Allied Health & Nursing
Convert units, compute doses, and titrate IV drips with zero room for error.
Build the base
foundationThe Metric Grid & ISMP Decimal Safety
Order reads '0.5 g' but the vial is labeled in mg. A misplaced decimal here is a 10× or 1000× overdose — the single most cited medication-error mechanism (ISMP). Move the decimal three places per metric step, always write the leading zero, never the trailing zero. Build the muscle memory before a code situation tests it.
foundationRoman Numerals, Apothecary & Military Time
Old chart order: 'gr X q4h, start 1400.' You must translate the Roman dose (grains), convert grains → milligrams using the apothecary equivalence, schedule the q4h doses on a 24-hour clock, and document with no AM/PM ambiguity.
foundationI&O Balance: Multi-Source Conversion & Net Calculation
End-of-shift charting: patient consumed 8 oz juice, 6 oz broth, 1 cup ice chips (count as ½ volume), got 500 mL D5W IV, voided 850 mL urine, lost 150 mL emesis, and 200 mL via NG suction. Convert everything to mL, total intake vs output, and flag if net balance crosses ±500 mL — a clinical alert threshold.
Daily-job math
coreDesired-over-Have Dosage Algebra
Order: 75 mg morphine sulfate. Available: 50 mg/mL prefilled. Compute the volume to draw using the Desired/Have × Vehicle formula. Then re-run for a tablet order (250 mg ordered, 125 mg tablets) and a suspension (250 mg ordered, 125 mg/5 mL).
corePediatric Weight-Based Dosing & Safe-Range Verification
Amoxicillin 25 mg/kg/day divided q8h for a 44 lb child. Safe range: 20–40 mg/kg/day. Convert lb → kg, compute daily and per-dose, verify within safe range, and check the dispensed volume against the suspension strength (250 mg/5 mL).
Master-class problems
masterIV Drip Rates: Gravity vs Pump Math
Hang 1000 mL NS over 8 hr by gravity with a 15 gtt/mL macrodrip set. Then re-compute on a pump (mL/hr removes drop factor). Compare a microdrip pediatric set (60 gtt/mL) where mL/hr numerically equals gtt/min — a clinical shortcut.
masterHeparin Titration & aPTT-Driven Nomogram
70 kg patient on weight-based heparin protocol: bolus 80 u/kg, then 18 u/kg/hr. Bag: 25,000 units in 250 mL D5W. Compute bolus volume, initial pump rate, then re-titrate when aPTT returns at 92 sec (target 60–80): nomogram says decrease rate by 2 u/kg/hr.