Most Difficult Dose Calc Conversions Review

A lot of nursing students miss questions on the dose calc exam simply because they don't know which do scout conversions to use and when. So in this video we are going to walk through how to pick and use the right dose calc conversions so that you can get them right and pass your exams. So hit that subscribe button and click the notification bell and let's dive in. The first big one. And this is so, so important my friend. You can't convert units accurately until you know the metric system and how it works. So here's my favorite memory trick that I really really like for this one. King Henry doesn't usually drink chocolate milk. This stands for kilo Hecto deca base unit. Now here, this is grams deci, centi and milli. So for nursing we really only care about three of these. That's grams, milligrams and micrograms. And here's an NCLEX critical thinking point. Huge one, really, really important. When you see micrograms and milligrams in the same dose problem, stop and think which unit is the medication available in versus what's ordered? For me, oftentimes one of those will be what the medication comes in, like milligrams. But it could also be what the doctor wants to give it in is micrograms or vice versa. The opposite. And here's the magic number to remember here my friend. 1000. Okay? 1000. One gram equals 1000 milligrams and one milligram is equal to 1000 micrograms. Okay, 1000. That's your number here. And milligrams are bigger than micrograms. Okay? When you think micrograms, think micro, like super small, like microbiology or something like that. There are 1000 micrograms in one milligram. Now let's practice here using my SIP six step framework. If you don't know my step by step process for getting every dose calc question correct on your exams, you've got to download my free dose calc cheat sheet that walks you through all of it. Okay? Dosage calculations does not have to be super over complicated in nursing school. And my six step process will give you the exact steps to follow to really make sure that you ace your exam. So be sure to click the link in the description below to snag that. So here's our question here the doctor orders zero 0.5 milligrams for your patient, but you have 250 microgram tablets available to you. How many tablets will you give? So step number one here. What unit do we need to end up with at the end? And here's it's asking for tablets. Okay, so step two then, what's the order? 0.5 milligrams is what the doctor ordered here. Now step three, what conversions do we need? 1 milligram equals 1,000 micrograms, right? And 250 micrograms equals one tablet. Those are the two conversions that we need to write down here. And when we write them out, we need to make sure here, this is so important that the units cross out so we're only left with tablets at the end, which is what we want here. So milligrams needs to cross out and micrograms needs to needs to cross out so we only have tablets left following this method. It's very simple. And my dose calc cheat sheet will walk you through all of it here. If you're confused at all, so be sure to click the link down below and snag that. Now step four, solve the problem. We'll multiply across the top, multiply across the bottom, and then we divide those two numbers. So 0.5 times 1 times 1000 equals 500 and 250 times 1 is 250 and then divide. So 5, 200 divided by 250 is 2. So the answer here is two tablets. Now step number five is to just write the answer appropriately. There's no rounding here because it's a whole number. So two tablets is the correct answer. And step number six, I always like a double check. Does two tablets make sense? And yes, you can rework the problem to check your math. That's super important. And a big NCLEX tip for you here is if your final answer seems way too big or way too small, check your conversions. Okay, did you move the decimal to the right place? Did you set up the equation properly so that all the units cancel out? And did you multiply and divide correctly? Those are really the three big areas where I see students really get stuck. So always do a double check. It really could save you on the dose calc exam. Now the second tricky dose calc conversion is pounds to kilograms. And you've heard this a gazillion times. This is the conversion that will make or break your pediatric and your critical care dose calculations. The magic number here is 2.2. Okay, remember 2 and 2, there are 2.2 pounds in 1 kilogram. So 1 kilogram equals 2.2 pounds. So let's use this six step framework with a weight based dose calc question here. So here's the question your patient weighs 154 pounds and the doctor ordered 2 milligrams per kilogram. How many milligrams total will you give to this patient? So step number one, what unit do we need at the end? Well here we need milligrams total dose. Now step number two, what's the order? 2 milligrams per kilogram for a 154 pound patient is what the doctor ordered. Now step number three, we have to look at what conversions we need. 150, 54 pounds needs to become kilograms and our conversion is 1 kilogram equals 2.2 pounds. Right. Then multiply by 2 milligrams per kilogram. Then step four is to solve the problem. We're going to multiply across the top, multiply across the bottom and then we're going to divide those two numbers. So we've got 2 times 150, 4 times 1 equals 308. And 1 times 1 times 2.2 equals 2.2. And now divide. So 308 divided by 2.2 equals 140. Now step number five is to write this appropriately. So 140 milligrams, it's a whole number. So there's no rounding here. So we're good to go. Now step number six is to double check, Always double check your work. Rework the problem to make sure that you lined everything up correctly and did the math correctly. And this super important NCLEX tip here is if a problem gives you a weight based dose calc like milligrams per kilogram, but the weight that the problem gives you is in pounds, your first step is always to convert the weight to kilograms so that you don't forget it will just make the rest of the problem go a whole lot smoother for you. And I have a whole bunch of other videos actually that walk you through dose calc conversions and weight based calculations. So I'm going to link those in the description below for you so that you can really ghost. Just go through those, get as much practice as you need so you can build your confidence with solving those weight based type problems. Now the next tricky does cow conversion is grains and these can honestly be so frustrating and you'll see why in just a second. These show up because some old school medications still use the apothecary method or system. So here's what you need to know about this. The magic number here is 60 milligrams equals one grain for most medications. But here's the thing my friend, here's the kicker. Some Medications like aspirin and Tylenol specifically use 65 milligrams, equals one grain. Like what? So when I do those count conversions personally, I usually use 65 milligrams to one grain, because that's typically what the question is going to be asking you for aspirin and Tylenol. But just know that sometimes it can also be 60. So that's the frustrating part here. So here's your NCLEX strategy for this. If the problem doesn't tell you which conversion to use, go with 60. Okay, go with 60 milligrams equals one grain. But if it mentions aspirin or Tylenol, acetaminophen or iron, okay, think 65. So here's our question here to practice. Your patient gets phenobarbital, 1.5 grains. How many milligrams is this? All right, so step number one, what unit do we need to end up with at the end? Milligrams. Because that is what the question here is asking us for. And then step number two, what did the doctor order now? The patient is getting 1.5 grains here. Okay, now step number three. What conversions do we need to get from those grains to milligrams? So one grain equals 60 milligrams here, because this is not talking about acetaminophen, aspirin, or iron. So the conversion is 60 milligrams to one grain. Step number four now is to solve the problem. We'll just multiply across the top, across the bottom, and then we will divide those two numbers. So 1.5 times 60 equals 90, and 1 times 1 equals 1, and then divide. So 90 divided by 1 is 90. So the answer is 90 milligrams. And then step five is to write the answer appropriately. Okay, rounding rules and decim. So there's no rounding here again, because it's a whole number. So that one is pretty easy. No rounding rules, no decimals to move. And then step six, double check the math and make sure you set up everything correctly and all the units cancel out. So here's a key critical thinking tip for grains. Always double check them, okay? Because that conversion is not easy. It's not intuitive. As the base 10 metric system that we're used to, you need to make sure, really, that you're using the right conversion. It's either going to be 65 or 60 milligrams per grain. Now, this next one trips up so many nursing students, so let's walk through it. Here's what you need to know. The magic number here is 60 minutes equals one hour, right? There are 60 minutes in one hour, right? That is not the tricky part though, my friend. The difficult part here is knowing when to use this conversion. The biggest thing that you will want to watch for is the phrase IV pump in your exam questions. Okay, so IV pumps, they're typically set in milliliters per hour. So anytime you see a dose calc question about an IV pump, you should use milliliters per hour. Unless the question tells you something different. Let's use the six step framework for this as well. Now, the order here is to infuse 100 milliliters over 3:30 minutes. What's the milliliters per hour IV rate that you will set this IV pump to? So our step number one, what unit do we need at the end? This is milliliters per hour. Step two, what did the doctor order? 100 milliliters over 30 minutes. And then step three, what conversions do we need here? We need to get from minutes in order in the order to hours in the IV pump. So we'll use the conversion. 60 minutes is equal to one hour, right? And then step four, we multiply across the top across the bottom and then we divide. So 100 times 60 equals 6030 times 1 equals 30 and then 6000 divided by 30 is 200. So here the answer is 200 milliliters per hour. Now step five is to write your answer appropriately. All right? We don't need any rounding rules or decimal rules here because it's a whole number. So we just leave it as 200ml per hour. Now step six is to double check, go back, double check your math because you definitely don't want to get any dose calc problems wrong here on your exam, right? And here's an NCLEX double check for you. If you are infusing something over less than an hour, your milliliters per hour hour rate that you set will be higher than the total volume because you're needing to give it faster than that full hour would allow you to do. But if it's over more than an hour, your rate will be lower. So use this as kind of a double check. And now our next tricky conversion factor is having multiple conversions in the same dose calc problem. Now, I get a lot of of pushback, my friend, like a lot on using dimensional analysis because so many nursing students love the formula method. But my friend, I am telling you right now, the longer you're in nursing school, the more that you're going to realize that dimensional analysis is really the way to go. Because really, the more complicated that the dose calc problems get, the more the formulas will break on you. And trust me, you do not want to be sitting in your nursing school exam wondering what formula to use, how to use it, or wondering if you're using it the right way. So let's use my six step framework for this complex problem. If you haven't already, be sure to download my free dose calc cheat sheet. All right? This is going to walk you through all of this, okay. And help make it so much easier. So the link is down below for you to grab that. So our order here is to give lidocaine 2 milligrams per minute to prevent cardiac arrhythmias. In our patient, you have one gram in 250 milliliters. How many milliliters per hour will you give? So step number one, what unit do we need at the end? This is milliliters per hour. Step two, what's the order? Two milligrams of lidocaine per minute is the order. So that's what I put there on the left. Now step three, what conversions do we need? Well, the question says the lidocaine solution comes in 1 gram per 25050 milliliter solution. So that will go here in our conversions. Then one gram equals 1000 milligrams, right? And 60 minutes of course equals one hour. Now step four is to set it up, multiply across the top, across the bottom and divide those two numbers. So two times 250 times one times 60 equals 30,000. And one times one times a thousand times one is equals a thousand. And 30,000 divided by 1,000 equals 30. So the answer here is 30 milliliters per hour. Now step five is to write the answer appropriately using the correct zeros and rounding rules. Now the answer here is 30ml per hour. So there's no rounding that we have to do. We don't need to add or take away any zeros, nothing like that. We are all good here. Now step, step six is to double check. Units cancel correctly. Okay. Milligrams cancel out, minutes cancel out and we end up with milliliters. Okay, we're good to go. Now nclex, critical thinking point here for you. Look at your units. Okay. Do they cancel correctly? Milliliters is on the top. Milligrams cancels out. Minutes cancel out and you end up with milliliters per hour. So this is perfect. Now here are my top three dose count conversion tips and I also have some big nclex tips to watch for in just a second. So number one, never do conversions in your head, my friend. Your brain will totally play tricks on you when you are under pressure. So write every single step out or you likely will miss something. The number two, be the unit police, okay? Be obsessed with the units, all right? Write them out with every number. Make sure that they cancel out correctly. The units don't lie. And then number three, use reality checks and ask yourself, does this answer actually make sense for this question? If you're converting from a bigger unit to a smaller unit, your number should get bigger and vice versa. Now here are my top NCLEX tips for surviving dose count questions on your exam. Tip number one, if you see micrograms, slow down, okay? These problems are testing your attention to detail with your decimal placement. So make sure that your decimal is in the correct place. Now, tip number two for the NCLEX is weight based calculations. These are huge to know. Anytime a question is asking you to convert pounds to kilograms, that is your cue that this is a weight based question that they're asking and they're testing you on safety. And oftentimes especially these will be pediatric dose calc safety questions. So they're super important. And then tip number three is the IV rate calculations. These often have multiple steps, okay? So don't rush through it. Set up your dimensional analysis carefully. Make sure all of your units cancel out. This is absolutely key because if they don't cancel out or if you don't set it up correctly, you'll get it wrong, right? Which is not what we want here. And I actually have a whole video walking you through exactly how to answer IV dose calc questions. I have that video right here for you. So be sure to watch that next if you need a review on that before you take your exam. And if you like this video, write love in the comments below because that is what we do around here, my friend. Hit that subscribe button and click the notification bell so you never miss another dose calc video that I have coming for you. And as always, my friend, go become the nurse that God created only you to be. And I will see you next time on the Nursing school show.