Download RU Medical Math - Rutgers: School of Health Professions

Department of Interdisciplinary Studies
IDST 1400
Medical Mathematics
Revised – 2016 by: Marilyn Donahue
Course Description
This course will provide a review of basic mathematical calculations and will instruct the learner on how to convert equivalents from one system to
another and accurately mix and measure drugs. Emphasis will be placed on how these techniques are used in the administration of medications for
patient use.
Credits/Modes of Instruction
This is 3 credit course (~50 hours) that relies on hands-on activities, assignments, and discussion. Should the instructor feel that a class meeting(s) is
necessary, she/he will notify all student(s) via email or telephone of the class meeting time and location. The course instructor will organize the class
in coordination with Rutgers School of Health Professions syllabus, and communicate requirements with student, either by email or telephone.
Pre/Co requisites
All math remediation and successful high school completion of Dynamics of Health Care in Society
Instructor
The instructor will be a Rutgers SHP faculty (or adjunct) member.
Course Goals
The goals of this course is to provide a review of basic mathematical calculations, to instruct the learner on how to convert equivalents from one
system to another and accurately mix and measure drugs, to provide the learner with the necessary mathematical background needed for
pharmacology, and to provide the learner with the theory and skills necessary to administer medication safely. For the purpose of sharpening the
learners’ math calculation skills and to develop a logical sequence of operations in solving complex dosage calculations, No calculators are used
during this course
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Course Objectives
The objectives of this course will be met via on site participation/hands on learning, required readings, assignments, and discussions with preceptor.
1. Demonstrate accurately the addition, subtraction, multiplication, and division of fractions and mixed numbers.
2. Read and write decimals with 100 percent accuracy.
3. Add, subtract, multiply, and divide decimals with 100 percent accuracy.
4. Convert common fractions to decimals and decimals to fractions.
5. Convert percent to decimals, fractions to percent, percent to fraction, and decimals to percent.
6. Convert temperature from the Fahrenheit scale to centigrade scale and vice versa.
7. Convert from one unit of measure to another using the metric system, and household measures.
8. Locate and identify dosage information on medication labels and inserts.
9. Identify information listed on physician’s order sheet and medication administration record (MAR)
10. Demonstrate knowledge of the 6 Rights of Medication Administration and steps to avoid medical errors.
11. Demonstrate knowledge and skill of safe handling, use, and disposal of hypodermic needles and syringes.
12. Use ratio-proportion calculation method to prepare ordered dosages from prepared medications.
13. Use dimensional analysis and/or the formula method to calculate ordered dosages from prepared medications
14. Calculate medication dosages based on body weight.
15. Calculate medication dosages based on body surface areas.
16. Demonstrate knowledge and ability to accurately calculate flow rates for Intravenous solutions and medications.
17. Demonstrate knowledge and ability to accurately calculate titration ranges for Intravenous medications.
18. Assess calculated answers to determine if the answer obtained is logical; does the answer make sense based on normal, average dosages.
19. Calculate pediatric dosages based on body weight.
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Requirements for Completion
Attendance is required, as well as completion of all activities and assignments. Students will be required to arrange with preceptor a make-up date in
case of an absence. Assignments are expected to be submitted on their due date to the course preceptor. Late assignments will be marked down 1
point per day late.
Requirements
Weight
Attendance/Participation/Group Discussion
10%
Chapter Assignments/Classwork
10%
Chapter Quizzes
15%
Course Projects
 Humanitarian Aid Campaign Design & Research
 Virtual Medication Administration
25%
Unit Tests and Final Examination
40%
Total
100%
Evaluation and Grading
Grade Determination
The minimum level of satisfactory performance in this course is a ‘C’ or better. To receive a ‘C’ or better, students must first complete ALL course
requirements specified above, including meeting the minimum attendance expectation. Based on the evaluations methods and criteria previously
described, each requirement is then scored on a 0-100 point scale. The final letter grade is based on the weighted average of all requirements.
Upon successful completion of the course students will be eligible to take the Health Science Careers standardized exam to determine college
credit.
All students must attain a C (73) or better to earn college credits. Minimum passing standardized exam grade for all students must be at least 70
before calculations of college transcript grade can be determined.
The Rutgers grade listed on the student’s transcript will be comprised of 50% of the Rutgers-SHP standardized exam grade and 50% of the high
school course grade.
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Health Science Careers Program
Grading System
Weighted Average
of All
Requirements
Final
Letter
Grade
93-100
A
90-92.9
A-
87-89.9
B+
83-86.9
B
80-82.9
B-
77-79.9
C+
73-76.9
C
70-72.9
C-
67-69.9
D+
63-66.9
D
Less than 63
F
Unsatisfactory Performance/Progress
Unsatisfactory performance which may include late assignments and/or attendance or progress problems will be discussed individually on an as
needed basis.
Honor Code and Academic Integrity
(Refer to your SHP Student Handbook at http://shp.rutgers.edu/current_students/handbook.pdf)
The faculty of Rutgers School of Health Professions believes that students must observe and support high standards of honesty and integrity. For this
reason, all students in this course are expected to abide by the School's Honor Code and uphold its Code of Academic Integrity. As described in detail
in your Student Handbook, violations of the Code of Academic Integrity include cheating, plagiarism, fabrication and/or academic misconduct. All
such violations will be considered with gravest concern and may be punishable with sanctions as severe as suspension or dismissal. If you have not
previously affirmed the School's Honor Code (either in writing or electronically), you must submit a signed and dated copy of the Honor Code to the
instructor by the end of the first week of the semester. The Honor Code form is provided in the current SHP Student Handbook.
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General Learning Resources
Required Textbook(s)
Curren’s Math for Meds: Dosages and Solutions. by Anna M. Curren and Margaret H Witt. (2015). 11th edition. Or newest edition. ISBN -13:978-11115-4091-3. Cengage Learning, 200 First Stanford Place, 4th Floor, Stamford, CT
Practice Software Site http://www.delmarlearning.com/companions/content/1428310959/s_resources/MathforMeds11/mathformeds.html
Recommended Textbook/Software
Pharmacy Technician Handbook, by Lee Gootblatt. (2005). 1st ed. Or newest edition. Privately Published. Contact Mr. Gootblatt at
[email protected] or LinkedIn
Excellent resource for practice questions and alternative explanation of dosage calculations.
Virtual Clinical Excursions: Online and Print Workbook for Medical- Surgical Nursing. 9th Edition. 2014. Sharon Lewis, Shannon Ruff Dirksen, and
Margaret M. Heitkemper. Elsevier/ Mosby. ISBN 9780323221832
The Virtual Software that comes with the print workbook is an excellent project for learners to become familiar with Medication
Administration Records, professional duties, and virtual medication administration. It gives feedback at the end of the virtual shift.
Recommended Laboratory Supplies
Sterile safety needles for subdermal, subcutaneous and intramuscular
injections
Syringes: TB, Insulin, 3 mL, 10 mL
Medical Waste container
Alcohol swabs
2X2 gauze pads
Practice vials of bacteriostatic water
Practi-Powder vials
Practi-insulin vials
Practi-Ampules
IV Fluids 1000mL, 500 mL, and 50 mL
IV Pole to demonstrate gravity fed IV lines
IV Volumetric Pump/ Electronic Infusion Device
New Jersey Core Curriculum Content Standards (CCCS) are referenced and available at these links:
http://www.state.nj.us/education/cccs/2014/career/CareerReadyPractices.pdf Career Readiness
http://www.state.nj.us/education/cccs/2014/career/91.pdf Career Awareness, Exploration, and Preparation
http://www.state.nj.us/education/cccs/2014/career/93.pdf Career and Technical Education
http://www.state.nj.us/education/aps/cccs/math/CCSSguidance.pdf K-8 Math Standards for review section
http://www.corestandards.org/Math/Content/HSF/IF/ Math: High School Functions/ Interpreting Functions
http://www.corestandards.org/Math/Content/HSF/BF/ Math: High School Functions/ Building Functions
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Course Units/Schedule
Note: this schedule is a plan only, subject to change by the instructor as deemed necessary to achieve the course goals. Whenever possible, you will
be notified in advance of any changes, especially those affecting course requirements or grading.
Unit /
Week
Topical Outline
Assignments/ Field Activities/Resources
Evaluation
NJ CCCS
Daily worksheets
Chapter quizzes
Unit 1 Test
Review of Basic
Mathematics
All problem solving to be completed without
the use of calculators.
Unit 1
Unit 2
Review of Arithmetic for Medical Dosage
Relative Value, Addition and Subtraction of
Decimals.
 Convert decimals to fractions,
 Convert fractions to decimals.
 Round decimals to desired place
value.
Curren: Chapter 1
Lecture, worksheet
Review of basic math
3.NF.1 Fractions
Multiplication and Division of Decimals
 Multiply and divide decimals.
 Multiply and divide fractions.
 Simplify complex fractions. .
Curren: Chapter 2
Lecture, worksheet
Review of basic math
4.NF.5 , 4.NF.6,
4.NF.7 Decimal
Fractions
Solve Common Fraction Equations
 Whole number equations
 Decimal number equations
 Multiple number equations
Introduction to Drug Measures
Metric System
 Identify metric system units of
measure.
 State abbreviations for metric
system.
 Complete metric conversion
equations.
Curren: Chapter 3
Lecture, worksheet
Review of basic math
4.NF.3 , 4.NF.4
Number and
Operations Fractions
Unit, Percentage, mEq, Ratio, & Household
Measures, Temperature
Curren: Ch 5
Unit 2 Handout #2
Curren: Ch. 4,
Metric Conversion Table Unit 2 Handout #1
Gootblatt: Problem Set
Metric Conversion Worksheet
Daily worksheets
Chapter quizzes
Unit 2 Test
Review of Math,
Measurements
3.MD.2
Measurement using
Metric
6

Recognize dosages measured in:
International Units (units).
 Identify household units of measure.
State abbreviations for household
systems.
 State equivalents for household
system.
 Convert within household system.
 Write percentages as decimals and
fractions. Estimate an answer.
Convert Fahrenheit to Celcius, and
vice versa.
 Apply use of ratio and proportions to
applied math concepts.
 Solve practical problems
encountered by health care workers.
 Identify apothecary system units of
measure.
Marking Project Assignment
Period 1
 Global Health Issue
Project
 Medications/ Medical Supplies
o dose per person
o how many people
o cost of dose
 Distribution
Unit 3
Medication Administration
Oral Medication Labels & Dosage
Calculation
 Locate information on oral
medications, solid and liquid.
 Locate Dosage Strengths on labels
 Calculate average Dosages
Safe Medication Administration
 Read Medication Administration
Record (MAR) to identify meds
Household Conversion Chart & Temperature
Conversions Chart
4.MD.1, 4.MD.2
Measurement using
metric &
Household
measures
Conversions Worksheet
Laboratory: Measure liquids using a medicine
cup, syringes (without needles) various teaspoons
and tablespoons from home. Compare for
accuracy. Read the correct liquid measure in a
measuring cup at eye level.
3.MD.2
Measurement of
liquids & solids
Humanitarian Aide Campaign:
Research, Design and Present an
International Medical Relief Project
Handout: Assignment description
Powerpoint example
Project
Presentation
Grade
Due : 1 - 2 week
timeline
Career Awareness:
9.2.12.C.5,
9.2.12.C.6
Curren: Chapter 6
Images of Medication Labels in text
Practice Questions on StudyWare
Daily worksheets
Chapter quizzes
Unit 3 Test
CTE Standards for
Healthcare
Science:
Support Services
9.3.HL‐SUP.1-5
Curren: Chapter 7
Copies of MAR available
Discussion of the 6 Rights of Medication
Administration.
Career Readiness:
CRP7. Employ
valid and reliable
research strategies
CTE Standards for
Healthcare
Science:
7




Documentation of Meds given
The 6 “Rights of Medication
Administration”
Partnering with the Patient
Avoiding Medical Errors
Hypodermic Syringe Measurement
 Read the amount of liquid in a
syringe correctly
 OSHA Safety rules for handling
syringes and needles safely
 Proper technique for drawing
medications from vials
 Proper disposal and accounting of
syringes and needles.
Parenteral Medication Labels and Dosage
Calculation
 Read parenteral solution labels
 Identify dosage strengths
 Calculate average dosages from the
label
 Dosages in mL, mEq, units,
percentage and ratio strengths
YouTube Link “Beyond Blame” about medical
errors 6 minutes
https://www.youtube.com/watch?v=OkTiCY3qJJk
Therapeutic
Services
9.3.HL‐THR.1-4
Diagnostic
Services
9.3.HL‐DIA.4
Curren: Chapter 8
Laboratory: demonstration and use of syringes:
standard 3 mL , Tuberculin, 5 mL & 10 mL;
Sterile safety needles for intradermal TB,
subcutaneous, and intramuscular injections.
Technique for drawing medication from practice
vials, and glass ampules
Career Awareness
9.2.12.C.7 Ethics
9.2.12.C.8 Laws
Curren: Chapter 9
Read the images of the labels in text and answer
the end of chapter questions.
Complete StudyWare Chapter 9 quiz
CTE Standards for
Healthcare
Science:
Support Services
9.3.HL‐SUP.1-5
Career Readiness:
CRP2- Academic
& Technical Skill
Career Readiness:
CRP2- Academic
& Technical Skill
Reconstitution of Powdered Drugs
 Prepare solutions from powdered
drugs using directions on the vial
label or package insert
 Determine the expiration date and
time for reconstituted drug
 Calculate dosages for reconstituted
drugs.
Curren: Chapter 10
Laboratory: Using a 3 mL syringe with safety
needle to reconstitute a vial of practi-powder with
bacteriostatic water.
Measuring Insulin Doses
 Identify insulins in current us
 read insulin labels to identify type
Curren: Chapter 11
Insulin Types and Actions Handout
Practice dosage calculations
CTE Standards for
Healthcare
Science:
Support Services
9.3.HL‐SUP.1-5
Career Readiness
8




read calibrations on Insulin syringe
100units/mL
Measure single insulin dose
measure combined insulin dosages
Discuss injection sites and
techniques
CRP2- Academic
& Technical Skill
Laboratory: Using insulin syringes and needles
to draw up a single insulin dose and draw up a
combination dose of NPH and Regular insulin
using proper procedure.
Worksheet/Quiz on content.
CTE Standards for
Healthcare
Science:
Support Services
9.3.HL‐SUP.1-5
Career Readiness
CRP2- Academic
& Technical Skill
Unit 4
Dosage Calculations
Ratio and Proportion
 Define ratio, define proportion
 Solve dosage problems using ratio
and proportion
 Assess answers obtained to
determine if they are logical
Dimensional Analysis/ Units Conversion
 Use Dimensional Analysis to
calculate dosages
Unit 5
Curren: Chapter 12
Practice sheets
Assess answers to determine if the answer makes
sense according to average dosage amounts and
strengths.
Daily worksheets
Chapter quizzes
Unit 4 Test
High School
Functions:
HSF.IF.B.4
HSF.BF.A.1
Curren: Chapter 13
Practice Sheets
Assess answers to determine if the answer makes
sense according to average dosage amounts and
strengths.
Curren: Chapter 14
Formula Method
 Use the Formula Method to calculate Practice Sheets
Assess answers to determine if the answer makes
dosages
sense according to average dosage amounts and
strengths.
Dosage Calculations from Body Weight
and Body Surface Area
Adult and Pediatric Dosages based on Body Curren: Chapter 15
Weight
Practice calculations
Math Standards
7.EE.1, 7.EE.2
Expressions and
Equations
Career Readiness:
CRP8. Utilize
critical thinking to
make sense of
problems and
persevere in
solving them.
Daily worksheets
Chapter quizzes
Unit 5 Test
Math Standards
Expressions and
Equations
7.EE.1, 7.EE.2
9




Unit 6
High School
Functions:
HSF.IF.B.4
HSF.BF.A.1
Convert body weight from pounds to Determine if dosages ordered are within the
normal range
kilograms
Convert body weight from kilograms
to pounds
Calculate dosages using mcg/mg per
kg, or per lb.
Determine if dosages ordered are
within the normal range
Adult and Pediatric Dosages based on Body
Surface Area
 describe how and why body surface
area is used for dosage calculation
 Use the body surface area in m2 to
calculate dosages
 Assess the accuracy of dosages
prescribed on the basis of BSA
Intravenous Calculations
Intro to IV Therapy
 Primary, Secondary, Peripheral and
Central IV lines
 IV Drip chambers, roller and slide
clamps, on-line and indwelling
injection ports
 Heparin flush, heparin admixture,
and dosage strengths
 Volumetric pumps/ electronic
infusion device (EID), syringe
pumps, and Patient Controlled
Analgesics (PCA)
Flow Rate Calculations
 IV Tubing set calibrations
drops/minute (gtt/min)
 calculate flow rates using ratio and
proportion
 Calculate flow rates using DA
Career Readiness:
CRP8. Utilize
critical thinking to
make sense of
problems and
persevere in
solving them
Curren: Chapter 16
Without the use of a calculator, use the m2 given
for the BSA to calculate dosages on the Practice
sheet
Gootblatt: Practice Problem Set
Curren: Chapter 17
Laboratory: Demonstration of IV fluid
administration using gravity lines, primary and
secondary lines, and Volumetric Pumps.
Worksheet/Quiz on content.
Daily worksheets
Chapter quizzes
Unit 6 Test
Math Standards
Expressions and
Equations
7.EE.1, 7.EE.2
High School
Functions:
HSF.IF.B.4
HSF.BF.A.1
Career Readiness:
CRP8. Utilize
critical thinking to
make sense of
problems and
persevere in
solving them
Curren: Chapter 18
Worksheet calculations practice
Gootblatt Problem Set
StudyWare Chapter 18
10


Calculate flow rates using Formula
method
Recalculate flow rates to correct offschedule infusions
Infusion and Completion Times
 Infusion Times
 Completion times using military
time and standard time.
 Labeling the IV bag
Medication and Titration Calculations
 Flow rates to infuse ordered dosages
 Dosage and Flow rate based on kg
body weight
 Dosages and Flow Rate ranges for
titrated medications
Unit 7
Heparin Infusion
 Heparin Dosages
 mL/min flow rates for EID
 gtt/min flow rate for microdrip and
macrodrip IV tubing sets
 hourly dosage infusing from mL/hr
rate.
Pediatric Medication Calculations
Pediatric Oral and Parenteral Medications
 Explain how suspensions are
measured and administered
 Calculate pediatric dosages
 Precautions for IM and
Subcutaneous injections for infants
and children
Assess answers obtained to determine if they are
logical
Curren: Chapter 19
Worksheet calculations practice
Infusion time = How long the IV bag (or dose)
takes to empty.
Completion Time = What time of day the IV dose
is finished.
Curren: Chapter 20
Practice Sheets
This is the most challenging unit, all of the
previous math operations practices are used for
the IV calculations. Knowing the order of
operations is essential to solving the problems.
Assess answers obtained to determine if they are
logical.
Curren: Chapter 21
Carefully inspect the labels provided in the
textbook.
Practice problem sets using the preferred method
of calculating dosages.
Assess answers obtained to determine if they are
logical.
Curren: Chapter 22
Carefully inspect the labels provided in the
textbook.
Practice problem sets using the preferred method
of calculating dosages.
Assess answers obtained to determine if they are
logical.
Worksheet/quiz on content and dosages.
Daily worksheets
Chapter quizzes
Unit 7 Test
Math Standards
Expressions and
Equations
7.EE.1, 7.EE.2
High School
Functions:
HSF.IF.B.4
HSF.BF.A.1
11

Calculate pediatric IM and
subcutaneous dosages
Pediatric IV Medications
 Preparing and administering IV
medications for a solution bag and a
calibrated burette
 Necessity of an IV flush
 Calculate flow rates for the
administration of pediatric IV meds
 Use normal and daily ranges to
calculate and assess dosages
ordered.
Marking Project Assignment
Period 2
 MAR and Patient medical records
Project
 Identify and prepare medications
ordered for each patient on virtual
floor
 Use the 6 Rights of Medication
Administration
 Experience the pressure of caring for
numerous virtual patients during one
shift and administering all of their
medications correctly before the
clock runs out.
Career Readiness:
CRP8. Utilize
critical thinking to
make sense of
problems and
persevere in
solving them
Curren: Chapter 23
Practice problem sets using the preferred method
of calculating dosages.
Assess answers obtained to determine if they are
logical.
Worksheet/quiz on content and dosages.
Virtual Clinical Excursion Software
 Complete all shifts and receive virtual
preceptor’s report for each shift.
 Practice makes perfect, do the shift over
until its error free.
 For the Final Project Grade
o Students must select all patients at
the beginning of a shift and
complete the shift caring for all
patients in the same shift session
o Screen shots of the virtual
preceptor’s reports for each patient
on each shift to be sent to the
course instructor.
o Preceptor’s report will show a
completion times for each patient.
These must match, proving the
virtual patients were all cared for
during the same session.
Project Grade
Timeframe: 1 -2
weeks
CTE Standards for
Healthcare
Science:
Diagnostic
Services
9.3.HL‐DIA.2
Health Infomatics
9.3.HL‐HI.2
9.3.HL‐HI.3
Support Services
9.3.HL‐SUP.1
Therapeutic
Services
9.3.HL‐THR.2
9.3.HL‐THR.3
Career Readiness:
CRP1. Act as a
responsible and
contributing citizen
and employee.
CRP8. Utilize
critical thinking
CRP11. Use
technology to
enhance
productivity
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