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
12345678910111211:25 AM?12:2511:2523:2510:25

Practice exercise (made-up values, not clinical guidance). A dose is charted at 11:25 AM. Which entry is the same time on the 24-hour clock? Click it.

11:25 AM
  1. 112:25
  2. 211:25
  3. 323:25
  4. 410:25
2.Nursing math & unit conversionsHard
8 mcg/min? mg/h1 h = 60 min1 mg = 1000 mcg

Practice exercise (made-up values, not clinical guidance). An infusion delivers 8 mcg/min. Express this dose rate D in mg/h.

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

A child weighing 12 kg is prescribed 7.5 mg/kg of a drug. The stock solution contains 25 mg/mL. Draw up the dose: what volume V do you give?

12 kg7.5 mg/kg25 mg/mL
V = mL
4.Dosage calculationsHard
50%stockV₁ = ? mL

You must prepare 200 mL of a 0.5% (w/v) solution from a 50% (w/v) stock solution. What volume of stock V₁ do you need?

C₁ = 50%C₂ = 0.5%V₂ = 200 mL
V₁ = mL
5.IV infusion ratesMedium
250 mL20 gtt/mL8 h? gtt/min

Infuse 250 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.

250 mL8 h20 gtt/mL
R = gtt/min
6.IV infusion ratesHard
450 mL20 gtt/mL28 gtt/mint = ? h

A drip runs at 28 gtt/min through a set of 20 gtt/mL. There are 450 mL left in the bag. How many hours t until it is empty? Round to one decimal place.

28 gtt/min20 gtt/mL450 mL
t = h
7.IV fluids & fluid balanceMedium
IntakeOutput12-hour shiftwater150 mLjuice120 mLice chips100 mLIV infusion125 mL/h × 12 hIV antibiotic2 × 50 mLurine375 mLurine225 mLurine450 mLwound drain100 mLvomit200 mL

Practice exercise (made-up values, not clinical guidance). The record shows a patient's intake and output for one 12-hour shift. The patient weighs 103 kg. Find the average urine output U in mL/kg/h. Round to two decimal places.

103 kg12 hurine: 375 mLurine: 225 mLurine: 450 mLwound drain: 100 mLvomit: 200 mL
U = mL/kg/h
8.IV fluids & fluid balanceHard
1000 mL120 mL/hstart 13:1515:45: ? mL

Practice exercise (made-up values, not clinical guidance). A 1000 mL bag was started at 13:15 and runs by pump at 120 mL/h. How many mL V are left in the bag at 15:45?

1000 mL120 mL/h13:15 → 15:45
V = mL
9.Pediatric & critical-care dosingMedium
heparin 1 000 units/mL60 units/kg · 69 kg → V = ? mL

Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 60 units/kg for a patient who weighs 69 kg. The vial contains 1 000 units/mL. What volume V do you draw up? Round to one decimal place.

60 units/kg69 kg1 000 units/mL
V = mL
10.Pediatric & critical-care dosingHard
250 mg250 mLdobutamine21 mL/h78 kg? mcg/kg/min

Practice exercise (made-up values, not clinical guidance). A dobutamine infusion of 250 mg in 250 mL runs at 21 mL/h. The patient weighs 78 kg. What dose D in mcg/kg/min is the patient receiving? Round to one decimal place.

250 mg/250 mL21 mL/h78 kg
D = mcg/kg/min
11.Pharmacy calculationsMedium
penicillin G 5 000 000 unitsdiluent addedconcentration18.2 mL250 000 units/mL8.2 mL500 000 units/mL3.2 mL1 000 000 units/mL400 000 units → ? mL

Practice exercise (made-up values, not clinical guidance). A vial of penicillin G contains 5 000 000 units. Its practice label gives three strengths (see the table). You add 8.2 mL of diluent. The prescribed dose is 400 000 units. What volume V do you draw up? Round to one decimal place.

8.2 mL → 500 000 units/mL400 000 units
V = mL
12.Pharmacy calculationsHard
2.5%150 g+0.5%hydrocortisone? g2%hydrocortisone

Practice exercise (made-up values, not clinical guidance). You have 150 g of 2.5% hydrocortisone ointment. How many grams m of 0.5% hydrocortisone ointment must you add to make a 2% ointment? Round to the nearest whole gram.

150 g · 2.5%0.5%2%
m = g

3Solutions

1.Nursing math & unit conversions

Answer: 11:25

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

11 AM → 11

Answer

11:25

Answer

11:25
2.Nursing math & unit conversions

Answer: D = 0.48 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 = 8 mcg/min × (60 min/1 h) × (1 mg/1000 mcg)

Calculate

D = 8·60/1000 = 0.48 mg/h

Answer

D = 0.48 mg/h
3.Dosage calculations

Answer: V = 3.6 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 = 7.5·12 = 90 mg

Volume

V = 90/25 = 3.6 mL

On the syringe

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

Answer

V = 3.6 mL
4.Dosage calculations

Answer: V₁ = 2 mL

Solution strengths: a percentage strength is grams per 100 mL, so 1% = 1 g/100 mL = 10 mg/mL. A ratio strength 1:1000 means 1 g in 1000 mL = 1 mg/mL; 1:10 000 is 0.1 mg/mL. For a dilution the amount of drug stays the same: C₁·V₁ = C₂·V₂.

Volume of stock

V₁ = 0.5·200/50 = 2 mL

Answer

V₁ = 2 mL
5.IV infusion rates

Answer: R = 10 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 = 250·20/480 = 10.42 ≈ 10 gtt/min

Answer

R = 10 gtt/min

At the bedside you round to the nearest whole drop: 10 gtt/min.

6.IV infusion rates

Answer: t = 5.4 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

28·60/20 = 84 mL/h

Time left

t = 450/84 = 5.357 ≈ 5.4 h

Answer

t = 5.4 h
7.IV fluids & fluid balance

Answer: U = 0.85 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

375 + 225 + 450 = 1050 mL

Per kilogram per hour

U = 1050/(103·12) = 0.8495 ≈ 0.85 mL/kg/h

Answer

U = 0.85 mL/kg/h
8.IV fluids & fluid balance

Answer: V = 700 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

13:15 → 15:45 = 2.5 h

Volume infused

120·2.5 = 300 mL

Volume left

V = 1000 − 300 = 700 mL

Answer

V = 700 mL
9.Pediatric & critical-care dosing

Answer: V = 4.1 mL

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.

Units needed

60·69 = 4 140 units

Volume

V = 4140/1000 = 4.14 ≈ 4.1 mL

Answer

V = 4.1 mL
10.Pediatric & critical-care dosing

Answer: D = 4.5 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

21·1000 = 21000 mcg/h
21000/60 = 350 mcg/min

Per kilogram

D = 350/78 = 4.487 ≈ 4.5 mcg/kg/min

Answer

D = 4.5 mcg/kg/min
11.Pharmacy calculations

Answer: V = 0.8 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.

Concentration from the label

8.2 mL → 500 000 units/mL

Volume to give

V = 400 000/500 000 = 0.8 mL

Answer

V = 0.8 mL
12.Pharmacy calculations

Answer: m = 50 g

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.

Alligation parts

2.5%: 2 − 0.5 = 1.5 parts
0.5%: 2.5 − 2 = 0.5 parts

Scale to the amount you have

m = 150·0.5/1.5 = 50 g

Answer

m = 50 g

Check: 150 g + 50 g = 200 g of 2% ointment.

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