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NURS 3524 Study Guide - Nasogastric Intubation, Diluent, Hypervolemia


Department
Nursing
Course Code
NURS 3524
Professor
Mavoy Bertram

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NURS 3524 Med Wk 1
Pediatric Medication Administration
Credit to:
Jan Bazner-Chandler
CPNP, CNS, MSN, RN
Review
1 teaspoon = 5 mL / cc
1 tablespoon = 15 mL / cc
1 ounce = 30 mL /cc
Remember the clock!
How to calculate medication dose using ration / proportion.
16 oz = 1 pound (body weight)
IV Fluid Calculation Adult (Review)
Step # 1
Total number of milliliters ordered = ml / hr
number of hours to run
Step # 2
Milliliters per hour x tubing drip factor = gtt/min
Minutes
Pounds to Kilograms
Pounds to kilograms = pounds
2.2
In pediatrics you need to carry out to the hundredths (do not round especially in the infant or
small child)
Kilogram Example
20 pounds 5 ounces
First need to convert 5 ounces to a fraction of a pound 5 divided by 16 = 0.31
20.31 pounds divided by 2.2 = 9.23 kilograms
Notes medication would be calculated based on 9.23 kilograms. DO NOT ROUND to 9.2
New Calculations
Mg / kg dosing based on weight (kg)
Safe dosing ranges
IV pediatric infusion rates
IV administration of meds per volutrol or syringe pump.
24 hour fluid calculation
Medication dosage
For a dosage of medication to be safe, it must fall within the safe range as listed in a Drug
Handbook, PDR or other reliable drug reference
Dosage based on mg/kg and Body Surface Area
The dose of most pediatrics drugs is based on mg/kg body weight or Body Surface Area
(BSA) in meters squared.
For testing purposed mg / kg will be used.
BSA method of calculations may be seen in NICU, ICU and high acuity areas.
Particularly in the calculation of chemotherapy
Safe Medication Dose
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NURS 3524 Med Wk 1
Calculate daily dose ordered (Physician orders)
Calculate the low and high parameters of safe range (from drug book)
Compare the patient’s daily dose to the safe range to see if it falls within the safe zone.
Calculation
A child is 2 years and weighs 36 lbs is receiving Amoxicillin 215 mg po tid for a bilateral
otitis media (ear infection).
Patient weight in kg = 16.36 kg
Davis drug guide: PO (children) < 40 kg: 6.7 to 13.3 mg / kg q 8 hours.
(low range)16.36 x 6.7 = 109.6 mg q 8hours
(high range)16.36 x 13.3 = 217.5 mg q 8 hours
Safe range: 109.6 to 217.5 mg of Amoxicillin Q 8 hours.
Is the dose safe? Yes, it falls within the safe range.
How much medication do you give?
Physician order Amoxicillin 215 mg every 8 hours.
Suspension comes 250 mg per 5 ml.
250 mg 215 mg
5 ml = x ml
1075
250x
Give 4.3 mL / cc po every 8 hours
Safe Dose Ranges
Read the medication ranges carefully
Some are the dose range for 24 hours
Some are the dose range for q 8 hours
Some are the dose range for q 12 hours
Fluid Control
Crucial in the pediatric population
Units often have policies that children under a certain age are on a fluid control pump.
Key concepts
Fluid overload must be avoided
Time over which a medication should be administered is critical information
Minimal dilution (end concentration of medication) is important for medications such as
aminoglycosides.
Collecting therapeutic blood levels
Fluid overload
Know what the IV rate is.
Hourly recording of IV fluid intake.
Don’t try and catch up on fluids.
Calculate fluids used to administer IV medications into the hourly fluid calculations.
Daily Fluid Needs
Fluid needs should be calculated on every patient to assure that the infant / child is
receiving the correct amount of fluids.
Standard formula for pediatrics needs to be memorized.
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