1. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 10 Dosage Problems for Infants and Children

2. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Converting Ounces to Pounds 16 ounces = 1 lb An infant weighs 6 lbs 12 ounces Divide 12 ounces by 16 and get a decimal: 0.75 Add the answer to the pounds to get the total pounds 6 lbs + 0.75 pound = 6.75 pounds

3. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Converting Pounds to Kilograms 2.2 lbs = 1 kg A child weighs 35 lb Divide 35 lbs by 2.2 and round answer off to the nearest hundredth: 15.91 kg

4. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? An infant weighs 9 lbs. This is equal to 4.2 kg.

5. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False 2.2 lbs = 1 kg A infant weighs 9 lb Divide 9 lbs by 2.2 and round answer off to the nearest hundredth: 4.09 kg

6. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Steps and Rule – mg/kg Body Weight Convert pounds to kilograms, dividing by 2.2 Determine the safe dose range in milligrams per kilograms Decide whether the ordered dose is safe by comparing the order with the safe dose range listed in the reference Calculate the dose needed

7. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Sample Problem mg/kg Body Weight A child weighs 18 kg and has an order for Dilantin (phenytoin sodium) 30 mg po every 8 hours. The recommended dosage is 5 mg/kg/day in two or three equally divided dosages. Is the dosage safe? Determine the safe dose range in milligrams per kilograms: 18 kg × 5 mg/kg/day = 90 mg day. The safe dosage for this child per day is 90 mg. Decide whether the ordered dose is safe by comparing the order with the safe dose range listed in the reference: Yes, this dosage is safe.

8. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Steps and Rule – m 2 Medication Orders Find the BSA in m 2 Determine the safe dose using a reference Decide whether the ordered dose is safe Calculate the dose needed

9. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Steps to Solving Parenteral Pediatric Medications IVP Convert pounds to kilograms Determine the safe dose range in mg/kg using a drug reference Decide whether the ordered dose is safe by comparing the order with the safe dosage range listed in the reference Calculate the dose needed Check the reference for diluent and duration for administration

10. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question A child weighs 50.6 lbs and has an order for gentamicin 50 mg IVPB. The recommended dosage for a child is 6 to 7.5 mg/day divided every 8 hours. Is the dosage ordered safe?

11. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Yes, the dosage is safe. Convert pounds to kilograms: 50.6 lb = 23 kg Determine the safe dose range in mg/kg using a drug reference: 6 mg × 23 = 138 per day / 3 doses a day 46 mg/dose ---- 7.5 mg × 23 = 172.5 mg per day / 3 doses = 57.5 mg/dose

12. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins General Guidelines for Continuous IV Medication Continuous IV dosages are based on weight in kilograms Always use an infusion pump and/or volume control set Small bags of fluid used to prevent fluid overload Follow institutional requirements for continuous IV infusions Consult a pediatric text or drug reference to determine the safe dosage range