Pediatric Medication Calculations

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1 SECTION 7 Pediatric Medication Calculations CHAPTER 0 Pediatric Oral and Parenteral Medications CHAPTER Pediatric Intravenous Medications 00 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

2 CHAPTER 0 PEDIATRIC ORAL AND PARENTERAL MEDICATIONS 87 CHAPTER 0 Pediatric Oral and Parenteral Medications Objectives The learner will:. explain how suspensions are measured and administered.. calculate pediatric oral dosages.. list the precautions of IM and subcutaneous injection in infants and children.. calculate pediatric IM and subcutaneous dosages. Suggested Review Questions. What are the guidelines for measuring and administering medications supplied as a suspension?. What are the precautions related to preparing and administering medications to infants and children using the IM or subcutaneous route? Why are these precautions necessary?. What formula is used when calculating pediatric medication dosages? What are the essential elements to remember when calculating pediatric medication dosages? Answers to Review Questions. Guidelines for measuring and administering medications supplied as a suspension to ensure proper dosing include a. Mix medication thoroughly immediately prior to pouring the medication. b. Pour into plastic medicine cup or draw into oral syringe appropriately calibrated to volume prescribed. c. Administer promptly after medication is poured to prevent settling out of the insoluble components of the mixture. d. Verify that child has swallowed the medication.. When administering medications for IM or subcutaneous injection to children it is essential to inject the medications into the appropriate tissue in order to achieve the desired rate of medication absorption. The subcutaneous tissue of the upper arm is the preferred 00 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

3 88 SECTION 7 PEDIATRIC MEDICATION CALCULATIONS site for immunizations given via the subcutaneous route. Sites of insulin injections should be rotated using a specific schedule. Prepared insulin doses should be double-checked with another nurse to avoid critical medication errors. The vastus lateralis muscle is the preferred site for IM injections in infants and children up to age. The vastus lateralis is the largest muscle mass in children under the age of and is free of major nerves and blood vessels. The vastus lateralis or ventrogluteal site can be used in children over the age of. The ventrogluteal site is also free of major nerves and blood vessels, but properly positioning a child under the age of for injection into the ventrogluteal muscle can be difficult. Injections using the ventrogluteal site tend to be less painful than those using the vastus lateralis site. If absolutely necessary, the dorsogluteal muscle can be used for IM injections in children over the age of years. However, it is recommended that the dorsogluteal muscle be avoided due to the potential for damage to the sciatic nerve. The volume of medication injected per site is usually limited to ml.. The dimensional analysis process used to calculate medication dosages in adults can also be used when calculating medication dosages in children. The majority of medications in children are ordered in milligrams of drug per kilogram of body weight (/kg) or per square meters (m ) based on body surface area (BSA). If using a nomogram to determine BSA, be sure to use a pediatric nomogram. Pediatric medication dosages are usually calculated to the nearest hundredth and measured using a tuberculin syringe. All pediatric dosages must be compared with the safe dose range as published in the medication package insert, hospital formulary, or United States Pharmacopeia. 00 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

4 CHAPTER 0 PEDIATRIC ORAL AND PARENTERAL MEDICATIONS 89 Name Date Chapter 0: Pediatric Oral and Parenteral Medications Additional Practice Problems Read the labels below to prepare the pediatric doses indicated. Calculate dosages to nearest hundredth.. 00 of cefaclor PO. 00 of cefaclor PO. Biaxin 00 PO Used with permission from Abbott Laboratories Used with permission from Ranbaxy Pharmaceuticals Inc. Used with permission from Ranbaxy Pharmaceuticals Inc. 00 Cengage Learning. All Rights Reserved. Permission to reproduce granted for classroom use only.

5 90 SECTION 7 PEDIATRIC MEDICATION CALCULATIONS. of valproic syrup PO. 60 of acetaminophen PO of clindamycin IV 7. of meperidine IM Copyright Baxter International Inc. Used with permission from Bedford Laboratories, a division of Ben Venue Laboratories Inc. A Boehringer-Ingelheim Company. Used with permission from Bristol-Myers Squibb Company Used with permission from Abbott Laboratories 00 Cengage Learning. All Rights Reserved. Permission to reproduce granted for classroom use only.

6 CHAPTER 0 PEDIATRIC ORAL AND PARENTERAL MEDICATIONS 9 8. of morphine IM 9. 7 of Dilantin PO Used with permission from Pfizer Inc. Copyright Baxter International Inc. Prepare the pediatric doses ordered from the medication preparation available. Calculate dosages to nearest hundredth. 0. Ordered: tetracycline 7 PO Available: tetracycline oral suspension /. Ordered: digoxin 0. PO Available: digoxin elixir 0 mcg/ml. Ordered: penicillin 00,000 units IM Available: penicillin,000,000 units/ml. Ordered: clindamycin 60 PO Available: clindamycin oral solution 7 /. Ordered: fluconazole 60 PO Available: fluconazole oral suspension 0 /ml 00 Cengage Learning. All Rights Reserved. Permission to reproduce granted for classroom use only.

7 9 SECTION 7 PEDIATRIC MEDICATION CALCULATIONS. Ordered: methylprednisolone 0 IM Available: methylprednisolone /ml 6. Ordered: furosemide PO Available: furosemide oral solution 0 / 7. Ordered: erythromycin 60 PO Available: erythromycin oral suspension 00 / 8. Ordered: kanamycin IM Available: kanamycin sulfate 7 / ml 9. Ordered: azithromycin 80 PO Available: azithromycin oral suspension 00 / 0. Ordered: cefuroxime 7 IM Available: cefuroxime 70 /ml 00 Cengage Learning. All Rights Reserved. Permission to reproduce granted for classroom use only.

8 CHAPTER 0 PEDIATRIC ORAL AND PARENTERAL MEDICATIONS 9 Solutions to Additional Practice Problems Read the labels below to prepare the pediatric doses indicated. Calculate dosages to nearest hundredth = ml = 8 ml. 00 = ml 0 = = ml = 0.6 ml 6. ml 0 00 =. ml rounded to nearest hundredth =. ml 7. ml = = 0.6 ml 8. ml 0 = = 0. ml 0 00 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

9 9 SECTION 7 PEDIATRIC MEDICATION CALCULATIONS = =. Prepare the pediatric doses ordered from the medication preparation available. Calculate dosages to nearest hundredth = ml. Insert mcg to conversion into DA equation or convert mcg to before developing equation. Example solution shows mcg to conversion in the DA equation. ml 0 mcg 000 mcg 0. = =. 0. ml,000,000 units 00,000 units = = ml 60 = ml. ml 0 60 = =.. ml 0 = = 0.6 ml ml = ml = ml 00 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

10 CHAPTER 0 PEDIATRIC ORAL AND PARENTERAL MEDICATIONS 9 8. ml = =. ml = =. 0. ml 70 7 = = Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

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