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Lions and Tigers and Bears

… oh my!

IV rates and conversions and


equivalents … oh no!!

Plus more fun math …


Mary J Aigner RN, MSN, FNPC

Mary J. Aigner RN, MSN, FNPC


Ratio & Proportion Method
 What’s a ratio?
 Two number related to each other

 Why care?
 Meds often expressed in ratio form

Eg. 125mg/1 tablet or 125 mg:1 tablet


250mg/10ml or 250 mg:10 ml
proportion shows two equal ratios
eg. 4/12 = 1/3 or 4:12 = 1:3

 A proportion problem is missing one


element of the ratio
 Eg. 4:X = 1:3
 To solve, cross multiply
 Multiply outer numbers (4, 3)
 Multiply inner numbers (X,1)
 4X3 = 12, X times 1 means X equals one,
thus X = 12
But …
 You can use DA or
Dimentional
Analysis to solve
problems

 Just be aware that


there are many
ways to do the
same thing
Med example
 Dose ordered is 375mg and you have
tablets of 150mg … how many are needed?

 375mg:X = 150mg:1 tablet


 (The two mg cross each other out)
 Multiply outer (375 X 1 = 375)
 Multiply inner (150 times X = 150 X)
 Thus 375 = 150X, Divide 375 by 150
 Result is 2.5 tablets
Doing this same problem with DA
 We want 375 mg of medicine and
need to know how many tabs
 We have tablets that are 150mg each
 Want #/tab, Have 375mg/1 X 1
tab/150mg (cross out mg)
 Write:375/1 X 1 tab/150 which
results in 375/150, divided out is 2.5
tab
Correct me if I’m wrong!
Another way to use the proportion
method is to determine percents
 What is 75% of 4? 3 is what percent of 4?
75% of what number is 3?

 Method: Part/whole = percent/100

 Or in ratio form 3:4 = 75:100


 Multiply outer 3x100 = 300
 and Multiply inner 4 x 75 = 300)

 Percent – the number with the percent sign


 Part – the number with the word is
 Whole – the number with the word of
Figuring out IV flow rates

Flow Rate = (Volume) administrative set/time

 Identify the values of each factor


 Flow rate
 (volume) administrative set
 Time

Keep in mind that terminology


may vary for each factor
Other terms for factors
Factor Other Units
name(s) Represented
Flow rate Drip rate gtts/min or
Drop rate µgtts/min
Volume ------ cc, ml, or l

Administrative Set, drip gtts/ml, or


set factor, µgtts/ml
microdrip
Time ------- Min (divide by
60 to get hrs)
Plug identified values in …
 Flow rate = volume (admin set)/time
 (Volume times admin set divided by time)
 Eg. Volume is 250 ml
 Administrative set is 15 gtts/ml
 Time is 100 min

 Thus Flow rate = 250 ml X 15 gtts/ml / 100


min.
 (cross out ml, result is gtts/min)
 250X15=3750, divided by 100 = 37.5 gtts/min or
38 gtts min
 Can’t give half a drop so round up
Other IV info that is helpful
 Some meds are measured in units
 Eg. Penicillin, heparin, insulin, pitocin
 Definitions:
 Solute: dissolved substance (such as Na in
0.9% NS or Dextrose in D5W)
 Solvent: liquid in which solute is dissolved
 Percent concentration: number of grams
of solute in 100 ml of solution or solvent
 Titration: adjusting infusion or IV dosage
over time to obtain measurable response
Examples of IV solutions:

 D5W means 5% dextrose in 100 parts water or 5


g dextrose in 100 ml water
 So in 1000 ml, there would be 5 g dextrose x 10
or 50 g dextrose
 10% Na means 10%/10parts/10 g Na in 100 ml
water
 So in 1000 ml, there would be 10 g Na x 10 or
100 g Na

 What about Normal Saline? 0.9% NS?


 0.9 g Na or 0.9 parts Na per 100 ml water
 0.9 x 10 (to make 1000 ml) = 9 g Na in 100 ml
Solve for Time
Flow rate = volume (admin set)/time

 Ordered is 2 liters of 0.9% NS @ 75mcgtts/min


(µgtts/min)

 Thus write as: 75 µgtts/min=2000 ml times 60 µgtts/min / X


min
 Cross out two µgtts/min
 2000ml x 60 totals 120000:X min = 75:1
 Multiply outer and inner values
 120000 = 75 X, therefore X = 120000/75 or 1600 minutes
 Divide by 60 to get hours
 Answer is 26 hours and 40 min.
What about with an IV pump?
 Set to run at ml/hr

 Total infusion time = volume to infuse


 Either ml/min or ml/hr

 Run an IV of 500 ml for 6 hrs?


 6 hrs = 500 ml.
 Divide 500 by 6 = 83.3 ml/hr or 83 ml/hr
Word Problems
 Figure out from the text
 What is being asked?
 What info is extraneous (if any)?
 What is important information?

Mrs. G will start Zoloft 25 mg PO qd and


increase by 25 mg weekly until she
reaches 100 mg. How many weeks
will this take?
Words are just words
 Half-life
 Metabolism

Medicine A is metabolized in the kidney and has a half-life


of 16 hours. If she takes 20 mg at 0900 in the
morning, at what time will approximately 10 mg be in
her system?

To answer: Add 16 hours to 0900 or 0900 plus 12 hours


= 2100 plus another 4 hours = 2500 or 0100 the next
morning.
In this case, the information about the kidney was just
extra information.
What about calories?
 How many calories per gram?
 Protein = 4 (kilo)calories/gram
 Carbohydrates = 4 (kilo)calories/gram
 Fat = 9 (kilo)calories/gram

 So – figuring out calories means


multiplying caloric value (either 4 or 9)
times the number of grams then
adding up totals
And fluid counts?
 Convert if necessary from oz to ml
 Then add

 Eg. 12 oz coffee = 12 x 30 = 360 ml


 Eg. 4 oz OJ = 4 x 30 = 120 ml
 Eg. 8 oz water = 8 x 30 = 240 ml

 Total? 360 + 120 + 240 = 720 ml


References
& Sources for More Practice
 Just plain math (good for parents who help
with homework)
 http://amby.com/educate/math/

 Nurse’s math problems


 http://www.accd.edu/sac/nursing/math/

 http://www.delta.edu/tlc/TLCStdy/Support/mathforsci

 This site has good links, quizzes for practice, and


explains very clearly
Practice,
Practice,
Practice