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Pediatric Dosage Calculation Jordan and Logan Shaffer 11/08 How is Pediatric Dosage Calculation Different than Adults? • There is no standard dose • All doses are based on a recommended dosage based on: Body weight in kilograms (for this dosage test) Body Surface Area Begin by Converting to Kilograms • All MD orders will be ordered as a dose per kg • Convert the patient’s weight in lbs to kg by dividing the weight in lbs by 2.2 • Example: 50 lbs divide by 2.2 = 22.7272727272727 Round to tenths place = 22.7 kg Now you try! 1. Patients weight 48 lbs How many kg does the patient weigh? Patient weight 13.9 lbs How many kg does the patient weigh? Write your answer: The MD order The MD order can be written in several ways: • • In a daily total to be divided in equal doses Ex: 30mg/kg/day equally divided in three doses or Per dose Ex: 30mg/kg TID Lets Try it! Patients weight: 45 lbs 2. Give 30mg/kg/day equally divided in three doses How many mg per dose? How much is the 24 hr drug total? 3. Give 30mg/kg TID How many mg per dose? How much is the 24 hr drug total? Write your answers Is the dose safe? • All pediatric dosages have a recommended range in the drug guide • These ranges are typically based on a 24 hour total amount of a dosage in mg, mcg, gm, etc. Is the order safe? • A statement from the drug guide will be provided on the dosage test Ex: The drug guide states the recommended safe dosage is 3-5 mg/kg/day to be given in 2 divided doses Lets try it! 4. MD order Sporanox (itraconazole) 40 mg bid Patients weight 47 lbs Drug guide recommends 3-5mg/kg/day q12 hrs Is the dose safe? Write your answer Supply • Pediatric medication is typically supplied in liquid form • Some children can swallow pills or the medication may only come in tablet form • Most of the dosage assessment questions will consist of medication in liquid form, few questions will be in tablet form Remember…. • Supply is expressed as a dosage amount per a commonly used quantity • Example 250mg/5ml 100mg/ml 50mcg/1ml • This is different from the total amount of drug dosage in the bottle Calculate Liquid Medication Dose desired Dose on hand X quantity in ml = volume to be administered Lets try it! 5. MD order is to give 75 mg Supply is 250mg/5ml Calculate the amount to administer Write your answer Read a label • Some dosage questions will require you to read a drug label Mixing directions: Add 30 ml of water Mix Vigorously Discard after 5 days Zantac (ranitidine) Oral suspension 25mg/5ml Lets try it! 6. Using the medication label supplied, how many milliliters should be administered per dose if the MD order is 100 mg po qd? Write your answer Intravenous • Nothing new here…. Volume in ml x drop factor = gtt/min Time in min You are Ready!!! Lets put it all together 7. The physician orders Kantrex (kanamycin) oral suspension po 150 mg/kg/day in 2 divided doses. Supply Kantrex 500mg/5ml. Patients weight: 28 lbs How many milliliters should be administered per dose? Write your answer 8. The physician orders Prostigmin (neostigmine bromide) 8 mg q 4 hrs The drug guide recommended dosage is 2-4 mg/kg/day in divided doses Patients weight: 21 lbs Is the physicians order safe? Write your answer Careful…some may have patients weight in kg already! 9. The physician orders Primacor (milrinone lactate) 50 mcg IM stat. Supply: 0.2mg/ml Patients weight: 12 kg. How many milliliters should be administered per dose? Write your answer 10. The physician orders Sustiva (efavirenz) 20mg/kg po q 12 hrs. Supply: Sustiva 50 mg tablets Patients weight: 11 lbs How many tablets are to be administered per dose? Write your answer 11. The physician orders IV fluids as follows: Infuse 1000ml of 0. 45% normal saline solution in 10 hours IV. • Calculate the flow rate when the drop factor is 10 drops per milliliters Write your answer 12. An infusion of 700 ml of D5W was ordered to infuse at a rate of 25 gtt/min for 8 hours. The drop factor is 15 drops per milliliter. • After 3 hours the patient had received 120 milliliters. The nurse decides the flow rate must be recalculated. • Recalculate the flow rate____gtt/min Write your answer PRACTICE TEST TIME