NCLEX-RN - Safe Care, Dosage Calculations & Pharmacology

The basic dosage calculation formula is: $\text{Volume}=\frac{\text{Desired}}{\text{Have}}\times \text{Quantity}$.

Where:

The formula for calculating IV drip rate is: $\text{gtt/min}=\frac{\text{Volume (mL)}\times \text{Drop Factor}}{\text{Time (min)}}$.

Where:

The formula for calculating IV flow rate in mL/hr is: $\text{mL/hr}=\frac{\text{Total Volume (mL)}}{\text{Total Time (hr)}}$.

This calculation is crucial for programming IV pumps.

Pediatric dosing requires extreme caution due to differences in metabolism, distribution, and excretion. Key considerations include:
1. Weight-based dosing: Most pediatric medications are dosed in mg/kg/day or mg/kg/dose.
2. Body Surface Area (BSA): Some chemotherapy drugs or complex regimens use BSA.
3. Double-checking: Always have another nurse independently verify calculations.
4. Age-appropriate administration: Use appropriate devices (e.g., oral syringe) and routes.
5. Monitoring: Close observation for adverse effects.

The 'Five Rights' are fundamental to medication safety:
1. Right Patient: Verify patient identity using at least two identifiers.
2. Right Drug: Ensure the correct medication is being administered.
3. Right Dose: Confirm the dose matches the order and is appropriate for the patient.
4. Right Route: Administer the medication via the prescribed route.
5. Right Time: Give the medication at the scheduled time.

Heparin is a high-alert medication due to its narrow therapeutic index and high risk of causing significant patient harm (e.g., hemorrhage) when used incorrectly.

Safety Protocols:

Insulin is a high-alert medication due to the risk of hypoglycemia or hyperglycemia if dosed incorrectly.

Safety Protocols:

Medication reconciliation is the process of comparing a patient's current medication list with new medication orders to identify and resolve discrepancies. It is crucial for patient safety, especially during transitions of care (admission, transfer, discharge), to prevent medication errors such as omissions, duplications, dosing errors, or drug interactions.