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Easy Way to Remember Metric Conversions for Medical Math

Module 3 - The Metric System of Measurement and Conversions Using the Metric system

What's in this module?

Most of the world uses the metric system of measurement.  The United States is one of the very few exceptions.  We tend to use the household system of measurement in everyday situations. In the United States, the metric system tends to be used primarily in scientific and medical settings.

As a nurse, you will use the metric system in almost everything you do.  Medication orders are stated using the metric system with very few exceptions.  If you learn the relationships between the units of the metric system, converting units of measurement will be easy for you.

Summary of problem types in this module

In this module you will be working problems to change from one unit of measurement in the metric system to another unit of measurement.

Let's look at the basics of the metric system:

The image is in two parts. The first part is a line with equal intervals marked on it. The middle of the line is labeled with the unit meter. To the right of meter, the intervals are labeled deci, centi, and milli. To the left of meter, the intervals are labeled deca, hecto, and kilo. The second part of the image shows that the unit meter on the line can be replaced with liter and gram.

The metric system has three measurement bases, or basic units: meters (length), liters (volume), and grams (weight or mass).

The image is titled Metric Conversion Chart. It is meant to illustrate how to move the decimal point to the right to move to a smaller unit of measure and move the decimal point to the left for a larger unit of measure.There are 7 blocks side by side. The middle block is labeled one Basic Unit. Moving out from the center toward the right the blocks are labeled Deci- 0.1 units, Centi- 0.01 units, and Milli- 0.001 units. From the basic unit box moving outward toward the left, the boxes are labeled Deka- 10 units, Hecto- 100 units, and Kilo- 1000 units.

The prefixes in front of the base measurement tell you whether the amount is larger or smaller than the base measurement and how much larger or smaller.  Kilo- represents the largest unit on the chart, while milli- represents the smallest unit on the chart.  Conversions within a base of measure can be made by moving the decimal place.

Need an easy way to remember the relative sizes of the metric units?  Remember King Henry Died by Drinking Chocolate Milk.

The image is labeled Metric Conversion Stair-Step Method and provides a mnemonic for remembering the units from largest to smallest. Think of a set of stairs with the largest unit at the top step and the smallest unit at the bottom step. The basic unit is in the middle. Starting at the top step and working down are Kilo-, Hecto-, Deka-, the basic unit, Deci-, Centi, and Milli- The letters for the mnemonic are K, H, D, B, D, C, M. The mnemonic is King Henry Died By Drinking Chocolate Milk. Examples using the basic units of meter, gram, and liter are given. With the basic unit of meter, the units from largest to smallest are kilometer, hectometer, dekameter, meter, decimeter, centimeter and millimeter. Using gram as the basic unit, the units from largest to smallest are kilogram, hectogram, dekagram, gram, decigram, centigram, and milligram. Using liter as the basic unit, the units from largest to smallest are kiloliter, hectoliter, dekaliter, liter, deciliter, centiliter, and milliliter.

Equivalents to know

Conversion between the metric system and the system commonly used in the United States will be introduced as needed in later modules.  Illustrations of metric measurements are shown for reference.

These equivalents are the most commonly used in nursing:

WEIGHT MEASUREMENTS (Gram is the measurement base)

1 kg (kilogram) = 1000g (Note: g, G, Gm, gm are all abbreviations for gram)

1 g (gram) = 1000 mg (milligrams)

1 mg (milligram) = 1000 mcg (micrograms)

The image is of a teaspoon full of sugar. The caption is 1 gram of sugar is equal to one quarter of a teaspoon.

VOLUME MEASUREMENTS (Liter is the measurement base)

1 L (liter) = 1000 ml (milliliters)

The image is of two 2 liter bottles of soda.

LENGTH MEASUREMENTS (Meter is the measurement base.)

1 meter = 100 cm (centimeters)

1 cm (centimeter) = 10 mm (millimeters)

The image is of the front and back of a ruler where one side is marked off in inches and the other side is marked off in centimeters.

EQUIVALENTS ACROSS SYSTEMS

1 kg (kilogram) = 2.2 lb (pounds)

5 ml (milliliter) = 1 tsp (teaspoon)

30 ml (milliliter) = 1 oz (ounce)

2.5 cm (centimeters) = 1 inch

Converting temperature

Hospitals and emergency services often use the Celsius system of measuring temperature instead of the Fahrenheit system more familiar to us in the United States. The most frequent example of the use of Celsius in the medical setting is the measurement of body temperature.  Storage temperatures for medication and other substances may also be stated in Celsius.

This type of conversion is a situation in which you will need to remember a formula.

The image illustrates how to convert temperatures in Fahrenheit to Celsius and from Celsius to Fahrenheit. There are two formulas to memorize. To convert temperatures in degrees Fahrenheit to Celsius, subtract 32 and multiply by 0.5556. The number 0.5556 represents the fraction 5 over 9. An example is given to convert 50 degrees Fahrenheit to Celsius. To do so, subtract 32 from 50 to get 18 and then multiply 18 times 0.5556 to get the answer of 10 degrees Celsius. To convert temperatures in degrees Celsius to Fahrenheit, multiply by 1.8 and then add 32. The number 1.8 represents the fraction 9 fifths. An example of converting 30 degrees Celsius to degrees Fahrenheit is given. Multiply 30 times 1.8 to get 54, then add 32 to get a final answer of 86 degrees Fahrenheit.

Converting to military time

Military time is used by many hospitals and emergency services.  Military time reduces ambiguity because the A.M. and P.M. designations are not needed.  Colons are also not needed in recording military time.  Times are always recorded as four digits.

Times before 1:00 P.M. need no conversion.  Simply omit the colon and the A.M. designation.

The image is a table illustrating conversion of standard morning hours to military time. 1 A.M. is expressed as oh one hundred. 2 A.M. is expressed as oh two hundred. 3 A.M. is expressed at oh 3 hundred. Continue in that pattern to 10 A.M. which is expressed as ten hundred. 11 A.M. is expressed as eleven hundred. Noon is expressed as twelve hundred.

Afternoon and evening times starting with 1:00 P.M. are found by adding 1200 to the conventional time used in the United States.  Example:  1200 + 0100 = 1300; 1:00 P.M. is written as 1300.

The colon and the P.M. designation are omitted.  Times at or after 1300 are understood to be afternoon.  Midnight may be written as 0000 or 2400.  Follow the convention of the institution where you work when recording midnight.

Here are some easy examples:

12:00 noon  =  1200  (nothing is added to noon)

12:01 A.M. =  1201  (nothing is added to minutes after noon)

2:30 P.M. + 1200 = 1430 (the military time equivalent)

11:59 P.M. + 1200 = 2359 (the military time equivalent)

Image is a chart showing the comparison of regular clock time to military time for the afternoon hours.

Rounding rules to know

Only these general rounding rules for decimals will apply to this module.

  1. If the answer is less than one (1), take the math out three (3) places past the decimal point (the thousandth position) and round to two (2) places past the decimal point (the hundredth position).

  2. If the answer is greater than one (1), take the math out two (2) places past the decimal point (the hundredth position) and round to one (1) place past the decimal point (the tenth position).

  3. Do not include trailing zeros. (Ex: 12.0 ml would simply be expressed as 12 ml and 0.40 mg would be expressed as 0.4 mg)

  4. Always use a leading zero for numbers less than one. (Ex: .25 ml should be expressed as 0.25ml)

Starting factors and answer units

The starting factor (SF) is the amount you start with  - the quantity and the units you know.  It is the quantity and unit of measurement to be converted.

The answer unit (AU) is the equivalent quantity expressed in the units that you have available.  The AU is the unit of measurement you have in an amount equivalent to the SF (the amount you know).

Problem Type 1 –Conversions within the Metric System

A medication strength is listed as 0.25 mg per ml.  How many mcg are in one ml?

Here's the problem set up in the dimensional analysis format:

SF = 0.25 mg

AU = mcg

Equivalent:

1 mg = 1000 mcg

Equation:

The equation is 0.25 milligrams over 1 times 1000 micrograms over 1 milligram. Cancel milligrams. Solve the equation to get a final answer of 250 micrograms.

Note that conversions within a base unit of the metric system can be done by simply moving the decimal point:

0.25 mg = 250 mcg (The decimal is moved three places to the right)

Image of moving the decimal point three places to the right to convert 0.250 milligrams to 250 micrograms

Here's another example:

A medication is ordered at 500 mg per dose.   The dosage strength is 150 mg per ml.  How many ml will be given per dose?

This problem requires a conversion between weight and volume bases in the metric system.

SF = 500 mg

AU = ml

Equivalent:

1 ml = 150 mg

Equation:

The equation is 500 milligrams over 1 times 1 milliliter over 150 milligrams. Cancel milligrams. Solve the equation to get 500 milliliters over 150, which works out to 3.3 milliliters.

Note that the rounding rule for numbers >1 is used.  If you check your answer,

3.3 ml X 150 mg per ml  = 495 mg per dose

This answer is a close approximation to the actual dose ordered.  Measuring instruments for liquid medication can usually not be measured more closely than a tenth of a ml.

Problem Type 2 – Conversions Between the Metric System and the Household System

A nurse has measured the length of a wound as 4 inches.  How many cm long is the wound?

Here's the problem set up in the dimensional analysis format:

SF = 4 in

AU = cm

Equivalent:

           2.5 cm (centimeters) = 1 inch

Equation:

The equation is 4 inches over 1 times 2.5 centimeters over 1 inch. Cancel inches. Solve the equation to get an answer of 10 centimeters.

Here's another example:

A child weighs 56 lb.  A medication is ordered by weight in kg.  How many kg does the child weigh?

SF = 56 lb

AU = kg

Equivalent:

1 kg (kilogram) = 2.2 lb (pounds)

Equation:

The equation is 56 pounds over 1 times 1 kilogram over 2.2 pounds. Cancel pounds. Solve the equation to get an answer of 25.45 which rounds to 25.5 kilograms.

Use the rounding rule for numbers >1.

Problem Type 3 –Conversion of temperature

Examples:

A nurse has measured a client's temperature as 99.5 degrees F using a thermometer with only the Fahrenheit scale.  How many degrees Celsius is the temperature?

Formula:

(Degrees F – 32) X 0.5556 = Degrees C

Equation:

Open parenthesis 99.5 degrees Fahrenheit minus 32 close parenthesis times 0.5556 equals 37.5 degrees Centigrade

Use the rounding rule for numbers >1.

Here's another example:

A solution needs to be stored at 20 degrees C.  At what temperature should the storage unit be using the Fahrenheit scale?

Formula:

(Degrees C X 1.8) + 32 = Degrees F

Equation:

Open parenthesis 20 degrees Centigrade times 1.8 close parenthesis plus 32 equals 68 degrees Fahrenheit.

Use the rounding rule for numbers >1.

Problem Type 4 –Conversion of time

An intravenous solution started running at 8:00 A.M.  The solution will take 10 hours to complete.  At what time will the solution be finished (in military time)?  Convert the time back to standard time as used in the United States in order to inform the client's family when the solution will be finished.

To calculated the completion time, start with 0800 and add 10 hours to get an answer of 1800 hours

To convert to standard time, start with 1800 and subtract 1200 to get 6 o'clock pm.

Here's another example:

A medication is to be given every 6 hours.  The first dose was given at 6:00 P.M.  When should the next four doses be scheduled?

To calculate the time of the first dose, add 12 to 6 o'clock pm. That will give you an answer of 18. The military time for 6 o'clock pm is written as 1800.

To calculate the second dose, add 0600 to 1800 to get 2400, which is midnight. Midnight can also be written as 0000.

To calculate the third dose, add 0600 to 0000 to get 0600 hours.

To calculate the fourth dose, add 0600 to 0600 to get 1200 hours.

For as long as the client takes this medication, the doses will be scheduled to be given at 1800, 2400 (0000), 0600, and 1200.  These times will be recorded on the client's medication schedule in a hospital setting.

The outpatient client will be told to take the medication at 6:00 P.M., 12:00 A.M., 6:00 A.M., and 12:00 P.M.

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Source: https://getlibraryhelp.highlands.edu/c.php?g=937883&p=6759243

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