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Pediatric Dosage Calculation
Jordan and Logan Shaffer 11/08
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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
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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
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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?
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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
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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?
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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.
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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
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4. MD order Sporanox (itraconazole) 40 mg bidPatients weight 47 lbs
Drug guide recommends 3-5mg/kg/day q12 hrs
Is the dose safe?
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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
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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
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Calculate Liquid Medication
Dose desired
Dose on hand X quantity in ml
= volume to be administered
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Lets try it!
5. MD order is to give 75 mg
Supply is 250mg/5ml
Calculate the amount to administer
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Read a label
• Some dosage questions will require you to read a drug label
Mixing directions:Add 30 ml of water
Mix VigorouslyDiscard after 5 days
Zantac
(ranitidine)
Oral suspension25mg/5ml
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6. Using the medication label supplied, how many milliliters should be administered per dose if the MD order is 100 mg po qd?
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Intravenous
• Nothing new here….
Volume in ml x drop factor = gtt/min
Time in min
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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?
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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?
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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?
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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?
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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
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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
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PRACTICE TEST TIME