Name: _________________________________ Year/Section:

8
_______

TLE - CAREGIVING TLE_HECGPM7/8-0g-4

Quarter 2, Week 6, 7, and 8

Perform Basic Calculation

CHRISTINA N. MANUEL
TLE Teacher

Perform simple calculations

Computations involving ratios, fractions, proportions and conversions are performed.

LESSON 1
A GLANCE AT MEASUREMENTS AND CONVERSIONS
Dosage calculations involve measurements and conversions of the formulation, ingredients, and
components of drugs. Measurements and conversions must be calculated accurately to ensure that we
will be able to give the correct dosage to our patients.
INFORMATION SHEETS
Below is a table of most commonly used measurements with its corresponding conversions.

DOSAGE CALCULATION CONVERSIONS

1 liter (L) 1000 milliliters (ml)
1 ounce (oz) 30 milliliters (ml)
1 ounce (oz) 2 tablespoons (tbsp)
1 milliliter (ml) 1 cubic centimeter (cc)
1 gram (g) 1000 milligrams (mg)
1 pint 500 milligrams (mg)
1 milligram (mg) 1000 micrograms (mcg)
1 kilogram (kg) 1000 grams (g)
1 kilogram (kg) 2.2 pounds (lb)
1 inch (in) (") 2.5 centimeters (cm)
8 ounces (oz) 1 cup (c)
8 ounces (oz) 240 milliliters (ml)
grains (gr) X 650 milligrams (mg)
240 milliliters (ml) 1 cup (c)
1 coffee cup 6 ounces
1 cup 8 ounces
1 quart 1 liter
1 quart 2 pints
1 centimeter 10 millimeters
1 glass 12 ounces
Convert Celsius to Fahrenheit Convert Fahrenheit to Celsius subtract 32 then divide by
multiply by 1.8 then add 32 1.8

DRUG DOSE CALCULATION USING MEASUREMENTS / CONVERSIONS

Formula:
Desired Dose X Volume on Hand = Amount to be given
Concentration
Example 1. Doctor orders 5 mg of morphine to be administered intravenously to a patient with
substernal chest pain. You have 1 ml vial that contains 10mg of morphine (10 mg/ml). How many milliliters are
you going to have to draw up into a syringe and push IV into your patient’s IV line port?
What are given?
Desired Dose – 5 mg of morphine IV
Concentration – 10 mg
Volume on Hand – 1 ml
What is asked? Dosage to be given to the patient, in ml

METRIC CONVERSIONS

There are instances when we need to convert a unit of measurement to another when calculating for drug
dosages. The metric system of measurements is based on a number of basic measures or units.
Take a quick look at the table below.
QUANTITY UNIT SYMBOL
 length metre m
mass gram g
volume litre l
time second s

Large and small amounts of these units often have a prefix. Also, some common units of
measurement are prefix symbol multiplication factor.

PREFIX SYMBOL MULTIPLICATION FACTOR

mega m 1,000,000
kilo k 1,000
hector h 100
deka da 10
unit g, m, l, or s 1 1
deci d .1
centi c 0.01
milli m 0.001
micro mcg or μ 0.000001

For conversion of one metric unit to another will require us to move the decimal place to the
left or to the right.

To know how many decimal places to move, follow these steps:

1. Write the metric scale.

2. Find out what the two units in the problem are.
3. Count the number of units from the given one to the desired one.

Example 1.

Convert .1 decigrams to micrograms

The decimal place is moved 3 places to the right using
mg -- kg -- hg -- dag -- g -- dg -- cg -- mg -- mcg
Therefore, 0.1 dg = 1000 mg
Example 2.
Convert 250 millilitres to litres
The decimal place is moved 3 places to the left
ml -- kl -- hl -- dal -- l -- dl -- cl -- ml -- mcl
Therefore, 250 ml = 0.250 l
NUTSHELL…..
Still a lot of health professionals are having difficulty with drug calculations. Is it because
they don’t like Math? Before administration, some drugs require some sort of calculation
and some of which requires simple to complex conversion. Don’t make life complicated.
Look for the best alternative measurement system which could make all the difference and
make things easy for you.

LESSON 2
CALCULATING ORAL DRUG DOSAGES

A Glance at Oral Drugs

These substances which are administered orally can be in the form of tablet, capsule, or liquid. Oral
drugs are mostly available in a limited number of strengths or concentrations. It is, therefore, very
important that you have the skill to calculate prescribed dosages for different drug forms.
Interpreting Oral Drug Labels
For you to administer an oral drug safely, you must make sure that it is the correct drug with the right
dosage. Therefore, it is very vital that you would be able to read and interpret oral drug labels.
1. Identify the Drug Name
Know the difference between the brand name and generic name. Verify the generic name first. If the
drug has two names, the generic name usually appears in lowercase print and sometimes in
parentheses. The generic names are the active ingredients in the medicine. Whether the brand name of
generic name is used, be very careful when reading the label to avoid errors.
Important:
Pay attention to the active, or generic name, since too much of an active ingredient can be harmful if you take
more than one product with the same active ingredient without knowing it.

2. See the Dosage Strength

After identifying the drug name, look for the dose strength on the label.
mportant:
Pay close attention to the labels of two same drugs which may look exactly alike aside from that of the
dose strength. One of them might indicate 125mg and the other one is 250mg. Be keen in checking the
dose strength because it forms part of the dosage calculation.

3. Check the Expiration Date

You also have to check the expiry date. It is a vital information which is sometimes overlooked.

Tip: For best shelf life, store all medications in a cool, dry place.

Calculating Drug Dosages

Most of the time, you will use ratios in proportion to compute for drug dosages. At this point in time, you
should already be familiar in dealing with the equation using ratios in proportions.

Rules in Calculating Drug Dosages

Remember the rules to accurately calculate drug dosages and eliminate errors as well.
1. Use the correct units of measure to avoid errors in calculating doses.
2. Be careful in placing decimal and zero.
3. Double-check strange answers.
Steps in Calculating Drug Dosages Using Ratios in Proportion
1. Prepare the equation by using ratios in proportion.
2. Start with the solution by considering that the product of the means is equivalent to the product of
the extremes. Means being the middle items and extremes being the external items.
3. Solve for the value of X.
4. Double check your work by completing the equation using ratios in proportion.
Example 1:
How many ml of a medicine are in two bottles if one bottle has 60 ml?
Step 1. Prepare the equation by using ratios in proportion.
1 bottle : 60 ml :: 2 bottles : X
Step 2: Start with the solution by considering that the product of the means is equivalent to the product of the
extremes. Means being the inner items and extremes being the external items.
60 ml x 2 bottles = 1 bottle x X
Step 3: Solve for the value of X. In the given problem, the value of X refers to
60 ml x 2 bottles = 1 bottle x X

120 ml = 1 X
or
X = 120 ml
Therefore, the 2 bottles contain 20ml of medicine.
Step 4: Double check your work by completing the equation using ratios in proportion.
1 bottle : 60 ml :: 2 bottles : 120 ml

Example 2:
How many mg of a drug are in 4 capsules if 3 capsules contain 1500 mg?
Equation:
3 capsules : 1500 mg :: 4 capsules : X
Solution:
1500 mg x 4 capsules = 3 capsules x X
6000 mg = 3 X Complete Equation:
X = 6000 mg / 3 3 capsules : 1500 mg :: 4 capsules : 2000 mg
X = 2000 mg
NUTSHELL….
1. Always read the drug labels carefully.
2. Identify the difference between the brand and generic name.
3. Paying close attention to the dosage strength is very vital in calculating the dosage for oral drugs
4. Expiry date is an important information as well in interpreting the drug labels.

LESSON 3
A GLANCE AT RECTAL DRUGS

Rectal drugs are medications prepared specifically for insertion into the rectum. They could
be in the form of cream, lotion, or ointment. Administering the drugs rectally is best for
patients who cannot take drugs orally. Rectal drugs include enemas and suppositories.
Interpret Rectal Drug Labels
As we administer medicines to our patients, it is vital to read drug labels at all times. Paying
close attention to the drug labels helps us calculate the dosage we will give to our patients.
- identify the drug name / generic name
- check for the dose strength
- expiration date

Types of Rectal Drugs

1. Enema - the injection of liquid into the rectum through the anus for cleansing, for stimulating
evacuation of the bowels, or for other therapeutic or diagnostic purposes.
2. Suppository - a small piece of medicated substance, usually conical, ovoid, or cylindrical,
introduced into a body passage, as the rectum or vagina, where body heat causes it to melt.

Dosage Calculation for Rectal Drugs

Suppository is considered to be the most used form of rectal medicine. By calculating the
number of suppositories we give to the patient, we will use the ratios in proportion method.

Example 1:
Calculate for a suppository dosage supposing a patient needs 250 mg of a suppository and
the package label says 125 mg.
Using ratios in proportion, we will find the value of X (number of suppository needed) and our
equation will be written as follows:
1 suppository : 125 mg :: X ( # of suppository needed) : 250 mg
Let us compute…
125 mg x X ( # of suppository needed ) = 1 suppository x 250 mg
125 mg ( X ) = 1 x 250 mg
125 mg ( X ) = 250 mg
X = 250 mg / 125 mg
X = 2 suppositories

To sum it up, we will have to give 2 suppositories to the patient since 2 suppositories equal
250 mg.

Example 2:
A doctor asked the nurse to give the patient 20 mg of suppository. The suppositories on the
shelf show 10 mg each. How many pieces of suppository should you give to the patient? This is how
to solve it using ratios in proportion method. Let our equation be read as:

1 suppository : 10 mg :: X ( # of suppository needed ) : 20 mg

Let us compute for X which is the number of suppository needed
10 mg x X = 1 suppository x 20 mg
10 mg ( X ) = 1 x 20 mg
X = 20 mg / 10 mg
X = 2 suppositories

Since the patient needs 20 mg of suppository, we will give him / her 2 suppositories with 10
mg each. To check, 2 suppositories multiplied to 10 mg will give us 20 mg of suppository.

NUTSHELL….

Make sure to read or interpret the labels carefully.

1. The two types of rectal drugs are enema and suppository.
2. Suppository is the most commonly used rectal drug.
3. Using ratios in proportion method is the best way to calculate the dosage for rectal drugs.

LESSON 4 A GLANCE AT CALCULATING PEDIATRIC DOSAGES FOR ORAL

DRUGS

In calculating drug dosages for pediatric patients, we have to bear in mind that children are
completely different from adults. An inaccurate dosage is more likely to harm a child than
that of an adult.

Administering Pediatric Oral Drugs

Infants and young children who can hardly take tablets or capsules are given oral drugs in
the form of liquid. In some cases wherein liquid medicines are not available, you may crush
a tablet and mix it with a little amount of liquid. If the medication is mixed in a large amount
of liquid (full bottle), the child will not get the entire dose if he is unable to finish the liquid.

Important:
Do not mix crushed tablet with breast milk and infant formula because it may lead to feeding
refusal in the future.

Devices Used in Giving Out Pediatric Oral Drugs

1. cup - can be used by bigger children
2. dropper - usually used for infants
3. syringe - usually used for infants
4. hollow-handle spoon - usually used for toddlers
Safety Key Points in Giving Medications to Children
1. Check the child's mouth to ensure that he has swallowed the oral drugs.
2. Carefully mix oral drugs that come in suspension form.
Tips in Calculating Safe Pediatric Drug Dosages
1. Use a calculator in solving equations.
2. Ask advice from a formulary or consult a drug handbook to verify a drug dose. If still in doubt, call
a pharmacist.
3. Keep a record of your patient's weight in kilograms so you do not have to estimate it or
weigh him all the time.
Methods Used in Calculating Pediatric Doses
1. Body Surface Area (BSA) Method - also called the dosage-per-kilogram-of-body-weight
method; considered to be the most accurate and safest method in calculating pediatric doses
2. Clark's Rule - uses child's weight to calculate approximate dosage
3. Young's Rule - normally used for children who are two years of age or more
4. Fried's Rule - normally used for children who are two years of age or less

A. Body Surface Area (BSA) Method

We will have to use the nomogram to determine a child's BSA then setup an equation using the
formula.
Here is the formula:

Average adult dose ( child's BSA in m² ÷ average adult BSA ) = Child's dose in mg
Note: Average adult BSA = 1.73 m²

Sample:

We have to compute for a child's dose who weighs 40 lbs. and 36" tall. What is the safe
drug dose if the average adult dose is 500mg. Using the nomogram, the child's BSA is 0.72m².

Computation Based on BSA Method

500mg ( 0.72 m² ÷ 1.73 m² ) = child's dose in mg

500mg ( .42 ) = child's dose
500mg ( .42 ) = 210mg
child's dose = 210mg

B. Clark’s Rule
Clark's Rule uses Weight in lbs., NEVER in kg.
Here is the formula:

Adult dose (child's weight ÷ 150) = Approximate child's dose

Simple Sample:

We have to compute for a 2-year old child's dose who weighs 28 lbs. wherein the adult dose is 500mg.

Computation Based on Clark's Rule

500mg ( 28 ÷ 150 ) = approximate child's dose

500mg ( .19 ) = approximate child's dose
500mg ( .19 ) = 95mg
approximate child's dose = 95mg

C. Young’s Rule for Children from 1 to 12 years old

Young’s Rule uses age in years. (Which makes it easier to remember, the word young refers to age)

Here is the formula:

Adult dose [ child's age in year ÷ ( child's age in year +12 ) ] = Approximate child's dose

Same Simple Sample:

We have to compute for a 2-year old child's dose who weighs 28 lbs. Wherein the adult dose
is 500mg. Note that the weight has no bearing using Young's Rule.

Computation Based on Young's Rule

500mg [ 2 ÷ ( 2 + 12 ) ] = approximate child's dose

500mg ( 2 ÷ 14 ) = approximate child's dose
500mg ( .14 ) = approximate child's dose
500mg ( .14 ) = 70 mg
Approximate child's dose = 70 mg

D. Fried’s Rule for Infants and Children up to 2 years

Fried's Rule uses age in months.

Here is the formula:

Adult dose ( child's age in months ÷ 150 ) = Approximate child's dose

Still the Same Simple Sample:

We have to compute for a 2-year old child's dose who weighs 28 lbs. wherein the adult dose
is 500mg. Note that the weight has no bearing using Fried's Rule.

Computation Based on Fried's Rule

500mg [ ( 2 x 12 months ) ÷ 150 ] = approximate child's dose

500mg ( 24 ÷ 150 ) = approximate child's dose
500mg ( .16 ) = approximate child's dose
500mg ( .16 ) = 80 mg
Approximate child's dose = 80 mg
Important:
Every medical caregiver, including the medical assistant needs to be familiar with these
rules.

NUTSHELL….

1. Children need special medication and require special care because of their size, metabolism, and
other factors.
2. Choose the best device for administering pediatric oral drugs
3. Be familiar with all the methods used in calculating pediatric doses
- Body Surface Area (BSA) Method
- Clark's Rule
- Young's Rule
- Fried's Rule

Sta. Maria National High School

Sta. Maria, Alfonso Lista, Ifugao

LEARNING ACTIVITY SHEET – TLE CAREGIVING 8

Quarter 2 - Week 6, 7 and 8

Name: ___________________________ Yr. & Sec. _______

After reading the content of this module, you are now ready to answer the following activities
in this LAS (Learning Activity Sheet). Read before you start and follow the instruction carefully.
WRITE YOUR ANSWER ON THIS ACTIVITY SHEET.
A. ACTIVITY 1. WRITTEN TASK 1: Match the items in Column A with their descriptions in
Column B. Write the letter of your choice in the space provided for each item.

Column A Column B

_____ 1. dosage calculations a. medication prepared for insertion into the

rectum
_____ 2. ratio b. a part of a whole
_____ 3. rectal drugs c. comparison of two numbers
_____ 4. Body Surface Area (BSA) Method d. used in writing fractions
_____ 5. proportion e. an equation stating that two ratios or two
 fractions are equal
_____ 6. nomogram f. missing or unknown value
_____ 7. fraction g. the middle numbers in two ratios
_____ 8. x in an equation h. dosage-per-kilogram-of-body weight
_____ 9. colon i. used to determine a child's BSA
_____ 10. slash j. used in writing ratios
k. conversion of the formulation,
ingredients and components of drugs
2. Directions: Convert the following as stated. Write your answer on the space provided for each item.
1. 15 ml = _____ tsps.
2. 5 kgs = _____ lbs.
3. 36 °C = _____ °F
4. 2.5 ft = _____ in
5. 60 cc = _____ ml

3. Write an O, if the statement is true and an X, if the statement is false.

1. _____ Oral drugs can be in tablet, capsule, or liquid form.
2. _____ Reading carefully the drug labels is useless in administering medicines to the patients.
3. _____ Medicines of the same brand name and generic name do not necessarily have the same
dosage strength.
4. _____ The unknown value in calculation is usually represented by a " ___ ".
5. _____ The adult's average Body Surface Area (BSA) is 1.68 m².
6. _____ An inaccurate dosage can more likely harm an adult than a child.
7. _____ Body Surface Area (BSA) Method is considered to be the most accurate and safest method in
calculating pedriatic dosages.
8. _____ A suppository is the most common form of rectal drugs.
9. _____ Administering the drugs rectally is also best for patients who are unable to take drugs orally.
10. ____ Generic name in a drug label is usually written in uppercase and in parentheses.

B. ACTIVITY 1. PERFORMANCE TASK 1: SOLVE THE FOLLOWING PROBLEMS. SHOW

YOUR SOLUTION BELOW EACH ITEM.

1. Gwyneth weighs 15 kg and scheduled to receive .5 ml / kg of her medicine. How

much ml should the patient receive?

2. Determine the weight of your patient in kilograms who weighs 105 lbs.

3. How many milligrams of a medicine are in 5 capsules if 3 contain 15 mg?

4. 3,600 ml / day is equal to __________? _

__________

5. Marion was ordered by the doctor to take 500 mg of a paracetamol every 6 hours.
Each paracetamol contains 250 mg. How many paracetamol will be taken in a day?

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Parent’s Name and Signature