1. Math and Dosage Calculations for Medical Careers
PowerPoint® to accompany
Math and Dosage Calculations for Medical Careers
Second Edition
Booth • Whaley
Chapter 4
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

2. Chapter 4 Equipment for Dosage Measurement

3. Learning Objectives Identify equipment used to administer medication.
When you have completed Chapter 4, you will be able to:
Identify equipment used to administer medication.
Indicate the appropriate equipment for delivering various types of medicine.
Chapter 4

4. Learning Objectives (con’t)
Measure medications using the calibrations on the equipment.
Describe the method of administration appropriate for each piece of measuring equipment.
Chapter 4

5. Introduction
In order to prepare the correct dosage of medications, you must know how to use equipment properly.
Oral
Parenteral – bypassing the digestive tract
IM, IV, ID , Sub-Q
Topical
Transdermal
Drops, sprays, & mists
Vaginal & Rectal
Chapter 4

6. Oral Medication Administration
Measuring devices have a series of calibrations or marks numbered at varying intervals.
Calibrations enable you to measure the amount of liquid in the container.
Compare the calibration with the desired dose of medication.
Be sure that they match the order.
Chapter 4

7. Oral Medication Administration (con’t)
Medicine cups
Droppers
Calibrated spoons
Oral syringes
Chapter 4

8. Medicine Cups
Meniscus – the bottom of the curved surface of a liquid in a cup or container.
Chapter 4

9. Medicine Cups (con’t) Rule 4 - 1
Do not use medicine cups for doses less than 5 mL, even if the cup has calibrations smaller than 5 mL.
Instead, use
a dropper
a calibrated spoon
an oral syringe
Chapter 4

10. Droppers
Used to measure and administer small amounts of oral liquid medication
Used to deliver medication to the eyes, ears, and nose
Chapter 4

11. Calibrated Spoons Often used with pediatric and elderly patients
Can administer medication directly into the mouth or into food or a beverage
Chapter 4

12. Oral Syringes Used especially for quantities less than 5 mL
Usually tinted
Not sterile
Chapter 4

13. Oral and Hypodermic Syringes
Oral syringes
off-center tips
tinted in color
non-sterile
Hypodermic syringes
centered tips
clear in color
sterile
Chapter 4

14. Oral Syringes (con’t) Rule 4 - 2
Never attach a hypodermic needle to an oral syringe.
Never inject an oral dose.
In emergencies, you may use a hypodermic syringe without a needle to measure and administer liquid oral doses, but never while its needle is attached.
Chapter 4

15. Other Equipment for Oral Medications
If the patient cannot take medication orally, medications can be administered through a tube to the stomach.
Types
Nasogastric tube
PEG tube
Jejunostomy tube
Chapter 4

16. Error Alert!
Equipment used to administer medication must be measured accurately using the equipment’s calibrations.
Chapter 4

17. Review and Practice Determine if the statements below are true.
You may us a hypodermic syringe with a needle to measure liquid for oral administration.
False
Oral and hypodermic syringes are identical in appearance.
False
Excellent!
Chapter 4

18. Review and Practice Excellent!
Measuring spoons used for baking are acceptable for measuring liquid medications.
True
Oral medication comes in a bottle labeled 200 mg/5 cc. The dose to be administered is 600 mg. Which of the following is the correct dose? a. 1 tsp b. 2 tsp c. 1 tbs d. 2 tbs
c . 1 tbs = 15 mL
Excellent!
Chapter 4

19. Hypodermic Syringes Plunger Barrel Syringe hub Needle Leading Ring
Chapter 4

20. Hypodermic Syringes (con’t)
Parenteral administration
Usually used to deliver medications by injection
intravenous (IV)
intramuscular (IM)
intradermal (ID)
subcutaneous (Sub-Q)
Chapter 4

21. Hypodermic Syringes (con’t)
Common standard syringe
Have scales calibrated in cubic centimeters (cc)
Allowing for measurement of small doses
Usually uses the metric system
May also use the minim scale from the apothecary system
Chapter 4

22. Types of Syringes 3 mL syringe Prefilled syringes Insulin syringes
Tuberculin syringes
Safety syringes
Syringes to establish intravenous lines
Large-capacity syringes
Chapter 4

23. Standard 3 mL (cc) Syringe
Calibrated in cubic centimeters (cc) or milliliters (mL)
May have divisions of tenths, two-tenths, or hundredths of a cubic centimeter
May also use minims
Click to View Syringe
Chapter 4

24. Prefilled Syringes
Prefilled with a single, standard dose of medication
Use once and discard
Usually marked in tenths of a mL
Measure the dose carefully; discard any excess medication
Chapter 4

25. Prefilled Syringes (con’t)
Rule When using a prefilled syringe, always examine the markings to determine whether the syringe is calibrated in milliliters or milligrams and calculate the dose accordingly.
Chapter 4

26. Insulin Syringes Used only to measure and administer insulin
Insulin syringes are unique
Measured in units
Available in 50 and 100 Units
Chapter 4

27. Insulin Syringes (con’t)
Rule Never use any type of syringe other than an insulin syringe to measure and administer insulin.
Chapter 4

28. Insulin Syringes (con’t)
100-Unit Insulin Syringe
50-Unit Insulin Syringe
Chapter 4

29. Tuberculin Syringes Used for doses less than 1 mL Examples:
PPD skin test
Vaccines
Heparin
Pediatric medicines
Allergen extracts
Chapter 4

30. Tuberculin Syringes (con’t)
Calibrated in hundredths of a mL
1mL tuberculin syringe
0.5 mL tuberculin syringe
Chapter 4

31. Safety Syringes
Needles are protected by plastic shields to help prevent needle sticks.
100-unit insulin safety syringe
Chapter 4

32. Syringes for Established Intravenous Lines
Used to administer medication through already established intravenous lines (lines that deliver medications and fluids directly into a patient’s vein)
Use the injection port
Enables you to deliver drugs on a periodic basis and to dilute the medication
Chapter 4

33. Syringes for Established Intravenous Lines (con’t)
Needleless syringe
Plastic injection tip
Chapter 4

34. Large-Capacity Syringes
Not all medication can be delivered in doses of 3 mL or less
Syringes with 5 mL, 6 mL, 12 mL are available
Look carefully at the marks to measure an accurate amount of medication
Chapter 4

35. Large-Capacity Syringes (con’t)
5 mL, 6 mL, 10 mL, 12 mL or more
10 mL syringe
Chapter 4

36. Error Alert!
Pay close attention to the calibration of any syringe you use.
Check the marks carefully.
Chapter 4

37. Ampules, Vials, and Cartridges
Chapter 4

38. Ampule Glass container Usually holds one dose of medication Snaps open
Use a standard syringe to withdraw the medication
Chapter 4

39. Vial Container covered with a rubber stopper
May contain more than a single dose of medication
Either liquid or powder form of medication
Chapter 4

40. Cartridge Prefilled container shaped like a syringe barrel
Usually holds one dose of medication
Fits a reusable syringe
Examples:
Tubex
Carpuject
Chapter 4

41. Preparing an Injection
Rule 4 - 5
In most circumstances, the person who prepares a syringe for injection should deliver the injection. Exceptions include:
Pharmacy technicians who prefill syringes for nurses, medical assistants, or patients
Nurses or medical assistants preparing a syringe for a physician
Health-care workers teaching a patient to administer his or her own medication
Chapter 4

42. Needle Gauge and Length
You must choose a needle with an appropriate gauge
Gauge
Interior diameter
Smaller gauges correspond to larger diameters
An 18-gauge needle is wider than a 22-gauge needle
More viscous drugs and deeper injections require needles with smaller gauges or larger needle diameters
Chapter 4

43. Needle Gauge and Length (con’t)
The injection site determines length.
Length must be long enough to reach the desired area of tissue.
Length must not be so long that it penetrates beyond the desired area.
Chapter 4

44. Needle Gauge and Length (con’t)
Type of Injection
Needle Gauge
Length for Adults (inches)
Intradermal
25 – 26
Subcutaneous
23 – 27
Intramuscular
18 – 23
1 – 2
Chapter 4

45. Review and Practice Determine if the statements below are true.
You can use an insulin syringe to measure 6 mL of medication.
False
A patient is punctured each time a syringe is used with an established intravenous line.
False
Excellent!
Chapter 4

46. Topical Medications Gels, creams, ointments, and pastes
They are applied directly to the skin
Use a glove, tongue blade, or cotton-tipped applicator
Avoid letting any of the medication contact your own skin
Chapter 4

47. Transdermal Medications
These often use a self-adhesive patch
Maintains a consistent level of medication in the blood
Place the medication on clean, dry, hairless skin with no rash or irritation and with good circulation
Rotate placement sites
Remove older patches and dispose of them
Mark each new patch with your initials, the date, and the time
Chapter 4

48. Transdermal Medications (con’t)
Examples
cardiovascular drugs
hormones
allergy medications
pain medications
Chapter 4

49. Drops Deliver medications to the nose, eyes, and ears
Also called instillations
Use the equipment that comes with the drug to administer the medication
Droppers and plastic squeeze bottles are used
Chapter 4

50. Sprays These are used to deliver medication to the nose and throat.
Squeeze bottles and atomizers are used.
Chapter 4

51. Mists
Vaporizers, or steam inhalers, use boiling water to create a mist that the patient inhales.
Nebulizers and metered dose inhalers (MDI) are also used to deliver medication to the patient.
Chapter 4

52. Vaginal and Rectal Medications
Suppositories
Tablets
Douches for liquid forms of medication
Creams and foams
Rectal
Suppositories
Enemas for liquid forms of medication
Creams and foams
Chapter 4

53. Apply your Knowledge
What kind of utensil is often used to deliver medication to the eyes and ears?
Answer: Dropper
Chapter 4

54. Apply your Knowledge
What kind of syringe is used to deliver vaccinations?
Answer: Tuberculin
Chapter 4

55. Apply your Knowledge How many mL are indicated on this syringe?
Answer: 1.6 mL
Chapter 4

56. Equipment for Dosage Measurement
Nothing will work unless you do. --Maya Angelou
THE END
Chapter 4