Event 1: How to Crack Dosage Calculation – The Must-Knows

00:00 Let's go ahead and get started, because we want to make sure we get every second in for how to crack dosage calculation, the must knows with Prof Lawes.

00:09 So we're going to go ahead and start looking at what we're talking about today.

00:15 But first I want to introduce myself.

00:17 For those of you who have not been with us before, I'm Nicole Shinn. I'm responsible for student engagement Lecturio.

00:25 So thank you all for being here and taking some time out of your busy schedule. I love talking to you all and of course our wonderful Prof.

00:32 Lawes, who's going to be our main speaker, of course.

00:36 And she's going to get you all set and dose calculation.

00:39 I know you all got into nursing just to do more math, right? That's what you came here for, right? So but first I want to go ahead and take it over. I'm kind of giving you a sneak peek, um, and show you some of the resources that we have.

00:55 Um, and the reason why I want to do this is because one, if you're not already a Lecturio Nursing premium member.

01:02 You should be. Um, but also just so you have a quick rundown of what the resources look like. Now, today we're going to focus, of course, on dosage calc, but we have all, um, of the top nursing school topics.

01:16 So don't feel afraid, like you're like, oh, I need this and we don't have that. You're going to see everything is here.

01:22 One of the things that we do that I really love is that we don't do a la carte pricing.

01:28 So whenever we add more resources in, if you're a member, you get access to those resources.

01:33 So and we're always adding new stuff.

01:36 But since today we're going to focus on dosage calc.

01:38 You can see these are the resources.

01:40 And I just want to show you where to find them so that if you're, um, already a member or if you're new and you're not quite sure when you go to the video library, if you click on, of course, dosage calculation, it's going to take you right there.

01:54 Okay. Now a couple things I want to point out.

01:56 So there are 20 lessons in here.

01:59 So we walk through 20 different videos where you're going to learn, um, different things, whether we're going to do a case, do a question, or walk through a question, show you how to convert.

02:11 Everything is in here.

02:12 So you want to make sure that if this is what you're focusing on right now, that you check this out, because these are 20 of the best dose calculation lessons you're going to find.

02:23 And you'll notice, too, that our videos are short and sweet.

02:26 They're short and concise.

02:27 And we do that because we want to make sure, um, that you're retaining everything. So we know through learning science that if videos are too long then you don't have that retention.

02:36 So this is where you're going to find them. You want to make sure you go through.

02:40 You can add them to your personal study plan or your Lecturio resources.

02:43 But this is what you get with us okay.

02:49 So this is going to get you started.

02:51 And then you can come in here, um, with your resources and finish it up.

02:55 The other thing I want to show you is that in our question bank, we also have exam prep dosage calculation questions.

03:03 And I just want to show you how to get to that too.

03:05 So you're going to click on Create Custom Test.

03:09 And then once you do that I just want to point out how you're going to put these parameters in so you can have an understanding.

03:14 So of course you're going to put in those normal parameters there. But what you're going to see is right here we have 37 dosage calculation questions.

03:23 So simply just click off of systems.

03:25 If you just want to do dosage calc and then click on Dosage calc okay.

03:29 And then you can of course you don't have to do all of them at one time. That might be too much. Um but you can do that there.

03:34 Now, what I want to show you, which is the best part, is that, um, after you take these exam prep Qbank dosage calculation questions, you're going to get our, um, adaptive review.

03:47 And the reason why I want to show you this is because this is really where the learning happens too, right? So what you're going to see is once you scroll down, you're going to see subjects.

03:58 And I have it on, um, last limit to last attempt.

04:02 So it's just showing like the last time that I went in and took a qbank.

04:07 But you'll see right here I can simply click on the top button here, click right here dosage calculation.

04:13 And then once I start the adaptive review it's going to go through.

04:17 And it's going to give me a review based on um, the questions that I got incorrect when I took my last dosage calculation.

04:26 Qbank. And this is really important because you see, I have a personal there's profiles there.

04:31 Look at her. So you can see right here I have a personal playlist.

04:34 This is Adaptive Review where it's gone through. And we've picked everything that you got incorrect. And we're going back through now giving you that playlist so you can go through and make sure that you're reviewing and having a better understanding so you don't have to figure it out.

04:49 It's already done for you.

04:50 And that's an excellent resource because you want to make sure that you're spending time on the things that are going to really count and matter and not trying to figure out what's going on. So this adaptive review is something that like is really a great time saver, and it's going to help you to build a retain and take in that information and get it way faster. So if you right now are in the middle of Calgary, you're studying it now.

05:16 Um, this is the perfect resource, even if you're a senior, right? Like you may, you know, that might have been the course that just you could go back through and use these resources.

05:26 So again, we're focusing on dosage calculation today.

05:30 But as you can see when I went into the video library we have all the topics that you're looking for. So that is just a brief overview.

05:37 I don't want to take up too much time.

05:41 Um, because I want to make sure that we get in here and I apologize.

05:45 I'm middle fingers, but for those of you who aren't members, you want to make sure you take advantage of this plan.

05:52 So we have a one month.

05:54 So this is no obligations 14.99 a month.

05:57 So if you just want to get in one month a dosage calc okay we get it.

06:02 You can do that. And that's a month by month plan.

06:05 Or you can do the one year plan.

06:07 And the one year plan is fabulous because it doesn't matter even where you are in your program, you can use these resources to help you.

06:15 If you're again a senior, you need to fill in some knowledge gaps before maybe another end.

06:20 Of course, if you have your exit, of course exits are coming up.

06:23 I can't believe it's already marked. So exits are coming up, right? You need to fill in those knowledge gaps for exits.

06:29 Um, even when you're going to take boards, there's things that you need to go back and review and look at. And so we're here to do that for you.

06:36 So I know a year seems like a long time, but even we have practicing, um, nurses that use us for reference.

06:43 So it's a great resource to have.

06:45 So take advantage of that special deal here.

06:48 So now without further ado, Let me turn it over to Prof.

06:53 Lawes. Who's going to give you the must knows for dosage calculation? Prof. Lawes. There we go.

07:02 Great. I was talking to Rosa.

07:05 Well thank you. Nicole.

07:07 Hey, guys. So. Oh, you're going to be with me the whole hour, and I'm already talking like this.

07:13 Would you mind just saying thank you? Nicole. She is our number one student cheerleader at Lecturio. So in the chat, just let her know.

07:20 Thank you. Glad she's here.

07:22 Let her know that because she is your huge advocate at Lecturio.

07:27 You want to get to know her for sure, because that's who she focuses on her students. Now I see some of you have asked a lot of questions about, hey, what about next gen? Yes, we've got you covered.

07:38 We can help you get ready for next gen.

07:40 So if you graduate in 2023, you're going to be taking next gen questions.

07:45 If I heard some people say we've got some Sooners out there from oh you.

07:48 Yes. Your school has actually adopted.

07:51 Lecturio. So you get more and more of this stuff.

07:53 But what excites me the most is people that are getting started early because you're giving yourself the best foundation to start.

08:01 So let's roll into content.

08:03 Okay, now how many of you, if you say you're math averse? Like ten. I hate math or one I'm the best.

08:12 So ten is you hate it.

08:13 One is you love math. You think it's fantastic? Give me your number. Oh, look.

08:18 Look at all the tens. My people.

08:22 You are my people. Okay, well, I'm so glad that you're here.

08:27 And those of you guys that are like ones and threes, you're going to sail through this. So enjoy it.

08:31 Because that's how nursing school goes.

08:34 Some things you're like yes I get this.

08:36 And other things you're like, help me, I don't understand and we've got you covered. So let's go over a little bit of the teaching like Nicole's told you, I'm going to go through one session here and kind of give you an overview and highlights, but in our subscription you've got 20 separate lessons looking at things and you can rewind them, replay them and also download our slides right from it.

09:00 Hello from the Philippines.

09:02 We love the Philippines.

09:03 I love got to meet some people there recently.

09:06 Okay, so we have three things that we're covering in this session.

09:10 So every time before you sit down to study I want you to think about what are my goals.

09:14 Why am I here? What am I studying? Not just oh my goodness, I've got a test coming up.

09:20 So for this one we're going to talk about conversions.

09:22 We're going to talk about weight based medication.

09:25 And I'm going to talk to you about IV drip factors and IV flow rates okay.

09:29 So those are the three things we're going to talk about.

09:32 So first let's take a look at conversions.

09:35 We're going to kind of get you warmed up. Dip your toes in the water so you can get feeling really good. We're going to talk about conversions.

09:42 And there are some things that you have to memorize okay.

09:46 Now I'm going to focus on the slide set and making eye contact with you.

09:51 But there are a whole team of people that are reading all the questions in the chat, and they're going to help answer those.

09:58 So if I miss something and I likely will because I'm going to be focusing on teaching you, they'll wrap it up at the end so we can ask questions.

10:05 And Nicole is always open to us having conversation at the end and answering questions. So hang on.

10:12 Let's start with conversions.

10:14 Okay. Now we have a handout which, um, Sarah made for you.

10:18 She's not here today, but I'll make sure she knows that you really liked her handout. But do you see how you look? There you go. Click on the handout you see here on our form.

10:27 We show you where to do that in the upper right hand corner.

10:30 You want to click on handouts and you can download a conversion for you.

10:34 We have lots of cheat sheets at Lecturio which I love those because they tell you just what you need to know about certain topics.

10:42 So don't miss downloading the handout.

10:44 It's yours. You can save it, you can print it and it will help you keep in mind all the most important conversions.

10:50 So let's start talking about actual conversions.

10:53 So this is a two liter bottle of water, right? It's very healthy. Mine would have probably been a two liter bottle of Diet Mountain Dew.

11:02 But I'm glad we're going with the healthier choice of a two liter bottle of water.

11:06 So what's the unit of measure here? Now you're thinking like, really? You just said it's a two liter bottle of water.

11:17 Okay. That is the key to getting the math right in conversions is paying attention to what you have and what you're trying to change it into, what you're trying to convert it into.

11:29 So we know that when you look at that before it, deci means one tenth. Centi means 1/100.

11:35 Milli means 1/1000. So a deciliter is a 10th of a liter.

11:41 A centiliter, which you don't hear very often is 100th of a liter and a milliliter is 1,000th of a liter. So therefore, you just do the math backwards, right? If I want one liter, it would take ten deciliters or 100cl or 1000ml to make one liter.

12:04 Now, if you're in one of those countries that has, um, unlike the US, converted to the metric system and you use it everywhere, just know that in the US our pop is sold in liters.

12:14 And that's about it. So that's our biggest our pop in our water.

12:19 So that's um, we're behind you guys.

12:22 So if you're thinking this is so easy, man, enjoy it because we live in a place where we have to do that math.

12:29 It's somewhat new to most of us because we don't use the metric system in other areas.

12:35 So that's okay. When you went back here, when we looked at this, we saw Santa and Mila.

12:41 You just put it in front of liter. That's a unit of measurement. We're good to go.

12:44 That's pretty straightforward. But what are the two different systems? What if you have pounds and you need to get kilograms, or you have kilograms and you need to get pounds.

12:53 Because when we're talking about dosage calculations some medications are given based on weight. So this is what you need to memorize.

13:01 And some of you may already be there if you are celebrate.

13:05 That is the balm. If you've already got this down, I want you to be really excited that you know more than you think you know.

13:13 If you don't know them yet, no problem.

13:15 We'll help you get that.

13:16 Okay, so one kilogram equals 2.2 pounds, which is why most of us would prefer a weight be reported in kilograms instead of pounds one ounce.

13:26 And we're talking about a liquid ounce is 30ml.

13:30 One cup is eight ounces.

13:33 So therefore it will be 240ml.

13:36 And one teaspoon is 4.929ml which we're just going to call that five.

13:41 I know that doesn't follow the rules of rounding, but really that's how it's looked at as five milliliters equals one teaspoon.

13:51 Okay. So if one teaspoon equals five milliliters how many teaspoons are there in an ounce. Tell me in the chat.

13:59 So one teaspoon equals five milliliters.

14:02 How many teaspoons are in an ounce.

14:10 There you go. And you did that math mostly in your head.

14:14 Super cool. Now those of you that are getting ready thinking about the NCLEX, you'll have a write on wipe off board.

14:20 Well, NCLEX world, you can write on it, but you can't really wipe it off.

14:23 You have to raise your hand to get another board. But you'll have to check with your schools what they'll allow you to have when you're testing.

14:30 Sometimes they'll let you have scratch paper.

14:32 Sometimes they will not.

14:33 Sometimes they just want you to use an on screen calculator.

14:35 And that's the same format on the NCLEX.

14:38 But the answer to success, Excess, right? If you want to raise your scores in testing is do it systematically.

14:46 Do it the same way every time and go through and make sure you're very clear on what you're adding or subtracting. So let's practice.

14:53 Okay I've got four questions here.

14:56 I'm not going to read these to you now. But we're going to look at these four different types of conversion practice problems one at a time.

15:03 Ready. Okay. So so I know you're ready.

15:07 I'd like to see your favorite ice cream in the in the chat.

15:12 What's your favorite ice cream.

15:18 Oh cookies and cream. Yeah. Chocolate butter pecan.

15:20 Ooh, goody goody gumdrops.

15:22 You guys, you have very sophisticated ice cream palettes.

15:25 Excellent, I love it. Grape-nut ice cream.

15:29 Okay, I'm gonna have to. I'm gonna have to. I'm gonna have to pass judgment on that one.

15:33 Okay, so first problem, you have orders for two ounces of cough sirup. How many milliliters would this be? Well, you think through what do I have milliliters or what do I want milliliters I have ounces. So to convert it I know there are 30ml in one ounce.

15:49 Now why do I know that.

15:51 Well because that was on the list of things we had to memorize okay.

15:54 That was on the things we had to memorize.

15:55 So if we know 30ml in one ounce then the math is pretty easy.

16:00 Two ounces has 60ml because we just multiply two times 30.

16:04 That gives us 60ml okay.

16:06 Everybody with me. Yeah it does get harder.

16:10 But enjoy enjoy the success as we go along.

16:14 Now let's look at the second problem.

16:16 If my patient weighs 200 pounds how many kilograms would this be.

16:20 Okay. Again we're converting from one kind of measurement to another type of measurement.

16:25 So we want to know desired is kilograms.

16:28 What I have is pounds.

16:29 I know there are 2.2 pounds in one kilogram.

16:33 So if I divide 200 by 2.2 that will give me Nine one kilograms.

16:40 Okay, so it's what I have, right? 200 pounds divided by 2.2kg.

16:46 Because I've memorized that conversion.

16:48 I know I have 90.91kg now.

16:51 Some hospitals use both.

16:53 They use pounds and kilograms when they're weighing patients or they might use one or the other. Either way, a nursing test, you're going to have to be able to convert from pounds to kilograms.

17:04 Now problem number three okay.

17:06 Your patient drank two cups of coffee.

17:09 How many mils of intake would this be? Now what we have is one cup.

17:15 So we'll convert that cup to ounces which is eight.

17:18 Why do we know that? That's on our list of things you have to memorize.

17:21 So a cup equals eight ounces.

17:24 If I was baking a cake and I needed a cup of milk, I would pour eight ounces of milk into a measuring cup.

17:30 So one cup equals eight ounces.

17:32 If we want to convert that to mils you do eight for ounces times 30 mils equals 240ml in each cup. So I know that I have 240ml in one cup.

17:46 But look at what the patient drank two cups.

17:49 So I need to do two times 240 equals 480ml.

17:56 And that's what I would chart for this patient. Again you're thinking I could have done that. Some of you are thinking I could have done that in my head. You sure could have. But when we're doing things that are really critically important for patients, you want to make sure you're systematic and you're safe.

18:12 So walk yourself through that.

18:13 This is how you pass the dosage calc exam so you can go to clinicals is you want to be very thorough and make sure you're adding up the right numbers for what the question is asking you. Now problem number four we got a lot more words here.

18:26 But don't worry, we'll get it.

18:28 So you have an order to give a total of one gram of medication in a 24 hour period.

18:34 Okay. This is different. It's going to be way more fun.

18:36 So I the order from the healthcare provider that could be a nurse practitioner or physician in order to give a total of one gram in 24 hours.

18:47 Now here's the other rules.

18:48 The medication should be administered in equal doses every six hours.

18:53 That makes sense. How many milligrams will be in each dose? Ah! Pay attention. That's what they're telling you.

19:00 They're. They're asking you how many milligrams will each dose be? That last sentence can really change the whole question.

19:08 So you want to make sure we're walking through this.

19:10 It's going to feel easier to you while we're walking through it.

19:13 But the most important thing is you practice without us.

19:16 So how many milligrams in each dose? Let's see how we do it.

19:19 We know that we have one gram desired for equal doses in a 24 hour period.

19:25 We want to know what's the number of milligrams for each dose.

19:28 So we take one gram we know equals 1000mg.

19:33 Why that's on our list to memorize.

19:36 So there's 1000mg in one gram.

19:40 I know that's what you're going to get in 24 hours. 1000mg.

19:44 Now I have to just divide 1000mg.

19:47 I've got the unit right by four.

19:49 That means each one of those four doses needs to be 250mg per dose.

19:55 You're thinking like, wow, dosage calc is pretty easy.

19:58 Hey, I promise you, it is.

20:00 But the numbers don't always come out as pretty as we're doing it for you here.

20:05 But we wanted to do that so you could easily check your math.

20:08 Take the same care, though, when you're converting these types of medications and dosage calculations with real patients and for your dosage, calc exams. Okay, so we just talked about the first of three.

20:21 What was the first part.

20:22 What do we call that. It started with a C.

20:26 What kind of dosage calculations did we talk about.

20:28 The word starts with a C.

20:30 Conversions. Yes I am super impressed.

20:35 Alright, you guys are sharp today so we've got conversions now we're going into weight based. Okay. So let's take a look at how we do that.

20:43 And once you understand these simple concepts can be pretty good. But here is the number one concept on NCLEX. Whether you haven't started nursing school you're already in nursing school or you're going to take the NCLEX tomorrow.

20:56 Safety first. That is the main concept that you'll be tested on in on NCLEX and on your nursing exams. Do you recognize when a patient's in trouble? Do you recognize those signs and symptoms and do you know what to do.

21:10 So with dosage calculation we're talking about safety. Finding a safe dose usually requires calculating a dose based on body weight.

21:18 Not all drugs are based on body weight, but you'll learn the ones that are.

21:23 So in order a dose for a neonate or an infant is going to be infinitely smaller than a dose for an adult, right? The usual dose of units that we would use neonates and infants.

21:34 It's usually weighed in kilograms, adults pounds or kilograms.

21:39 And remember, the dosages may be caught in some other units.

21:42 They won't be MCG micrograms or milligram milligrams per kilogram, per pound or per day. So remember how we did that.

21:52 Hey I want you to get 1000mg a day divided into four doses.

21:58 But we didn't have the patient's weight in there.

22:00 Now we're going to do questions that are like based on this patient's weight. You want them to get X number of micrograms per kilogram per day.

22:10 We'll walk through that type of math.

22:12 So always always always double check your work before you give a medication to a patient when it comes to dosage calculation.

22:20 Look at this. They named a medication for me right.

22:22 So let's start with a pediatric oral liquid medication.

22:27 Okay. So pediatric oral liquid medications. Remember I was never brave enough to do pediatrics in my career.

22:32 I always did the big people because the tiny dosages you guys give to pediatric patients kind of freaks me out. But let me show you how to do it.

22:40 Now, there are a lot of words on this label.

22:43 Look at the right. That's the prettier side, right? That tells us that we've got the pharmaceutical company.

22:50 They made Lawes because our instructional design people have a sense of humor. It's called Bug away for an oral suspension.

22:56 And we know that we have how many milligrams in five mils.

23:01 So tell me in the chat, how many milligrams of bug away do we have in five mils? There you go.

23:07 So how many milligrams would we have per mil? How many milligrams of bug away do we have per milliliter? Excellent. You guys are catching on right.

23:20 So we have 250mg in five milliliters.

23:25 So if we divide 250 by five we'll know how many milligrams we have in one milliliter.

23:32 And the answer is 50. Okay, you guys got that.

23:35 So learning how to read a label is really important in nursing school.

23:39 But you've got this. You've been reading for a very long period of time.

23:43 Slow down. Read the full words, make sure you understand what it means, and you're going to be just fine, I promise.

23:50 So pediatric oral liquid medications sometimes provide a range, a safe range of medication that the patient can get in a 24 hour period, just like the one we did previously, remember, 1000mg in 24 hours.

24:03 But oftentimes with pediatrics, it's going to be what they can get in 24 hours based on their weight.

24:09 So take a look at this label right.

24:12 You see usual dose prior to mixing each five mils shake well before using.

24:17 Those are four categories.

24:19 But we're looking for what's the recommendation on this label for a daily dose for children, it says the usual dose for children is what? To what? There we go. Oh, you're right on it.

24:32 Good job. See, there in the very top line for children 20 to 40mg/kg per day.

24:41 So 20 to 40. Here's our range.

24:43 20 is going to be the lowest we want them to get.

24:46 40 is going to be the maximum.

24:48 We want them to get milligrams per kilogram per day.

24:53 So in a 24 hour period the range is from 20 to 40mg/kg per day.

25:00 So why are we doing this so slowly? Because we know how sharp you are.

25:05 All you need is someone to show you this, and then you practice it, and you're going to be right on target.

25:11 So, adults, we don't care here.

25:13 But look, it's not weight based for adults, but it is for pediatrics.

25:17 So that's something you want to keep an eye on and looking for.

25:20 So for this pediatric patient we're going to figure out what is the safe range.

25:25 We don't want to give them less than 20mg/kg a day or it won't be effective.

25:30 We don't want to give them more than 40mg/kg per day because it could be toxic, maybe even harm in organ.

25:39 So we've got this, and we know that the pediatric oral medications, they give us this safe range in a 24 hour period.

25:46 And then we're going to divide this in three doses meaning every eight hours.

25:52 Now when you see this, when you see the little QQ8H, you guys know what that means.

26:00 Q means every. Right. So we're going to give this medication every eight hours.

26:08 So we're going to figure out hey what is this.

26:11 Yeah. Good. Well there's a lot of medical terminology to learn, but you'll do yourself well. Keep studying that stuff.

26:17 You'll do great. And we'll drop little hints for you as we go through.

26:20 So we know that we're going to get 20 to 40mg/kg per day in three doses.

26:25 That means we're going to give it every eight hours for that medication.

26:29 So we looked at our label.

26:30 We got our safe range.

26:31 There it is in the blue line right up there 20 to 40 because we have a range milligrams per kilogram per day. And then we're going to get that total and then divide it by three because we're going to give it every eight hours. So let's figure the lowest range first. Look over here.

26:50 We're going to give you a ten kilogram child.

26:52 You're welcome. That's why we wanted the math to be straightforward for you.

26:56 So you didn't get wrapped up in trying to calculate things.

27:00 So ten times 20 equals 200mg.

27:04 Now where did this 20 come from? It came from right here because we know we have the lowest amount is 20mg/kg per day.

27:13 The ten represents the child's weight which is ten kilograms.

27:17 So the lowest therapeutic dose is ten times 20 equals 200.

27:23 Now let's figure the top range like the most.

27:26 This kid can get the highest safe range.

27:29 So we've got right up here.

27:30 It tells us 20 to 40. So down here, child's weight ten times 40 equals 400mg per day okay. So that means since this child weighs ten kilograms, the range would be anywhere between 200 and 400mg a day.

27:49 Now, why are we going over this? Because your job as a nurse is to make sure that when even if the physician has ordered it, the pharmacist has filled it.

28:00 You have all the legal, professional and ethical responsibility to triple check that dosage and make sure it's safe for this particular child.

28:10 So you want to make sure that whatever the healthcare provider has ordered falls within this range, right? So we've got one day is 24 hours, three doses in a day. We know that we would divide that by three because that gives us every eight hours. You guys already had that.

28:24 So if the order reads to give 125mg every eight hours, is this safe? So I'm going to give you just a second.

28:35 See if you did the math on your own and some scratch paper, what would you do? I'm going to give you just a couple of seconds to set up to set up your reprogram.

28:43 Then we'll walk through it. Okay.

28:51 Now what we're asking you to do there is to predict.

28:53 Predict means try and answer something.

28:55 Try to guess. Even if you get it wrong, you are warming up your brain to remember that information, so it's always good to try.

29:03 Prediction. Don't just flip right to the back to the answers.

29:07 That really doesn't help you learn.

29:09 You want to make sure you tax your brain.

29:11 Asking your brain questions is the best way to learn.

29:15 This can be your worst enemy a highlighter if you use it, let's say, indiscriminately.

29:20 And you like, come see me in my office.

29:22 And when you open up your textbook, I'm like, whoa, I gotta wear sunglasses because you have just colored everything.

29:29 That's not helping you learn.

29:31 So predicting things will really help you get that brain ready to absorb information.

29:37 So let's go on. 125mg times three doses.

29:43 That would equal 375mg in one day.

29:48 Everybody follow on the math.

29:50 So would this be safe? Well, 375 is in between 200 the lowest and 400 the highest.

29:58 So yep this is safe. So see you can totally do these questions when they come up on your dosage calc exams. So what if the order read give 200mg every eight hours.

30:13 Is this safe? Well, you know how to do the math, right? So predict. What do you think? Right? No. Not safe because 200 times three equals 600.

30:25 And we know the safe range is between 200 and 400.

30:30 So what would you do? Hold this medication.

30:33 Contact the healthcare provider.

30:35 You would not administer it.

30:36 And remember in the rules in our scope of practice, nurses can never change the dosage, right? That has to be ordered by the healthcare provider.

30:45 We can't give them a little more.

30:46 Give them a little less. That is not within our scope of practice.

30:49 So you would never want to do that.

30:52 Remember, we're talking about your legal responsibility.

30:55 So what you have to do when a medication is ordered in divided doses is make sure the total daily dose is right within that safe therapeutic range.

31:06 Make sure it's not too low and it's not too high because if it was too low, I'd want to call the healthcare provider also.

31:14 Now how often does this happen? Well, the sad answer is more than we wish it did.

31:19 But you're not going to see it on an everyday basis.

31:23 But the thing is, you don't know.

31:25 So that's why we always have to check the medications.

31:29 We don't have time today. But I would tell you a story about my dad.

31:33 Um, a nurse saved his life because the wrong medication got ordered by a physician.

31:39 A pharmacist filled it.

31:40 That it was the nurse who recognized it was not safe for him to get that medication.

31:45 So that's why we do what we do.

31:47 We're a team. We all need each other.

31:49 Healthcare providers, pharmacists, nurses, respiratory therapists we all have to work together because we are all human.

31:56 We need each other. So keep that in mind.

31:59 Just because it's ordered doesn't mean you should give it.

32:02 All right, let's go on. Excuse me.

32:06 We're going to do some practice.

32:07 Ready? So we're talking about our legal responsibility for safety.

32:12 If we have an order that reads 250mg of cough, not po. Q6 hours. Is this safe? Okay, now I know you guys are predicting. I'm going to give you a second to think about it.

32:25 Then we'll walk through it.

32:37 Okay, so I know this order said 250mg Po every six hours.

32:45 So in a 24 hour period, this kid is going to get four doses because every six hours. Excuse me, there be four doses in a 24 hour period.

32:57 So four doses times 250mg equals 1000mg in 24 hours.

33:05 Now our job is to figure out is that within the therapeutic range? Now when I see you guys are doing it okay.

33:11 So we see on the label right here see what it says 50mg/kg per day.

33:19 Okay. So let's see what we've got with the math.

33:22 So 35mg times 50mg a day equals 1750mg.

33:30 Now sit with that for just a second.

33:40 1750mg a day. What does that number represent? So what do these numbers mean? We said 35kg. That is the child's weight.

33:57 50mg per day tells me this is what is going to be safe.

34:02 We've got 1750. So yes four doses times 250 is 1000mg in 24 hours. Remember what we determined was safe.

34:16 1000 up to 1750mg is safe for a 35 kilogram kid.

34:24 Okay. So is this making sense? This is a little different than the one we did before, which is why we put this in here.

34:30 This one doesn't have the range.

34:32 The other one said between 200 and 400.

34:35 This one is just saying up to 50mg a day is safe for this child to get.

34:40 So we take the kid's weight 35kg times 50mg a day.

34:46 That's why we know this is the most this kid can take in a day.

34:49 When we did the math, the order was 250mg for doses.

34:55 That gives us 1000, which is less than 1750.

35:00 So we're good. We don't have to call the healthcare provider.

35:04 Right. We got it because the dosage is still safe.

35:08 So the first one we did was a range.

35:10 We knew it had to be above this, but below this.

35:12 This one just told us that's the most the kid can have in a day.

35:16 Okay, you did it. Now, the first was conversions.

35:21 The second section was what? So first we did conversions.

35:26 The second session starts with a W weight based.

35:30 That's right. You guys are right on target.

35:33 Now we're going to talk about IVs.

35:36 Okay. So let me let you take a look at this.

35:39 Oh, wow. Okay. We have a very it's okay.

35:42 My picture went away for just a second, but I'm still here.

35:46 We have a primary IV line, and you don't want to be distracted by my amazing looks. Just kidding.

35:51 So, what I want you to look at right here is.

35:54 Wow. This is an IV pump setup.

35:58 Now it's okay. We can help you with IVs.

36:00 Don't be sad. Don't be afraid.

36:03 What I want you to look at here is that this is the pump, right? This is the primary IV.

36:10 This is what we call a piggyback.

36:13 So the primary IV is normally a bigger one like 500ml, which if I compared 500, how many 500 milliliter bags would it take to make 1000ml. How many? 500. Nice. You did the math.

36:33 You did the math. How many 1000 milliliter bags would it take to make one liter? You guys got it? Excellent.

36:46 All right. So when you're looking at this, this is our pump where we'd set the rate.

36:51 This is our primary set.

36:52 We put it lower than the secondary set.

36:55 The piggyback. Because it'll take this volume first.

36:58 Okay. You got it. Now, I.V.

37:00 tubing, drip chambers. We've got all kinds of information about IV lines in our courses.

37:07 So we don't have time today to break those down super specifically, but these are some of the important things I wanted you to know. The secondary IV tubing is shorter and it's also up there higher.

37:21 So when you see the secondary IV tubing, it just goes from here to here.

37:25 The primary tubing goes all the way down here.

37:28 We hang this higher so gravity can help us get that medication in first.

37:33 And when this medication is done we may be giving like an IV antibiotic or something like that. When that's done, this primary line will kick back in.

37:43 So don't let this be overwhelming.

37:46 What I want you to know is that this primary bag is usually bigger, and it runs all the time.

37:52 When the piggyback medication.

37:54 This might be something we give every four hours, every six hours, every eight hours. This medication infuses into the same IV line, so we don't have to stick the patient twice as long as the medications are compatible.

38:08 So we call it the little guy.

38:10 The piggyback set, an intravenous piggyback or an IV.

38:15 When you see that, you're going to see things IVB.

38:18 That's what it means. It means the tiny little bag where we're giving a medication like an antibiotic, etc.

38:24 when we say intermittent medications, this primary bag right here, this one is running all the time.

38:33 Okay. So it is running all the time.

38:37 Intermittent means I'm going to give it once every 4 hours or 6 hours.

38:40 So make sure you write that in your notes so you remember what the the meaning is of intermittent medication.

38:47 Those are the values you guys just did. We did them with sirups and oral things. But we can do the same thing with an IV piggyback.

38:52 So you'll work with your pharmacist to make sure these two medications, the one that's running here, the IV solution and this medication, they're compatible. Because if they're not compatible, bad things happen. Precipitate forms.

39:05 And it gets stuck in the IV line or they don't work as well.

39:08 So you do not want that to happen.

39:11 Okay. So the most important takeaway points here.

39:15 Here's an IV pump. This controls how fast the fluid goes in.

39:20 This is the primary bag.

39:21 And it is generally running all the time.

39:25 This is a piggyback and it runs intermittently.

39:28 However often the doses are ordered.

39:30 Now here's where it gets fun.

39:32 Okay, so we just kind of went over what an IV pump was and what the different bags were.

39:38 Now, when they call these macro drip sets or micro drip sets, which one is bigger? Macro or micro? Just by the word beautiful.

39:52 I love it. Okay. Spot on.

39:55 I knew you guys could get this.

39:57 Okay. Macro drip. We have those sets that are ten, 15 or 20 drops. So GT means drops the abbreviation GT.

40:10 Don't ask me how they got it right.

40:13 It's from another language.

40:14 Gt means drops. So what? It's telling me with a macro drip set, it can be ten drops in one milliliter.

40:24 Or 15 drops in one milliliter, or 20 drops in one milliliter.

40:31 Those are considered macro drip sets.

40:33 They're the bigger ones. So it literally means right here.

40:38 You guys have all seen the medical TV shows, right? Where you see the IVs and the fluid is little drops are coming down here.

40:44 And this macro drip set I would have to count ten drops 123, four, five, six, 789, ten.

41:00 It would take ten drops to equal one Milliliter.

41:06 So if I am in 20 drop macro drip tubing, how many drops would it take to equal one milliliter? See you guys.

41:20 Got it. Beautiful. Now, you see, with the macro drip sets, there are ten, 15 or 20 drops.

41:26 Now, um, if you look at the micro drip sets, look at those little ones.

41:31 How many drops would it take for one milliliter in a micro drip set that we have here? 60. Beautiful. So see why it's micro drip.

41:42 Those are tiny little drops.

41:44 Tiny tiny tiny little drops.

41:46 Now where do I get this information? Do you just have to memorize it? No. Look at the labels.

41:51 You look at the tubing.

41:53 Uh, the bag that the tubing comes in.

41:54 It will tell you how many drops for this particular tubing.

41:59 Does it take to make one milliliter? So usually IV fluids are written like how much you want the patient to get in in an hour. So 125mph means you'll get 125ml of fluid in one hour.

42:13 Now look at the second one.

42:14 0.9% normal saline at 125ml per hour for eight hours.

42:21 Okay. The difference between those two orders is that the second one says I just want you to give it for eight hours.

42:29 The first one says hang that saline at 125 an hour.

42:33 Now the third order says, I want you to give this IV same fluid 125 miles an hour, same rate.

42:42 But I want you to give 2000ml.

42:46 So it's not telling us the time.

42:48 It's telling us the amount.

42:50 So either you just start an IV and it keeps running.

42:54 You get an IV and they give you a time for how long they want you to run it, or they give you an IV, a rate and wants a volume that you want.

43:04 Okay. Got it. Right. So let's take a look at an order.

43:09 0.9% normal saline at 125 miles an hour, for a total of 2000ml.

43:17 Okay, that's a lot of words.

43:19 And when your brain is stressed on a dosage test, you want to go slower.

43:23 Okay. So look at this.

43:25 I know I have normal saline which come back on our pharmacy.

43:28 We'll tell you all about those different types of solutions. It's going to go at 125 miles an hour. But once it reaches 2000ml infused, we're going to stop it. So that's my order.

43:42 What I have is normal saline at 125 miles an hour.

43:45 I want to get to 2000 mils total.

43:49 So the way I do that, I take the total 2000 mils.

43:53 Yay! Look, our our units match up 2000 mils, 125 miles an hour.

43:59 Thank you. We don't have to convert anything.

44:01 We can just write. Go to 2000 mills divided by 125 mills.

44:07 That means I'm going to run this IV for 16 hours.

44:11 Okay, so you're going to run the IV for 16 total hours.

44:15 Everybody see how we got there? Because if you multiplied 16 times 125, you'd be right at 2000.

44:22 Good. All right. You are hanging with us today.

44:25 Excellent. Hey. And if you're feeling behind, don't worry about it. That's normal when you're starting new things.

44:31 So just keep going with the flow.

44:32 Tell yourself it's a new slide. Let's keep working on it.

44:36 Now I have an order for normal saline at 125 miles an hour, for a total of 2000 mils.

44:42 Well, this looks familiar.

44:43 Now they're asking me, and you can see these questions on dosage calc. How long would it take to infuse 2000ml.

44:51 So I've got normal saline at 125 miles an hour.

44:54 I want to make sure I give 2000 mils just the other way.

44:57 Right. At 2000 mils Mills going in at 125 an hour at 16.

45:02 So you may see the questions posed any any one of these formats on your test.

45:08 Relax. You got it. You can do it.

45:10 Now there's our drip chamber.

45:12 See it right here. Now remember this.

45:15 I said you would look for the drop factor on the label of the tubing.

45:19 So you want to take a stab at it? What do you think is the drop factor on this tubing that we've made up for? You've got the label there. Yes.

45:29 Our lean for the win you got in.

45:31 And then look at all you guys that get it right.

45:33 Right. Correct. Right here.

45:35 This tells us ten. So ten drops are in.

45:40 How many mils? Ten drops are in.

45:42 How many mils. Can you tell me in the chat? Beautiful. I would trust you guys to look at IV tubing now and know exactly what to do now. We always teach this in nursing school.

45:59 Because you can be somewhere that runs out of IV pumps.

46:01 You can be somewhere that doesn't have them. You can be without power.

46:05 So this is a skill that nurses need to know.

46:08 Hopefully you'll have access to IV pumps for really tricky meds, but if you don't, it's okay.

46:14 You can do this. So we've got an order for normal saline at 125 miles an hour.

46:19 But we don't have a pump.

46:21 We look at the IV tubing.

46:22 You guys are already ahead of the game. You know that? It is ten drops for one mil.

46:27 So I need to convert 125ml an hour to drops per minute.

46:34 Everybody with me. All right.

46:36 So tell me in the chat. Does that make sense.

46:39 We know we've got ten drops per mil.

46:41 And we want to go to 125mph.

46:44 Now you try and do the math and then I'm going to show you how to do it.

46:52 Okay. So we've got 125 miles an hour.

46:56 We're going to divide that by 60 because there's 60 minutes in one hour.

47:01 That means I want to figure out how much I need per minute.

47:04 So 125 for my order divided by 60 minutes means I need 2.08ml per minute.

47:12 Okay. Well that's awesome. Listen we're not going to be able to figure out the 0.08 if we don't have a pump. So we're going to calculate this.

47:20 That IV fluid will have to flow two milliliters every minute to go at 125ml in an hour. So two milliliters every minute.

47:31 What was the drip factor on our tubing.

47:33 Do you remember. Beautiful.

47:38 Yes I am so excited to be here with you guys today.

47:42 Excellent. Right. So now comes some cross-multiplying.

47:46 But you got this. So if there is ten drops, right? Ten drops in one milliliter equals how many drops in two milliliters.

47:56 So you cross multiply right.

47:59 20 equals one x. And that's what we know.

48:02 20 drops a minute. That means go you guys.

48:06 Awesome. That means the IV fluid will have to go.

48:08 20 drops every minute in order to infuse at 125ml an hour.

48:14 So then what you're going to do is you're going to zero in on that drip chamber.

48:18 You're going to use your watch the second hand, and you're going to count the drops and adjust the roller clamp so you can make it go faster or slower until you get right at that magical 20 drops per minute.

48:31 Excellent. See? You can do it.

48:34 So look what we covered today.

48:36 You know, conversions of medication administration.

48:39 We gave you a cheat sheet.

48:40 We've got accurate weight based.

48:42 You know, you can do it for a range.

48:44 Or you can also do it for just a maximum amount or dose.

48:48 You can do it with oral injectable.

48:50 And we even did that. Yeah.

48:51 You got it covered. You can do that with IV IV drip factors and IV flow rates.

48:57 You got it. If it's a pump, you just put the numbers in.

49:01 But I know that you guys are even capable of doing this with a drip factor on the tubing.

49:07 Okay, so I'm going to turn this back over to Miss Nicole because she's got some extra cool things for you. And I'm going to be here to answer any questions that you have.

49:17 That was excellent, as usual.

49:20 Um, and we have a few questions, so don't go away.

49:22 Where are you going? Come back. But we have a few questions that we want to make sure that we're able to, um, get you to answer really quickly.

49:31 So just to remind everyone, we'll leave this on the screen if you're interested in becoming a member and learning more and getting more resources from Lecturio, please feel free to click on that link or make sure you take down that information. And then also, um, Sonia had a keen eye and we showed our human side. And so we had an error in our handout.

49:53 So we now have a link up with the new handout.

49:57 So we apologize. Sometimes our human side comes out.

50:01 Um so get rid of the first one.

50:04 Um and right here just click download.

50:06 This is the revision. So we made the um correction.

50:09 Thank you Sonia. That is excellent that you were able to point that out.

50:13 That's so cool that she's on that. Thanks for thanks for helping to make it better.

50:16 We appreciate that. Sometimes we're looking at things so fast.

50:20 So anyway so get rid of the old one.

50:22 Keep the new one. Um, also.

50:25 So you'll see also if you're interested in becoming a member you can click on the Get Premium now and it'll take you directly there.

50:31 But before we go because we have a few minutes left.

50:34 So there were a couple questions that, um, some attendees had.

50:39 So one Charlotte would like to know, um, in hospitals, are you allowed to have a mini calculator on you? Oh, absolutely. And all of us do.

50:48 And you know, what we really use is most of us use our cell phones, So we use the calculator on our cell phones.

50:54 But there's often calculators at the desk if they don't walk away.

50:57 So yes. And and most nursing schools will let you have a calculator on the test or a lot of them have an online calculator on your exam.

51:06 So you should have access to that. But just ask your faculty.

51:09 They'll let you know about your nursing school test on the NCLEX.

51:12 There'll be a calculator in the drop down bar to have access to it there.

51:16 Too old fashioned way though.

51:18 Not not nothing fancy.

51:19 No Texas Instruments or anything.

51:21 I'm showing my age, so.

51:22 That's right. So, um, now Joanne had a question.

51:27 So the amount of drops in a milliliter I think has nothing to do with the consistency of the fluid. I guess that's a question, Johann.

51:36 That is brilliant. That is such a good question.

51:39 Yeah. Um, when you're thinking about hanging I.V.

51:41 fluids, they have about the same.

51:43 They're going to have the same thickness or consistency.

51:45 What changes is the osmolality? So we can talk about that all day I love it.

51:49 The difference between normal saline or half normal saline, or if you've got hyperosmotic solutions.

51:55 So correct, the type of IV fluids that are hung through that tubing are all pretty close to water, because you start with sterile water and you add some electrolytes to it.

52:05 So that is correct. So really thick things I can think of like the thickest thing I've ever given IV is albumin.

52:11 So don't ever drop one of those vials because it's super sticky.

52:16 I stuck my feet tucked to the floor all night long, and that one is just given at a really slow rate.

52:21 So excellent question.

52:23 I've never had anyone ask that, but it's brilliant.

52:26 I love how you're thinking.

52:27 That's excellent critical thinking.

52:31 And so we have a couple questions in the chat.

52:33 If you're already a member, just let go.

52:35 Email support Lecturio.

52:36 Com and I'll make sure, um, that you're able to get the pricing since you were an attendee today.

52:42 And then, um, Ibrahim has a question, how can I be the best in nursing? I love that there's so many, so many ways to answer that.

52:50 How can I be the how can I be the best in nursing? Yes. Well, you know what? Here's my prejudice. Anyone who comes and does an extra session like this and wants to learn. You're right there, my friend.

53:04 Just keep learning. Keep being humble.

53:06 Recognize that none of us know everything.

53:09 Work with a team. Find your people that you trust when you start working and practicing.

53:13 And just always be open to learning.

53:15 You can learn from everyone.

53:17 And man, I really hope you guys become part of our community.

53:20 We love to have you as part of our Lecturio family.

53:24 I mean, come hang out with us on our website.

53:26 You post questions there, we'll respond to there too.

53:29 We don't just pop in every once in a while for a free webinar.

53:32 We really want to make sure. But first of all, that you ask that question tells me you're already on your way.

53:37 And second, you take the time to do extra things at your school did not require your learners. You want to be great nurses.

53:44 And so that's all it takes, just the want to and to keep working at it being very open to be a learner and man.

53:51 Very impressed that you even asked that. Thank you. You're the kind of nurse I want taking care of my family.

53:55 That's what I was thinking. Exactly what I was thinking. That's exactly what I'm thinking. So, um, Melissa, I'm going to come to your question, but, um, you had a question about how to enroll.

54:04 There's a click premium.

54:06 Now just click on that and it'll take you right there.

54:09 And um, Melissa would like to know, do you always round down when you don't have a pump. Um, yes. Because like with 2.08 there, you just have to do your very best because that was like rounding is always the freakiest thing in nursing school, because it seems like different faculty have different roles and different settings.

54:29 Here's the good news about NCLEX. It will always be very specific.

54:32 It will tell you two round or not to round, but there's some guidelines like if if it's something like a tablet, I could only like cut it in half or maybe a quarter. I couldn't do it much more than that.

54:44 Same thing with IV fluids.

54:45 They're going to ask you to just kind of round like if it's five or greater, you would probably round up.

54:51 If it's less than that, you would round down for ivy drops and you would never be giving a vasoactive drip like epinephrine or, you know, levophed you wouldn't be giving those type of medications with a hey, we're going to guess at it thing.

55:05 You would never do that.

55:06 So we're just talking about not fluid volume overloading a patient.

55:10 If you did it off pump did that.

55:13 Did that help? I think they're not.

55:16 Yes I think they're saying yes.

55:18 Okay. Good. So we have a we have another question here.

55:22 Um, before we run out of time.

55:23 Let's see. Um, I just saw it now.

55:28 So, um, Tiffany would like to know how can I gain more confidence in nursing and getting rid of doubt? Feelings of doubt.

55:37 Oh, wow. Okay, that's a great question.

55:40 And Lynn, I that, um, is so helpful that what we're saying makes a lot of sense. And we are the people that you'll see on the website.

55:47 I do a lot of the teaching in med surg.

55:49 I teach the pharm course, um, I'm doing the geriatric course, and we have lots of specialist nurses who just want to help you guys as you're going through nursing school.

55:59 But if you want to know, like how do you get rid of the self doubt? I never want you to get rid of it completely.

56:06 Right? Because those are the nursing students that scare me, the ones that are over confident.

56:12 So I don't want you to be paralyzed, but I always want you to think I could make a mistake. Let me double check.

56:20 I might make an error. So I want to do everything I can consistently.

56:23 I don't want to be the nurse that shortcuts. If we're talking about medications, a lot of places where you guys work are going to have barcode scanners and things.

56:31 There's rules that are set up so you don't make a tragic error.

56:34 If you follow the case in Tennessee where the nurse took a shortcut, there was lots of other complicating factors, but long story short, they overrode the safety measures, and we ended up giving a patient a medication instead of sedating them.

56:50 Paralyzed them, and they ended up dying.

56:53 So anytime we take a shortcut, it's real tempting, especially when you're super busy.

56:57 But I want all of us to have a little bit of self doubt, just enough that makes us be careful, cautious, and not cut corners to follow the things we know to do about safety.

57:08 And then after that, just keep practicing.

57:11 Do what you can. Don't ever be afraid to ask for help.

57:15 And that's that's the best you can do.

57:17 But really that that's my advice.

57:18 Where please don't get rid of all the self doubt, because those are the people that if I wake up and they're taking care of me, I'm going to pull my own plug because I'm going to be real scared if they're taking care of me.

57:30 So in the effort and time, we have a few questions that are rolling in.

57:33 I want to let everyone know if you become a member.

57:36 With our videos, we actually have a discussion board with each lecturer.

57:40 So if there are questions that you would like answer that we weren't able to get to today.

57:45 If you go into that video lesson, um, and just put in discussion what your question is, we answer those to, um, and actually the lecturer, whoever's lecturing that video will respond.

57:56 Um, so just because we're getting close to cutting off in time, um, and so there was one question, um, about, um, does Lecturio have a special program for NCLEX? Do you want to take that? Prof. Lawes. Do you want me to? Hey, Abraham, when are you getting ready to sit? When are you getting ready to take your NCLEX? Can you let me know that? Yes. We do have resources for NCLEX.

58:22 Five months is taking it okay? Good yet? How well you know it.

58:29 Diego NCLEX, we love Lpns.

58:32 We are getting ready to film another boot camp for you guys.

58:35 So yes, we do have resources for you on that and you can contact us and we can help guide you. We have a quiz bank with lots and lots and lots and lots of questions.

58:44 We have spaced repetition and like Nicole was saying, when you join, you'll get the expert who gave you the lecture.

58:51 That's going to help you answer those questions that will do that.

58:54 And after a year, a year and a half, you can do it.

58:57 You can do it. You can do it.

58:59 So I just offer a bootcamp how to survive school.

59:05 I was just going to say there, I apologize.

59:08 I can't remember the name, but a question about, um, she's not in nursing school yet, so we have pre nursing too.

59:15 So you can take advantage of this offer.

59:17 Start now and start doing start with Pre-nursing.

59:20 So we we start from pre-nursing to licensure.

59:24 Um so keep that in mind.

59:27 But we are getting close to time.

59:29 So Prof. Loz, do you have any parting words.

59:31 Because your wisdom is exactly what we're here for.

59:35 Well, hey, I want you to know that, um, Canada.

59:39 So sorry, but we gave you the NCLEX.

59:41 So yes, your NCLEX is our NCLEX.

59:42 We all take the same NCLEX.

59:44 You're welcome. The other thing if you're not in nursing school yet, I wish I would have been as on top of things as you are when I went to nursing school.

59:53 Because we have things that will help you with chemistry, micro, all those other topics.

59:56 We have those. And then even if you didn't use that stuff, get in there and start looking at our nursing fundamentals course. We have clinical skills that we'll teach you how to start an IV on a real person.

1:00:08 One of our students volunteered to do that.

1:00:10 We'll teach you all those nursing things so you could save yourself a tremendous amount of time. Next thing I recommend here our pharmacology course.

1:00:17 Start learning those drugs. Now.

1:00:19 You'll be so ahead of the game.

1:00:20 And then you can dive right into med surg.

1:00:22 So hit the fundamentals, look at those skills and learn a lot of stuff. Pharmacology med surg.

1:00:28 You're going to be ahead of the game and you will thank yourself.

1:00:31 That's the best thing that you can do for yourself.

1:00:36 Well thank you all for joining us today. I apologize we apologize. We weren't. The questions just started rolling in and we just got to do a Q and A and just straight Q&A.

1:00:43 Um, and so we apologize, we didn't get to your question, but we will try our best to try to make sure that we can answer any questions.

1:00:50 Um, again, the discussion is a great way to do that was wonderful.

1:00:55 As usual, thank you so much for my privilege being here.

1:00:59 We we love hearing what you have to say.

1:01:01 Thank you all for coming.

1:01:03 We hope you enjoyed it.

1:01:04 We will see you the next time.

1:01:06 Be on the lookout. Check your email.

1:01:07 You will be getting a link to the recording so you can go back, watch it over and over again.

1:01:14 Have prop Lawes with you all the time.

1:01:16 That's right. So yes. So please look.

1:01:19 Look for that. Check your spam and we will see you all the next time.

1:01:23 Enjoy the rest of your day and we'll see you next time.

1:01:28 Have a great day. You can do it.

1:01:30 Bye guys. You can do it.

1:01:33 Bye bye.