Deck 12: Childrens Dosages

Question 1

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?

Answer 1

a. 160 mg (5 mL) is recommended manufacturer dose for a 3-year-old child
b. Safe to give. 160 mg.
c. 5 mL in the dosing cup (1 metric teaspoon)

Question 2

Directions: Calculate the 24-hour dose in milligrams. Use a calculator to solve these problems.
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

Directions: Calculate the 24-hour dose in milligrams. Use a calculator to solve these problems.
Order: 0.5 g q12h
What is the 24-hour dose in milligrams?

Answer 3

1000 mg

Question 4

Directions: Calculate the 24-hour dose in milligrams. Use a calculator to solve these problems.
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 5

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 to 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 6

Ordered: Digoxin 50 mg IV for a child with congestive heart failure
SDR: 0.015 to 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 it the nurse hold, recalculate, and contact prescriber promptly?
c. If safe to give, how many mL will you prepare?

Question 7

Directions: Calculate the 24-hour dose in milligrams. Use a calculator to solve these problems.
Order: 100 mg PO daily
Child's weight: 20 kg
SDR for this child's weight: 25 mg per kg per day
Safe or hold?

Question 8

Ordered: Furosemide 30 mg q12hr for a child with congestive heart failure weighing 35 lb
SDR: 0.5 to 2 mg per kg per dose q6-12h Use a calculator. Enter the data twice for verification.
a. Estimated weight in kilograms
b. Exact weight in kilograms to the nearest tenth
c. SDR for this child to nearest tenth of a mg
d. Ordered dose
e. Evaluation and decision
f. Volume to be administered (if applicable)

Question 9

An IV of 250 mL of lactated Ringer 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 hour's worth of the ordered flow rate.
How many mL will the nurse place in the buretrol to the nearest mL?

Question 10

Order:10 mg per kg
Weight or body surface area (BSA): 35 kg
What is the dose in milligrams?

Question 11

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 hour'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 12

Directions: Calculate the 24-hour dose in milligrams. Use a calculator to solve these problems.
Order: 50 mg PO daily
Child's weight: 22 lb
SDR for this child's weight: 10 to 20 mg per kg per day
Safe or hold?

Question 13

Order: 0.25 g per kg
Weight or body surface area (BSA): 13.2 lb
What is the dose in milligrams?

Question 14

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 solution from an existing infusion. It will be infused at the recommended rate of 1 minute per mL.
a. How long will it take to deliver the infusion
b. What will the flow rate be in mL per hr?

Question 15

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

Question 16

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 17

Order: 500 mg per m²
Weight or body surface area (BSA): BSA 0.45 m²
What is the dose in milligrams?

Question 18

Directions: Calculate the 24-hour dose in milligrams. Use a calculator to solve these problems.
Order: 0.25 g q8h
What is the 24-hour dose in milligrams?

Question 19

Order: 20 units per m²
Weight or body surface area (BSA): BSA 0.55 m²
What is the dose in milligrams?

Question 20

Directions: Calculate the 24-hour dose in milligrams. Use a calculator to solve these problems.
Order: 200 mg PO daily
Child's weight: 15 kg
SDR for this child's weight: 5 to 10 mg per kg per dose
Safe or hold?

Question 21

Ordered: 800 mg Cefotaxime sodium (Claforan) IV q6h per volume control device to be administered over 30 minutes for a 57-pound child
SDR: 25 to 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 kilograms
b. Exact weight in kilograms to the nearest tenth
c. SDR for this child
d. Ordered dose for this child and total for day
e. Amount of drug in milliliters to be administered

Question 22

Ordered: Methotrexate sodium 0.25 g for child with lymphoma who weighs
80 lb and is 125 cm tall.
SDR: 200 to 500 mg per m² every 2 to 4 weeks for lymphoma
BSA formula for m²: $\sqrt{\frac{\text { Height in centimeters } \times \text { weight in kilograms }}{3600}}$ a. BSA for this child (calculate formula)
b. SDR for this child
c. Ordered dose
d. Evaluation and decision

Question 23

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 to 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 24

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

Question 25

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

Question 26

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 body surface area (BSA): 0.6 m²
a. SDR for this child
b. Ordered dose
c. Evaluation and decision

Question 27

Ordered: Lidocaine HCL IV infusion 20 mcg per kg per min for a child with ventricular tachycardia who weighs 15 kg
SDR: 20 to 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 28

Ordered: Augmentin oral suspension 0.1 gram qid po, for a 5 year-old child with tonsillitis who weighs 20 kg
SDR: 20 to 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.