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This chapter covers essential dosage calculation methods for infants and children, focusing on weight conversion from ounces to pounds and pounds to kilograms. It provides step-by-step instructions for determining safe medication dosages based on body weight in mg/kg and BSA. Using practical examples, including calculating safe dosage ranges for medications like Dilantin and Gentamicin, this guide ensures accurate dosing by emphasizing critical checks against reference values. Key rules for continuous IV medication administration are also included.
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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
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
Question Is the following statement true or false? An infant weighs 9 lbs. This is equal to 4.2 kg.
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
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
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.
Steps and Rule – m2 Medication Orders • Find the BSA in m2 • Determine the safe dose using a reference • Decide whether the ordered dose is safe • Calculate the dose needed
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
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?
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
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