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Pediatric dosage calculation tutorial 2011(1).ppt


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Pediatric dosage calculation tutorial 2011(1).ppt

  1. 1. Pediatric Dosage Calculation Hello Class!!!!!!! Good luck in college.
  2. 2. How is Pediatric Dosage Calculation Different than Adults? <ul><li>There is no standard dose </li></ul><ul><li>All doses are based on a recommended dosage based on: </li></ul><ul><ul><li>Body weight in kilograms (for this dosage test) </li></ul></ul><ul><ul><li>Body Surface Area </li></ul></ul>
  3. 3. Begin by Converting to Kilograms <ul><li>All MD orders will be ordered as a dose per kg </li></ul><ul><li>Convert the patient’s weight in lbs to kg by dividing the weight in lbs by 2.2 </li></ul><ul><li>Example: </li></ul><ul><ul><li>50 lbs divide by 2.2 = 22.7272727272727 </li></ul></ul><ul><ul><li>Round to tenths place = 22.7 kg </li></ul></ul>
  4. 4. Now you try! <ul><li>1. Patients weight 48 lbs </li></ul><ul><li>How many kg does the patient weigh? </li></ul><ul><li>Patient weight 13.9 lbs </li></ul><ul><li>How many kg does the patient weigh? </li></ul>
  5. 5. Write your answer:
  6. 6. The MD order <ul><li>The MD order can be written in several ways: </li></ul><ul><ul><li>In a daily total to be divided in equal doses </li></ul></ul><ul><ul><li>Ex: 30mg/kg/day equally divided in three doses </li></ul></ul><ul><ul><li>or </li></ul></ul><ul><ul><li>Per dose </li></ul></ul><ul><ul><li>Ex: 30mg/kg TID </li></ul></ul>
  7. 7. Lets Try it! <ul><ul><li>Patients weight: 45 lbs </li></ul></ul><ul><ul><li>2. Give 30mg/kg/day equally divided in three doses </li></ul></ul><ul><ul><li>How many mg per dose? How much is the 24 hr drug total? </li></ul></ul><ul><ul><li>3. Give 30mg/kg TID </li></ul></ul><ul><ul><li>How many mg per dose? How much is the 24 hr drug total? </li></ul></ul>
  8. 8. Write your answers
  9. 9. Is the dose safe? <ul><li>All pediatric dosages have a recommended range in the drug guide </li></ul><ul><li>These ranges are typically based on a 24 hour total amount of a dosage in mg, mcg, gm, etc. </li></ul><ul><li>Remember how to convert mcg to mg, gram to mg etc . </li></ul>
  10. 10. Is the order safe? <ul><li>A statement from the drug guide will be provided on the dosage test </li></ul><ul><li>Ex: The drug guide states the recommended safe dosage is 3-5 mg/kg/day to be given in 2 divided doses </li></ul>
  11. 11. Lets try it! <ul><li>4. MD order Sporanox (itraconazole) 40 mg bid </li></ul><ul><ul><li>Patients weight 47 lbs </li></ul></ul><ul><ul><li>Drug guide recommends 3-5mg/kg/day q12 hrs </li></ul></ul><ul><ul><li>Is the dose safe? </li></ul></ul>
  12. 12. Write your answer
  13. 13. Supply <ul><li>Pediatric medication is typically supplied in liquid form </li></ul><ul><li>Some children can swallow pills or the medication may only come in tablet form </li></ul><ul><li>Most of the dosage assessment questions will consist of medication in liquid form, few questions will be in tablet form </li></ul>
  14. 14. Remember…. <ul><li>Supply is expressed as a dosage amount per a commonly used quantity </li></ul><ul><li>Example 250mg/5ml </li></ul><ul><li>100mg/ml </li></ul><ul><li>50mcg/1ml </li></ul><ul><li>This is different from the total amount of drug dosage in the bottle </li></ul>
  15. 15. Calculate Liquid Medication <ul><li>Dose desired </li></ul><ul><li>Dose on hand X quantity in ml </li></ul><ul><li>= volume to be administered </li></ul>
  16. 16. Lets try it! <ul><li>5. MD order is to give 75 mg </li></ul><ul><li>Supply is 250mg/5ml </li></ul><ul><li>Calculate the amount to administer </li></ul>
  17. 17. Write your answer
  18. 18. Read a label <ul><li>Some dosage questions will require you to read a drug label </li></ul>Mixing directions:Add 30 ml of water Mix VigorouslyDiscard after 5 days Zantac (ranitidine) Oral suspension25mg/5ml
  19. 19. Lets try it! <ul><li>6. Using the medication label supplied , how many milliliters should be administered per dose if the MD order is 100 mg po qd? </li></ul>
  20. 20. Write your answer
  21. 21. Ok, so how do you round? <ul><li>Look at it this way… </li></ul><ul><ul><li>If the calculated answer is <1 ml then round to the hundredths place as this amount could be easily administered in a 1 ml syringe </li></ul></ul><ul><ul><li>Example: If the answer was 0.75 ml, where would you draw the solution to in this syringe? </li></ul></ul>
  22. 22. What if the Answer is > 1 ml? <ul><li>If the calculated dose is greater than 1 ml then you round to the tenths place </li></ul><ul><li>Example- if the dose was 2.75 ml, using a 3 ml syringe you would need to round to 2.8ml, as 2.75ml can not be precisely administered </li></ul>
  23. 23. For Example <ul><li>If the answer is 0.3762901 </li></ul><ul><li>Round to 0.38ml…..don’t forget the zero in the ones place! </li></ul><ul><li>If the answer is 1.3762901 </li></ul><ul><li>Round to 1.4 ml </li></ul>
  24. 24. NEVER……. <ul><li>Round to a whole number!!!!! </li></ul><ul><li>If the answer is 1.89361 </li></ul><ul><li>Round to 1.9 ml NOT 2 ml </li></ul>
  25. 25. So Remember: <ul><li>< 1 ml rounds to 2 places to the right of the decimal place </li></ul><ul><li>>1 ml, kg, mg, mcg, anything else rounds to only 1 place to the right of the decimal place </li></ul>
  26. 26. Practice Rounding <ul><li>If you calculated the answer to be: </li></ul><ul><li>2.76001 mg, round to:__________ </li></ul><ul><li>0.609113 ml , round to:_________ </li></ul><ul><li>8.92778 ml, round to:__________ </li></ul><ul><li>0.78912, round to:__________ </li></ul><ul><li>13.119542 kg, round to:_______ </li></ul>
  27. 27. Intravenous <ul><li>Nothing new here…. </li></ul><ul><li>Volume in ml x drop factor = gtt/min </li></ul><ul><li>Time in min </li></ul>
  28. 28. You are Ready!!! Lets put it all together <ul><li>8. The physician orders Kantrex (kanamycin) oral suspension po 150 mg/kg/day in 2 divided doses. </li></ul><ul><li>Supply Kantrex 500mg/5ml. </li></ul><ul><li>Patients weight: 28 lbs </li></ul><ul><li>How many milliliters should be administered per dose? </li></ul>
  29. 29. Write your answer
  30. 30. <ul><li>9. The physician orders Prostigmin (neostigmine bromide) 8 mg q 4 hrs </li></ul><ul><li>The drug guide recommended dosage is 2-4 mg/kg/day in divided doses </li></ul><ul><li>Patients weight: 21 lbs </li></ul><ul><li>Is the physicians order safe? </li></ul>
  31. 31. Write your answer
  32. 32. Careful…some may have patients weight in kg already! <ul><li>10. The physician orders Primacor (milrinone lactate) 50 mcg IM stat. </li></ul><ul><li>Supply: 0.2mg/ml </li></ul><ul><li>Patients weight: 12 kg. </li></ul><ul><li>How many milliliters should be administered per dose? </li></ul>
  33. 33. Write your answer
  34. 34. <ul><li>11. The physician orders Sustiva (efavirenz) 20mg/kg po q 12 hrs. </li></ul><ul><ul><li>Supply: Sustiva 50 mg tablets </li></ul></ul><ul><ul><li>Patients weight: 11 lbs </li></ul></ul><ul><ul><li>How many tablets are to be administered per dose? </li></ul></ul>
  35. 35. Write your answer
  36. 36. <ul><li>12. The physician orders IV fluids as follows: Infuse 1000ml of 0. 45% normal saline solution in 10 hours IV. </li></ul><ul><li>Calculate the flow rate when the drop factor is 10 drops per milliliters </li></ul>
  37. 37. Write your answer
  38. 38. You are ready to take the practice test!