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Pa dosage class work part 1 ppt student ppt summer 2011
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Pa dosage class work part 1 ppt student ppt summer 2011

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  • 1. 1Dosage Calculations• TODAY WE WILL PROCEED WITHDOSAGE CALCULATIONS.• THIS PART IS THE REAL NURSINGSTUFF!!!!
  • 2. Dosage Variations• Reconstitution of powered drugs; single andmulti-strength• Pediatric meds• BSA• IV formulas• Heparin• Critical care medications2
  • 3. Reconstitution of Powered Medications• Solute• Solvent• Directions1. Read labelinstructions2. Add diluent3. Label and calculatedose to administer3
  • 4. 4Reconstitution of Powdered DrugsExample: Bottle of Oxacillin 2 g powderDirections on label: add 11.5ccsterile H20 for injectionEach 1.5 cc = 250 mgDose ordered is 500mg IMHow many________ cc’s will we give?250 mg: 1.5cc :: 500 mg : Xcc250X = 500mg x 1.5250X= 750X = 3cc
  • 5. Reconstituting Medications• For Calculating Purposes:• DO NOT USE the added diluent for calculating yourdose. (see previous example)• INSTEAD USE THE RESULTINGCONCENTRATION, e.g. in the previous example itsaid the resulting concentration will be, 250mg =1.5 ml5
  • 6. 6Single Dose ReconstitutionExample 2Order reads• Give 750mg of Ampicillin q4h IV.On hand• Ampicillin 1 g vial in powered form.• Reconstitution directions say:add 2ml sterile water for injection. Each ml contains500mg Ampicillin.How many ml would you give each dose
  • 7. 7Multiple Strength SolutionsOrder readsPenicillin G 2,250,000 units IM now.ON HandPenicillin 20 million unit vialReconstitution reads:• Add 11.5cc for 1,000,000 units/ml, 33cc for 500,000units/ml, and 75cc for 250,000 units/ml• Using the appropriate concentration, how many cc’sshould be given for this dose
  • 8. Label Example8
  • 9. 9MEDICAL QUESTION OF THE DAY• QUESTION:• WHAT IS AN ELIXIR
  • 10. 10DOSAGE CALCUATIONBY WEIGHTORDER:Vancomycin IV 5 mg/kgPatient weights 209 lbs209 ÷ 2.2 = 95 kg95 kg X 5 mg = 475 mg
  • 11. 11Pediatric Medications
  • 12. 12Dosage Calculation3 Steps1. Convert lbs. – kgs. divide by 2.22. Calculate daily dosage3. Compare to recommended safe dose.
  • 13. 13Order: Amoxicillin 125 mgP.O. q.8***Patient weight 22 lbsIS THIS DOSE SAFE?STEPS:1. 22 ÷ 2.2 = 10 kg2. 125mg q 8hr. = 125 mg x 324 hrs ÷q 8 hrs. = 3 x /day= 375 mg per day
  • 14. 14
  • 15. 15Pediatric Dosage3. Recommended safe dose of Amoxicillin is20-40 mg/kg/day.20mg x 10kg = 200mg /day40 mg x 10 kg = 400mg /daySo daily safe range is200mg – 400mg /dayPatient’s daily dose is 375 mg/daySo patient’s daily dose falls within SAFE range
  • 16. Pediatric DosageExample 2• Order reads: Oxycodone 3mg p.o. now• Patient weighs 30 lbs.• Recommended safe dose of Oxycodone is0.15 mg/kg/doseIs this dose safe?16
  • 17. Example 3• Order reads: Gentamycin 5mg/kg/day divided in2 doses.• The infant weighs• 22lbs.• On hand is: Gentamycin 80mg/2ml• How many cc’s should the infant receive perdose?17
  • 18. 18DOSAGE SAFETY• A TRAGIC MEDICATIONERROR LED TO DEATH OF 9- MONTH OLD INFANT.THE DR. ORDERED .5mg IV MSO4THE person who transcribed med DID NOT SEE THE DECIMAL MADE ITA (5 mg)DOSE ON MAR. (Medicine administration record)BABY received 2 (5mg) DOSESTWO HOURS APART.THIS IS 10 TIMES THE NORMAL DOSE TWICE!! BABY DIED!!New System POE many safety features !! Electronic recordsimproving safety
  • 19. 19BSA(Body Surface Area)Noted as M2
  • 20. 20Example** If you are given a recommended pediatric doseand BSA, use this formula**Drug A : 15 mg/M2(Recommended Pediatric Dose)Pts. BSA = 0.48 M2Just multiplyDosage: 15 x 0.48(BSA) =7.2 mg
  • 21. 21Recommended AdultDose OnlyFormula on sheetIF NO RECOMMENDED CHILD DOSEIS AVAILABLE USEChild’s BSA X (times)1.7 M² adult dose(average adult BSA)WILL GIVE YOU CHILD’S DOSE
  • 22. 22Example with no recommendedpediatric dose givenDRUG C = 25 mg( RECOMMENDED ADULTDOSE OF DRUG)CHILD’S BSA = 0.47 M ²0.47 M ² X 25 mg = 7 mg1.7 M ² CHILD’SDOSE
  • 23. 23Example #2• Child BSA = 0.6m²• Recommended Adult dose of• Keflex = 500 mg• Find the child dose
  • 24. 24NON-METRICBSA =wt (lbs) x ht (in)3131METRICBSA =WT (kg) x ht (cm)3600**May use to calculate adult orpediatric dose
  • 25. 25AVERAGE 4YR OLD17KG and 103 CM360010317x3600175149..486. or.697m2or 0.7m2===
  • 26. 26BSA• Example 2• Calculate the BSA for adult whoweighs 200lbs and is 59”tall
  • 27. 27MEDICAL HUMOR• QUESTION• WHAT IS A MICROGRAM