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### Pharmacy calculations power pointmp

1. 1. Pharmacy Calculations3rd Edition Mary F. Powers & Janet B. Wakelin © 2010 Morton Publishing
2. 2. Chapter 1: Learning Objectives After completing this chapter the student will be able to: 1) Explain the meaning of Roman Numerals and Arabic Numerals 2) Convert Roman Numerals to Arabic Numerals 3) Convert Arabic Numerals to Roman Numerals 4) Determine the number of tablets or capsules needed to fill a prescription that has the quantity written in Roman Numerals
3. 3. Chapter 1: Key Terms  Roman Numerals – numeral system based in ancient Rome that uses letters and combinations of letters  Arabic Numerals – numeral system in common use today based on the ten digits 0, 1, 2, 3, 4, 5, 6, 7, 8, 9
4. 4. Chapter 1: Roman Numerals A letter repeated once or twice repeats its value that many times. Ex: XXX = 30 One or more letters that is placed after another letter of greater value increases the greater value by the amount of the smaller. EX: VI = 6 A letter placed before another letter of greater value decreases the greater value by the amount of the smaller Ex: IV = 4
5. 5. Chapter 2: Learning Objectives After completing this chapter the student will be able to: 1) Define the terms fraction, numerator and denominator 2) Explain the relationship between the numerator and the denominator in a fraction 3) Define the term reciprocal 4) Explain why a denominator cannot be zero 5) Convert fractions to decimals 6) Convert decimals to fractions
6. 6. Chapter 2: Key Terms  Whole numbers – expressions in the Arabic System for the numbers 1, 2, 3, 4, 5, etc.  Fraction – expression in the Arabic system to represent part of a whole  Numerator – the top number in a fraction  Denominator – the bottom number in a fraction  Decimal – a special type of fraction in which the denominator is a number that is a power of 10  Equivalent fractions – fractions that represent the same amount  Reciprocals – two different fractions that when multiplied together equal 1
7. 7. Chapter 2: Example 3/4 = 0.75
8. 8. Chapter 2: Example 2/5 = 0.4
9. 9. Chapter 3: Learning Objectives After completing this chapter the student will be able to: 1) Explain how to reduce a fraction to lowest terms 2) Define the terms prime factor and common factor 3) Determine the greatest common factor of a fraction 4) Reduce fractions to lowest terms
10. 10. Chapter 3: Key Terms  Simplifying a fraction – reducing a fraction so the numerator and denominator are the smallest whole numbers possible  Greatest common factor – the whole number that both numerator and denominator can be divided by to reduce the fraction  Prime factor – a whole number divisible by only one and itself  Canceling – dividing the numerator a denominator of a fraction by al common factors
11. 11. Chapter 3: Reducing a fraction to lowest terms  List the prime factors of both the numerator and denominator.  Find the prime factors common to both the numerator and denominator.  Divide the numerator and denominator by all of the prime factors that are common to both the numerator and denominator. (Also known as canceling)
12. 12. Chapter 4: Learning ObjectivesAfter completing this chapter the student will be able to:1) Define the term least common denominator2) Find equivalent fractions with common denominators for a pair of fractions that do not have common denominators3) Solve problems that require addition of fractions4) Solve problems that require subtractions of fractions
13. 13. Chapter 4: Key Terms Common denominator – two fractions have the same denominator Least common denominator – the common denominator for two fractions is the smallest possible whole number
14. 14. Chapter 4: Adding & Subtracting Fractions In order to add or subtract fractions with different denominators, you must first find equivalent fractions with common denominators. • First, find the smallest multiple for the denominator of both numbers • Then rewrite the fractions as equivalent fractions with the smallest multiple of both numbers as the denominator
15. 15. Chapter 5: Learning ObjectivesAfter completing this chapter the student will be able to:1) Describe the procedure for multiplying fractions2) Solve problems that require multiplying fractions3) Describe the procedure for dividing fractions4) Solve problems that require dividing fractions
16. 16. Chapter 5: Key Terms  Multiplying fractions – mathematical operation to obtain the products of the numbers in the numerators and products of the numbers in the denominators  Dividing fractions – mathematical operation to find the reciprocal of the fraction you are dividing by and then multiplying the fractions
17. 17. Chapter 5: Multiplying Fractions Unlike adding and subtracting, when multiplying fractions you do not need a common denominator. To multiply fractions: 1) First, multiply the numerators of the fractions (this results in a new numerator). 1) Then, multiply the denominators of the fractions (this results in a new denominator). 2) Then, simplify the resulting fraction if possible.
18. 18. Chapter 5: Dividing Fractions Dividing fractions is like multiplying fractions, except there is an additional step to convert the fraction you are dividing by, to its reciprocal. To divide fractions: 1) First, find the reciprocal of the fraction you are dividing by 2) Then, multiply the first fraction times the reciprocal determined in step 1 3) Then, simplify the resulting fraction by reducing to lowest terms, if possible.
19. 19. Chapter 6: Learning Objectives After completing this chapter the student will be able to: 1) Explain how decimal fractions are written 2) Express in words the value of decimal fractions 3) Express in numbers the value for decimal fractions that are given in words 4) Convert fractions to decimals
20. 20. Chapter 6: Key Terms • Decimal number system - number system that uses a notation so each number is expressed in base 10 by using one of the first nine integers or 0 in each place and letting each place value be a power of 10 • Power – the number of times that a number occurs as a factor in a product as indicated by an exponent
21. 21. Chapter 6: Examples  Eight hundred = 800  Eight hundredths = 0.08
22. 22. Chapter 7: Learning Objectives After completing this chapter the student will be able to: 1) Describe the procedure for rounding decimals 2) Demonstrate rounding decimals to the nearest tenth and hundredth 3) Define significant figures 4) Explain the importance of using significant figures in pharmacy calculations 5) List the four rules for assigning significant figures
23. 23. Chapter 7: Key Terms  Rounding decimals – process to eliminate unnecessary decimal numbers  Significant figures – when performing calculations that include measured quantities, the number of digits in a calculated number corresponding to the sensitivity of the measuring device
24. 24. Chapter 7: Rounding Decimals Find the place value for the number you want (this is called the rounding digit) and look at the digit just to the right of it.  If the number to the right of the rounding digit is less than 5, do not change the rounding digit, but drop all digits to the right of it.  If the number to the right of the rounding digit is greater than or equal to five, add one to the rounding digit and drop all digits to the right of it.
25. 25. Chapter 8: Learning Objectives After completing this chapter the student will be able to: 1) Perform addition of decimal numbers 2) Perform subtraction of decimal numbers
26. 26. Chapter 8: Key Terms  Adding decimals – mathematical operation like adding whole numbers, except the terms must be lined up so all the decimal points are in a vertical line.  Subtracting decimals – mathematical operation like subtracting whole numbers, except the terms must be lined up so all the decimal points are in a vertical line.
27. 27. Chapter 8: Adding Decimal Numbers 1) First, align the numbers in a vertical column so the decimal points are aligned. 2) Then, add each column of digits going from right to left. (When the sum of a column is greater than 10 you should “carry” the digits to the next column on the left.) 3) Then, place the decimal point in the answer so it is directly below the decimal points in the previous terms.
28. 28. Chapter 9: Learning Objectives After completing this chapter the student will be able to: 1) Define the terms product, dividend, divisor, and quotient 2) Perform multiplication with decimal numbers 3) Perform division with decimal numbers
29. 29. Chapter 9: Key Terms  Product – the number that results when numbers are multiplied together  Dividend – in division, the number that is divided  Divisor – in division, the number that the dividend is divided by  Quotient – the number that results when one number is divided by another
30. 30. Chapter 9: Multiplying Decimal Numbers  Line up the numbers on the right in the same way you would if there were no decimal points  Start at the right side and multiply each digit in the top number by each digit in the bottom number  Add the product resulting from multiplying each digit of the bottom number  Place the decimal point in the answer so that the number of decimal places in the answer equals the total number of decimal places in both numbers that were multiplied together
31. 31. Chapter 10: Learning Objectives After completing this chapter the student will be able to: 1) Define the terms ratio, proportion and dimensional analysis 2) Explain how to solve problems using ratio and proportion 3) Explain how to solve problems using dimensional analysis 4) Demonstrate how to solve common pharmacy problems using ratio and proportion and dimensional analysis
32. 32. Chapter 10: Key Terms Ratio – expression to compare two numbers Proportion – expression for two ratios that are equal Dimensional Analysis – method based on ratios and proportions to solve mathematical problems
33. 33. Chapter 10: Equal Ratios  3:6 = 12:24 = 6:12 = 15:30  3/6 = 12/24 = 6/12 = 15/30
34. 34. Chapter 10: Proportions  a:b = c:d  a/b = c/d *When two ratios are equal, the products of the means (middle numbers) equals the products of the extremes (outside numbers)
35. 35. Chapter 10: Dimensional Analysis Start by setting up a dimension analysis equation, so the units you want in the final answer are in the numerator of the first fraction of the dimensional analysis equation. Set up the next fraction in the dimensional analysis equation so the units of the numerator of the second fraction are the same as the units of the denominator of the first fraction (that is, so the units cancel when the fractions are multiplied). If necessary, set up the next fraction in the dimensional analysis equation so the units of the numerator of the third fraction are the same as the units of the denominator of the second fraction (that is, so the units cancel when the fractions are multiplied). Repeat setting up additional terms as many times as needed to solve the problem. Multiply the fractions
36. 36. Always remember to checkyour work:  Set up is correct  Multiplication is correct
37. 37. Chapter 11: Learning ObjectivesAfter completing this chapter the student will be able to:1) Explain the relationship between percents and decimals2) Convert percents to decimals3) Convert decimals to percents
38. 38. Chapter 11: Key Terms Percent – per 100 or out of 100 Percent symbol – way to write a fraction with a denominator of 100
39. 39. Chapter 11: Percents Percents means “per one hundred”  15% = 0.15 = 15/100
40. 40. Chapter 12: Learning Objectives After completing this chapter the student will be able to: 1) Define the term exponent 2) Define the term scientific notation 3) Express numbers given in exponential form as whole numbers 4) Express large numbers in scientific notation
41. 41. Chapter 12: Key Terms  Exponents – short hand way to show how many times a number is multiplied times itself  Scientific notation – expressing a number as a product of a number between 1 and 10 and a power of 10.
42. 42. Chapter 12: Exponents 34 (exponent is 4) 34 = 3 x 3 x 3 x 3 = 81
43. 43. Chapter 12: Power of Zero Any number raised to the power of zero is 1:  50 = 1  40 = 1  1000 = 1
44. 44. Chapter 13: Learning Objectives After completing this chapter the student will be able to: 1) Describe the metric system 2) Identify the standard metric units for length, weight and volume 3) Define prefixes used in the metric system 4) Perform conversions between the metric system and household measurements 5) Perform conversions within the metric system 6) Interpret common pharmacy abbreviations
45. 45. Chapter 13: Key Terms  Metric system – system of measure based on the meter, liter and gram  Gram (g) – standard measure of weight in the metric system  Milliliter (ml or mL) – common measure of volume in the metric system  Meter (m) – standard measure of length in the metric system  Inscription – part of the prescription that provides information about the drug and amount  Signa (Sig) – part of the prescription that provides the directions for use
46. 46. Chapter 13: Examples  1,000 ml = 1 liter  1,000 mg = 1 gram  100 cm = 1 meter  1,000 g = 1 kg
47. 47. Chapter 14: Learning Objectives After completing this chapter the student will be able to: 1) Describe the significance of apothecary measure in pharmacy 2) Perform conversion from apothecary to metric units 3) Perform conversion from metric to apothecary units image © Dennis Hogan 2010
48. 48. Chapter 14: Key Terms  Apothecary system of measurement – one system of measurement associated with pharmaceuticals that uses ounces and grains  Metric system of measurement – one system of measurement associated with pharmaceuticals that uses grams, liters and meters
49. 49. Chapter 14: Apothecary Measures & Metric Equivalents Apothecary Measure Metric Equivalent 1 grain 64.8 mg (sometimes rounded to 65 mg) 1 dram 5 ml 1 fl. oz. 29.6 ml (sometimes rounded to 30 ml) 1 oz. (apothecary) 31 g
50. 50. Chapter 15: Learning Objectives After completing this chapter the student will be able to: 1) Explain the importance of proper storage temperatures for medications 2) Express an equation for converting Fahrenheit temperatures to Celsius 3) Perform calculations to convert temperature in degrees Fahrenheit to degrees Celsius 4) Perform calculations to convert temperature in degrees Celsius to degrees Fahrenheit
51. 51. Chapter 15: Key Terms Fahrenheit – temperature scale in which the boiling point of water is at 212 degrees above the zero of the scale and the freezing point of water is at 32 degrees above the zero point of the scale and abbreviated by F Celsius - temperature scale (also known as Centigrade) in which the boiling point of water is at 100 degrees above the zero of the scale and the freezing point of water is at the zero point of the scale and abbreviated by C
52. 52. Chapter 15: Formula Useful formula To Memorize: 9C = 5F – 160
53. 53. Chapter 16: Learning Objectives After completing this chapter the student will be able to: 1) Explain why compounds are sometimes prescribed 2) Perform calculations to determine the amounts of ingredients needed to prepare compounds image © Dennis Hogan 2010
54. 54. Chapter 16: Key Terms Compound – a prescription prepared in the pharmacy for a product that is not commercially available „qs‟ – abbreviation in the inscription of some compounds that means to “add up to” to the designated amount with the ingredient specified
55. 55. Chapter 16: Compound A prescription prepared in the pharmacy fora product that is not commercially available.
56. 56. Chapter 17: Learning ObjectivesAfter completing this chapter the student will be able to:1) Explain why pharmacy technicians in community practice perform calculations for days supply.2) Explain why the same drug in the same quantity could last different amounts of time for different patients.3) Explain how to calculate days supply for prescriptions for tablets, capsules, and oral liquids.4) Explain how to estimate days supply for eye drops, ear drops, creams and ointments.5) Explain how to calculate days supply for metered-dose inhalers, specialized dosing packs and insulin.6) Perform days supply calculations for prescriptions for tablets, capsules, oral liquids, insulin and metered-dose inhalers.7) Estimate days supply for prescriptions for creams, ointments, eye drops and ear drops.
57. 57. Chapter 17: Key Terms  Days supply – a best estimate of how many days a prescription should last if taken as prescribed. image © Dennis Hogan 2010
58. 58. Chapter 17  Calculating Days Supply for Creams and Ointments  Generally a best estimate because the pharmacist or pharmacy technician does not know exactly how much of the product the patient will apply for each dose.  The amount applied usually does not exceed 500 mg to 1 g.
59. 59. Chapter 17Calculating Days Supply for Insulin: Most insulin is 100 Units per ml Some insulin is 500 Units per ml
60. 60. Chapter 17Calculating Days Supply for Metered-Dose Inhalers Need to check manufacturer’s label to determine how many metered doses are in each container
61. 61. Chapter 17 Calculating Days Supply for Eye Drops and Ear Drops  The number of drops per ml can vary depending on the dropper as well as the viscosity of the solution or suspension.  For most eye drops and ear drops the range is 15-20 drops per ml.  20 drops per ml provides a good estimation for estimating days supply.
62. 62. Chapter 17 Calculating Days Supply for Specialized Dosing Packages  Need to check manufacturer’s labeling
63. 63. Chapter 18: Learning ObjectivesAfter completing this chapter the student will be able to:1) Describe how to adjust the fill quantity and refills to comply with limitations of third party programs.2) Explain how refills are adjusted for insulin prescriptions.3) Identify medications that must be dispensed in original, unopened packages.
64. 64. Chapter 18: Key Terms Short-filled prescription: an adjustment made to the amount of medication dispensed to comply with an insurer’s guidelines.
65. 65. Chapter 18: Adjusting Refills Adjusting Refills for Short-filled Prescriptions 1) Calculate the total number of tablets or capsules allowed by the prescriber (original fill + all refills) 2) Divide the total number of tablets or capsules by the number of tablets or capsules allowed per fill 3) The last refill may only allow for a partial refill (less than the previous fills) because the total amount dispensed cannot exceed the total number of tablets or capsules allowed by the prescriber (original fill + all refills)
66. 66. Chapter 19: Learning Objectives After completing this chapter the student will be able to: 1) Define the term dispensing fee. 2) Describe how co-pays are determined. 3) Define the term difference pricing. 4) Describe why some patients would be required to pay difference pricing.
67. 67. Chapter 19: Key Terms  Dispensing Fee – the amount a third party program contracts to pay a pharmacy for the pharmacy’s expenses associated with filling a prescription.  Co-pay – the amount a patient pays for a prescription covered by a third party program.  Difference Pricing – the amount in excess of the standard copy a patient must pay for a prescription when the third party program only covers the cost of a generic and a brand name drug is dispensed.
68. 68. Chapter 19: Difference In Pricing standard + difference in cost = difference co-pay between brand price co-pay and generic
69. 69. Chapter 20: Learning ObjectivesAfter completing this chapter the student will be able to:1) Explain how third party programs are billed for pharmacy compounds.2) Demonstrate an understanding that different third party companies have different procedures for reimbursing pharmacies for compounded prescriptions.
70. 70. Chapter 20: Key Terms  Third party programs – companies such as pharmacy benefit managers or insurers that are billed for prescriptions
71. 71. Chapter 20: Billing Compounds Dispensing + cost of + cost of = Fee selling ingredients time price
72. 72. Chapter 21: Learning Objectives After completing this chapter the student will be able to: 1) Describe how to make change for cash register transactions. 2) Calculate how much change is due when a patient or customer pays with a different amount of money that the amount due.
73. 73. Chapter 21: Key Terms  Cash payment – currency is used for payment of a prescription  Change – money returned when payment exceed the amount due
74. 74. Chapter 21: Example The price of a prescription is \$15.45 and the patient pays with \$20. How much change should you give to the patient?Count the change back to the patient. 1) 1 nickel makes \$15.50 2) 2 quarters makes \$16.00 3) 4 one dollar bills makes \$20.00
75. 75. Chapter 22: Learning Objectives After completing this chapter the student will be able to: 1) Define Usual & Customary price for a prescription 2) Describe how Usual & Customary price can be determined
76. 76. Chapter 22: Key Terms  U&C or Usual & Customary Price – the standard price for a prescription when the patient pays without third party coverage  AWP or Average Wholesale Price - the average price that wholesalers sell drugs to terminal distributors of drugs such as pharmacies
77. 77. Chapter 22One formula to determine U&C: AWP + professional fee = selling price of prescription
78. 78. Chapter 23: Learning Objectives After completing this chapter the student will be able to: 1) Describe what when pharmacies may offer discounts. 2) Demonstrate the ability to calculate 5% discounts and 10% discounts.
79. 79. Chapter 23: Key Terms  Discount – a reduction made from the regular price
80. 80. Chapter 23: 10% Discount A senior citizen is paying for a prescription for amoxicillin 250 mg #30. The U&C is \$8.49; however the patient qualifies for a 10% discount. How much will the patient pay? 10% of \$8.49 = \$0.85 so \$8.49 - \$0.85 = \$7.64
81. 81. Chapter 24: Learning ObjectivesAfter completing this chapter the student will be able to:1) Define the term gross profit.2) Define the term net profit.3) Calculate the gross profit and net profit for prescriptions
82. 82. Chapter 24: Key Terms  Gross Profit – the difference between the selling price of the prescription and the acquisition cost of the medication  Net profit – the difference between the selling price of the prescription and the sum of all costs associated with filling the prescription
83. 83. Chapter 24: Gross Profit/Net Profit  Gross profit = selling price – acquisition cost  Net profit = selling price – acquisition cost – dispensing fee
84. 84. Chapter 25: Learning Objectives After completing this chapter the student will be able to: 1) Explain why inventory affects the bottom line 2) Explain how minimum/maximum level inventory systems work 3) Calculate reorder quantities using minimum/maximum inventory levels
85. 85. Chapter 25: Key Terms Inventory – a list of the goods on hand Inventory control – supervising the supply and accessibility of the goods on hand in order to insure adequate supply without excessive oversupply
86. 86. Chapter 25: Inventory Systems In minimum/maximum level inventory systems, drugs are reordered up to the maximum inventory level when the minimum inventory level is reached image © Dennis Hogan 2010
87. 87. Chapter 26: Learning Objectives After completing this chapter the student will be able to: 1) Describe Daily Cash Reports 2) Identify the sources of payment for Daily Cash Reports (e.g., cash, checks, bank charges) 3) Demonstrate the ability to balance a Cash Report
88. 88. Chapter 26: Key Terms  Daily Cash Report – format to account for the daily cash balance  Bank Charges – transactions processed through credit cards  House Charges – transactions processed through an in- house system for credit  Paid Outs – money taken from the cash register to pay for store expenses
89. 89. Chapter 27: Learning Objectives After completing this chapter the student will be able to: 1) Describe three different parenteral routes of administration 2) Define IV, IM and SC 3) Calculate parenteral doses using ratio and proportion
90. 90. Chapter 27: Key Terms  Parenteral medications – medications injected into the body by different routes (other than the gastrointestinal)  IV – intravenous  IM – intramuscular  SC - subcutaneous
91. 91. Most institutional calculations problemscan be solved using ratio andproportion.
92. 92. Chapter 28: Learning Objectives After completing this chapter the student will be able to: 1) Explain why some parenteral medications are available in powder form. 2) List two sources where a technician could find how much diluent is needed for reconstituting a parenteral drug 3) Calculate powder volume 4) Calculate the concentration of drug for reconstituted medications 5) Calculate the volume of reconstituted medications needed to deliver a specific dose of medication
93. 93. Chapter 28: Key Terms  Powdered drug preparations – drugs that have limited stability in solution and are reconstituted at the time of use from a powder form  Powder volume – the space occupied by the powder in a powdered drug preparation  Reconstitution – adding a specified amount of diluent to a powdered drug preparation prior to administration
94. 94. Chapter 28: Powder Volume Powder = Final - volume of diluent added volume volume
95. 95. Chapter 29: Learning Objectives After completing this chapter the student will be able to: 1) Define the term percentage strength 2) Determine how much solution can be prepared from a given weight of ingredient to make a specific percentage strength concentration of the solution 3) Calculate the amount of an ingredient present in a volume of solution when the concentration of the solution is expressed in percentage strength 4) Determine how much of a concentrated solution is needed to prepare a medication order for a more dilute solution when strengths of the concentrated solution and medication order are expressed in percents
96. 96. Chapter 29: Key Terms Percentage strength – weight in grams of drug per 100 ml of solution D5W – 5 grams of dextrose in 100 ml of solution Normal saline – 0.9 grams of sodium chloride in 100 ml of solution Concentrated Sodium Chloride Solution – 23.4 grams of sodium chloride in 100 ml of solution
97. 97. Chapter 29: Examples  D5W (Dextrose 5% in Water) 5 grams dextrose per 100 ml  Normal Saline (0.9% Sodium Chloride) 0.9 grams NaCl per 100 ml
98. 98. Chapter 30: Learning Objectives After completing this chapter the student will be able to:  Convert ratios to fractions  Convert percentages to ratios  Convert ratios to percentages  Reduce ratios to lowest terms  Use ratio and proportion to calculate the amount of an ingredient needed to prepare a concentration of a specific ratio strength
99. 99. Chapter 30: Key Terms  Ratio – a comparison of one quantity to another similar quantity  Terms of the ratio – quantities compared in a ratio and separated by a colon  w/v – expression of concentration for a solid ingredient in a liquid preparation  v/v – expression of concentration for a liquid ingredient in a liquid preparation  w/w – expression of concentration for a solid ingredient in a solid preparation
100. 100. Chapter 30: Example Ratios can be expressed as fractions  1:1,000 = 1/1,000
101. 101. Chapter 31: Learning ObjectivesAfter completing this chapter the student will be able to:1) List three examples when dosing based on body weight is important2) Calculate medication doses based on body weight
102. 102. Chapter 31: Key Terms mg/kg – milligrams of drug per kilogram of body weight mcg/kg – micrograms of drug per kilogram of body weight mg/lb – milligrams of drug per pound of body weight image © Dennis Hogan 2010
103. 103. Chapter 31 For dosing by weight use conversion factor 1 kg = 2.2 lb.
104. 104. Chapter 32: Learning Objectives After completing this chapter the student will be able to: 1) Identify what types of drugs are dosed based on body surface area 2) Use a nomogram to calculate body surface area 3) Perform dosing calculations for drugs based on body surface area
105. 105. Chapter 32: Key Terms  BSA – body surface area (expressed in m2)  Nomogram – chart used to calculate body surface area as a function of height and weight
106. 106. Chapter 32: Using a Nomogram A nomogram has three columns:  Height (expressed in centimeters and inches)  Body Surface Area (BSA) (expressed in m2)  Weight (expressed in kilograms and pounds)
107. 107. Chapter 33: Learning Objectives After completing this chapter the student will be able to: 1) Calculate the rate of infusion if the volume of infusion and the time of the infusion are known 2) Calculate the rate of flow for an IV in drops/min if the calibration of the IV set is known along with the volume of the infusion and the time of the infusion 3) Calculate the rate of flow for an IV in ml/hour if the volume of the infusion and the time of the infusion is known
108. 108. Chapter 33: Key Terms  Infusion rate – the volume of solution or drug to be administered in a set amount of time for an intravenous preparation  ml/min – milliliters of IV solution administered per minute  ml/hr – milliliters of IV solution administered per hour  mg/min – milligrams of drug administered per minute  drops/min – drops of IV solution administered per minute  IV set – tubing and equipment for delivering IVs  Calibrated – the number of drops per ml for a given IV set
109. 109. Chapter 33: Infusion Rates Volume/time = rate
110. 110. Chapter 34: Learning ObjectivesAfter completing this chapter the student will be able to:1) Calculate the resulting strength of a solution that has been diluted from a more concentrated strength2) Calculate the amount of diluent needed to prepare a less concentrated preparation from a more concentrated preparation
111. 111. Chapter 34: Key Terms  Dilution – a less concentrated preparation of medication prepared from a more concentrated preparation  Diluent – liquid added to a more concentrated preparation to make a less concentrated preparation
112. 112. When performing calculations thatinvolve dilutions, it is important todistinguish between differentsolutions.
113. 113. Chapter 35: Learning Objectives After completing this chapter the student will be able to: 1) Describe how to set up an alligation 2) Use alligation to determine how to prepare a concentration of an ingredient from two different concentrations of the same ingredient when the desired concentration is in between the concentrations of the two available concentrations
114. 114. Chapter 35: Key Terms Alligation – type of calculation to determine how much of two different concentrations of the same ingredient are needed to prepare a concentration that is in between Part – relative amount of an ingredient
115. 115. Chapter 35: Alligation Higher % strength Number of parts of Higher % strength solution Required % strength Lower % strength Number of parts of Lower % strength solution
116. 116. Chapter 36: Learning Objectives After completing this chapter the student will be able to: 1) Define the terms parenteral nutrition solution and hyperalimentation solution 2) Explain the difference between a TPN and a PPN 3) Identify possible base solutions used in TPNs and PPNs 4) Identify possible additives used in TPNs and PPNs 5) Perform calculations to determine the amounts of ingredients needed to prepare TPNs and PPNs
117. 117. Chapter 36: Key Terms  Parenteral nutrition solution – solution to provide nutrition to patients via IV (also known as hyperalimentation solution)  Hyperalimentation solution – solution to provide nutrition to patients via IV (also known as parenteral nutrition solution)  TPN – total parenteral nutrition solution that provides all necessary nutrients for a patient  PPN – partial parenteral nutrition solution that provides some nutrients for a patient who is also receiving nutrition by another type of feeding  Base solution – for a TPN or PPN, can consist of carbohydrates, proteins, or essential fatty acid emulsions  Additives – for a TPN or PPN, can consist of electrolytes, vitamins, trace elements, insulin, and/or other additives as prescribed to be include in the TPN or PPN
118. 118. Chapter 36: Total Parenteral Nutrition Typically a TPN will have 6 to 10 additives mixed with a base solution
119. 119. Chapter 37: Learning ObjectivesAfter completing this chapter the student will be able to:1) Calculate the volume of a drug that is needed to deliver a specific dose of a medication using information provided on the manufacturer’s label2) Describe how powdered medications that require reconstitution are prepared to deliver the prescribed dose of a medication
120. 120. Chapter 37: Key Terms Reconstitution – adding a specified amount of diluent to a powdered drug preparation prior to administration