WITH APPLICATIONS TO : ; : GENERAL AND SPECIALTY AREAS

Transcription

1 f Fourth Edition WITH APPLICATIONS TO : ; : GENERAL AND SPECIALTY AREAS Joyce LeFever Kee, RN, MS Associate Professor Emerita College of Health and Nursing Sciences University of Delaware Newark, Delaware Sally M. Marshall, RN, MSN Nursing Service Department of Veterans Affairs Regional Office and Medical Center Wilmineton, Delaware W.B. SAUNDERS COMPANY A Harcourt Health Sciences Company Philadelphia London Montreal Sydney Tokyo

2 contents part on* V 'i v. -. '-.- J basic math review 1; objectives, %? number systems, 3 amble system, 3 \ roman system,3 conversion of systems; 3 ; examples/ 4 practice 1 problems: roman numerals, 4 fractions, 4 example, l< proper, improper, and mixed fractions, 5 multiplying fractions, 5 : examples, 6 dividing: fractions, 6 examples, 6 decimal fractions, 6 decimals, 7 examples, 8 multiplying decimals, 8. examples dividing decimals, 8 ; example, 9 practice problems: decimals, 9 ratio and proportion, 9 examples, 10 practice problems: ratio and proportion, 10 percentage, 11 \ example, 11., practice] problems: percentage, 11 : answers, 11 post-math test, 13.; roman and arable numerals, 13 fractions; 13 decimals, 14. ; ratio and proportion, 15. percentage, 16! answers; 16 ^ ' '. : J :

3 swi CONTENTS part two systems, conversion, and methods of drug calculation 11 chapter 1 systems used for drug administration 19 objectives, 19 metric system, 20 conversion within the metric system, 21 examples, 22 practice problems: metric conversions, 24 apothecary system, 25 conversion within the apothecary system, 26 examples, 27 practice problems: apothecary system, 28 household system, 28 conversion within the household system, 29 examples, 29 practice problems: household system, 30 answers, 31 summary practice problems, 31 answers: summary practice problems, 32 chapter 1 conversion within the metric apothecary, and household systems 33 objectives, 33 units, mill/equivalents, and percents, 34 metric, apothecary, and household equivalents, 35 conversion in metric and apothecary systems by weight, 35 examples, 36 practice problems: conversion by weight, 37 conversion in metric, apothecary, and household systems by liquid volume, 38 examples, 38 practice problems: conversion by liquid volume, 39 - answers, 40 summary practice problems, 41 weight: metric and apothecary conversion, 41 volume: metric, apothecary, and household conversion, 42 answers: summary practice problems, 43 chapter % interpretation of drug labels, drug orders, charting, "5 rights," and abbreviations 45 objectives, 45

4 CONTENTS interpreting drug labels, 46 example, 46 example 1: oral drug (solid form), 47 example 2: oral-drug (liquid form), 48 example 3: injectable drug, 48 practice problems: interpretation of drug labels, 49 military time versus traditional (universal) time, 51 drug differentiation, 52 examples, 52 drug orders, 52 practice problems: interpretation of drug orders, 54 charting medications, 55 methods of drug distribution, 56 the "5 rights" in drug administration, 56 right client, 57 right drug, 57 right dose, 57 right time, 59 right route, 59 abbreviations, 60 a. drug form 60 b. drug measurements, 60 c. routes of drug administration, 60 d. times of drug administration, 61 practice problems: abbreviations, 61 answers, 62 chapter M.,.- alternative methods for drug administration 65 objectives, 65 transdermal patch, 66 inhalation, 66 metered-dose inhaler, 67 " metered-dose inhaler with spacer, 68 nasal inhaler, 68 nasal spray and drops, 69 nasal spray, 69 nose drops, 70 eye drops and ointment, 70 eye drops, 70 eye ointment, 71 ear drops, 71 pharyngeal spray, mouthwash, and lozenge, 73 methods, 73

5 xwflis CONTENTS topical preparations: lotions, cream, and ointment, 73 methods, 73,74 i! rectal suppository, 74 i methods, 74 ' i ' '..; Vaginal suppository, cream, and ointment, 75 s methods of calculation.. v 77 objectives, 77 : drug calculation, 78 method 1: basic formula, 78 examples, 78 : method 2: ratio and proportion, 80 < ; examples, 81 method 3: fractional equation, 83 : ; examples, 83 ; : ; method 4: dimensional analysis, 85 '.. =.; examples, 86 i calculation for individualized drug dosing, 87 \ body weight, 87 ; : examples, 87 ;... ' " body surface area, 88 ':.'.' examples, 88, ;" '' :i. '..-.'.''""-,' summary practice problems, answers, 100 \ part three ; 1 1 calculations for oral, injectable, and intravenous drugs 103 chapter I -! oral and enterai preparations with clinical applications objectives, 105 i tablets and capsules, 106 T examples, 108 l i, ; \. liquids, 109 j examples, 109 sublingual tablets, 110 examples, 111 ; practice problems: oral medications, 112 enterai nutrition and drug administration, 123, enterai feedings, 123 : examples, 126 practice problems: percent of enterai solutions, 127 enterai medications, 127 :

6 CONTENTS Jdx calculation of dilution for enterai medications, 128 examples, 129 practice problems: enterai medications, 130 answers, 130 chapter 7 injectable preparations with clinical applications objectives, 137 injectable preparations, 138 vials and ampules, 138 syringes, 139 needles, 142 practice problems: needles, , intradermal injections, 145 subcutaneous injections, 145 calculation for subcutaneous injections, 146 examples, 146 practice problems: subcutaneous injections, 147 insulin injections, 149 types of insulin, 150 mixing insulins, 151 ; example, practice problems: insulin, 151 : continuous subcutaneous insulin infusion (CSII) pumps; 153 intramuscular injections, 153 drug solutions for injection, 154 examples, 155 reconstitute of powdered drugs, 156 examples, 156 mixing of injectable drugs, 157 examples, 158 practice problems: intramuscular injections, 160 chapter 8 ; intravenous preparations with clinical applications... objectives, 177 intravenous access sites, 178 intermittent infusion devices, 180 direct intravenous injections, wo practice problems: direct IV injection, 182 I continuous intravenous administration, 184 intravenous sets, 184 calculation of intravenous flow rate, 186 { safety considerations, 187 '. mixing drugs used for continous intravenous administration, !'. ::.;:. ; ; 177

7 xit CONTENTS examples, 188, practice problems: continous intravenous administration, 190 intermittent intravenous administration, 192 secondary intravenous sets, 192 electronic intravenous delivery devices, 194 > flow rates for infusion devices, '' calculating flow rates for intravenous drugs and electrolytes, 195 patient-controlled analgesia (PCA), 195 examples, 197! practice problems: intermittent intravenous administration, 200 answers, 206 part four calculations for specialty areas 213 chapter i pediatrics 215 objectives, 215 factors influencing pediatric drug administration, 216 oral, 216 intramuscular, 217 ' intravenous, 217 pediatric drug calculations, 218 dosage per kilogram body weight, 219 examples, 219 dosage per body surface area, 221 example, 221 practice problems, 223 i. oral, 223 ; //. intramuscular, 226 Hi. intravenous, 227 pediatric dosage from adult dosage, 231 body surface area formula, 231 example, 231. age rules, 232 body weight rule, 232 answers, 233 chapter 1 1 critical care 239 objectives, 239 calculating amount of drug or concentration of a, solution, 240 calculating units per milliliter, 240 example, 240, calculating milligrams per milliliter, 241

8 CONTENTS JJKi example, 241 calculating micrograms per milliliter, 241 example, 241 practice problems: calculating concentration of a solution, 242 calculating infusion rate for concentration and volume per unit time, 243 concentration and volume per hour and minute with a drug in units, 244 example, 244 concentration and volume per hour and minute with a drug in miligrams, 244 example, 244 concentration and volume per minute and hour with a drug in micrograms, 245 example, 245 practice problems: calculating infusion rate, 246 calculating infusion rates of a drug for specific body weight per unit time, 247 micrograms per kilogram body weight, 248 example, 248 basic fractional formula, 249 example, 249 practice problems: calculating infusion rate for specific body weight, 250 titration of infusion rate, 251 example, 252 practice problems: titration of infusion rate, 254 total amount of drug infused over time, 255 example, 256 practice problems: total amount of drug infused over time, 256 answers, 257 pediatric critical care 275 objectives, 275 factors influencing intravenous administration, 276 calculating accuracy of dilution parameters, 276 examples, 276 summary practice problems, 279 answers, 280 chapter ',>. labor and delivery 283 objectives, 283 factors influencing intravenous fluid and drug management, 284

9 mtii CONTENTS titration of medications with maintenance intravenous fluids, 284 administration by concentration, 285 example, 285. secondary iv, 285 primary iv, 286 administration by volume, 286 example, 286 / intravenous loading dose, 287 example, 287 intravenous fluid bolus, 289 example, 289 summary practice problems, 290 answers, 291 chapter 13 community 2< objectives, 295 metric to household conversion, 296 practice problems, 296 preparing a solution of a desired concentration, 298 changing a ratio to fractions and percentage, 299 example, 299 i practice problems, 299 calculating a solution from a ratio, 300 examples, 300 calculating a solution from a percentage, 301 example, 301 ; preparing a weaker solution from a stronger solution, 301 example, 301 ; ; guidelines for home solutions, 302 home infusion therapy, 303 practice problems, 303 answers, 305 part five post-test drug calculations 309 references 3; ; appendix Ik guidelines for administration of medication 3' general drug administration, 342

10 CONTENTS xxfis oral medications, 342 injectable medications, 343 intravenous flow and medications, 344 appendix B nomograms body surface area nomogram, 348 west nomogram, index. 351