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
12345678910111217:10?4:10 PM7:10 PM5:10 AM5:10 PM

Practice exercise (made-up values, not clinical guidance). A dose is charted at 17:10 (24-hour clock). Which entry is the same time on the 12-hour clock? Click it.

17:10
  1. 14:10 PM
  2. 27:10 PM
  3. 35:10 AM
  4. 45:10 PM
2.Nursing math & unit conversionsHard
2 tsp · 4/day · 10 d? × 150 mL1 tsp = 5 mL

Practice exercise (made-up values, not clinical guidance). A prescription reads 2 tsp of an oral suspension four times a day for 10 days. The suspension comes in 150 mL bottles. Using 1 tsp = 5 mL, how many whole bottles N must be supplied so the course is complete?

2 tspfour times a day10 days150 mL1 tsp = 5 mL
N =
3.Dosage calculationsMedium
024681010 mL

A child weighing 30 kg is prescribed 2 mg/kg of a drug. The stock solution contains 50 mg/mL. Draw up the dose: what volume V do you give?

30 kg2 mg/kg50 mg/mL
V = mL
4.Dosage calculationsHard
40 mg/1 mLV = ? mL

A child weighing 8 kg is prescribed 10 mg/kg per dose of an oral suspension that contains 40 mg in 1 mL. What volume V do you give?

8 kg10 mg/kg40 mg/1 mL
V = mL
5.IV infusion ratesMedium
1000 mL15 gtt/mL3 h? gtt/min

Infuse 1000 mL over 3 hours with a giving set of 15 gtt/mL. Find the drip rate R in drops per minute. Round to the nearest whole number.

1000 mL3 h15 gtt/mL
R = gtt/min
6.IV infusion ratesHard
600 mL20 gtt/mL32 gtt/mint = ? h

A drip runs at 32 gtt/min through a set of 20 gtt/mL. There are 600 mL left in the bag. How many hours t until it is empty? Round to one decimal place.

32 gtt/min20 gtt/mL600 mL
t = h
7.IV fluids & fluid balanceMedium
IntakeOutput8-hour shiftsoup250 mLjelly120 mLtea240 mLIV infusion50 mL/h × 8 hIV antibiotic2 × 50 mLurine400 mLurine250 mLurine475 mLurine150 mL

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 total intake I in mL.

soup: 250 mLjelly: 120 mLtea: 240 mLIV infusion: 50 mL/h × 8 hIV antibiotic: 2 × 50 mL
I = mL
8.IV fluids & fluid balanceHard
500 mL50 mL/hstart 11:1518:45: ? mL

Practice exercise (made-up values, not clinical guidance). A 500 mL bag was started at 11:15 and runs by pump at 50 mL/h. How many mL V are left in the bag at 18:45?

500 mL50 mL/h11:15 → 18:45
V = mL
9.Pediatric & critical-care dosingMedium
20 000 units500 mLheparin? mL/h103 kg15 units/kg/h

Practice exercise (made-up values, not clinical guidance). A bag contains 20 000 units of heparin in 500 mL. The order is 15 units/kg/h for a patient who weighs 103 kg. At what rate R do you set the pump, in mL/h? Round to one decimal place.

20 000 units/500 mL15 units/kg/h103 kg
R = mL/h
10.Pediatric & critical-care dosingHard
800 mg500 mLdopamine? mL/h106 kg6 mcg/kg/min

Practice exercise (made-up values, not clinical guidance). A bag contains dopamine 800 mg in 500 mL. The order is 6 mcg/kg/min for a patient who weighs 106 kg. At what rate R do you set the pump, in mL/h? Round to one decimal place.

800 mg/500 mL6 mcg/kg/min106 kg
R = mL/h
11.Pharmacy calculationsMedium
024681010 mL

A solution has a ratio strength of 1:10 000. You need 0.28 mg. Draw up the volume in the 10 mL syringe: what volume V is that?

1:10 0000.28 mg
V = mL
12.Pharmacy calculationsHard
0123455 mL

A vial holds 2000 mg of powder. You add 4.6 mL of diluent, and the powder adds 0.4 mL of volume. The prescription is 520 mg. Draw up the dose: what volume V do you give?

2000 mg4.6 mL + 0.4 mL520 mg
V = mL

3Solutions

1.Nursing math & unit conversions

Answer: 5:10 PM

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

17 − 12 = 5 → PM

Answer

5:10 PM

Answer

5:10 PM
2.Nursing math & unit conversions

Answer: N = 3

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.

Total volume

10 mL × 4 × 10 = 400 mL

Bottles

400/150 = 2.667 → N = 3

Answer

N = 3
3.Dosage calculations

Answer: V = 1.2 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 = 2·30 = 60 mg

Volume

V = 60/50 = 1.2 mL

On the syringe

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

Answer

V = 1.2 mL
4.Dosage calculations

Answer: V = 2 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.

Dose from weight

10·8 = 80 mg

Volume

V = (80/40)·1 = 2 mL

Answer

V = 2 mL
5.IV infusion rates

Answer: R = 83 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

3·60 = 180 min

Drip rate

R = 1000·15/180 = 83.33 ≈ 83 gtt/min

Answer

R = 83 gtt/min

At the bedside you round to the nearest whole drop: 83 gtt/min.

6.IV infusion rates

Answer: t = 6.3 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

32·60/20 = 96 mL/h

Time left

t = 600/96 = 6.25 ≈ 6.3 h

Answer

t = 6.3 h
7.IV fluids & fluid balance

Answer: I = 1110 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: 250 + 120 + 240 = 610 mL
IV infusion: 50·8 = 400 mL
IV antibiotic: 2·50 = 100 mL
I = 1110 mL

Answer

I = 1110 mL
8.IV fluids & fluid balance

Answer: V = 125 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

11:15 → 18:45 = 7.5 h

Volume infused

50·7.5 = 375 mL

Volume left

V = 500 − 375 = 125 mL

Answer

V = 125 mL
9.Pediatric & critical-care dosing

Answer: R = 38.6 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.

Units per hour

15·103 = 1 545 units/h

Concentration

20 000/500 = 40 units/mL

Pump rate

R = 1545/40 = 38.63 ≈ 38.6 mL/h

Answer

R = 38.6 mL/h
10.Pediatric & critical-care dosing

Answer: R = 23.9 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

800 mg = 800 000 mcg
800 000/500 = 1600 mcg/mL

Dose per minute and per hour

6·106 = 636 mcg/min
636·60 = 38160 mcg/h

Pump rate

R = 38160/1600 = 23.85 ≈ 23.9 mL/h

Answer

R = 23.9 mL/h
11.Pharmacy calculations

Answer: V = 2.8 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.

Strength in mg/mL

1000 mg/10 000 mL = 0.1 mg/mL

Volume

V = 0.28/0.1 = 2.8 mL

Answer

V = 2.8 mL
12.Pharmacy calculations

Answer: V = 1.3 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

4.6 + 0.4 = 5 mL
C = 2000/5 = 400 mg/mL

Volume

V = 520/400 = 1.3 mL

Answer

V = 1.3 mL

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