Chapter 10 Dosage Problems for Infants and Children

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 10 Dosage Problems for

Infants and Children


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

Chapter 10 Dosage Problems for Infants and Children

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