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NAPLEX BABY > Calculations *** > Flashcards

Calculations *** Flashcards

1
Q

1 tsp (t) =

A

5 mL

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2
Q

1 tbsp (T) =

A

15 mL

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3
Q

1 fl oz =

A

30 mL

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4
Q

1 cup =

A

8 oz, 240 mL

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5
Q

1 pint =

A

16 oz, 480 mL

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6
Q

1 quart =

A

2 pints, 960 mL

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7
Q

1 gallon =

A

4 quarts, 3,840 mL

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8
Q

1 kg =

A

2.2 lbs

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9
Q

1 oz =

A

28.4 g

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10
Q

1 lb =

A

454g

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11
Q

1 grain (gr) =

A

65 mg

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12
Q

1 inch =

A

2.54 cm

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13
Q

1 meter =

A

100 cm

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14
Q

ratio relationships

A

4:8 = 4/8 = 1/2

ex: 2:3 = 2 parts + 3 parts = 5 total parts, use ratios to fine out what 1 part is and then multiply by 2 and 3 to find the amount of drug in each ratio segment

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15
Q

Order of Operations

A

B-PEMDAS
-brackets –> parenthesis –> exponents –> multiplication and division –> addition and subtraction

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16
Q

corrected phenytoin level formula

A

(total phenytoin) / (0.2 * albumin) + 0.1

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17
Q

Precent Strength *

A

–> % W/V = g/100 mL (solid mixed into a liquid)

–> % V/V = mL/100 mL (liquid mixed into a liquid)

–> % W/W = g/100 g (solid mixed into a solid

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18
Q

Common IV Fluids

A

–> NA = 0.9% (W/V) NaCl
- 1/2 NS = 0.45% (W/V) NaCl
- 1/4 NS = 0.225 (W/V) NaCl
–> D5W = 5% (W/V) dextrose in water
–> D20W = 20% dextrose in water

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19
Q

Ratio Strength

A

-most multi-step calculations will require converting ratio strength to percentage strength. If a ratio strength is presented in a problem, convert it to a percentage strength and convert it back if needed

-Ratio strength –> percentage strength
% strength = 100/ratio strength

-Percentage strength –> ratio strength
ratio strength = 100/% strength

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20
Q

Parts per million

A

PPM –> Percentage strength
- move the decimal left 4 places

Percentage strength –> PPM
-move the decimal right 4 places

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21
Q

Specific gravity

A

-ratio of the density of a substance to the density of water
–> water has a specific gravity of 1
–> < 1 = lighter than water
–> > 1 = heavier than water

SG = g/mL

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22
Q

Dilutions and Concentrations equation

A

Q1C1 = Q2C2

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23
Q

Osmolarity formula

A

(wt (g/L)/MW (g/mole) * # of particles * 1,000

24
Q

Isotonicity, E value equation

A

E = (58.5) (i) / (MW of drug)(1.8)

25
Q

once the E value is determined, what are the 3 steps to follow when doing isotonicity problems

A

1) calculate the total amount of Nacl needed to make the final product/rx isotonic by multiplying 0.9% NS by desired volume of the rx
2) calculate the amount of NaCL represented by the drug. - multiply the total drug amount (in ml or grams) by the E value
3) subtract step 2 from step 1 to determine the total amount of NaCl needed to prepare an isotonic rx

26
Q

moles and millimoles equations

A

mols: g/MW

mmols: mg/MW

27
Q

Milliequivalents formula

A

mEq = mg* valence/MW

28
Q

calorie sources in enteral and parenteral admin*

A

Carbs:
-Enteral: 4 kcal/gram
-Parenteral: 3.4 kcal/gram (glycerol: 4.3)

Fat:
-Enteral: 9 kcal/gram
-Parenteral: product specific ( 10% = 1.1, 20%=2, 30% =3)

Protein:
-Enteral: 4 kcal/gram
-Parenteral: 4 kcal/gram

29
Q

Fluid requirement determination when pt is > 20 kg

A

fluid requirement = 1500 mL + [(20 mL)(weight in kg - 20)]

30
Q

Determining Caloric needs: BEE and TEE

A

BEE (males) = 66,37 + 13.75(wt in kg) + 5(ht in cm) - 6.76(age)
BEE (females) = 655.1 + 9.6(wt in kg) + 1.85(ht in cm) - 4.68(age)

TEE= BEE * activity factor * stress factor

31
Q

Protein Requirements

A

Non-hospitilized/non-stressed: 0.8-1 g/kg/day
Hospitalized/malnourished: 1.2-2 g/kg/day

32
Q

Nitrogen intake formula

A

= grams of protein / 6.25

33
Q

Non-protein Calories to Nitrogen Ratio

A

1) calculate the grams of nitrogen supplied per day ( 1 g N = 6.25 g of protein)
2) then divide the total non-protein calories (dextrose + lipids) by the grams of nitrogen

Desirable NPC:N ratios:
- 80:1: the most severely stressed patients
-100:1: severely stressed patients
-150:1: unstressed patients

34
Q

Amino Acid Calculation

A

protein source = 4 kcal/gram

35
Q

Carbohydrates calculation

A

Eternal: 4 kcal/gram
Parenteral: 3.4 kcal/gram

36
Q

Fat Calculations

A

EN: 9 kcal/gram
PN: 10% = 1.1 kcal, 20% = 2 kcal, 30% = 3 kcal

37
Q

Corrected Calcium formula

A

*calculate when albumin is LOW

= calcium + [(4-albumin)(0.8)]

38
Q

Calcium and phosphate solubility

A

-choose calcium gluconate over calcium chloride b/c it has a lower risk of precipitation with phosphates
-add phosphate first, after the dextrose and amino acids
—> the calcium and phosphate added together should not exceed 45 meq/L

39
Q

Drug + nutrient interactions with enteral feeding

A

–> hold feedings 1 hr before and 1-2 hrs after feedings

-Warfarin: enteral products bind to warfarin = dec INR, hold feedings 1 hr before and 1-2 hrs after feedings

-Tetracyclines, quinolones, levothyroxine: will chelate with cations; separate from tube feeds

-Ciprofloxacin: oral suspension is oil based + not compatible; crush IR tabs and mix that way

-Phenytoin: levels are reduced when drug binds to feeding solution, separate from tube feeds by 2 hrs

40
Q

Body Mass Index (BMI) equations

A

= [weight (kg)] / [height (m)^2]

=[weight (lbs)] / [height(in)^2] * 703

25-29.9 = overweight
>/ 30 = obese

41
Q

Formulas for Ideal Body Weight

A

Males: 50 kg + (2.3 kg)(# inches over 5 feet

Female: 45.5 kg + (2.3)(# inches over 5 feet)

42
Q

Adjusted Body Weight formula

A

= IBW + 0.4(TBW- IBW)

43
Q

Which weight to use for drug dosing: underweight

A

-TBX < IBW

–> use TBW for ALL medications

44
Q

Which weight to use for drug dosing: normal weight

A

TBW = IBW (or < 120% of IBW)

–> use TBW for MOST medications
–> *use IBW for aminophylline, thepphyline and acyclovir

45
Q

Which weight to use for drug dosing: Obese

A

TBW >/ 120% of IBW

–> *use IBW for aminophylline, thepphyline and acyclovir
–> use TBW for LMWHs, UFH, and vancomycin
–> use adjusted body weight for aminoglycosides

46
Q

Flow rates step by step example

A

1) 1st fraction is the drug concentration (400 mg/250 mL)- since we are usually solving for ml/hr –> put the ml on top
2) 2nd fraction converts the drug weight from mg to mcg (1 mg/ 1000 mcg)
3) 3rd fraction is the rate of administration (x mcg/min or hr)
4) 4th fraction is to convert min to hr if needed

47
Q

Renal function and Crcl estimation

A

-as kidney function declines, the level of Scr increases

–> BUN: Scr ratio > 20:1 = dehydration

(figure out by BUN/Scr = X:1)

48
Q

Interpreting ABGs*

A

1: is it an acidosis or alkalosis?
–> low ph: acidosis
–> high ph: alkalosis

2: What other lab values are abnormal?
–> Respiratory:
- low Co2 = alkalosis
-high Co2 = acidosis
–> Metabolic:
-high HCO3: alkalosis
-low HCO3: acidosis

3: Match pH with abnormal lab value in step 2:
EX: loc pH, high CO2 & normal HCO3: respiratory acidosis

4: ex: low pH, low CO2 and low HCO3
–> match w/ pH and the other one is the compensated part)
= metabolic acidosis with respiratory compensation

respiratory opposite, metabolic equal

49
Q

Anion gap formula and interpretation

A

AG: Na- Cl- HCO3

AG > 12 = + anion gap acidosis

–> CUTE DIMPLES (cyanide, uremia, toluene, ethanol, diabetic ketoacidosis, isoniazid, methanol, propylene glycol, lactic acidosis, ethylene glycol, salicylates) = causes of a gap acidosis

50
Q

Buffer Systems and Ionization

A

-if the pH > pKa, more of the acid is ionized, and more of the conjugate based is UN-ionized

-if the pH = pKa, the ionized and un-ionized forms are equal

-if the pH < pKa, more of the acid is un-ionized, and more of the conjugated base is ionized.

51
Q

Weak acid and weak base formulas*

A

Weak acid:
-pH = pKa + log (salt/acid)

Weak base:
-pH = (14- pKb) + log (base/salt)

52
Q

Percent Ionization equations*

A

Weak acid:
= 100 / 1 + 10 ^ (pka - ph)

Weak base:
100 / 1+ 10 ^ (ph- pka)

53
Q

Drug conversions: calcium carbonate and calcium citrate*

A

-calcium carbonate: 40% elemental Ca
-calcium citrate: 21% elemental Ca

54
Q

Drug conversions: Aminophyline to theophylline *

A

A –> T : Multiply by 0.8

T –> A: Divide by 0.8

55
Q

Absolute Neutrophil Count (ANC) formula*

A

ANC = WBC * [(% neut + % bands) / 100]

Normal ANC = 2200 - 8000
Neutropenia = < 1000
Severe Neutropenia = < 500
Profound neutropenia = < 100

NAPLEX BABY (23 decks)

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