Pediatric Dosage Calculation Professor Shaffer 2012-2013.
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Transcript of Pediatric Dosage Calculation Professor Shaffer 2012-2013.
![Page 1: Pediatric Dosage Calculation Professor Shaffer 2012-2013.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649d875503460f94a6c236/html5/thumbnails/1.jpg)
Pediatric Dosage Calculation
Professor Shaffer 2012-2013
![Page 2: Pediatric Dosage Calculation Professor Shaffer 2012-2013.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649d875503460f94a6c236/html5/thumbnails/2.jpg)
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 (dose not specified) after
further calculation to be divided in equal doses
Ex: 30mg/kg/day administer orally equally divided in three doses
or• Per dose
Ex: 15mg/kg administer orally twice daily
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Lets Try it!
Patients weight: 45 lbs
2. Give 30mg/kg/day administer orally equally divided into three doses
How many mg per dose? How much is the 24 hr drug total?
3. Give 30mg/kg administer orally in three divided doses
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.
• Remember how to convert mcg to mg, gram to mg etc.
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Is the order safe?
• A statement from the drug guide will be provided on the dosage assessment test
Ex: The drug guide states the recommended safe dosage is 3-5 mg/kg/day to be administered orally in 2 divided doses
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Lets try it!
4. MD order Sporanox (itraconazole) 40 mg administer orally twice dailyPatients weight 47 lbs
Drug guide recommends 3-5mg/kg/day
administer orally in 2 divided doses.
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/mL
• 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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Lets try it!
6. Using the medication label supplied above, how many milliliters should be administered per dose if the MD order is 100 mg administer orally once daily?
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Ok, so how do you round?Look at it this way…
– If the calculated answer is <1 mL then round to the hundredths place as this amount could be easily administered in a 1 mL syringe
Example: If the answer was 0.75 mL, where would you draw the solution to in this syringe?
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What if the Answer is > 1 ml?
• If the calculated dose is greater than 1 ml then you round to the tenths place
• Example- if the dose was 2.75 ml, using a 3 ml syringe you would need to round to 2.8ml, as 2.75ml can not be precisely administered
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For Example
• If the answer is 0.3762901
• Round to 0.38mL…..don’t forget the zero in the ones place!
• If the answer is 1.3762901
• Round to 1.4 mL
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NEVER…….
• Round to a whole number!!!!!
• If the answer is 1.89361
• Round to 1.9 mL NOT 2 mL
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So Remember:
• < 1 mL rounds to 2 places to the right of the decimal place
• >1 mL, kg, mg, mcg, anything else rounds to only 1 place to the right of the decimal place
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Practice Rounding
• If you calculated the answer to be:
a.2.76001 mg, round to:__________
b.0.609113 mL , round to:_________
c.8.92778 mL, round to:__________
d.0.78912, round to:__________
e.13.119542 kg, round to:_______
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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
8. The physician orders Kantrex (kanamycin) oral suspension 150 mg/kg/day administer orally in 2 divided doses.
Supply Kantrex 500mg/5mL.
Patients weight: 28 lbs
How many milliliters should be administered per dose?
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9. The physician orders Prostigmin (neostigmine bromide) 8 mg administer orally every 4 hrs
The drug guide recommended dosage is 2-4 mg/kg/day to be administered 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!
10. The physician orders Primacor (milrinone lactate) 50 mcg administer IM stat.
Supply: 0.2mg/mL
Patients weight: 12 kg.
How many milliliters should be administered per dose?
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11. The physician orders Sustiva (efavirenz) 20mg/kg administer orally twice dailySupply: Sustiva 50 mg tablets
Patients weight: 11 lbs
How many tablets are to be administered per dose?
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12. 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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You are ready to take the practice test! Time yourself…you need to be
able to complete in 30 minutes