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**preview**shows pages 1-2. to view the full**6 pages of the document.**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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