Deck 12: Pediatric Medications

Question 1

Order: 0.25 g q8h.
What is the 24-hr dose in mg?

Answer 1

750 mg

Question 2

Order: 15 mg po bid.
Child's weight: 10 kg.
SDR for this child's weight: 3 mg per kg per day in 3 divided doses.
Safe or hold?

Answer 2

30 mg in 3 divided doses (10 mg per dose)
Hold (insufficient frequency schedule; single dose overdoses)

Question 3

Order: 500 mcg per kg.
Weight or BSA: 11 lb.
What is the dose in mg?

Answer 3

2.5 mg

Question 4

Order: 0.25 g po qid.
Child's weight: 20 kg.
SDR for this child's weight: 25-50 mg per kg day in 4 divided doses.
Safe or hold?

Question 5

Order: 0.5 g q12h.
What is the 24-hr dose in mg?

Question 6

Order: 5 mg per kg stat.
Child's weight: 10 kg.
SDR for this child's weight: 60 mg maximum per dose.
Safe or hold?

Question 7

Order: 400 mcg q6h.
What is the 24-hr dose in mg?

Question 8

Order: 20 mg per m².
Weight or BSA: BSA 0.55 m².
What is the dose in mg?

Question 9

Order: 0.1 g qid.
What is the 24-hr dose in mg?

Question 10

Order: 50 mcg q4h.
What is the 24-hr dose in mg?

Question 11

Order: 500 mg per m².
Weight or BSA: 0.45 m².
What is the dose in mg?

Question 12

Order: 1 mg po daily.
Child's weight: 5 kg.
SDR for this child's weight: 100-200 mcg per kg per day.
Safe or hold?

Question 13

Order: 200 mg po daily.
Child's weight: 15 kg.
SDR for this child's weight: 5-10 mg per kg per dose.
Safe or hold?

Question 14

Order: 0.1 mg intravenously (IV) bid.
Child's weight: 8 kg.
SDR for this child's weight: 25 mcg per kg per day in 2 divided doses.
Safe or hold?

Question 15

Order: 50 mg po daily.
Child's weight: 22 lb.
SDR for this child's weight: 10-20 mg per kg per day.
Safe or hold?

Question 16

Order: 10 mg per kg.
Weight (BSA): 35 kg.
What is the dose in mg?

Question 17

Order: 1 g po daily.
Child's weight: 40 kg.
SDR for this child's weight: 25-50 mg per kg per day.
Safe or hold?

Question 18

Order: 100 mg po daily.
Child's weight: 20 kg.
SDR for this child's weight: 2-5 mg per kg per day.
Safe or hold?

Question 19

Order: 0.25 g per kg.
Weight or BSA: 13.2 lb.
What is the dose in mg?

Question 20

Order: 2 mg IV daily in AM.
Child's weight: 15 kg.
SDR for this child's weight: 50-100 mcg per kg per dose per day.
Safe or hold?

Question 21

Ordered: Infant's acetaminophen suspension concentrated drops 160 mg for a 3-year-old child with a fever who weighs 30 lb. a. What is the recommended dose in mg and mL for this medicine for this child?
b. If safe, how many mL will you be administering?
c. Which is more concentrated, the children's acetaminophen (problem 34) or the infant's acetaminophen?

Question 22

An infant weighs 5 lb 8 oz.
a. How many total lb does the child weigh to the nearest tenth of a lb?
b. What is the infant's estimated weight in kg?
c. How many kg does the infant weigh to the nearest tenth of a kg?

Question 23

Ordered: Digoxin 50 mg IV for a child with congestive heart failure.
SDR: 0.015-0.35 mg per kg.
Child's weight: 10 kg.
a. What is the SDR for this child?
b. Decision: Is the ordered dose safe to give or should the nurse hold it, recalculate it, and contact the prescriber promptly?
c. If safe to give, how many mL will you prepare?

Question 24

Ordered: Morphine sulfate 5 mg subcutaneous stat for a child in pain who weighs 20 kg.
SDR: 0.1-0.2 mg per kg per dose.
Use a calculator to determine the SDR. a. What is the SDR?
b. Is the dose safe to give, or should you hold it and contact the prescriber promptly after rechecking the order and recalculating dose?
c. If it is safe to give, then how many mL will you prepare?

Question 25

A child weighs 30 lb 4 oz.
a. How many total lb does the child weigh to the nearest tenth of a lb?
b. What is the child's estimated weight in kg?
c. What is the child's actual weight in kg?

Question 26

Ordered: Methotrexate sodium 0.25 g for child with lymphoma who weighs 80 lb and is 125 cm tall.
SDR: 200-500 mg per m² every 2-4 weeks for lymphoma.
BSA formula for m²: .
a. BSA for this child (calculate formula)
b. SDR for this child
c. Ordered dose
d. Evaluation and decision

Question 27

Ordered: Mycostatin (nystatin) oral syrup 200,000 units bid for a 4-month-old infant with thrush (oral candidiasis).
SDR for children and infants over 3 months: 250,000-500,000 units per day.
Directions: Place half the dose in either side of the mouth. a. Is the order within the SDR?
b. How many mL will you prepare?
c. How many mL will you administer on each side of the mouth?

Question 28

An IV of 250 mL of lactated Ringer's solution is ordered q24h for a child.
Pediatric policy states that a buretrol must be used and that it may only contain a maximum of 2 hr's worth of the ordered flow rate.
How many mL will the nurse place in the buretrol to the nearest mL?

Question 29

Ordered: Dilantin 30 mg q12h po daily for a child with a seizure disorder who weighs 12 kg.
SDR: 5 mg per kg per day in 2-3 equally divided dosages.
Available: Dilantin 30 mg per cap.
a. What is the SDR?
b. Is the dose safe to give, or should you hold it and contact the prescriber promptly after rechecking the order and recalculating the dose?

Question 30

Ordered: Morphine sulfate 3.5 mg IV for an adolescent undergoing a procedure.
SDR: Adolescents: 3-4 mg IV. May be repeated in 5 min if necessary. a. Is the order safe for this child?
b. If safe, how many mL will you prepare?

Question 31

Which of the following conversion formulas is correct for lb and kg?

A) OR
B)

Question 32

Ordered: Furosemide 15 mg IV, initial dose for a child with edema.
The nurse plans to deliver the medication in a volume-control device, filling the container up to 20 mL with lactated Ringer's solution from an existing infusion. It will be infused at the recommended rate of 1 min per mL.
a. How long will it take to deliver the infusion?
b. What will the flow rate be in mL per hr?

Question 33

Ordered: Furosemide 30 mg q12h for a child with congestive heart failure weighing 35 lb.
SDR: 0.5-2 mg per kg per dose q6-12h. Use a calculator. Enter the data twice for verification.
a. Estimated weight in kg
b. Exact weight in kg to the nearest tenth
c. SDR for this child to nearest tenth of an mg
d. Ordered dose
e. Evaluation and decision
f. Volume to be administered (if applicable)

Question 34

Ordered: Cleocin (clindamycin) pediatric solution 100 mg po q6h for a child with a severe respiratory infection who weighs 40 lb.
SDR: 8-25 mg per kg per 24 hr in 4 divided doses. Use a calculator. Enter data twice for verification.
a. Estimated weight in kg
b. Exact weight in kg to the nearest tenth
c. SDR for this child to nearest tenth of an mg
d. Total daily dose ordered
e. Evaluation and decision
f. Amount to be given (if applicable), rounded to nearest tenth of an mL

Question 35

A medicated IV of 100 mL of D5W q5h is ordered for a child. Pediatric policy states that a buretrol must be used and that it may only contain a maximum of 1 hr's worth of the ordered flow rate.
a. How many mL will the nurse place in the buretrol?
b. What is the purpose of the buretrol?

Question 36

Ordered: Doxorubicin HCl 18 mg daily for 3 days for a child with a neoplasm.
SDR: 30 mg per m² once each day for 3 days.
Child's BSA: 0.6 m².
a. SDR for this child
b. Ordered dose
c. Evaluation and decision

Question 37

Ordered: Lanoxin 62.5 mcg po stat for a child with heart failure.
How many tablet(s) will you give?

Question 38

Ordered: Aminophylline IV in D5W at 0.7 mg per kg per hr for a 1-year-old child with asthma. Child's weight is 12 kg. The IV 250 mg aminophylline per 250 mL started just a short time earlier is flowing at 5 mL per hr when you enter the room to care for the child.
SDR: 0.6-0.7 mg per kg per hr.
a. SDR of mL per hr for this child
b. Ordered flow rate in mg per hr
c. Ordered flow rate in mL per hr
d. Current flow rate in mL per hr
e. Evaluation and decision

Question 39

Ordered: Children's acetaminophen suspension 160 mg po stat for a 3-year-old child with a fever who weighs 30 lb. a. What is the recommended dose in mg and mL for this child?
b. If safe, how many mg will you be administering?
c. How many mL equivalents will you give using the calibrated equipment supplied with the medicine?

Question 40

Ordered: 800 mg Cefotaxime sodium (Claforan) IV q6h per volume-control device to be administered over 30 min for a 57-lb child.
SDR: 25-50 mg per kg q6h.
Available: 1 g vial diluted to a total of 20 mL with sterile water for injection.
a. Estimated weight in kg
b. Exact weight in kg to the nearest tenth
c. SDR for this child
d. Ordered dose for this child and total for day
e. Amount of drug in mL to be administered

Question 41

Ordered: Synthroid (levothyroxine sodium) 0.15 mg po every morning for a child with hypothyroidism who weighs 40 lb.
SDR: 4-5 mcg per kg per day po. a. Estimated weight in kg
b. Exact weight in kg to the nearest tenth
c. SDR for this child (to the nearest tenth of an mg)
d. Dose ordered
e. Evaluation and decision
f. Amount to be administered (if applicable)

Question 42

Ordered: Lidocaine HCL IV infusion 20 mcg per kg per min for a child with ventricular tachycardia who weighs 15 kg.
SDR: 20-50 mcg per kg per min.
Directions for dilution: Add 6 mg per kg of Lidocaine to a compatible solution to make a total of 100 mL.
Infusing when you arrive on duty: Lidocaine HCl IV at 20 mL per hr.
a. SDR in mcg per min, mcg per hr, and mg per hr
b. Ordered flow rate in mg per hr
c. Evaluation and decision: Is the order safe?
d. Ordered flow rate in mL per hr (to the nearest whole number) using the concentration of 6 mg per kg in 100 mL of solution
e. Evaluation and decision regarding existing flow rate

Question 43

Ordered: Potassium chloride 10 mEq to be added to an IV of D5W to make a total of 100 mL to be administered in a volume-control device over 1.25 hr for a child with hypokalemia who weighs 30 lb.
SDR: 0.5-1 mEq per kg per hr. Do not exceed 10 mEq per hr.
a. Estimated weight in kg
b. Exact weight in kg to the nearest tenth
c. SDR for this child
d. Dose ordered per hr
e. Evaluation and decision
f. Flow rate in mL per hr (if applicable)

Question 44

Ordered: Augmentin oral suspension 0.1 g qid po, for a 5-year-old child with tonsillitis who weighs 20 kg.
SDR: 20-40 mg per kg per day in 4 divided doses. a. SDR for this child
b. Evaluation and decision (state reason[s])
c. Estimate and calculate the dose if safe

Question 45

Ordered: Midazolam 1 mg IV injection stat for a child in status epilepticus who weighs 44 lb.
SDR: 0.05-0.1 mg per kg. Up to 0.6 mg per kg may be needed.
a. Estimated weight in kg
b. Exact weight in kg to the nearest tenth
c. SDR for this child
d. Ordered dose
e. Evaluation and decision