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 drip-rate calculation gives 115.429 gtt/min. The rule in this exercise is that drip rates are rounded to the nearest whole drop. What value x do you record?
115.429 gtt/min
x = gtt/min
2.Nursing math & unit conversionsHard
Practice exercise (made-up values, not clinical guidance). During a shift a patient takes 2 fl oz of juice, 2 cups of tea, ½ tsp of cough syrup, 4 tbsp of liquid supplement. Using the equivalents given, find the total oral intake V in mL.
1 fl oz = 30 mL1 cup = 8 fl oz = 240 mL1 tsp = 5 mL1 tbsp = 15 mL
V = mL
3.Dosage calculationsMedium
A child weighing 16 kg is prescribed 2 mg/kg of a drug. The stock solution contains 10 mg/mL. Draw up the dose: what volume V do you give?
16 kg2 mg/kg10 mg/mL
V = mL
4.Dosage calculationsHard
A patient weighs 149.6 lb. The prescription is 2 mg/kg as a single dose, and the stock contains 200 mg in 5 mL. Using 1 kg = 2.2 lb, what volume V do you give?
149.6 lb2 mg/kg200 mg/5 mL1 kg = 2.2 lb
V = mL
5.IV infusion ratesMedium
Infuse 1500 mL over 10 hours with a giving set of 15 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.
1500 mL10 h15 gtt/mL
R = gtt/min
6.IV infusion ratesHard
A bag contains 250 mg of a drug in 50 mL and runs at 10 mL/h. How many milligrams per hour D does the patient receive?
250 mg/50 mL10 mL/h
D = mg/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 12-hour shift. The IV infusion ran at the rate shown for the whole shift. Find the total intake I in mL. Count ice chips as half their volume.
Practice exercise (made-up values, not clinical guidance). A 1000 mL infusion starts at 13:00 at 150 mL/h. After 3 hours the rate is changed to 125 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 · 3 h125 mL/h
t = h
9.Pediatric & critical-care dosingMedium
Practice exercise (made-up values, not clinical guidance). An infusion of 50 units of regular insulin in 50 mL runs at 3 mL/h. How many units per hour D does the patient receive?
50 units/50 mL3 mL/h
D = units/h
10.Pediatric & critical-care dosingHard
Practice exercise (made-up values, not clinical guidance). A patient who weighs 78 kg has an order for norepinephrine at 4 mcg/min. The bag contains 4 mg in 250 mL. Find the pump rate R in mL/h. Round to one decimal place.
4 mg/250 mL4 mcg/min78 kg
R = mL/h
11.Pharmacy calculationsMedium
A solution has a ratio strength of 1:1000. You need 0.17 mg. Draw up the volume in the 1 mL syringe: what volume V is that?
1:10000.17 mg
V = mL
12.Pharmacy calculationsHard
A vial holds 250 mg of powder. You add 9.6 mL of diluent, and the powder adds 0.4 mL of volume. The prescription is 20 mg. Draw up the dose: what volume V do you give?
250 mg9.6 mL + 0.4 mL20 mg
V = mL
3Solutions
1.Nursing math & unit conversions
Answer: x = 115 gtt/min
Rounding: look at the digit just after the place you round to: 5 or more rounds up, 4 or less leaves the digit as it is. Round only the final answer, never the steps. Typical exam rules: volumes of 1 mL or more to the nearest tenth, volumes below 1 mL to the nearest hundredth, drip rates to whole drops and weights to one decimal place; always follow the rule the question states.
Digit in the ones place
115.429 → 5
Only the next digit decides
115.429 → 4
4 is 4 or less, so 5 stays.
The digits after it (29) are ignored: round once, never step by step.
Round
x = 115 gtt/min
Answer
x = 115 gtt/min
2.Nursing math & unit conversions
Answer: V = 602.5 mL
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.
Each item in mL
2 fl oz = 2·30 = 60 mL
2 cups = 2·240 = 480 mL
½ tsp = 0.5·5 = 2.5 mL
4 tbsp = 4·15 = 60 mL
Add
V = 60 + 480 + 2.5 + 60 = 602.5 mL
Answer
V = 602.5 mL
3.Dosage calculations
Answer: V = 3.2 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 = 2·16 = 32 mg
Volume
V = 32/10 = 3.2 mL
On the syringe
On this 10 mL syringe every small line is 0.2 mL.
Answer
V = 3.2 mL
4.Dosage calculations
Answer: V = 3.4 mL
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.
Weight in kg
149.6/2.2 = 68 kg
Dose
2·68 = 136 mg
Volume
V = (136/200)·5 = 3.4 mL
Answer
V = 3.4 mL
5.IV infusion rates
Answer: R = 38 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
10·60 = 600 min
Drip rate
R = 1500·15/600 = 37.5 ≈ 38 gtt/min
Answer
R = 38 gtt/min
At the bedside you round to the nearest whole drop: 38 gtt/min.
6.IV infusion rates
Answer: D = 50 mg/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.
Concentration
250/50 = 5 mg/mL
Dose rate
D = 5·10 = 50 mg/h
Answer
D = 50 mg/h
7.IV fluids & fluid balance
Answer: I = 1520 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.
Add the intake
oral: 300 + 200 + 200 = 700 mL
ice chips: 240/2 = 120 mL
IV infusion: 50·12 = 600 mL
IV antibiotic: 1·100 = 100 mL
I = 1520 mL
Answer
I = 1520 mL
8.IV fluids & fluid balance
Answer: t = 7.4 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
150·3 = 450 mL
1000 − 450 = 550 mL left
Second part
550/125 = 4.4 h
Total time
t = 3 + 4.4 = 7.4 h
Answer
t = 7.4 h
That is about 7 h 24 min, so the bag runs out at about 20:24.
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
50/50 = 1 units/mL
Units per hour
D = 3·1 = 3 units/h
Answer
D = 3 units/h
10.Pediatric & critical-care dosing
Answer: R = 15 mL/h
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
4 000/250 = 16 mcg/mL
Dose per hour
The order is per minute for the whole patient, so the weight is not needed.
4·60 = 240 mcg/h
Pump rate
R = 240/16 = 15 mL/h
Answer
R = 15 mL/h
11.Pharmacy calculations
Answer: V = 0.17 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 = 0.17/1 = 0.17 mL
Answer
V = 0.17 mL
12.Pharmacy calculations
Answer: V = 0.8 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.