Do you struggle with drug calculations or clinical applications of numeracy?
If you need to brush up your maths skills, Numeracy in Nursing and Healthcare is the perfect textbook to help you through your nursing programme. The text starts out with basic adding and subtracting and works up to more advanced principles like SI units, drug administration, common clinical measurements and how to understand statistics in research articles. By illustrating how maths is relevant to clinical practice, Numeracy in Nursing and Healthcare is a great tool to help you increase your confidence and excel in your studies and career.
Key features:
Step-by-step examples make understanding concepts easy
Look Out sections highlight common mistakes
Time to Try and What Did You Learn? questions help you apply what you have learned
Key Point boxes provide helpful hints for good problem-solving technique
Web links direct you to further reading and examples.
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The things you don’t want to ask about but need to know
You need to be able to add and subtract to complete patient records accurately.
You must be confident with basic arithmetic skills so that you are able to work out correct drug doses to ensure patient safety.
When you have completed this chapter, you should be able to:
• Identify your strengths and areas needing further practice or help.
• Understand the different ways in which the four basic operations of arithmetic can be written.
• Add and subtract single and multiple columns of figures without a calculator.
• Multiply and divide simple numbers without a calculator.
• Understand how exponents are used to simplify large whole numbers.
• Use ‘BODMAS’ to work out calculations that involve different types of operation.
• Use a calculator with care.
• Meet some of the numeracy outcomes in the Essential Skills Clusters (NMC 2010):
33 (1) Is competent in basic medicine calculations.
(2) Is competent in the process of medication-related calculations in the nursing field.
The language
Table 1.1 shows the symbols that will be used in this chapter – more later! You are probably familiar with them, which is good, but just refresh your memory of these and the rules that apply to them.
Table 1.1
Applying the Theory
You will learn more about + and −being used to identify positive or negative charges on particles in physiology.
In the UK, blood is identified as being one of four types: A, B, AB or O. In addition, an individual either has or does not have the rhesus factor. The blood is then described as rhesus positive (if the individual has the factor) or negative (if the individual does not). This is written as Rh +ve or Rh −ve.
Look Out
It is important that the correct blood is given to a patient in need of a blood transfusion, so it is safer to write positive or negative in full so that there is no doubt about the rhesus status of the patient or the blood to be transfused.
1.1 Addition
Your Starting Point for Addition
Without using a calculator, write down the answers to the following questions.
(a) 4 + 5 = ______
(b) 3 + 7 = ______
(c) 12 + 8 = ______
(d) 33 + 67 = ______
(e) 45 + 55 = ______
(f) 47 + 53 = ______
(g) 137 + 21 + 241 = ______
(h) 613 + 13 + 252 = ______
(i) 573 + 37 + 145 = ______
(j) 388 + 133 + 49 = ______
Answers are at the end of the chapter.
If you had these all correct, skip through to Section 1.2 Subtraction.
Let’s start at the beginning – a very good place to start. When you write you begin with ABC, when you sing you begin with doh–ray–me and in maths you start with 123. Each individual figure is a numeral but in everyday speech we call them numbers.
Whole numbers are those without fractions, e.g. 7, 21, 155, 3742. They are sometimes called integers.
One of the most important concepts is that of number bonds. This is the technical way of adding the numbers together.
Number bonds 1 to 10
0 1 2 3 4 5 6 7 8 9 10
These are the numbers that can be added together to make a total of 10.
Numbers can be added together in any order:
0 + 10 = 10
1 + 9 = 10
2 + 8 = 10
3 + 7 = 10
4 + 6 = 10
5 + 5 = 10
6 + 4 = 10
7 + 3 = 10
8 + 2 = 10
9 + 1 = 10
10 + 0 = 10
Can you see a pattern? The first numbers go up by 1. The second numbers go down by 1.
What is the answer to the following?
8 + 2 =
2 + 8 =
Which sum was easier to work out? Why was it easier?
Counting on
0 1 2 3 4 5 6 7 8 9 10
Numbers can be added in any order but it is easier to start with the bigger number and count on. You can also use the line of numbers to check this method if you are not confident. Consider
3 + 7 =
This can be done as 7 + 3, keeping 7 in your head and counting on 3.
Hint: Look for the bigger number, keep it in your head and count on.
(a) 2 + 8 = ______
(b) 4 + 6 = ______
(c) 1 + 9 = ______
(d) 3 + 7 = ______
You should have got 10 for all these answers.
Now try these. What do you need to make 10?
(a) 9 + ___
(b) 5 + ___
(c) 7 + ___
(d) 10 + ___
(e) 2 + ___
(f) 1 + ___
(g) 3 + ___
(h) 0 + ___
(i) 4 + ___
(j) 6 + ___
(k) 8 + ___
Answers are at the end of the chapter.
Have you got the idea? If you are confident that you understand the concept of number bonds 1–10, then move on to place value.
Place value
You are now familiar with numbers up to 10 and how they can be added together to make 10. Each time the answer was 10, but the way in which you reached it may have been so automatic that you didn’t think about the rule.
