Chapter 13: Pediatric Medication Calculations

Chapter 13: Pediatric Medication Calculations

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

2. Ordered: Drug X 125 mg 4 times daily

SDR for children: 20-30 mg/kg/day in 4 divided doses

Child’s weight: 50 lb. Use a calculator.

1. Estimated weight in kg:
2. Child’s weight in kilograms to the nearest tenth:
3. Calculate the SDR for this child. Low safe dose:

High safe dose:

1. Decision: safe or unsafe order? State the reason.

 

ANS:

1. Estimate: approximately 25 kg (50 ÷ 2)
2. 22.7 kg
3. 454 mg/day (20 ´ 22.7); 681 mg/day (30 ´ 22.7)
4. Safe. Order falls within SDR.

 

PTS:    1

 

 

10. Ordered: amikacin sulfate 600 mg IV infusion q8h, for a child with an infection

Pediatric SDR: 5-7.5 mg/kg q8h, not to exceed 1.5 g/24 hr

Child’s weight: 40 kg

Available: IV amikacin 1 g in 250 mL D₅W

1. SDR for this child:
2. Decision: safe or unsafe order? State the reason.

If safe to give, what flow rate should the nurse set on the pump?

1. DA equation:
2. Evaluation:

 

ANS:

1. 200 mg low safe dose

300 mg high safe dose

1. Unsafe. Order exceeds SDR. Hold medication and contact prescriber immediately for orders. Document.
2. N/A
3. N/A

 

PTS:    1

 

13. Ordered: A bronchodilator, Aminophylline, 8 mg per hour continuous infusion, for a child who received an appropriate loading dose, on a pump based upon frequent and current serum theophylline levels for a child with asthma. Obtain a serum theophylline concentration level 4 hrs after infusion is started and call prescriber.

SDR: 0.8 mg/kg/hr for continuous infusion after appropriate loading dose. Child’s weight is 40 kg.

Remove 20 mL from a 500 mL D₅W IV and add the Aminophylline. Total mL will remain approximately 500 mL.

1. SDR for this child:
2. Evaluation: Safe to give or hold and clarify promptly with prescriber?
3. Flow rate if applicable:

DA:

1. Evaluation:

 

ANS:

1. SDR: 0.8 mg ´ 40 kg = 32 mg per hr
2. Evaluation: Hold and clarify promptly with the prescriber: Is an underdose.
3. N/A
4. N/A

 

PTS:    1

 

14. Ordered: Hydrocortisone, IV push, 50 mg bolus dose, for an adolescent with adrenal insufficiency. Patient weight is 45 kg.

SDR: 1-2 mg per kg

IV bolus: Dilute each 250 mg or fraction thereof with 2 mL bacteriostatic SW and give over 3 minutes.

1. SDR for this patient:
2. Evaluation: Safe to administer or hold and contact prescriber promptly?
3. Amount to withdraw from the vial:

Estimate:

DA:

Evaluation:

Total mL for IV bolus (prepared dose plus diluent added):

1. mL per minute to administer:

DA:

1. Draw an arrow indicating the volume administered at end of first minute and second minute.

 

ANS:

1. SDR: 45-90 mg
2. Evaluation: Safe to administer
3. Estimate: of 2 mL; less than 0.5 mL

Estimate support Answer. Equation is balanced.

2. Total mL for IV bolus: 2.4 mL – 0.4 mL medication = 2 mL diluent
3. 0.8 mL per minute

DA:

 

PTS:    1