Solutions To Dosages

Clinical

Dosages

Study Guides

Some people are not so happy about this class because it involves numbers and stuff and a lot of people do not like numbers.

And just remember when you're taking those clinical dosage tests, you have FOUR tries. How fun- you get to work yourself into a  nervous frenzy four times (then you fail). Just kidding, I don't actually know anyone who didn't make it at least on time #4. 

Nothing can make me lose sleep like a dosages test and my hands sweat just thinking about it. Once my friend James said as a joke, "Math test today!" (he's a riot). Instant tachycardia and diaphoresis. Then five minutes later, my teacher said FOR REAL , "It's time for the math test." I had to be defibrillated. How did I miss that it was dosage test day?

So in case you just failed test #3 or just want some extra practice for Dosages and Solutions, here are some resources:

PRACTICE SHEETS

Lots Of Practice Problems With Answers

This is REALLY REALLY REALLY good:

DosageHelp.Com

Quizzes And Explanations Page

100 Dosage Problems

VIDEOS

Are You Scared Of Clinical Math?

A Rather Nice Dosages Channel

Khan Academy Gets In On The Action-Unit Conversions

Australian Clinical Math

(which is the same as American clinical math, just with a nicer accent)

Five Rights/Med Admin/Routes

Fundamentals Of Medication Administration

Types Of Insulin

Simple Nursing-Insulin

APPS

Apps

Mr. S's Rounding Rules:

That sounds like a kids' show or something

(These are, like, official and stuff)

Zero Rules for Decimals

1.    All numbers less than 1 must have a zero placed before the decimal point.

a.    Example:  .5 should be written 0.5

b.    Example:  .032 should be written 0.032

2.    Leave no trailing zeros after the decimal point.

a.    Example:  3.0 should be written 3

b.    Example:  5.380 should be written 5.38

c.    Example:  6.2003700 should be written 6.20037

Decimal Rounding-Off Rule

1.     Determine to which place value to the right of the decimal point you are rounding off the number.  Look at the digit following that place value.

a.    If that digit is 5 or larger, then drop that digit and add 1 to the previous digit.

                                          i.    Example: 5.26 rounded to the tenths place = 5.3

b.    If that digit is 4 or less, then drop that digit.

                                          i.    Example: 5.234 rounded to the hundredths place = 5.23

2.    Weights and Temperatures should be rounded to tenths.

Syringe Selection

1.    Dosages more than 1 mL in volume should be calculated and rounded off to the tenths place and then administered in a 3-mL syringe.

2.    Dosages less than 0.5 mL in volume should be calculated and rounded off to the hundredths place and then administered in a 1-mL syringe.

3.    Dosages more than 0.5 mL and less than 1 mL in volume can be calculated and administered in either a 1-mL syringe (round calculation to hundredths) or a 3-mL syringe (round calculation to tenths).

IV Rounding

1.  IV rates calculated in drops per minute (gtt/min) should be rounded to the appropriate whole number.

            a. A calculated rate of 12.6 gtt/min is rounded to 13 gtt/min.

            b. A calculated rate of 14.2 gtt/min is rounded to 14 gtt/min.

2.  IV rates calculated in milliliters per hour (mL/hr) should be rounded to the appropriate whole number.

            a. A calculated rate of 84.5 mL/hr is rounded to 85 mL/hr.

            b. A calculated rate of 23.3 is rounded to 23 mL/hr.

Doing Drugs

Study Guides

Dosages

Foundations

DRUGS

Most instructors will say to break things down in to classes, and gain an understanding of these classes (i.e. Calcium Channel Blockers). 

Look for clues in the name of the drug as to what class it is, i.e. Propranolol (“-lol”) = Beta Blocker. 

Focus on adverse effects and side effects, and nursing actions within the drug classes (i.e. hold a beta blocker or digitalis if the HR is below 60).

HOWEVER, I WILL ADD TO THIS... KNOW THE MECHANISM OF ACTION of the drug. This is something that vastly improved my memory and understanding of drugs. This will very often give you an idea of what the adverse and side effects are, and thus, what you need to be thinking that you will need to watch for as a nurse. Check out the LEHNE book early! It sucks to get to know another book, but it is awesome… at least look at the chapter summaries. 

·         In knowing the mechanism of action, you will do very well to especially understand the heart and respiratory drugs' mechanism of action especially.

 A big part of this is knowing the This means is that you will need to know the difference between SYMPATHETIC and PARASYMPATHETIC actions of drugs in the body. Knowing these two concepts will make many, many drugs easier to figure out what their side effects will be. This may seem challenging at first, but if you make time for it, I promise it will pay off. 

  Know these concepts as thoroughly as possible, and why:

o   CNS depression: mostly focused on HR, RR, Reflexes, and a depressed level of consciousness

o   The RAAS feedback system

o   Sympathetic vs. parasympathetic, aka (though not perfectly interchangeably) Anticholinergic vs. cholinergic

o   Giving a drug on an empty stomach usually means 1h before or 2h after meals

o   Drugs are often metabolized by the liver, and excreted by the kidneys. This means, if you have poorly functioning kidneys, drugs won’t be excreted, and will build up in the blood = toxicity!

·         An example of thinking of the Mechanism of action:

Many bronchodilators work by activating the sympathetic nervous system (thus, this is their MOA). What does that even mean?

o   Well, sympathetic=fight or flight. If you were being chased by a T-Rex, you'd need a lot of what? SUGAR (glucose) and OXYGEN. So the bronchodilators will DILATE the bronchial airway smooth muscle, letting more O2 in.

o   So think: if it affects the sympathetic nervous system, what will that look like?

§  An INCREASED HR, NERVOUSNESS, SWEATING, and dry mouth, potentially raising blood sugar, amongst other things.

§  So, if you are totally lost on a test question about a bronchodilator, know that it likely activates the sympathetic (fight or fight) nervous system, so think of what that may cause. 

·         READ THE CHAPTERS IN LEHNE ABOUT THE SYMPATHETIC AND PARASYMPATHETIC NERVOUS SYSTEM, and ACETYLCHOLINE. 
This stuff will come in VERY handy throughout your education, especially when studying cardiac, respiratory, and nervous system. So, especially Adult health 1 and 2. 

·         Again, especially AH1 and 2, but for everyone else as well… basically:

Parasympathetic=CHOLINERGIC.

Sympathetic=anticholinergic (sometimes listed as “sympathomimetic…” think: “mimes, or mimics, the sympathetic response)

This means it will either activate or suppression of acetylcholine (“chol”). Read Lehne, and understand what happens in different systems when Acetylcholine is allowed to work, or inversely, when it is inhibited.

Focus on the basics of what this means…for example, parasympathetic (cholinergic) generally means it will increase secretions or GI motility, lower the heart and blood pressure, and generally stimulate the “rest and digest” system (thus, potentially causing diarrhea).

Sympathetic is basically the opposite; it has a more stimulating, drying effect on the body. Sympathetic acting drugs are particularly good for increasing the blood pressure or heart rate, constricting blood vessels, and for drying up secretions (constricts vessels to stop runny nose, for example). 

Again, READ LEHNE!

REMEMBER EVOLVE HAS A FREE LINK TO LEHNE AND CHAPTER QUESTIONS!!!

Great LINK:

Drug Class Endings and Quizzes