Deck 7: Pediatrics

Question 1

A child has a respiratory infection. , Order: cefixime (Suprax) 80 mg, PO, q12h , Child's weight: 44 lb, or 20 kg , Pediatric dose parameter: 8 mg/kg/day in a single dose or two divided doses , Drug available: Suprax 100 mg/5 mL oral suspension
a. Is the dose within safe dose parameters? Explain.
b. How many milliliters of Suprax would you give per dose?

Answer 1

a. Yes. The dose is 80 mg x2/day (q12h) = 160 mg/day, and parameter is 8 mg/kg/day x 20 kg = 160 mg/day, or the same.
b. 4 mL of Suprax per dose

Question 2

A small child has an ear infection. , Order: amoxicillin (Amoxil) 75 mg, PO, q8h , Child's weight: 70 lb, or 32 kg , Pediatric dose parameter: 20 to 40 mg/kg/day in three divided doses , Drug available:
a. How many milligrams of amoxicillin would the child receive per day?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters of Amoxil would you give per dose?

Answer 2

a. 75 mg x 3 doses (q8h) = 225 mg/day
b. Not safe, the dose (20 mg/kg/day x 32 kg = 640 mg/day) is less than the parameter (40 mg/kg/day x32 kg = 1280 mg/day) and is subtherapeutic.
c. 3 mL of Amoxil per dose. The nurse may want to check with the physician to see whether this dose is adequate. RP: 125 mg : 5 mL = 75 mg : x mL, 375/125 = 3 mL

Question 3

A child has a staph infection. , Order: clindamycin 150 mg, PO, q6h , Child's weight: 40 lb, or 18 kg , Pediatric dose parameter: 8 to 25 mg/kg/day in three or four divided doses , Drug available: clindamycin 75 mg/mL oral solution
a. How many milligrams of clindamycin would the child receive per day?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters of clindamycin would you give per dose?

Answer 3

a. 150 mgx4/day (q6h) = 600 mg/day
b. No. The clindamycin dose (600 mg/day) exceeds the safe dose parameters (8 mg/kg/day x18 kg = 144 mg/day to 25 mg/kg/day x 18 kg = 450 mg/day). Drug dose per day is unsafe.
c. Do not give; notify the physician at once.

Question 4

A child has otitis media. , Order: cefaclor (Ceclor) 0.25 g, PO, q8h , Child's weight: 66 lb , Pediatric dose parameter: 20 to 40 mg/kg/day in three divided doses; maximum: 1 g/day , Drug available: Ceclor 250 mg/5 mL
a. How many kilograms does the child weigh?
b. How many milligrams would the child receive per day?
c. Is the dose within safe dose parameters? Explain.
d. How many milliliters of Ceclor would you give per dose?

Question 5

A child has otitis media. , Order: cefaclor (Ceclor) 100 mg, PO, q8h , Child's weight: 30 lb , Pediatric dose parameter: 20 to 40 mg/kg/day in three divided doses , Drug available:
a. How many kilograms does the child weigh?
b. How many milligrams would the child receive per day?
c. Is the dose within safe dose parameters? Explain.
d. How many milliliters of Ceclor would you give per dose?

Question 6

A child has a strep infection. , Order: Penicillin V 100 mg, PO, q6h , Child's weight: 14 kg , Pediatric dose parameter: 15 to 50 mg/kg/day in three to six divided doses , Drug available:
a. How many milligrams would the child receive per day?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters would you give the child per dose?

Question 7

A child has seizures. , Order: phenytoin (Dilantin) 50 mg, PO, bid , Child's weight: 16 kg , Pediatric dose parameter: 3 to 8 mg/kg/day , Drugs available: Dilantin 30 mg/5 mL and Dilantin 100 mg/5 mL
a. How many milligrams would the child receive per day?
b. What is the dose parameter according to the child's weight?
c. Is the dose within safe dose parameters?
d. How many milliliters would you give the child per dose?

Question 8

A child has seizures. , Order: phenytoin (Dilantin) 125 mg, PO, daily , Child's height and weight: 36 in, 45 lb , Pediatric dose parameter: 250 mg/m²/day maximum , Drugs available: Dilantin 30 mg/5 mL and 100 mg/5 mL
a. What is the child's body surface area (BSA) in meters squared (m²)? (Use nomogram to determine BSA.)
b. What is the dose parameter according to the child's BSA?
c. Is the dose within safe dose parameters? Explain.
d. Which bottle of Dilantin would you use?
e. How many milliliters would you give the child per day?

Question 9

A child has a respiratory infection. , Order: cefadroxil (Duricef) 400 mg, PO, q12h , Child's weight: 32 kg , Pediatric dose parameter: maximum 30 mg/kg/day in two divided doses , Drugs available:
a. What is the dose parameter according to the child's weight?
b. Is the dose within safe dose parameters? Explain.
c. Which bottle of Duricef would you use?
d. How many milliliters would you give the child per dose?

Question 10

A child has a systemic infection. , Order: ampicillin 150 mg, PO, q6h , Child's weight: 12 kg , Pediatric dose parameter: 50 to 100 mg/kg/day in four divided doses , Drug available:
a. How many milligrams of ampicillin would the child receive per day?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters would you give the child per dose?

Question 11

A child has a lower respiratory infection. , Order: loracarbef (Lorabid) 250 mg, PO, q12h , Child's weight: 66 lb (30 kg) , Pediatric dose parameters: 15 to 30 mg/kg/day divided into two doses taken 1 hour ac or 2 hours pc , Drugs available:
a. What is the dose parameter according to the child's weight?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters would you give the child per dose?

Question 12

A child (12 years old) has hypertension. , Order: methyldopa (Aldomet) 250 mg, PO, bid , Child's weight: 110 lb , Pediatric dose parameter: 10 mg/kg/day in two to four divided doses , Drug available:
a. How many kilograms does the child weigh?
b. How many milligrams would the child receive per day?
c. Is the dose within safe dose parameters? Explain.
d. How many milliliters of Aldomet would you give the child per dose?

Question 13

A child has pain. , Order: codeine 0.25 g, PO, q4 to 6h, prn , Child's height and weight: 42 in, 50 lb , Pediatric dose parameter: 100 mg/m²/day , Drug available: codeine 15 mg tablets
a. What is the child's BSA (m²)? (Use nomogram.)
b. What is the dose parameter according to the child's BSA? (Convert grams to milligrams.)
c. Is the dose within safe dose parameters? Explain.
d. How many tablets would you give the child per dose?

Question 14

Infant (2 months old) has congestive heart failure. , Order: digoxin (Lanoxin); initially: 0.1 mg, PO, q8h x 3 doses , Child's weight: 8 lb , Pediatric dose: Child 1 month to 2 years old: 0.035 to 0.06 mg/kg/day in three divided doses for 24 hours , Drug available: Lanoxin 50 mcg (0.05 mg)/mL elixir
a. What is the dose parameter according to the infant's weight?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters would you give the child per dose?

Question 15

A child has a streptococcal infection. , Order: lincomycin 0.5 g, PO, q8h , Child's weight: 88 lb , Pediatric dose parameters: 30 to 60 mg/kg in three to four divided doses , Drug available: lincomycin 500 mg tablets
a. How many kilograms does the child weigh?
b. What is the dose parameter according to the child's weight?
c. Is the dose within safe dose parameters? Explain.
d. How many tablets should the child receive per dose?

Question 16

A child has a urinary tract infection. , Order: sulfisoxazole (Gantrisin) 300 mg, PO, q6h , Child's weight: 33 lb , Pediatric dose parameter: 120 to 150 mg/kg/day; maximum: 6 g/day , Drug available: Gantrisin 500 mg/5 mL
a. How many kilograms does the child weigh?
b. What is the dose parameter according to the child's weight?
c. Is the dose within safe dose parameters? Explain.
d. How many milliliters would you give the child per dose?

Question 17

A child has a urinary tract infection. , Order: sulfisoxazole (Gantrisin) 0.75 g, PO, q6h , Child's height and weight: 56 in, 75 lb , Pediatric dose parameter: Up to 4 g/m² in four divided doses , Drug available: Gantrisin 500 mg/5 mL
a. What is the child's BSA (m²)? (Use nomogram.)
b. What is the dose parameter according to the child's BSA?
c. Is the dose within safe dose parameters? Explain.
d. How many milliliters of Gantrisin would you give the child per dose?

Question 18

A child has a urinary tract infection. , Order: trimethoprim (TMP)/sulfamethoxazole (SMZ) (Septra) 60/300 mg, PO, q12h , Child's weight: 15 kg , Pediatric dose: TMP 8 mg/SMZ 40 mg/kg/day in two divided doses , Drug available: TMP 40 mg/SMZ 200 mg/5 mL
a. What is the dose parameter according to the child's weight?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters would you give the child per dose?

Question 19

A child has a respiratory infection. , Order: amoxicillin/clavulanate (Augmentin) 0.25 g, PO, q8h , Child's weight: 60 lb , Pediatric dose parameter: 20 to 40 mg/kg/day in three divided doses , Drug available: Augmentin 250 mg/5 mL
a. How many kilograms does the child weigh?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters of Augmentin would you give the child per dose?

Question 20

A child has cancer. , Order: chlorambucil (Leukeran) 4.5 mg/m² per single dose , Child's height and weight: 58 in, 92 lb , Pediatric dose parameter: See order , Drug available: Leukeran 2 mg tablets
a. What is the child's BSA (m²)? (Use nomogram.)
b. Is the dose within safe dose parameters? Explain.
c. How many tablets would you give the child?

Question 21

A child has pruritus. , Order: diphenhydramine (Benadryl) 25 mg, PO, q6h , Child's weight: 22 lb , Pediatric dose parameter: 5 mg/kg/day , Drug available: Benadryl 12.5 mg/5 mL
a. How many kilograms does the child weigh?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters would you give per dose?

Question 22

A child (3 years old) has a fever. , Order: acetaminophen (Tylenol) 120 mg, PO, q4h x 4 doses/day, prn for temperature greater than 102° F , Child's weight: 15 kg , Pediatric dose: 120 to 160 mg tid, qid; maximum: 480 mg/day , Drug available:
a. Is the dose within safe dose parameters? Explain.
b. How many milliliters of Tylenol would you give per dose?

Question 23

A child has a Varicella zoster infection. , Order: acyclovir (Zovirax) 400 mg, PO, q8h, x 7 days , Child's height and weight: 46 in, 55 lb , Pediatric dose parameter: 500 mg/m² maximum dose, q8h , Drug available:
a. What is the child's BSA (m²)? (Use nomogram.)
b. What is the dose parameter according to the child's BSA?
c. Is the dose within safe dose parameters? Explain.
d. How many milliliters would you give the child per dose?

Question 24

A child has seizures. , Order: ethosuximide (Zarontin) 125 mg, PO, bid , Child's weight: 24 kg , Pediatric dose parameter: 20 mg/kg/day; maximum: 1.5 g/day , Drug available: Zarontin 250 mg/5 mL
a. Is the dose within safe dose parameters? Explain.
b. How many milliliters of Zarontin would you give per dose?

Question 25

A child has attention deficit hyperactivity disorder (ADHD). , Order: methylphenidate HCl (Ritalin) 7.5 mg, PO, daily in AM , Drugs available: Ritalin 5 mg and 10 mg tablets
a. Which bottle of Ritalin would you use?
b. How many tablets would you give?

Question 26

A child has ADHD. , Order: methylphenidate HCl (Ritalin) 15 mg, PO, daily , Drugs available: Ritalin 5 mg and 10 mg tablets
a. Which bottle of Ritalin would you use?
b. How many tablets would you give?

Question 27

A child has a systemic infection. , Order: tobramycin (Nebcin) 15 mg, IV, q6h , Child's weight: 12 kg , Pediatric dose parameter: 6 to 7.5 mg/kg/day in three or four divided doses , Drug available:
a. How many milligrams of Nebcin would the child receive per day?
b. What is the dose parameter according to the child's weight?
c. Is the dose within safe dose parameters? Explain.
d. How many milliliters (IV) of Nebcin would be mixed into the IV fluids?

Question 28

A child has a severe respiratory infection. , Order: kanamycin (Kantrex) 50 mg, IV, q8h , Child's weight: 44 lb , Pediatric dose parameter: 15 mg/kg/day in two or three divided doses , Drug available:
a. How many kilograms does the child weigh?
b. What is the dose parameter according to the child's weight?
c. Is the dose within safe dose parameters? Explain.
d. How many milliliters (IV) of drug would be mixed into the IV fluids?

Question 29

A child has congestive heart failure. , Order: digoxin (Lanoxin) 0.25 mg, IV, loading dose (LD) , Child's weight: 35 lb, or 16 kg , Pediatric dose parameter: 0.015 to 0.035 mg/kg over 5 min, LD , Drug available:
a. What is the dose parameter according to the child's weight?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters of Lanoxin would you give the child?

Question 30

A child has a systemic infection. , Order: oxacillin 200 mg, IV, q6h , Child's weight: 13 kg , Pediatric dose parameter: 50 to 100 mg/kg/day in four to six divided doses , Drug available: 250 mg/1.5 mL after reconstitution
a. What is the dose parameter according to the child's weight?
b. Is the dose within safe dose parameters? Explain.
c. How many milliliters of diluent would you mix with oxacillin?
d. How many milliliters (IV) of oxacillin would be mixed into the IV fluids?

Question 31

A child has narcotic-induced respiratory depression. , Order: naloxone HCl (Narcan) 0.32 mg, IM, stat. , Child's weight: 32 kg , Pediatric dose parameter: 0.01 mg/kg, IM/IV, q2 to 3 min, prn , Drug available:
a. What is the dose parameter?
b. How many milliliters of Narcan would you give the child?

Question 32

A child has postoperative vomiting. , Order: ondansetron 0.15 mg/kg/dose in 50 mL of D₅W over 30 minutesPatient weight: 47 lb , Drug available: Ondansetron 40 mg/20 mL multiple dose vial
a. How many kilograms does the patient weigh?
b. What is the total dose of ondansetron?
c. How many milliliters should you add to the D₅W?

Question 33

, Order: clofarabine 63 mg in 250 mL D₅W over 2 hours , Child's height and weight: 4 ft 6 in and 86 lb , Pediatric dose parameter: 52 mg/m² with range of 11.25 mg/m² to 70 mg/m² per day , Drug available: clofarabine 20 mg in 20 mL for injection
a. What is the child's BSA (m²)?
b. What is the dose according to the child's BSA?
c. Is the dose with in safe dose parameters? Explain.
d. How many milliliters would you give per dose?

Question 34

A child has HIV. , Order: atovaquone (Mepron) 300 mg PO daily with meal , Child's age and weight: 18 months old and 22 lb , Pediatric dose parameter: 30 mg/kg with a range of 10 to 40 mg/kg , Drug available: Mepron suspension 750 mg in 5 mL.
a. What is the child's weight in kilograms?
b. What is the dose?
c. Is the dosage within safe dosage parameters? Explain.
d. How many milliliters would you give per dose?

Question 35

A child has HIV. , Order: fosamprenavir (Lexiva) 500 mg PO bid , Child's age and weight: 3 years old and 34 lbPediatric dosage parameter: Daily dose not to exceed 1400 mg/day , Drug available: fosamprenavir suspension 50 mg/mL
a. How many milliliters of fosamprenavir should be given per dose?
b. Is the total drug dosage within safe parameters? Explain.

Question 36

A child has appendicitis. , Order: piperacillin and tazobactam (Zosyn) 3.6 g/450 mg IV q8h, dilute in 50 mL and infuse over 30 minutes , Child's age and weight: 8 years old and 36 kg , Pediatric dose parameter: 100 mg/kg , Drug available: Zosyn 4 g/500 mg reconstitute with 20 mL sterile water.
a. Is the drug dosage correct? Calculate dosage based upon piperacillin only.
b. How many mL of Zosyn should be given per dose?
c. What will be the total amount of fluid to be infused?

Question 37

A child 10 years old had surgery; nausea and vomiting has occurred because of narcotics used for pain. , Order: ondansetron (Zofran) 2 mg, po, 30 minutes before narcotic administration, q8h, prn , Drug available: How many milliliters should the child receive 30 minutes before the administration of the narcotic?

Question 38

A child has a serious fungal infection. , Order: fluconazole (Diflucan) 100 mg PO, per day for 10 days , Child's weight, age: 55 lb; 7 years old , Pediatric dose: 6 to 12 mg/kg/day , Drug available:
a. How many kilograms does the child weigh?
b. Is the total drug dosage within safe parameters? Explain.
c. How many milliliters should the child receive per dose?