% = 10x mg/mL. A ratio strength 1:n is 1 g in n mL. After reconstitution the concentration is the powder's dose over the final volume (diluent + powder volume). Then volume = dose/concentration.

Final volume and concentration

3.5 + 0.5 = 4 mL
C = 2000/4 = 500 mg/mL

Volume

V = 1300/500 = 2.6 mL

Answer

V = 2.6 mL

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