Pediatric and Adult Dosages

Question 1

True or false: those who administer medications to patients are legally responsible for recognizing incorrect and unsafe dosages, for holding the medication, and for alerting the prescriber when incorrect and unsafe dosages are discovered.

Answer 1

True

Question 2

To consult recommended dosages of medications:

Answer 2

reputable drug reference.

Question 3

Usually recommended based on the requirements of an adult of average weight.

Answer 3

Dosage

Question 4

Lists a minimum and maximum safe dosage, allowing the nurse to compare what is ordered to what is recommended, considering the individual patient.

Answer 4

Dosage range

Question 5

BSA

Answer 5

Body surface area

Question 6

There are ___ methods currently used for calculating safe pediatric dosages.

Answer 6

2

Question 7

The two methods currently used for calculating safe pediatric dosages:

Answer 7

Body weight and body surface area (BSA).

Question 8

An example would be milligrams of dosage per kilogram.

Answer 8

Body weight

Question 9

Measured in square metres.

Answer 9

Body surface area (BSA)

Question 10

True or false: the body weight method for calculating safe pediatric dosages is more common.

Answer 10

True

Question 11

Based on both weight and height.

Answer 11

Body surface area (BSA)

Question 12

Primarily used in critical care situations and oncology.

Answer 12

Body surface area (BSA)

Question 13

True or false: body weight and BSA are also used for adults in critical care situations and the calculations are the same.

Answer 13

True

Question 14

1 kg = ___lbs

Answer 14

2.2

Question 15

2.2 lbs = ___ kg

Answer 15

1

Question 16

1 lb = ___ oz

Answer 16

16

Question 17

16 oz = ___ lb

Answer 17

1

Question 18

Compared to larger persons, infants (birth to 1 year) have a ___ percentage of body water and a ___ ability to absorb water-soluble drugs, which may necessitate ___ dosages of oral and parenteral drugs.

Answer 18

greater

diminished

higher

Question 19

True or false: numerically, the infant’s or child’s dosage appears smaller, but pediatric dosages are frequently much larger proportionally per kilogram of body weight than the usual adult dosage.

Answer 19

True

Question 20

References that should be considered for more in-depth information of pediatric dosages are drug formularies in the ___, the ___ ___m___ (CPS, eCPS) (aka the Canadian Drug Reference for Health Professionals), and scholarly pediatric drug references.

Answer 20

institution

Compendium of Pharmaceuticals and Specialties

Question 21

*When converting ___ to ___, round the ___ weight to one decimal place (tenths).

Answer 21

pounds

kilograms

kilogram

Question 22

The nurse compares the ordered dosage to the ___ ___ ___ from a reputable drug resource.

Answer 22

recommended safe dosage

Question 23

The intent of this is to ensure that the order dosage is sage before calculating the amount to give and administering the dose to the patient.

Answer 23

Comparing ordered dosage to the recommended safe dosage

Question 24

True or false: the dosage per kg may be mg/kg, mcg/kg, g/kg, mEq/kg, units/kg, and so on.

Answer 24

True

Question 25

To verify safe pediatric dosage:

1. ___ the child’s weight from pounds to kilograms (rounded to tenths) if necessary.
2. Calculate the ___ ___ in mg/kg or mcg/kg (rounded to tenths) for a child of this weight, as recommended by a reputable drug reference: multiply mg/kg by the child’s weight in kg.
3. ___ the ordered dosage to the recommended pediatric dosage and decide whether the dosage is safe.
4. If safe, ___ the amount to give and administer the dose. If the dosage seems unsafe, consult with the ordering practitioner and pharmacist before administering the drug.

Answer 25

Convert

safe dosage

Compare

calculate

Question 26

Use a ___ mL syringe measured in ___ of a millilitre for volumes less than 1 mL (0.37 mL).

Answer 26

1

hundredths

Question 27

Drugs intended to be given either one time when necessary or immediately (stat).

Answer 27

Single-dose drugs

Question 28

Dosage ordered by the body weight method is based on ___/___/___ and calculated by multiplying the recommended drug ___ by the patient ___ in ___ for each ___.

Answer 28

mg/kg/dose

weight

kg

dose

Question 29

Use a ___ mL syringe measured in ___ of a millilitre for volumes greater than 1 mL (1.3 mL).

Answer 29

3

tenths

Question 30

Use a ___ mL or ___ mL syringe measured in ___ of a millilitre for volumes less than 1 mL (0.6 mL).

Question 31

Measure 0.33 mL in a ___ mL syringe.

Answer 31

1

Question 32

Round 1.33 mL to 1.3 mL, and measure in a ___ mL syringe.

Answer 32

3

Question 33

Measure 0.6 mL in either a ___ mL or ___ mL syringe (notice that the amount is measured in tenths and is greater than 0.5 mL, so the ___ mL syringe is preferable for dexterity.)

Answer 33

1

3 x2

Question 34

Measure 0.65 mL in a ___ mL syringe (notice that the amount is measured in hundredths and is less than 1 mL.) The volume would need to be rounded if a ___ mL syringe is used. However, the ___ mL syringe would provide a more accurate dose.

Answer 34

1

3

1

Question 35

When calculating parenteral dosages:

1. For an amount greater than 1 mL, round the amount to be administered to the ___. Measure in a ___ mL syringe.
2. For an amount less than 0.5 mL, round the amount to be administered to the ___. Measure in a ___ mL syringe.
3. An amount of 0.5 to 1 mL, calculated in ___, can be accurately measured in either a ___ mL or ___ mL syringe.

Answer 35

tenths 3

hundredths 1

tenths 1 3

Question 36

Intended to produce a continuous therapeutic effect over 24 hours. They are recommended as a total daily dosage: mg/kg/day to be divided into some number of individual doses, such as “three divided doses,” “four divided doses,” and “divided doses every 8 hours.”

Answer 36

Routine or round-the-clock drugs

Question 37

“Three divided doses” means the drug total daily dosage is divided equally and is administered 3 times per day, either TID or q___h. Likewise, “four divided doses” means the total daily drug dosage is divided equally and administered 4 times per day, either QID or q___h. Recommendations such as “divided doses every 8 hours” specify that the total daily drug dosage should be divided equally and administered q___h.

Answer 37

8

6

8

Question 38

True or false: many medications have a minimum and maximum recommended mg/kg range per day to be divided into some number of doses.

Answer 38

True

Question 39

True or false: the manufacturers of some medications provide a recommended range of mg/kg/day, and specify a maximum allowable total amount per day.

Answer 39

True

Question 40

___ can also be unsafe. If the medication is necessary for the treatment or comfort of the patient, then giving too little can o cause harm. Dosage that is less than the recommended therapeutic amount is also considered unsafe because it may be ineffective.

Answer 40

Underdosage

Question 41

Once an adolescent reaches a weight of 50 kg (110 lb) or greater, the ___ adult dosage is frequently prescribed instead of a dosage calculated by weight. The prescriber must ensure that the order for a child’s dosage does not exceed the maximum adult dosage recommended by the manufacturer.

Answer 41

standard

Question 42

Medications that contain two drugs combined into one solution or suspension.

Answer 42

Combination drugs

Question 43

To calculate the safe dosage of combination medications, the nurse should consult a pediatric drug reference. Often, the nurse will need to calculate the safe dosage for ___ of the medications combined in the solution or suspension.

Answer 43

each

Question 44

Usually ordered by the amount to give or dose volume.

Answer 44

Combination drugs

Question 45

Adult dosage recommendations are often found on the label as well, but may be found in the ___. It is always important to refer to the ___ when the information is not found on the label.

Answer 45

insert

Question 46

To use the body weight method to verify the safety of pediatric and adult dosages:

■ ___ body weight from pounds and ounces to kilograms: 1 kg = 2.2 lb; 1 lb = 16 oz.

■ ___ the recommended safe dosage in mg/kg.

■ ___ the ordered dosage with the recommended dosage to decide whether the dosage is safe.

■ If the dosage is safe, calculate the amount to give for ___ dose; if not, notify the prescriber.

■ Combination drugs are ordered by dose ___. Check a reputable drug reference to be sure the dose ordered contains the safe amount of each drug as recommended.

Answer 46

Convert

Calculate

Compare

one

volume

Question 47

This is the only way to ensure that the drug to be administered is not an overdose or an underdose.

Answer 47

Recommended dosage calculation with a high and low range

Question 48

The prescriber ordered tobramycin 9.5 mg IV q8h for a 2-week-old infant who weighed 5 kg and had a serious infection. The recommended dosage for children and infants greater than 1 week old is 1.5 to 1.9 mg/kg q6h, or 2 to 2.5 mg/kg q8h. The nurse calculated the minimum and maximum recommended dose by multiplying the recommended dosage for q6h by the infant’s weight.

Minimum single q8h dose: 2 mg/kg × 5 kg = 10 mg
Maximum single q8h dose: 2.5 mg/kg × 5 kg = 12.5 mg
Minimum single q6h dose: 1.5 mg/kg × 5 kg = 7.5 mg
Maximum single q6h dose: 1.9 mg/kg × 5 kg = 9.5 mg
The nurse did not recognize that the ordered dose was too low because she used the q6h not the q8h recommended range. The dose of 9.5 mg/dose falls below the range for q8h (10 mg–12.5 mg), so the infant was underdosed. However the drug was given q6h, 4 times a day, for a 38 mg per day total, which is greater than if given 3 times per day (total 28.5 mg/day). That daily dose would be slightly greater than the safe range of 30–37.5 mg.