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Dosage calculators

1. PO dosage calculator - solids i.e. tablets, caplets, capsules, lozenges 2. PO dosage calculator - liquids calculates liquid medications such as acetaminophen 3.
elixir IV dosage calculator calculates IV medications such as furosemide and digoxin

Calculate IV rates

1. IV rate (gtt/min) calculates IV rates without using an IV pump 2. IV rate (mL/hr) calculates IV rates when given a time limit when IV must be infused 3. mcg/min as mL/hr calculates IV medication rates such as norepinephrine and 4.
nitroglycerine mcg/kg/min as mL/hr dopamine calculates IV medication rates such as nitroprusside and

Calculate infusion time

1. IV time (hrs)

given an IV rate, calculates the duration of an IV

Calculate dosage given or infusing There are times when the only way to figure out how much medication is being infused is by looking at the information on the IV bag and the rate of the infusion.

1. mL/hr as dose/hr calculates the dose of medications infusing such as heparin 2. mL/hr as mcg/min calculates the dose of medications infusing such as nitroglycerine
and norepinephrine

3. mL/hr as mcg/kg/min
and nitroprusside Clinical Calculators

calculates the dose of medications infusing such as dobutamine

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

pediatric dose calculator converts an adult dosage into a pediatric using BSA O2 remaining in e-cylinder calculates how much O2 is left according to rate infusing bsa calculator calculates the BSA according to height and weight drug absorption (Pka) determines how well a medication will be absorbed into the body O.R. fluid requirements calculates IV rate according to the type of surgery N.P.O. fluid replacement calculates fluid replacement for time NPO allowable blood loss calculates how much blood can be lost without needing a transfusion estimated blood volume estimates how much blood is in a person's body Ideal Body Weight (IBW) compares an individuals weight against a statistical norm Adjusted Body Weight (ABW) calculates the ABW in obese persons for more accurate drug dosing

11. ABG interpreter interprets a respiratory or metabolic cause for pH disorders.


Conversion Calculators

1. 2. 3. 4. 5. 6. 7. 8.

F,C conversions converts Fahrenheit and Celsius temperatures pounds to kilograms converts pound and kilogram weights inches to centimeters converts inch and centimeter lengths foot, inch to centimeters converts foot, inch and centimeter lengths (i.e 5'3" = 160 cm) non-metric to metric converts gr, tsp, tbs, oz, cup, min, dr to metric metric units converts between metric weights and volumes % solutions to mg/mL converts % solution into mg/mL concentration epinephrine solutions to mg/mL chart that converts a ratio into a mg/mL concentration

Drug Calculators

1. Propofol bolus/infusion calculates how many mL to push for intubation or rates for 2.
Example You have received report on a patient with a heparin drip but the nurse forgot to say what dosage the drip was infusing at. The heparin bag is labeled 25,000 units in 250 mL NS and the IV pump is infusing at 20 mL/hr. In this example, 20 mL/hr = rate, an infusion. 25,000 units = dosage available 250 mL = volume available So the dosage ordered, an infusion, = 2000 units/hour See the example below. sedation and maintenance Muscle relaxants calculates how many mL to push for intubation

Formula rate x dose available mL available Using the formula on the example above looks like this: 20cc/hr x 25,000units 250mL which = 2000 units/hr Example

A patient is on a norepinephrine drip infusing at 56 cc/hr. There is no titration table table at the bedside. The IV bag is labeled 32 mg norepinephrine in 500cc Dextrose 5%. How many mcg/min is the patient receiving? Use the example below to see how to solve this problem with the calculator. rate = 56mL/hr dose available = 32mg mL available = 500mL

With the calculator, we see the patient is recieving 60 mcg/min of norepinephrine. This is a higher than recommended dose!!! Formula In this example, first determine how many milligrams/hour is being delivered by the IV pump. The rate of the IV pump (mL/hr) is divided by the volume of the IV bag (mL available), then multiply this result by the total amount of medication (mg) in the IV bag. rate x dose available mL available becomes 56mL/hr x 32mg 500mL which = 3.58 mg/hr Next, after the milligrams/hour has been determined, use the next formula to convert from milligrams/hour to mcg/min. mg x 60min 1000 becomes 3.58mg x 1000 60min which is 59.7 mcg/min (yikes!) Example You have received a patient from another hospital on a dopamine drip except no information was given about it. The bag is labeled with the concentration of 800 mg in 500cc of D5W. The IV

pump is infusing at 53 cc/hr and the patient weighs 70kg. How much dopamine is this patient receiving? Use the example below to see how this problem was solved. rate = 53mL/hr weight = 70kg dose available = 800 ml available = 500

Using the calculator, we know the patient is receiving 20 mcg/kg/min of dopamine. Formula Using the example above, first determine how many milligrams/hour is being delivered by the IV pump. The rate of the IV (cc/hr) is divided by the volume of the IV bag (mL available), then multiply this result by the total amount of medication (mg) in the IV bag. rate x dose available mL available becomes 53mL/hr x 800mg 500mL which = 84.8 mg/hr Next, after the milligrams/hour has been determined, use the next formula to convert from milligrams/hour to mcg/kg/min. mg x 1000 / kg 60min becomes 84.8mg x 1000 / 70 60min which = 20.2 mcg/kg/min Example The doctor has ordered an antibiotic whose average adult dose is 250 mg per day. What would the dosage for this medication be on a child who is 100 cm in length and weighs 25 kg? See the example below.

In this example, 115 mg of medication would be given. Formula First, the body surface area (BSA) must be determined: kg0.425 x cm0.725 x 0.007184 = BSA The above formula is just one method for determining BSA. Results with other formulas will vary. Next, the following formula* is used: BSA x adult dose = approx. child dose 1.73 You are transporting your patient, who has emphysema, from your unit to radiology for a CT scan. Without oxygen at 6 L/min, your patient's O2 saturation on room air drops to 75%. It will take you 10 minutes to get there and back. The portable O2 tank you grabbed has 500 psi left in it. Do you have enough oxygen left for the trip? See the example below

At 500 psi with a flow rate of 6 liters per min, there are 28 minutes of oxygen left. Yes, there is enough for the trip. Formula My text book uses the following formula and data: capacity (in L) / service pressure (in psi) = remaining contents (in L) / gauge pressure (in psi)

1. The service capacity for an e-cylinder carrying oxygen is 1900 psi. 2. The volume of oxygen in an e-cylinder is 660 liters.
Now entering the values listed above: 660 L / 1900 psi = remaining contents (in L) / gauge pressure (in psi) I find it easier to look at this formula this way: 0.35 x psi on gauge L/min to be delivered The 0.35 comes from dividing 660 by 1900. In the example above: 0.35 x 500 psi = 28 min 6 L/min

Reference: Nagelhout, J. J., & Zaglaniczy, K., L. (2001). Nurse anesthesia (2nd ed.). Philadelphia: W.B. Saunders Co. If you see this message your web browser does not support JavaScript or you have disabled JavaScript on your browser. The calculator will not work without enabling JavaScript. I want to use a nomogram to determine BSA Example The doctor has ordered an antibiotic on 11 y/o Billy. The average adult dose is 250 mg. In order to calculate pediatric doses you must first determine Billy's body surface area (BSA). Billy is 157.5 cm in height and weighs 45 kg. Using the example below, plug in the numbers into the calculator to determine Billy's BSA.

Using the calculator, Billy's BSA is determined as 1.42 M2. Formula kg0.425 x cm0.725 x 0.007184 = BSA Example 1) The pH of the stomach is 2.5. The pKa of sodium pentothal is 7.4 and it is acidic. If a patient is given sodium pentothal orally instead of IV, will it put the patient to sleep? See the example below:

None of the sodium pentothal is ionized in the stomach. Therefore the patient would absorb 100% of this medication and it would put him to sleep. 2) A basic drug with a pKa of 7.8 is a known teratogen. If given IV to a pregnant woman whose blood pH is 7.4, will this drug cross the placenta and effect the baby? See the example below:

In this example, 72% of the drug is ionized which means 28% of the drug is unionized and will pass through the placenta to effect the baby. Basics on Ionization Ionized = water soluble = poor absorption through stomach, BBB, and placenta. Non-ionized = lipid soluble = absorbed well (cell membranes are composed of lipids)

For example, sodium (Na+) and chloride (Cl-) are both ionized. Cells must provide a channel for these ions to enter an otherwise impenetrable lipid membrane.

Formula Percent Ionized Formula

where x = -1 if acid drug or 1 if basic drug

Basic Rules pKa is defined as the pH were a drug exists as 50% ionized and 50% unionized

If pKa - pH = 0, then 50% of drug is ionized and 50% is unionized

An acid in an acid solution will not ionize An acid in a basic solution will ionize A base in a basic solution will not ionize A base in an acid solution will ionize

If pKa - pH = 0.5, then the solution is 75% ionized/ 25% unionized or 75% unionized/ 25% ionized

If pKa - pH > 1 then the solution is 99-100% ionized or 99-100% unionized* Slight discrepancy between this statement and formula used for calculator. Formula used indicates solutions would be 90-100% ionized or unionized. These rules were taken from my Nursing 605 course. My chemistry background is weak and I'm unable to verify the formula used. Other than this, the formula follows the basic rules.

Example What is the NPO deficit for a patient who weighs 50 kg who has been NPO for 10 hours prior to surgery? The answer is 1 liter (500 mL 1st hour, 250 mL 2nd hour, and 250 mL 3rd hour). See how the numbers were used on the calculator below.

Formula IV fluid replacement for NPO deficit = 2mL/kg for each hour NPO prior to surgery. 50% of this deficit is replaced within the first hour of surgery with the remaining 50% being replaced over the next 2 hours. If the patient stayed in the hospital overnight with an IV infusing while NPO, subtract this amount from the NPO deficit. In the example above: 2 mL/kg/hr = 2 x 50 x 10 = 1000 @1st hr, 500 mL will be replaced 2nd hr, 250 mL will be replaced 3rd hr, 2hr 250 mL will be replaced If in this example, the patient stayed in the hospital overnight with an IV infusion at 100 mL/hr while NPO, all their NPO deficit (1 liter) would already be replaced.

Formulas Allowable Blood Loss (ABL)*

EBV x (Hi - Hf) = ABL Hi Hi = initial Hct Hf = final lowest acceptable Hct

Estimated Blood Volume (EBV)

EBV = weight (kg) x average blood volume

Average blood volumes** Age Premature Neonates Full Term Neonates Infants Adult Men Adult Women Blood volume 95 mL/kg 85 mL/kg 80 mL/kg 75 mL/kg 65 mL/kg

Normal Hct Values*** Men 42-52% Women 37-47%

If the patient is obese, using the IBW or ABW will give more accuracy than an actual weight.

Example Question: Before surgery is to take place, what is the estimated blood volume (EBV) of a female patient weighing 50 kg? Also, what is the allowable blood loss (ABL) of this patient if her Hct is 45?

In the example above, EBV = 50kg x 65 (adult woman's blood volume) = 3250 The initial Hct (Hi) = 45%, her current Hct The final lowest acceptable Hct (Hf) = 30% (What ever cut off is used clinically to decide how low the individual's Hct will be allowed to drop. Thirty percent is used in this calculator but in reality this will vary from case to case.) So the example would look like this: 3250 x (45 30) 45

= 1083

Using this rough estimate, the patient in this example could loose 1083 mL of blood without needing a transfusion.

Replacing Blood Loss "Ideally, blood loss should be replaced with crystalloid or colloid solutions to maintain intravascular volume (normovolemia) until the danger of anemia outweighs the risks of transfusion. At that point, further blood loss is replaced with transfusions of red blood cells to maintain hemoglobin concentration (or hematocrit) at that level. For most patients, that point corresponds to a hemoglobin between 7 and 10 g/dL (or a hematocrit of 21-30%). Below a hemoglobin concentration of 7 g/dL, the resting cardiac output has to increase greatly to maintain normal oxygen delivery" (Morgan & Mikhail, 1996).

Estimating blood loss*** Dry sponges 4x4 hold ~ 10 mL blood Ray-techs ~ 10-20 mL blood Lap sponges ~ 100 mL blood Pediatric cases should have sponges & gauze weighed for blood loss**

Blood loss replacement*** Replace 1 mL blood with: 3 mL crystalloid (i.e. NS, Dextrose, LR) 1 mL colloid (i.e. albumin**, Hespan, Dextran) 1 mL whole blood 1 mL PRBC Formulas Allowable Blood Loss (ABL)*

EBV x (Hi - Hf) = ABL Hi Hi = initial Hct Hf = final lowest acceptable Hct

Estimated Blood Volume (EBV)

EBV = weight (kg) x average blood volume

Average blood volumes** Age Premature Neonates Full Term Neonates Infants Adult Men Adult Women Blood volume 95 mL/kg 85 mL/kg 80 mL/kg 75 mL/kg 65 mL/kg

Normal Hct Values*** Men 42-52% Women 37-47%

If the patient is obese, using the IBW or ABW will give more accuracy than an actual weight.

Example Question: Before surgery is to take place, what is the estimated blood volume (EBV) of a female patient weighing 50 kg? Also, what is the allowable blood loss (ABL) of this patient if her Hct is 45?

In the example above, EBV = 50kg x 65 (adult woman's blood volume) = 3250 The initial Hct (Hi) = 45%, her current Hct The final lowest acceptable Hct (Hf) = 30% (What ever cut off is used clinically to decide how low the individual's Hct will be allowed to drop. Thirty percent is used in this calculator but in reality this will vary from case to case.) So the example would look like this:

3250 x (45 30) 45

= 1083

Using this rough estimate, the patient in this example could loose 1083 mL of blood without needing a transfusion.

Replacing Blood Loss "Ideally, blood loss should be replaced with crystalloid or colloid solutions to maintain intravascular volume (normovolemia) until the danger of anemia outweighs the risks of transfusion. At that point, further blood loss is replaced with transfusions of red blood cells to maintain hemoglobin concentration (or hematocrit) at that level. For most patients, that point corresponds to a hemoglobin between 7 and 10 g/dL (or a hematocrit of 21-30%). Below a hemoglobin concentration of 7 g/dL, the resting cardiac output has to increase greatly to maintain normal oxygen delivery" (Morgan & Mikhail, 1996).

Estimating blood loss*** Dry sponges 4x4 hold ~ 10 mL blood Ray-techs ~ 10-20 mL blood Lap sponges ~ 100 mL blood Pediatric cases should have sponges & gauze weighed for blood loss**

Blood loss replacement*** Replace 1 mL blood with: 3 mL crystalloid (i.e. NS, Dextrose, LR) 1 mL colloid (i.e. albumin**, Hespan, Dextran) 1 mL whole blood 1 mL PRBC

Formulas Allowable Blood Loss (ABL)*

EBV x (Hi - Hf) = ABL Hi Hi = initial Hct Hf = final lowest acceptable Hct

Estimated Blood Volume (EBV)

EBV = weight (kg) x average blood volume

Average blood volumes** Age Premature Neonates Full Term Neonates Infants Adult Men Adult Women Blood volume 95 mL/kg 85 mL/kg 80 mL/kg 75 mL/kg 65 mL/kg

Normal Hct Values*** Men 42-52% Women 37-47%

If the patient is obese, using the IBW or ABW will give more accuracy than an actual weight.

Example

Question: Before surgery is to take place, what is the estimated blood volume (EBV) of a female patient weighing 50 kg? Also, what is the allowable blood loss (ABL) of this patient if her Hct is 45?

In the example above, EBV = 50kg x 65 (adult woman's blood volume) = 3250 The initial Hct (Hi) = 45%, her current Hct The final lowest acceptable Hct (Hf) = 30% (What ever cut off is used clinically to decide how low the individual's Hct will be allowed to drop. Thirty percent is used in this calculator but in reality this will vary from case to case.) So the example would look like this: 3250 x (45 30) 45

= 1083

Using this rough estimate, the patient in this example could loose 1083 mL of blood without needing a transfusion.

Replacing Blood Loss "Ideally, blood loss should be replaced with crystalloid or colloid solutions to maintain intravascular volume (normovolemia) until the danger of anemia outweighs the risks of transfusion. At that point, further blood loss is replaced with transfusions of red blood cells to maintain hemoglobin concentration (or hematocrit) at that level. For most patients, that point corresponds to a hemoglobin between 7 and 10 g/dL (or a hematocrit of 21-30%). Below a hemoglobin concentration of 7 g/dL, the resting cardiac output has to increase greatly to maintain normal oxygen delivery" (Morgan & Mikhail, 1996).

Estimating blood loss*** Dry sponges 4x4 hold ~ 10 mL blood Ray-techs ~ 10-20 mL blood Lap sponges ~ 100 mL blood Pediatric cases should have sponges & gauze weighed for blood loss**

Blood loss replacement*** Replace 1 mL blood with:

3 mL crystalloid (i.e. NS, Dextrose, LR) 1 mL colloid (i.e. albumin**, Hespan, Dextran) 1 mL whole blood 1 mL PRBC

Formulas Allowable Blood Loss (ABL)*

EBV x (Hi - Hf) = ABL Hi Hi = initial Hct Hf = final lowest acceptable Hct

Estimated Blood Volume (EBV)

EBV = weight (kg) x average blood volume

Average blood volumes** Age Premature Neonates Full Term Neonates Infants Adult Men Adult Women Blood volume 95 mL/kg 85 mL/kg 80 mL/kg 75 mL/kg 65 mL/kg

Normal Hct Values*** Men 42-52% Women 37-47%

If the patient is obese, using the IBW or ABW will give more accuracy than an actual weight.

Example Question: Before surgery is to take place, what is the estimated blood volume (EBV) of a female patient weighing 50 kg? Also, what is the allowable blood loss (ABL) of this patient if her Hct is 45?

In the example above, EBV = 50kg x 65 (adult woman's blood volume) = 3250 The initial Hct (Hi) = 45%, her current Hct The final lowest acceptable Hct (Hf) = 30% (What ever cut off is used clinically to decide how low the individual's Hct will be allowed to drop. Thirty percent is used in this calculator but in reality this will vary from case to case.) So the example would look like this: 3250 x (45 30) 45

= 1083

Using this rough estimate, the patient in this example could loose 1083 mL of blood without needing a transfusion.

Replacing Blood Loss "Ideally, blood loss should be replaced with crystalloid or colloid solutions to maintain intravascular volume (normovolemia) until the danger of anemia outweighs the risks of transfusion. At that point, further blood loss is replaced with transfusions of red blood cells to maintain hemoglobin concentration (or hematocrit) at that level. For most patients, that point corresponds to a hemoglobin between 7 and 10 g/dL (or a hematocrit of 21-30%). Below a hemoglobin concentration of 7 g/dL, the resting cardiac output has to increase greatly to maintain normal oxygen delivery" (Morgan & Mikhail, 1996).

Estimating blood loss*** Dry sponges 4x4 hold ~ 10 mL blood Ray-techs ~ 10-20 mL blood Lap sponges ~ 100 mL blood

Pediatric cases should have sponges & gauze weighed for blood loss**

Blood loss replacement*** Replace 1 mL blood with: 3 mL crystalloid (i.e. NS, Dextrose, LR) 1 mL colloid (i.e. albumin**, Hespan, Dextran) 1 mL whole blood 1 mL PRBC

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