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Systems of Measurement and Common Equivalents

Systems of Measurement and Common Equivalents

Objectives
After completing this chapter, you will successfully be able to:

• Identify measurements included in the metric, apothecaries’, and household

systems.
• Understand abbreviations used in the metric, apothecaries’, and household
systems.
• Calculate intake and output necessary for accurate recording in a medical record.
• Differentiate between Fahrenheit and Celsius thermometers used for monitoring
temperature.
• Differentiate between standard time and military time necessary for accurate
recording in a medical record.

Preventing Medication Errors

Medication calculation need not be difficult if you have a problem-solving method that is
easy to understand and implement. In addition, you need to understand common
equivalents and units of measurement to visualize all parts of a medication dosage calculation
problem. Understanding common equivalents and units of measurement will assist you in
preventing medication errors related to incorrect dosage.

This chapter will help you to understand the measurement systems used for medication
administration. This knowledge is necessary to accurately implement the problem-solving method
of dimensional analysis.

Systems of Measurement
Three systems of measurement are used for medication dosage administration: the metric system, the apothecaries’
system, and the household system. To be able to accurately administer medication, you must understand all three of
these systems.

The Metric System

The metric system is a decimal system of weights and measures based on units of ten in which gram, meter, and
liter are the basic units of measurement. However, gram and liter are the only measurements from the metric system
that are used in medication administration. The meter is a unit of distance, the gram (abbreviated g or gm) is a unit
of weight, and the liter (abbreviated L) is a unit of volume.
The most frequently used metric units of weight and their equivalents are summarized in Box 2.1.

Another way to understand the metric units of weight and their equivalents is to visualize the relationship between the
measurements and equivalents displayed in Figure 2.1.

The most frequently used metric units for volume and their equivalents are summarized in Box 2.2.

Box 2.1 Metric System Units of Weight and Equivalents

• 1 kilogram (kg)
• 1 gram (g)
• 1 milligram (mg)
• 1 microgram (mcg)
• 1 kg = 1000 g
• 1 g = 1000 mg
• 1 mg = 1000 mcg

Figure 2.1. Metric system units of weight and equivalents.

Box 2.2 Metric System Units of Volume and Equivalents

• 1 liter (L)
• 1 milliliter (mL)
• 1 L = 1000 mL
 Figure 2.2. Metric system units of volume and

equivalents.

Another way to understand the metric units of volume and their equivalents is to visualize the relationship between
the measurements and equivalents displayed in Figure 2.2.

The Apothecaries’ System

The apothecaries’ system is a system of measuring and weighing drugs and solutions in which fractions are used to
identify parts of the unit of measure. The basic units of measurement in the apothecaries’ system include weights and
liquid volume. Although the apothecaries’ system may be replaced by the metric system, it is still necessary to
understand it because some physicians continue to order medications using this system, and they also may include
Roman numerals in the medication order.

The most frequently used measurements and equivalents within the apothecaries’ system’s units of weight are
summarized in Box 2.3, and the most frequently used measurements and equivalents within the apothecaries’ system’s
units of volume are summarized in Box 2.4. Figure 2.3 can help you visualize the equivalents for weight and volume.

The Household System

The use of household measurements is considered inaccurate because of the varying sizes of cups, glasses, and eating
utensils, and this system generally has been replaced with the metric system. However, as patient care moves away
from hospitals, which use the metric system, and into the community, it is once again necessary for the nurse to have
an understanding of the household measurement system to be able to use and teach it to clients and families.

Box 2.3 Apothecaries’ System Units of Weight and Equivalents

• 1 pound (lb)
• 1 ounce (oz)
• 1 dram (dr)
• 1 grain (gr)
• 1 lb = 16 oz
• 1 oz = 8 dr
• 1 dr = 60 gr
Box 2.4 Apothecaries’ System Units of Volume and Equivalents

• 1 gallon (gal)
• 1 quart (qt)
• 1 pint (pt)
• 1 fluid ounce (fl oz)
• 1 fluid dram (fl dr)
• 1 minim (M)
• 1 gal = 4 qt
• 1 qt = 2 pt
• 1 pt = 16 fl oz
• 1 fl oz = 8 fl dr
• 1 fl dr = 60 M
• 1 fl oz = 1 oz
• 1 fl dr = 1 dr
 Figure 2.3. Apothecaries’ system of equivalents for weight and volume. Please note that the

figures are not shown to scale.

Box 2.5 Household Measurement System and Equivalents

• 1 cup
• 1 tablespoon (tbsp or T)
• 1 teaspoon (tsp or t)
• 1 drop (gtt)
• 1 cup = 8 ounces (oz)
• 2 Tbsp = 1 oz
• 3 tsp = 1 tbsp
• 1 tsp = 60 gtt
Figure 2.4. Household measurement system and equivalents for volume. Please note that

the figures are not shown to scale.

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Jun 30, 2016 | Posted by drzezo in PHARMACY | Comments Off on Systems of Measurement and

Common Equivalents

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BACHELOR OF SCIENCE IN NURSING:
NCMA 113 - FUNDAMENTALS OF NURSING
COURSE MODULE COURSE LAB WEEK
6 6 7

MEDICATION 1 – CONVERSION by Francis A. Vasquez, MAN, RN

✓ Read course and laboratory unit objectives

✓ Read study guide prior to class attendance
✓ Read required learning resources; refer to course unit terminologies for jargons
✓ Participate in weekly discussion board (Canvas)
✓ Answer and submit course unit tasks

At the end of this unit, the students are expected to:

Cognitive:
1. Understand the basic concepts in medication or drug orders.
2. Identify different types of drug orders.
3. Identify different parts of a drug order.
4. Describe various routes in administering medications.
5. Accurately convert values using different system of measurements.

Affective:
1. Listen attentively during class discussions
2. Demonstrate tact and respect when challenging other people’s opinions and ideas
3. Accept comments and reactions of classmates on one’s opinions openly and graciously.
Psychomotor:
1. Participate actively during class discussions and group activities
2. Express opinion and thoughts in front of the class

Berman, A., Synder, S., & Frandsen, G. (2016) Kozier & Erb’s Fundamentals of Nursing
Concepts, Process and Practice 10th Edition (pp 776-851). England: Pearson Education Limited

Access Pearson MyLab – Access your instructo’s course – Click eText Berman 10e – then

Click no. 35 Medication – Read and study this chapter

STUDY GUIDE:

Introduction
Administration of medication is one of the most common tasks performed by a nurse that requires
systematic, organized and accurate drug preparation, administration and documentation that are needed
to ensure client’s safety and possible resolution of his health problems. Drug administration entails one’s
accountability. Its means that the nurse is responsible or answerable in every medication he administers
to his client. That is why a thorough assessment of the client’s condition prior to drug administration and
client evaluation during the course of drug therapy are equally important to know if the client needs the
drug and the client’s response to the drug.

Medication

“A medication or a drug is a substance administered for the diagnosis, cure, treatment, or relief of a
symptom or for prevention of disease.” (Kozier and Erb, 2016). Drugs have different therapeutic action
such as the following:
1. Palliative – it relieves the symptoms of the disease but does not treat the disease itself. Examples
are the pain relievers such as mefenamic acid, Morphine and aspirin
2. Curative- it cures the disease process itself. Example of this are the antibiotics or antiviral drugs
such as penicillin, ampillicin
3. Supportive- it maintains body function until treatment takes over. Example is paracetamol for fever
4. Substitutive- it replaces body fluid or substances. Example is Insulin for diabetes
5. Chemotherapeutic- it destroys malignant cells. Example is Vincristine for Leukemia
6. Restorative- it restores client’s health. Example of this are the vitamins and mineral supplements.

Medication or Drug Orders

The doctor or physician assesses and evaluates client’s condition and makes the clinical judgement
and orders specific drug or drugs for the client to take. It is important for the nurse to get used with
different parts and types of drug orders because different types of drug orders have different types of
urgency for the nurse to carry out.
Important Parts of Medication Orders:

1. Client’s Full Name- for accurate identification of the client

2. Date and time the order is written- for documentation and monitoring purposes. In some agencies, a
drug order for narcotics is only valid for 48 hours, hence, if the doctor did not make any order to
cancel or continue that narcotic drug, his order is automatically cancelled after 48 hrs. The nurse
should not carry out that order anymore.
3. Name of the drug to be administered- this must be clearly written. The name of the drug could be in
generic name or with brand name beside it.
4. Dosage of the drug- the doctor is one who determines the dosage or strength of the drug to be given
to the client, for example 500 mg of Ampicillin. The nurse calculates the amount to be given to the
client based on the dosage ordered by the doctor.
5. Frequency of administration- this indicates the number of times the client will take the drug in a day
or the number of times the nurse will administer the drug to the client in a 24-hour basis. Example is
“ Ampicillin 500 mg 1 cap p.o. QID”. The dosage or strength of the drug is 500 mg to be given QID
which means 4 times a day therefore the client will receive a total of 2,000 mg of Ampicilin within 24
hours or 1 day.
6. Route of administration- this implies how the drug is to be given to the client. Example is “p.o.” which
literally means “per orem” or by mouth; SC or subcutaneously via injection.
7. Signature of the person writing the order.- once the order is signed by the doctor, the order becomes
legal.

Types of Drug or Medication Orders:

1. Standing Order- is a drug order that must be carried out as specified by the doctor until it is
cancelled or changed by the doctor.
Example: April 28, 2020, 7:00 am – Bactrim Forte 500 mg 1 tab BID.
Let’s interpret the order. Administer 1 tablet of a 500 mg Bactrim Forte twice a day (BID). This was
ordered on April 28, 2020 at 7 am. For BID, the drug is usually given twice a day at 8:00 am and
6:00 pm although the time may vary from one agency to another. So for April 28, the nurse will
administer the drug at 8 am and 6 pm. If the doctor did not visit the client on April 29, and did not
make any order or changes on his Bactrim order, are you going to continue giving the drug on April
29? The answer is YES because again, a standing order is carried out as specified by the doctor
until it is cancelled or changed. Example of cancellation: “DC Bactrim forte 500 mg BID” DC means
discontinue. Changes can be made on the dosage of the drug. The doctor can increase the dose of
Bactrim forte from 500 mg to 1 gram or decrease it from 500 mg to 250 mg. In some cases, the
doctor can change the frequency of drug administration from BID (twice a day) to TID ( thrice a day)
increasing or decreasing the frequency of drug administration can ultimately affect the total dosage
of the drug the client receives in a day even without changing the strength of the drug administered
per dose. For example:

Ampicillin 500 mg IV (intravenously) q (every) 6 hrs ANST (after negative skin test)

VS
Ampicillin 500 mg intravenously (IV) q 8 hrs ANST(-)

In q 6 hrs, the client receives the Ampicillin 500 mg 4x a day (24 hrs divided by 6 hrs) giving the
client a total of 24-hour dosage of 2,000 mg (500 mg x 4 doses).
In q 8 hrs, the client receives the Ampicillin 500mg 3 x a day (24 hrs divided by 8 hrs) giving the
client a total of 24-hour dosage of 1,500 mg (500 mg x 3 doses).

Lastly, the doctor can change the drug itself. Let’s say from Bactrim to Ampicillin.
2. Single Order- a drug order that must be carried ONLY ONCE. This is a one-time order only.
Example: Penstrep ¼ IM ( intramuscularly) before discharge. Here, the nurse will only administer
the drug before the client goes home or upon discharge from the hospital.

3. Stat order- a drug order that must be carried out AT ONCE or Immediately. Example is “Morphine
sulfate 10 mg IV stat”

4. prn order- a drug order that must be carried when needed or when necessary. It allows the nurse
to administer the drug if based on his knowledge and assessment, the client needs the drug.
Example is “Buscopan 10 mg 1 tablet for abdominal pain”

Common Medical Abbreviation related to Medication that you need to remember:

OD- once a day - the drug is given at 8 am or 9 am unless specified by the doctor
BID- twice a day- the drug is given at 8 am and 6 pm
TID- thrice a day- the drug is given at 8 am, 12 nn or 1pm and 6 pm
QID- four times a day- the drug is given at 8am, 12nn, 4pm and 8 pm
prn- whenever necessary, no specific time unless time interval is specified by the doctor
Example- Buscopan 10 mg 1 tab prn for abdominal pain
Buscopan 10 mg 1 tab prn q 4 hrs for abdominal pain
In the first example, you can give Buscopan when necessary, but the 2nd example you can give
Buscopan whenever necessary but the nurse must observe a 4-hour interval between doses. If the
client is still in pain and the 4-hour interval is not yet done, the nurse can re-assess the client and
can refer the client’s severity of pain to the doctor.
q- every
q4 hrs- every for hours. The drug is given at 4am-8am-12nn-4pm-8pm-12mn. The drug is given 6x a
day (24 hrs divided by 4 hrs) or RTC (Round-the-clock)
q6 hrs- every 6 hours. The drug is given at 6 am-12nn-6pm- 12 mn. The drug is given 4x a day (24 hrs
divided by 6 hours) or RTC
q8 hrs- every 8 hours. The drug is given at 8am-4pm-12mn. The drug is given 3x a day (24hrs divided
by 8) or RTC
p.o.- per orem or by mouth
SL- sublingual- the medication is placed under the tongue
ID- intradermal
SC-Subcutaneous
IM-Intramuscular
IV-Intravenous
IO-intraoseous
o.d.- occulus dexter or right eye
o.s.- occulus sinister or left eye
o.u.- occulus uterque or both eyes or each eye
a.d. –right ear
a.s- left ear
a.u. both ears
HS- hours of sleep, at bed time or half strength
mg- milligrams
gm or G- gram
gr- grain
ml-milliliter
cc-cubic centimeters
L-liter
Neb-nebule
Amp-ampule
tsp-teaspoon
tbsp.-table spoon
ODBB- once a day before breakfast
R- refused
NA-not available
P- prescribed- This means that the drug is NA in the hospital by a prescription is already given to the
client’s relative to buy the drug outside the hospital.
syr- syrup
susp- suspension
elix-elixir
supp- suppository (rectal)
pess- vaginal suppository
gtt- drop; gtts- drops

Interpreting Drug Orders:

When the doctor gives a written medication order, the nurse must analyze the drug order before he
carries out the order. One basic way to interpret the drug order for beginners like you is to translate
the drug order in a sentence form. For example:

1. “Tetracyline 250 mg 1 tab p.o. TID.

Interpretation: Administer 1 tablet of 250 milligrams of Tetracycline orally three times a day.
2. “ Lanoxin 0.25 mg 1 tab OD”
Interpretation: Give 1 tablet of 0.25 milligrams of Lanoxin orally once a day.
3. “Solucortef 80 mg IV q 8 hrs”
Interpretation: Administer intravenously 80 milligrams of Solucortef every eight hours.
4. “Nifedipine 10 mg SL stat”
Interpratation: Immediately administer sublingually 10 milligrams of Nifedipine.
5. “ Ventolin inhal 1 neb q 4hrs prn for DOB”
Interpretation: “If necessary for difficulty of breathing, perform inhalation with 1 nebule of ventolin
every four hours.

10 Rights the Nurse Must Observe in Administering Medications:

1. Right Client or Patient

- Administer the drug to the right client.
- Ask the client to state his full name if applicable.
- Counter check the stated name to his identification band.
2. Right Medication or Drug
- Give the medication ordered by the doctor. You may also counter check if the medication card is
up to date by checking the Doctor’s order found in the client’s chart.
3. Right Dose
- Administer the drug with the dose ordered by the doctor.
- Carefully and accurately compute the dosage of the drug.
- Be familiar with usual range of dose of the drug that you are preparing and administering.
- Question the dose if it is beyond the usual range of dose.
4. Right Time or frequency
- Administer the drug according to the frequency indicated by the doctor and following the
hospital’s or agency’s policy of drug administration. For example OD- 8 am, BID 8 am and 6 pm
- Since the nurse cannot administer all the drugs of all his patients at the same time, some
agencies allow the nurse to administer the drug 30 minutes early or 30 minutes late. Follow
agency policy.
5. Right Route
- Administer the drug based on the order of the doctor and check if the route is safe for the client.
6. Right Client Education
 - Explain to the client why he is receiving the drug, how will the drug help her condition, what to
expect and possible side effects.
7. Right Documentation
- Document or record each drug you administered. In case if a drug is not administered, be sure
to record the reason why the drug was not administered. Possible reasons are: R, NA, or P.
- Notify the doctor for any drug not administered.
8. Right to Refuse
- A client of legal has the right to refuse any medication. Your responsibility is to make the client
informed of the possible consequences of his action. In some agencies, the client needs to sign
a Refusal Form. Be sure to inform the client’s doctor.
9. Right Assessment
- Some medications like prn medications require assessment form the nurse.
10. Right Evaluation
- Evaluating the client after drug administration allows the nurse to monitor the client’s response
to the drug or if there are any side effects or adverse reactions the client is experiencing.

Routes of Drug Administration:

1. Oral Route-
Form: Solid – Tablet, capsule, caplet, lozenge
Liquid- Syrup, drops, elixir, suspension, emulsion, extract,
2. Sublingual- the drug is placed under the tongue
3. Buccal- the drug is placed near the cheek
4. Topical- the medication is applied on the skin or mucus membrane
Forms: Cream, soap, powder, liniment, patch, ointment, lotion, shampoo, paste, tincture,
suppository, pessary, gel, inhalation (Note: make an advance reading on the definitions of
items in numbers 1 and 4)
5. Parenteral
a. Intradermal
b. Subcutaneos
c. Intramuscular
d. Intravenous

System of Measurements
Before we proceed to calculating drug dosages, let us review converting units of measurements. It is
essential for the nurse to memorize conversion table below:

Weight Equivalents between Metric and Apothecaries Systems (Kozier and Erbs, 2016)

Metric Apothecaries
60 mg 1 grain
1g 15 grains
4g 1 dram
30 g 1 ounce
500 g 1.1 pound (lb)
1,000 g (1 kg) 2.2 lbs

With in metric system:

1 gm = 1,000 mg 1,000 mcg = 1 mg
1 kg = 1,000 g
Approximate Volume Equivalents: Metric, Apothecaries and Household Systems
(Kozier & Erbs, 2016)

Metric Apothecaries Household

1 ml 15 minims (min or mn) 15 drops (gtt)
5 ml 1 fluid dram 1 tsp
15 ml 3 fluid drams 1 tbsp
30 ml 1 fluid ounce same
250 ml 1 cup (c) same
500 ml 1 pint (pt) same
1,000 ml 1 quart (qt) same
4,000 ml 1 gallon (gal) same

Volume to weight: 1 ml = 1 gram

Using the above conversion table, let’s practice.

1. Convert 3 tsp to ml
Solution:

3 tsp x 5 ml = 15 ml or 15 ml
1 1 tsp 1

2. Convert 90 mg to grain
Solution:
90 mg x 1 gr = 90 = 1.5 gr (grain)
1 60 mg 60

3, Convert 4 ounces to tablespoon

Solution:

4 oz x 30 ml x 1 tbsp = 120 = 8 tbsp

1 1 oz 15 ml 15

4. Convert 2 ½ cups to gram

Solution:

2.5 C x 250 ml x 1 g = 625 ml

1 1C 1 ml

6. ¼ gr = mg
Solution: If 60 mg = 1 gr
Then X mg = ¼ gr or 0.25 gr

X= (60 mg x 0.25)
1

X= 15 mg

Or: 0.25 gr X 60 mg = 0.25 x 60 = 15 mg

1 1 gr 1
FURTHER READINGS:

Medication Administration: NCLEX RN

www.registerednursing.org> NCLEX RN exam

1. Computer device or laptop with internet access

• Watch: “What is the Metric Table for Nursing Calculation” via Youtube
https://www.youtube.com/watch?v=aGMLRnWGanM
Watch: “Metric Conversions Made Easy | How Solve in Metric
Conversions w/ Dimensional Analysis (Vid 1)”

https://www.youtube.com/watch?v=0N6SmKVWZdI
Answer the following problems and submit your computation to your instructor:
Each problem is equivalent to 5 points.

1. Convert 90 grains to mg.

2. 3 ounces and 1 ½ tablespoon of water is equivalent to how many tsp?
3. If the client’s body weight is 102.5 kg, this is equivalent to how many pounds?
4. How many macrodrops can be derived from 60 ml of fluid?
5. 100 grains is equivalent to how many grams?
6. A client is experiencing vaginal bleeding. The nurse place a new perineal pad on the client
that weighs 75 grams. After 2 hours the pad is soaked with blood and weighs 150 mgs. How many
ml of blood the patient lost?
:

Berman, A., Synder, S., & Frandsen, G. (2016) Kozier & Erb’s Fundamentals of Nursing
Concepts, Process and Practice 10th Edition (pp 776-851). England: Pearson Education Limited