Maths for Nurses: Numeracy: The Essentials

This booklet will provide an overview of the basic numeracy skills for Nursing students. If you have any problems in answering the questions within the booklet please contact skills@library.leeds.ac.uk for personal help using the maths support drop-in sessions. Also check out these e-videos and quizzes: University of Leeds Maths for nurses Queens University Belfast Numeracy skills for drug calculations.

Contents
1. Place Value 2. Times Tables 3. Addition 4. Multiplication 5. Subtraction 6. Division 7. Combined Functions 8. Converting Weights and Volumes 9. Fractions & Decimals 10. Basic Drug Calculations 11. Percentages
Acknowledgement: The original document was designed and produced by Queens University Belfast, Student Guidance Centre

1. Place value
10

In any number each digit has a different place value. Going from left to right we have Hundreds, Tens, Units, tenths, and hundredths There are 10 hundredths in 1 tenth 10 tenths in 1 unit, 10 units in 1 ten, and 10 tens in 1 thousand

10

To move digits one column to the left e.g. Units toThe Tens, numbers you xAFTER 10. a decimal point represent a fraction To move digits one column to the right, e.g. Hundreds of 1. to Tens, you 100 Example: if we multiply the following number by 10 H T 2 U 3 . . t 4 h 5

it becomes: H 2 T 3 U 4 . . t 5 h

Note what has happened to the digits. The number 23.45 has become 234.5, each digit moving 1 place to the left.. The digits move The digits move The digits move The digits move The digits move The digits move 1 2 3 1 2 3 place to the left places to the left places to the left place to the right places to the right places to the right when multiplying when multiplying when multiplying when dividing when dividing when dividing by 100 by 10 100 1000 10 1000

by

by by by

Ordering Numbers To determine the highest number start from the left and go through each place value selecting the highest digit(s) until just one number is left. 15.18 14.94 15.3 14.09 1 .18 14.94 .3 15. 14.09 15.18 15.3 is the highest number

Examples to try; find the lowest number in the following questions: (a) (i) 87.87 (ii) 87.97 (iii) 88.07 (iv) 88.1 (b) (i) 0.23 (ii) 0.2 (iii) 0.32 (iv) 0.3 (c) (i) 624.01 (ii) 642.01 (iii) 624.0 (iv) 624.1

2. Times Tables

TIPS Try learning by rote as many as you can and then use what you know to work out what you dont know. 5 times tables always end in either 5 or 0 You can use your fingers for 9 times tables: Hold your hands in front of you with your fingers spread out. For 9 X 3 bend your third finger down. (9 X 4 would be the fourth finger etc.) You have 2 fingers in front of the bent finger and 7 after the bent finger Thus the answer must be 27!
Alternatively for the 9 times tables use the 10 times tables and subtract one lot of the number you are multiplying by.. To work out the 4 times tables double and double again. Knowing how to square numbers is useful ie 1 x 1 = 1, 2 x 2 =4, 3 x 3 =9, 4 x 4 =16, 5 x 5 =25, 6 x 6 =36, 7 x 7 =49, 8 x 8 =64, 9 x 9 = 81, 10 x 10 = 100 Its useful to know that x 12 is the same as x 10 and x 2 and adding the two results.

One of the best interactive web resources for times tables is BBC Skillswise: http://www.bbc.co.uk/skillswise/numbers/wholenumbers/multiplication/timestables/index.shtml

Examples to try; using the table above or otherwise, calculate the following: (a) 9 x 8 (b) 7 x 12 (c) 6 x 9 (d) 4 x 7 (e) 5 x 11 (f) 3 x 8 (g) 11 x 12

3. Addition
Keep the decimal point in the same place. If you get a number greater than 10 then write down the number of units and carry the number of tens over to the next column on the left. e.g. 89 +15 104 9 + 5 = 14 write down 4 and carry the 1 over

Examples to try: (a) 37.4 +78.9 .9 (b) INPUT: I.V. Fluids Oral Fluids 1300 +275 (c) OUTPUT: Urine 1 2 5 0 Vomit 100 Wound +45

+7

Keep decimal point in same place

4. Multiplication
Ignore the decimal point until the end. The rule is that you count the number of decimal places in your question and apply the same number to the answer. Carry over tens as before. If multiplying by a number with two or more digits, treat them separately, remembering to put one zero on the far right column when multiplying by tens, two zeros for hundreds etc. e.g. 4.2 x81 42 3360 3 4 0.2

split x 81 into (x1 and x80) x1 x 80 i.e. x 10 (ie put one zero down) and then x 8 since there is one decimal place in the question, there should be the same in the answer.

Examples to try: (a) A patient is to receive 2.5 micrograms per kilogram. What dose is required if the patient weighs 79 kilograms?
If one tablet contains 20 milligrams, how many milligrams would 4 tablets contain?

(b)

5. Subtraction
Keep the decimal point in the same place. Borrow 1 from the column on the left if necessary. e.g. 67 12 . 16 - 24.9 47.7 Examples to try: (a) Jamie weighed 4.2 kilograms at birth. By week 2 his weight had dropped to 3.8 kilograms. How much weight had he lost in grams? What is the difference in kg between 1.6 kilograms and 825 grams?

(b)

6. Division
Keep the decimal point in the same place. Divide into each digit in turn, from left to right. Carry over tens if applicable.

e.g. 8 1 12 40 0 1 5

If dividing by decimals then make into whole numbers by multiplying.

e.g. 20 is

4|2 25 . 10 20

. 2 Simplify fractions by halving (if even), or try 0by63, 5, 5 or 7. This should reduce the need for long division. Furthermore, the same number of zeros can be removed in top and bottom numbers in the fraction to aid simplification.

Examples to try: (a) 225 6 (b) 1500 250 (c) 1000 8

7. Combined
Question: A baby is to be fed 75ml every 3 hours. How much is this per day? Solution: 24 hours in a day, so there are 24 3 = 8 feeds per day. The total amount is 8 x 75 = 600ml.

Examples to try: (a) (b) If 5ml contains 100mg, how many mg would there be in 20ml? If a patient is to receive 1500ml over 24hrs, how much is this in ml/hr?

8. Converting Weights and Volumes

a) Metric to metric The following diagram can help remind you whether to x or . Put in order from largest to smallest, then draw an arrow down with 1000 beside it, and an arrow up with x 1000 beside it.

x 1000

kilograms grams milligrams micrograms nanograms

milligrams to micrograms = x 1000 grams to kilograms = 1000 1000 e.g. 568 milligrams to grams = 568.0 1000 (move digits 3 places to the right) = 0.568 gm

Examples to try: (a) (b) (c) (d)

45 grams to kilograms 0.75 grams to milligrams 0.025 milligrams to micrograms 650ml to litres Note: 1 litre (l) = 1000 millilitres (ml)

b) Metric to imperial and imperial to imperial

1kilogram (kg) = 2.2 pounds (lb) 1 stone (st) 1 pound (lb) = 14 pounds (lb) = 16 ounces (oz)

Question: A child weighs 2 stone 3lb, what is this weight in kg? Solution: 2 stone = 2 x 14 lb = 28lb Total weight in kg = 31 2.2 = So the child weighs (28 + 3) lb = 31lb 11|155.00 14.1 kg (approximately)

Examples to try: (e) (f) 3 stone 10lb to kilograms 2 stone 4lb to kilograms

9. Fractions & Decimals

Learn the following fractions: 1/10 = 0.1 Therefore 1/100 = 0.01 6/10 = 6 x 0.1 = 0.6 3/100 = 3 x 0.1 = 0.03

1/5 = 0.2 1/4 = 0.25 1/3 = 0.33 (recurring) 1/2 = 0.5

4/5 3/4 2/3

= 4 x 0.2 = 0.8 = 3 x 0.25 = 0.75 = 2 x 0.33 = 0.66

Note: You could simplify the fractions first by top and bottom by 5 and then workout 2x 50 = 100. When rounding decimals to 1 decimal place, look at the second d.p. and if it is 5 or above then round up, if less than 5 then keep it the same. For example: 1.274 = 1.3 to 1 d.p. 1.234 = 1.2 to 1 d.p.

When adding decimals, keep d.p. in the same place. When multiplying decimals, count the number of d.p.s in the question and apply the same to the answer. Examples to try: (a) Find 4/10 of 42 Write the following to 1 d.p. (b) Find 3/4 of 420 (d) 3.333 (c) Find 1/3 of 39.6 (e) 0.657

(f) 23.97

10. Basic Drug Calculations

Use the following formula: or e.g. 240 milligrams is prescribed. The stock dose is 120 milligrams/5ml. What volume would you give? Solution:

Examples to try: (a) 6 milligrams is required. Stock is 10 milligrams/4ml. What volume is required? (b) A patient required 10000 units. Stock is 25000 units/ml. What volume is required?

11. Percentages
Always out of 100 As a decimal, 0.1 = 0.10 = 10% 30% of 150 Examples to try: (a) Work out 20% of 65 (b)(i) A patient is to receive IV Fluids over 8 hours. What % would be administered after 6hrs? (b)(ii) How long would it take to administer 50%? and 0.06 = 6% (use the hundredths column to determine value)

Answers

1. Place Value (a) (i) 87.87 2. Times Tables (a) 72 3. Addition (a) 116.3 (b) 1575 4. Multiplication (a) 197.5 milligrams (b) 80 milligrams 5. Subtraction (a) 400 grams (b) 775 grams 6. Division (a) 37.5 7. Combined (a) 400 milligrams (b) 62.5 = 63ml/hr (b) 6 (c) 125 (c) 1395 (b) 84 (c) 54 (d) 28 (e) 55 (f) 24 (g) 132 (b) (ii) 0.2 (c) (iii) 6240

8. Converting Weights and Volumes (a) 0.045 kilograms (b) 750 milligrams (c) 25 micrograms (d) 0.65 litres (e) 23.6kg (f) 14.5kg 9. Fractions & Decimals (a) 16.8 (d) 3.3 (b) 315 (e) 0.7 (c) 13.2 (f) 24.0

10. Basic Drug Calculations (a) 2.4ml (b) 0.4ml 11. Percentages (a) 13 (b) 75% (c) 4 hours