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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
once the E value is determined, what are the 3 steps to follow when doing isotonicity problems
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
moles and millimoles equations
mols: g/MW mmols: mg/MW
27
Milliequivalents formula
mEq = mg* valence/MW
28
calorie sources in enteral and parenteral admin*
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
Fluid requirement determination when pt is > 20 kg
fluid requirement = 1500 mL + [(20 mL)(weight in kg - 20)]
30
Determining Caloric needs: BEE and TEE
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
Protein Requirements
Non-hospitilized/non-stressed: 0.8-1 g/kg/day Hospitalized/malnourished: 1.2-2 g/kg/day
32
Nitrogen intake formula
= grams of protein / 6.25
33
Non-protein Calories to Nitrogen Ratio
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
Amino Acid Calculation
protein source = 4 kcal/gram
35
Carbohydrates calculation
Eternal: 4 kcal/gram Parenteral: 3.4 kcal/gram
36
Fat Calculations
EN: 9 kcal/gram PN: 10% = 1.1 kcal, 20% = 2 kcal, 30% = 3 kcal
37
Corrected Calcium formula
*calculate when albumin is LOW = calcium + [(4-albumin)(0.8)]
38
Calcium and phosphate solubility
-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
Drug + nutrient interactions with enteral feeding
--> 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
Body Mass Index (BMI) equations
= [weight (kg)] / [height (m)^2] =[weight (lbs)] / [height(in)^2] * 703 25-29.9 = overweight >/ 30 = obese
41
Formulas for Ideal Body Weight
Males: 50 kg + (2.3 kg)(# inches over 5 feet Female: 45.5 kg + (2.3)(# inches over 5 feet)
42
Adjusted Body Weight formula
= IBW + 0.4(TBW- IBW)
43
Which weight to use for drug dosing: underweight
-TBX < IBW --> use TBW for ALL medications
44
Which weight to use for drug dosing: normal weight
TBW = IBW (or < 120% of IBW) --> use TBW for MOST medications --> *use IBW for aminophylline, thepphyline and acyclovir
45
Which weight to use for drug dosing: Obese
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
Flow rates step by step example
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
Renal function and Crcl estimation
-as kidney function declines, the level of Scr increases --> BUN: Scr ratio > 20:1 = dehydration (figure out by BUN/Scr = X:1)
48
Interpreting ABGs*
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
Anion gap formula and interpretation
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
Buffer Systems and Ionization
-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
Weak acid and weak base formulas*
Weak acid: -pH = pKa + log (salt/acid) Weak base: -pH = (14- pKb) + log (base/salt)
52
Percent Ionization equations*
Weak acid: = 100 / 1 + 10 ^ (pka - ph) Weak base: 100 / 1+ 10 ^ (ph- pka)
53
Drug conversions: calcium carbonate and calcium citrate*
-calcium carbonate: 40% elemental Ca -calcium citrate: 21% elemental Ca
54
Drug conversions: Aminophyline to theophylline *
A --> T : Multiply by 0.8 T --> A: Divide by 0.8
55
Absolute Neutrophil Count (ANC) formula*
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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