Write the given quantity with its unit and the unit you want.
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.
Write it as a fraction so that the unwanted unit cancels; for a rate, use one fraction per unit that changes.
Check the direction: a smaller unit gives a bigger number.
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
Convert the ordered dose and the stock strength to the same unit.
Use desired over have times quantity: (D/H) × Q.
For weight-based doses, multiply by the weight in kg first, then divide the daily dose by the number of doses.
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
Pump rate in mL/h: volume divided by time in hours.
Drip rate in drops/min: volume × drop factor divided by time in minutes.
For time remaining: volume left divided by the rate.
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
Practice exercise (made-up values, not clinical guidance). A patient is 151 cm tall. Using 1 in = 2.54 cm, find the height h in inches. Round to one decimal place.
151 cm1 in = 2.54 cm
h = in
2.Nursing math & unit conversionsHard
Practice exercise (made-up values, not clinical guidance). An infusion delivers 8 mg/h. Express this dose rate D in mcg/min. Round to one decimal place.
8 mg/h1 mg = 1000 mcg1 h = 60 min
D = mcg/min
3.Dosage calculationsMedium
A child weighing 6 kg is prescribed 4 mg/kg of a drug. The stock solution contains 10 mg/mL. Draw up the dose: what volume V do you give?
6 kg4 mg/kg10 mg/mL
V = mL
4.Dosage calculationsHard
An infusion contains 20000 units of a drug in 500 mL. The prescription is 1500 units per hour. At what rate R do you set the pump, in mL/h?
20000 units/500 mL1500 units/h
R = mL/h
5.IV infusion ratesMedium
Infuse 500 mL over 8 hours with a giving set of 20 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
500 mL8 h20 gtt/mL
R = gtt/min
6.IV infusion ratesHard
A drip runs at 25 gtt/min through a set of 60 gtt/mL. There are 400 mL left in the bag. How many hours t until it is empty?
25 gtt/min60 gtt/mL400 mL
t = h
7.IV fluids & fluid balanceMedium
Practice exercise (made-up values, not clinical guidance). The record shows a patient's intake and output for one 8-hour shift. The IV infusion ran at the rate shown for the whole shift. Find the fluid balance B = intake − output in mL (a negative answer means a net loss). Count ice chips as half their volume.
Practice exercise (made-up values, not clinical guidance). A 1000 mL infusion starts at 07:00 at 150 mL/h. After 4 hours the rate is changed to 80 mL/h and is not changed again. How many hours t after the start will the bag be empty? Round to one decimal place.
1000 mL150 mL/h · 4 h80 mL/h
t = h
9.Pediatric & critical-care dosingMedium
Practice exercise (made-up values, not clinical guidance). An infusion of 100 units of regular insulin in 100 mL runs at 3 mL/h. How many units per hour D does the patient receive?
100 units/100 mL3 mL/h
D = units/h
10.Pediatric & critical-care dosingHard
Practice exercise (made-up values, not clinical guidance). A dobutamine infusion of 500 mg in 250 mL runs at 28 mL/h. The patient weighs 92 kg. What dose D in mcg/kg/min is the patient receiving? Round to one decimal place.
500 mg/250 mL28 mL/h92 kg
D = mcg/kg/min
11.Pharmacy calculationsMedium
A solution has a ratio strength of 1:1000. You need 0.21 mg. Draw up the volume in the 1 mL syringe: what volume V is that?
1:10000.21 mg
V = mL
12.Pharmacy calculationsHard
Practice exercise (made-up values, not clinical guidance). You must prepare 450 mL of 20% dextrose by mixing 50% and 5% dextrose. How many mL V of the 5% solution do you need? Round to the nearest whole mL.
50%5%20%450 mL
V = mL
3Solutions
1.Nursing math & unit conversions
Answer: h = 59.4 in
Household measures and weight: nursing exams use rounded equivalents: 1 teaspoon (tsp) = 5 mL, 1 tablespoon (tbsp) = 15 mL = 3 tsp, 1 fluid ounce (fl oz) = 30 mL = 2 tbsp, and 1 cup = 8 fl oz = 240 mL. For weight, 1 kg = 2.2 lb and 1 lb = 16 oz; for length, 1 inch = 2.54 cm. Set the conversion up so that the unit you do not want cancels out.
Centimetres to inches
h = 151/2.54 = 59.45 ≈ 59.4 in
Answer
h = 59.4 in
2.Nursing math & unit conversions
Answer: D = 133.3 mcg/min
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 = 8 mg/h × (1000 mcg/1 mg) × (1 h/60 min)
Calculate
D = 8000/60 = 133.3 mcg/min
Answer
D = 133.3 mcg/min
3.Dosage calculations
Answer: V = 2.4 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 = 4·6 = 24 mg
Volume
V = 24/10 = 2.4 mL
On the syringe
On this 10 mL syringe every small line is 0.2 mL.
Answer
V = 2.4 mL
4.Dosage calculations
Answer: R = 37.5 mL/h
Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.
Concentration
20000/500 = 40 units/mL
Pump rate
R = 1500/40 = 37.5 mL/h
Answer
R = 37.5 mL/h
5.IV infusion rates
Answer: R = 21 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
8·60 = 480 min
Drip rate
R = 500·20/480 = 20.83 ≈ 21 gtt/min
Answer
R = 21 gtt/min
At the bedside you round to the nearest whole drop: 21 gtt/min.
6.IV infusion rates
Answer: t = 16 h
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.
Rate in mL/h
25·60/60 = 25 mL/h
Time left
t = 400/25 = 16 h
Answer
t = 16 h
7.IV fluids & fluid balance
Answer: B = 370 mL
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 intake
oral: 200 + 200 + 100 = 500 mL
ice chips: 240/2 = 120 mL
IV infusion: 50·8 = 400 mL
IV antibiotic: 1·50 = 50 mL
total intake = 1070 mL
Total output
150 + 325 + 225 = 700 mL
Balance
B = 1070 − 700 = 370 mL
Answer
B = 370 mL
Positive: more fluid went in than came out.
8.IV fluids & fluid balance
Answer: t = 9 h
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.
First part
150·4 = 600 mL
1000 − 600 = 400 mL left
Second part
400/80 = 5 h
Total time
t = 4 + 5 = 9 h
Answer
t = 9 h
That is about 9 h 00 min, so the bag runs out at about 16:00.
9.Pediatric & critical-care dosing
Answer: D = 3 units/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
100/100 = 1 units/mL
Units per hour
D = 3·1 = 3 units/h
Answer
D = 3 units/h
10.Pediatric & critical-care dosing
Answer: D = 10.1 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
500 000/250 = 2000 mcg/mL
Micrograms per minute
28·2000 = 56000 mcg/h
56000/60 = 933.3 mcg/min
Per kilogram
D = 933.3/92 = 10.14 ≈ 10.1 mcg/kg/min
Answer
D = 10.1 mcg/kg/min
11.Pharmacy calculations
Answer: V = 0.21 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.
Strength in mg/mL
1000 mg/1000 mL = 1 mg/mL
Volume
V = 0.21/1 = 0.21 mL
Answer
V = 0.21 mL
12.Pharmacy calculations
Answer: V = 300 mL
Alligation: to mix a higher strength H and a lower strength L into a target strength T, take (T − L) parts of H and (H − T) parts of L. The parts are crossed: each stock gets the distance from the target to the other stock. Water or a plain base counts as 0%. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.