Pediatric Medication Calculations Lets Practice Important Factors when

Pediatric Medication Calculations Let’s Practice!

Important Factors when Giving Meds to Children • ALWAYS check the ordered drug and dose with a reliable drug resource BEFORE giving • Follow the policies and procedures of the facility • Most pediatric units require two RN’s to check: – The original medication order by the PCP in chart – Drug reference for drug and dose for child’s age, weight in kg. and diagnosis – The calculations done to determine the correct dose

Calculating the Dose • Find Infant/child’s weight in kilograms (kg) – PCP may have used admission weight – If child’s weight changes during hospitalization, recalculate safe dose and consult with instructor/primary nurse • Look up dose recommended for child based on age and weight • Calculate the dose • Compare to ordered dose and medication sheet • With any discrepancies, CHECK before GIVING!

Let’s Practice • • If you have a calculator/phone, take it out Need child’s weight in kg. If weight listed in pounds, convert to kg. Example: – Child weighs 30 pounds • 30 /2. 2 = 13. 6363 kg DON’T ROUND YET - Infant weighs 8 pounds 8/2. 2 = 3. 6363 kg

Example 1. • Calculate the dose of amoxicillin suspension in m. Ls for otitis media for a 1 yr-old child weighing 22 lb. The dose required is 40 mg/kg/day divided BID and the suspension comes in a concentration of 400 mg/5 m. L. Step 1. Convert pounds to kg: 22 lb × 1 kg/2. 2 lb = 10 kg Step 2. Calculate the dose in mg: 10 kg × 40 mg/kg/day = 400 mg/day Step 3. Divide the dose by the frequency: 400 mg/day ÷ 2 (BID) = 200 mg/dose BID Step 4. Convert the mg dose to m. L: 200 mg/dose ÷ 400 mg/5 m. L = 2. 5 m. L BID • Pediatric Dosage Calculations is a sample topic found in Davis's Drug Guide.

Example 2 Calculate the dose of ceftriaxone in m. Ls for meningitis for a 5 -yr-old weighing 18 kg. The dose required is 100 mg/kg/day given IV once daily and the drug comes pre-diluted in a concentration of 40 mg/m. L. How many mg. will you give: Daily? __________ Each dose? ________ How many ml. will you give for each dose? ____

Here are the Calculations • Step 1. Calculate the dose in mg: 18 kg × 100 mg/kg/day = 1800 mg/day • Step 2. Divide the dose by the frequency: 1800 mg/day ÷ 1 (daily) = 1800 mg/dose • Step 3. Convert the mg dose to m. L: 1800 mg/dose ÷ 40 mg/m. L = 45 m. L once daily

Calculating using Ranges • Azithromycin (Zithromax) • Recommended range for children is 5 mg to 20 mg per kilogram of body weight per day (mg/kg/day), once daily for three to five days. • Child weighs 25 lbs. • What is the dose range for this child?

Zithromax Calculations • 25 lbs/ 2. 2 = 11. 363636 kg • 5 mg to 20 mg per kilogram per day (mg/kg/day) Now Calculate the Range • 11. 363636 kg X 5 mg = 56. 8181 mg • 11. 363636 kg X 20 mg = 227. 2727 mg • Safe range for this child is 56. 82 mg to 227. 27 mg per day

Safe range for this child is 56. 82 mg to 227. 27 mg per day • Med order is Azithromycin 100 mg PO daily • Dose 100 mg is within the safe recommended range • Safe to give this med and dose

One more problem. . . • The recommended daily digoxin dose for treating heart failure in children age 2 to 5 years old is between 10 and 15 mcg per kg of body weight • The 3 year old child weighs 32 pounds • The order is Digoxin 100 mcg BID PO by elixir • The Digoxin elixer has 0. 05 mg/m. L • How many ml will you give for each dose? ___

Digoxin Calculations • Step 1: 32 lbs / 2. 2 = 14. 545454 kg • Step 2: Recommended dose range is 14. 5454 X 10 = 145. 4545 mcg 14. 5454 X 15 = 218. 181 mcg 145. 45 – 218. 18 mcg / day (Round to hundredths here) • Step 3: Ordered dose is Digoxin 100 mcg BID PO = 200 mcg/day (Dose within range) • Step 4: Digoxin elixer has 0. 05 mg/m. L so Convert dose from 100 mcg = 0. 1 mg • Step 5: Dose 0. 1 mg / 0. 05 mg/m. L X 1 = 2 ml • Answer is 2 ml each dose. REMEMBER to LABEL!

Practice, Practice. . . • Complete the problems on the Pediatric Med Practice forms on Canvas Modules. Tab) • Answer Key also provided • Refer to Kee text • Read the problem carefully, follow directions and always label the answers • DO WELL on the Med Quiz!