Nursing Knowledge Base

Question 1

Medical errors

Answer 1

More people die from medical errors than from chronic lower respiratory diseases, accidents, stroke, Alzheimer’s disease, and diabetes mellitus

Question 2

Medication Application to Nursing Practice

Answer 2

• Everyone administering medications should review the medication list at each patient encounter.
• Use computerized physician order entry (CPOE) when possible to
• Standardize practice.
• Improve legibility of orders.
• Alert and update health care providers on side effects, drug interactions, and new orders.
• Use an electronic medical record when possible and interface this with CPOE if available to improve communication and alert all
providers to administration times
• Bar-coding medications linked to patient identification bracelets improves safety and provides one last opportunity to identify a medication error
• Use smart pumps to administer intravenous medications.
• Medication reconciliation identifies medication discrepancies and
prevents errors.
• Patient, family caregiver, and provider education can be used to prevent medication errors.

Question 3

Conversions Within One System

Answer 3

Converting measurements within one system is relatively easy; simply
divide or multiply in the metric system. To change milligrams to grams,
divide by 1000, moving the decimal 3 points to the left. e.g.
1000mg=1g,
350mg=0.35g

To convert liters to milliliters, multiply by 1000 or move the decimal 3
points to the right.
e.g.
1L=1000mL
0.25L=250mL

Question 4

Example Page 2077

Answer 4

The health care provider orders 500 mg of amoxicillin to be
administered in a gastric tube every 8 hours. The bo􀄴le of amoxicillin is
labeled 400 mg/5 mL. Use the following steps to calculate how much
amoxicillin to give:
1. Estimate the answer: The amount to be given is a little more than
the labeled dose per 5 mL (unit dose) that is provided in the
solution; therefore, the answer is a little more than 5 mL.
2. Set up the proportion:

400mg 500mg
———- = ————
5ml x ml

3. Cross-multiply the means and the extremes:

400x = 500x5
400x = 2500

4. Divide both sides by the number before x:

400x 2500
——– = ——–
400 400

x = 2500
———
400

x= 6.25ml

5. Compare the estimate in Step 1 with the answer in Step 4: The answer (6.25 mL) is close to the estimated amount (a little more than 5 mL). Therefore, the answer is correct; prepare and
   administer 6.25 mL in the patient’s gastric tube.

Question 5

Dimensional Analysis

Answer 5

Example: The health care provider orders 0.45 g penicillin V potassium
through a gastric tube. The vial label reads: penicillin V potassium 125
mg/5 mL.
1. Identify the unit of measure that you need to administer. This
medication is given in a gastric tube, which is a liquid medication;
therefore, the answer will be in milliliters (mL).
2. Estimate the answer. The medication order is more than 3 times
but less than 4 times the unit dose in the vial; thus, the answer is
more than 15 mL but less than 20 mL.
3. Place the name or appropriate abbreviation for x on the left side
of the equation.
x mL =

4. Place available information from the problem in a fraction format on the right side of the equation. Since the medication will be administered in milliliters, place mL in the numerator.

x mL = 5mL
——–
125mg

5. Look at the medication order and add other factors into the problem. Set up the numerator so it matches the unit in the previous denominator. The order is for 0.45 g, and the medication
   is available in 125-mg bottles. Knowing that 1 g = 1000 mg, add this conversion to the calculation.

x mL = 5mL x 1000 mg x 0.45g
——— ———– ——
125mg 1g 1

6. Cancel out like units of measurement on the right side of the equation.
7. Reduce to the lowest terms if possible and solve the problem or solve for x. Label your answer.

x mL = 5 x 1000 x 0.45
           ------------------------
                     125
x = 2250
      --------
      125
x = 18 mL

Compare the estimate from Step 2 with the answer in Step 7. The
calculated answer is 18 mL, which is between 15 mL and 20 mL.
This matches the estimate made in Step 2. Prepare and administer
18 mL of medication as ordered.

Question 6

Pediatric doses

Answer 6

Calculations require special caution
Most pediatric medications are ordered in milligrams per kilogram (mg/kg). Therefore, weigh the patient in kilograms beforeadministering medications. Avoid converting the patient’s weight
from pounds to kilograms to prevent errors. Different formulas and methods are used to calculate medication
dosages in children. The two most common methods of calculating pediatric dosages are based on a child’s weight or BSA.