Intermediate / Tina Jones Med Math Questions 1. Problem type: Total daily dose calculation Medication: Oxycodone @ hospital Suppose Ms. Jones reports a pain rating greater than 4. For this pain rating, the prescriber’s order allows oxycodone, 5 mg, 1 tab, by mouth, every 4 hrs. Assume that for her first day of hospitalization, she takes all available doses in 24 hours. How many mg of oxycodone will she have ingested? HINT Multiply the number of doses Ms. Jones would take in a single day by the number of tablets taken. SAMPLE SOLUTION 1. Determine how many doses Ms. Jones would take in 24 hours. 24 hours x 1 dose = 6 doses 4 hours 2. Multiply the number of doses by the number of milligrams per dose of oxycodone. 6 doses x 5 mg = 30 mg 1 dose ANSWER Number: 30 Units: mg 2. Problem type: Total daily dose calculation Medication: Oxycodone @ hospital Suppose Ms. Jones reports a pain rating greater than 4. For this pain rating, the prescriber’s order allows oxycodone, 5 mg, 1 tab, by mouth, every 4 hrs. Assume that on her second day of hospitalization, Ms. Jones only reports a pain rating greater than 4 two times. How many mg of oxycodone will she have ingested? HINT Multiply the number of doses that Ms. Jones took by the number of tablets. SAMPLE SOLUTION 1. Multiply the dosage by the number of tablets per dose. 2 doses x 1 tablet = 2 tablets 1 dose 3. Multiply the dosage of oxycodone by the number of tablets. 2 tablets x 5 mg = 10 mg 1 tablet ANSWER Number: 10 Units: mg 3. Problem type: Dosage calculation + weightbased dosage Medication: Promethazine @ hospital hypothetical Children older than 2 can be administered promethazine rectally as an antihistamine, at a dosage of 0.125 mg/kg every 4 to 6 hours. Assume you were administering this to a child who weighed 27.5 lbs. How much promethazine should this child be administered at one time? Round your answer to hundredths. HINT Convert pounds to kilograms, and multiply the weight by the dosage. SAMPLE SOLUTION 1. Convert pounds (lbs) to kilograms (kg). 27.5 lbs x 1 kg = 12.5 kg 2.20 lb 2. Multiply dosage by the number of kilograms. 0.125 mg x 12.5 kg = 1.56 mg kg ANSWER Number: 1.56 Units: mg 4. Problem type: Total daily dose calculation Medication: Albuterol @ hospital Ms. Jones’ orders include albuterol, 2 puffs every 4 hours as needed for wheezing. The dosage of the albuterol is 90 mcg/spray. Assume she takes the ordered amount of her inhaler two times in a single day. How many mcg of albuterol will she have been administered on that day? HINT Multiply the number of doses by the number of sprays per dose. Then, multiply the number of sprays by the dosage per spray. SAMPLE SOLUTION 1. Multiply the number of doses by the number of sprays per dose. 2 doses x 2 sprays = 4 total sprays 1 dose 3. Multiply the dosage per spray by the number of sprays. 4 sprays x 90 mcg = 360 mcg 1 spray ANSWER Number: 360 Units: mcg 5. Problem type: Total daily dose calculation Medication: Albuterol @ hospital Albuterol also has an oral route, and can be administered to adults 24 mg, 34 times daily. Suppose Ms. Jones had been ordered 4 mg, 3 times daily, for the duration of her hospital stay. How many mg of albuterol would she take in a single day? HINT Multiply the number of mg in each dose by the number of doses ordered per day. SAMPLE SOLUTION 1. Multiply the dosage by the number of doses taken in one day. 3 doses x 4 mg = 12 mg 1 dose ANSWER Number: 12 Units: mg 6. Problem type: Dosage calculation + stock on hand Medication: Promethazine @ hospital Suppose Ms. Jones reports an upset stomach. Ms. Jones’ orders include promethazine 25 mg by mouth q4h PRN nausea. If the pharmacy only stocks 12.5 mg tablets , how many tablets should be administered to Ms. Jones each time? HINT You can use the equation below, where X is the number of tablets that should be administered. D (ordered dose ) x Quantity = X H (dose on hand) SAMPLE SOLUTION 1. Determine what information you have. D (ordered dose) = 25 mg H (dose on hand) = 12.5 mg Q (quantity) = 1 tablet 2. Plug into the equation and solve. D (25 mg ) x 1 tablet = X H (12.5 mg) X = 2 tablets ANSWER Number: 2 Units: tablets 7. Problem type: IV flow Medication: Clindamycin @ hospital You are administering the order clindamycin 600 mg IV q6h (600 mg / 50 mL 0.9% NaCl) to Ms. Jones. The order is to be infused in 20 minutes. What is the IV flow rate in mL/hr rounded to the nearest whole number? HINT Divide the volume to be infused by the time, converting minutes to hours. SAMPLE SOLUTION 1. Divide the volume to be infused by the time, converting minutes to hours. 50 mL x 1 x 60 minutes = 150 mL/hour 20 minutes 1 hour ANSWER Number: 150 Units: mL/hr 8. Problem type: Dosage calculation Medication: Insulin lispro @ hospital The provider ordered insulin lispro on a sliding scale for 1 unit/10 g CHO subcutaneous + 1 unit/50 points above 150 BG. Ms. Jones has a premeal BG level of 232 and will eat a meal that contains 40 g CHO. How many units of insulin should be administered? Round your answer down to the nearest whole unit. HINT Add the units calculated from the sliding scale to the units necessary for the patient’s current BG level. SAMPLE SOLUTION 1. Perform the sliding scale calculation (1 unit/10g CHO) . 40 g CHO x 1 unit = 4 units 10 g CHO 2. Subtract 150 from Mrs. Jones’s premeal BG. 232 BG 150 BG = 82 points 3. Multiply 82 points by the number of units per 50 points. 82 points x 1 unit = 1.64 50 points Round down to the next whole unit = 1 unit 4. Add the units calculated from the sliding scale to the units necessary for the patient’s current BG level. 4 units + 1 unit = 5 units ANSWER Number: 5 Units: units of insulin 9. Problem type: Total daily dosage Medication: Acetaminophen @ hospital Ms. Jones has an order for 325 mg, 2 tabs, by mouth q6h PRN temp. > 100.5 F. The Davis’s Drug Guide reports that acetaminophen has a maximum recommended dosage of 4 g/day. How many whole tablets can Ms. Jones take without exceeding the recommended maximum dosage? HINT There are 1000 mg in one gram. SAMPLE SOLUTION 1. Determine how many milligrams are in 4 grams. 4 g x 1000 mg = 4000 mg 1 g 2. Determine how many 325 mg tablets go into 4000 mg. 4000 mg x 1 tablet = 12.3 tablets 325 mg 3. Consider that the dosage may not exceed 2,000 mg, and you may only administer whole tablets. Round down to the nearest whole tablet = 12 tablets ANSWER Number: 12 Units: tablets 10. Problem type: Dosage calculation + unit conversion Medication: Acetaminophen @ hospital Ms. Jones has an order for 325 mg, 2 tabs, by mouth q6h PRN temp. > 100.5 F. For the last 12 hours, Ms. Jones has had a temperature of 101.1 F. Following the orders, how many grams of acetaminophen has been administered to Ms. Jones? Round your answer to tenths. HIN Determine how many doses Ms. Jones has taken, then determine how many grams per dose. SAMPLE SOLUTION 1. Determine how many times in 12 hours Ms. Jones took a dose. 12 hours x 1 dose = 2 doses 6 hour 2. Determine the total milligrams by multiplying the number of doses by the number of milligrams per dose (considering the number of tablets per dose). 2 doses x 2 tablets x 325 mg = 1300 mg 1 dose 1 tablet 3. Determine how many grams were taken by converting mg to g. 1300 mg x 1 g = 1.3 g 1000 mg ANSWER Number: 1.3 Units: g 11. Problem type: Dosage calculation + unit conversion Medication: Insulin glargine @ hospital Ms. Jones has an order for insulin glargine, 18 units subcutaneous daily at 5:00pm. You are using U100 insulin (100 units per mL). What is the required dose in mL? Round your answer to hundredths. HINT Convert the number of units to mL. SAMPLE SOLUTION 1. Convert the number of units to mL. 18 units x 1 mL = 0.18 mL 1 dose 100 units dose ANSWER Number: 0.18 Units: mL/dose 12. Problem type: IV flow Medication: Oxacillin @ hospital You are administering the order for an IV push of oxacillin, 500 mg IV q6h (100 mg/mL 0.9%NaCl) to Ms. Jones. The order is to be infused in 10 minutes. What is the IV flow rate in mL/hr ? HINT Divide the volume to be infused by the time, converting minutes to hours. SAMPLE SOLUTION 1. Calculate the number of mL to be infused. 500 mg x 1 mL = 5 mL 100 mg 2. Divide the volume to be infused by the time, converting minutes to hours. 5 mL x 1 x 60 minutes = 30 mL/hour 10 minutes 1 hour ANSWER Number: 30 Units: mL/hr 13. Problem type: Total daily dose calculation Medication: Ibuprofen @ home When at home, Ms. Jones takes 34 tablets of 200 mg ibuprofen for pain associated with menstrual cramps. The Davis’s Drug Guide reports that, when used as an antidysmenorrheal medication, ibuprofen has a maximum recommended dosage of 1.2 g/day. If Ms. Jones takes the maximum amount of ibuprofen allowed, how many tablets of ibuprofen will she have taken in one day? HINT There are 1000 mg in one gram. SAMPLE SOLUTION 1. Determine how many milligrams are in 1.2 grams. 1.2 g x 1000 mg = 1200 mg 1 g 2. Determine how many 200 mg tablets go into 1200 mg. 1200 mg x 1 tablet = 6 tablets 200 mg ANSWER Number: 6 Units: tablets 14. Problem type: Total daily dose calculation Medication: Metformin @ home hypothetical Suppose that after discharge from the hospital Ms. Jones is prescribed metformin 500 mg PO twice a day for her type 2 diabetes. The pharmacy dispenses 500 mg tablets. How many tablets should Ms. Jones take daily? HINT Multiply the number of doses Ms. Jones would take in a single day by the number of tablets prescribed. SAMPLE SOLUTION 1. Multiply the dosage by the number of tablets per dose. 2 doses x 1 tablets = 2 tablets 1 dose ANSWER Number: 2 Units: tablets 15. Problem type: Total daily dose calculation Medication: Tramadol @ home Prior to Ms. Jones’ hospitalization, she was prescribed tramadol 50 mg, 2 tabs, BID PO PRN severe pain. Suppose Ms. Jones took 2 doses in one day. How many mg would Ms. Jones have taken? HINT Multiply the number of doses that Ms. Jones took by the number of tablets. SAMPLE SOLUTION 1. Multiply the dosage by the number of tablets per dose. 2 doses x 2 tablets = 4 tablets 1 dose 3. Multiply the dosage of tramadol by the number of tablets. 4 tablets x 50 mg = 200 mg 1 tablet ANSWER Number: 200 Units: mg
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