1. Pediatric Medication Calculations
Let’s Practice!

2. Important Factors when Giving Meds to Children
ALWAYS check the ordered drug and dose with a reliable drug resource BEFORE giving
Follow the policies and procedures of the facility
Most pediatric units require two RN’s to check:
The original medication order by the PCP in chart
Drug reference for drug and dose for child’s age, weight in kg. and diagnosis
The calculations done to determine the correct dose

3. Calculating the Dose Find Infant/child’s weight in kilograms (kg)
PCP may have used admission weight
If child’s weight changes during hospitalization, recalculate safe dose and consult with instructor/primary nurse
Look up dose recommended for child based on age and weight
Calculate the dose
Compare to ordered dose and medication sheet
With any discrepancies, CHECK before GIVING!

4. Let’s Practice If you have a calculator/phone, take it out
Need child’s weight in kg.
If weight listed in pounds, convert to kg.
Example:
Child weighs 30 pounds
30 /2.2 = kg DON’T ROUND YET
- Infant weighs 8 pounds
8/2.2 = kg

5. Example 1.
Calculate the dose of amoxicillin suspension in mLs for otitis media for a 1-yr-old child weighing 22 lb. The dose required is 40 mg/kg/day divided BID and the suspension comes in a concentration of 400 mg/5 mL.
Step 1. Convert pounds to kg: 22 lb × 1 kg/2.2 lb = 10 kg
Step 2. Calculate the dose in mg: 10 kg × 40 mg/kg/day = 400 mg/day
Step 3. Divide the dose by the frequency: 400 mg/day ÷ 2 (BID) = 200 mg/dose BID
Step 4. Convert the mg dose to mL: 200 mg/dose ÷ 400 mg/5 mL = 2.5 mL BID
Pediatric Dosage Calculations is a sample topic found in Davis's Drug Guide.

6. Example 2
Calculate the dose of ceftriaxone in mLs for meningitis for a 5-yr-old weighing 18 kg. The dose required is 100 mg/kg/day given IV once daily and the drug comes pre-diluted in a concentration of 40 mg/mL. How many mg. will you give: Daily? ___________________ Each dose?_______________ How many ml. will you give for each dose?________

7. Here are the Calculations
Step 1. Calculate the dose in mg: 18 kg × 100 mg/kg/day = 1800 mg/day
Step 2. Divide the dose by the frequency:1800 mg/day ÷ 1 (daily) = 1800 mg/dose
Step 3. Convert the mg dose to mL: 1800 mg/dose ÷ 40 mg/mL = 45 mL once daily

8. Calculating using Ranges
Azithromycin (Zithromax)
Recommended range for children is 5 mg to 20 mg per kilogram of body weight per day (mg/kg/day), once daily for three to five days.
Child weighs 25 lbs.
What is the dose range for this child?

9. Zithromax Calculations
25 lbs/ 2.2 = kg
5 mg to 20 mg per kilogram per day (mg/kg/day)
Now Calculate the Range
kg X 5 mg = mg
kg X 20 mg = mg
Safe range for this child is
56.82mg to mg per day

10. Safe range for this child is 56.82mg to 227.27 mg per day
Med order is Azithromycin 100 mg PO daily
Dose 100 mg is within the safe recommended range
Safe to give this med and dose

11. One more problem . . .
The recommended daily digoxin dose for treating heart failure in children age 2 to 5 years old is between 10 and 15 mcg per kg of body weight
The 3 year old child weighs 32 pounds
The order is Digoxin 100 mcg BID PO by elixir
The Digoxin elixer has 0.05mg/mL
How many ml will you give for each dose?___

12. Digoxin Calculations Step 1: 32 lbs / 2.2 = 14.545454 kg
Step 2: Recommended dose range is
X 10 = mcg
X 15 = mcg
– mcg / day (Round to hundredths here)
Step 3: Ordered dose is Digoxin 100 mcg BID PO = 200mcg/day (Dose within range)
Step 4: Digoxin elixer has 0.05mg/mL so Convert dose from 100 mcg = 0.1 mg
Step 5: Dose 0.1 mg / 0.05mg/mL X 1 = 2 ml
Answer is 2 ml each dose. REMEMBER to LABEL!

13. Practice, Practice . . .
Complete the problems on the Pediatric Med Practice forms on Canvas ModulesTab)
Answer Key also provided
Refer to Kee text
Read the problem carefully, follow directions and always label the answers
DO WELL on the Med Quiz!