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NUR 263 Medication Module Objectives
At the end of this unit, the student should be able to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Convert pounds to kilograms.
Read medication label and be able to determine appropriate amount of
medication to withdraw to achieve patient correct dosage
Calculate the recommended safe dosage (RSD) of medications
Recognize if the drug is safe to administer by comparing the RSD to the
ordered dose.
Calculate the safe dosage using kilograms of body weight.
Calculate the amount of drug to be administered.
Interpret information on a drug label.
Question whether to administer or withhold a medication due to unsafe
dosage, and notify the nursing instructor or appropriate nursing personnel.
Accurately read a syringe.
Learning Activities:
Required:
Complete the attached Drug Calculation Practice Tests
Review Chapters 6 and 12 in the Nursing 131 textbook: Medical Dosage
Calculations
1
DIRECTIONS FOR CALCULATING DRUG DOSAGES
RULES:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Know your conversions- example (How many pounds are there in one
kilogram, teaspoons in a tablespoon, etc?)
Round all Kg weights and lb weight to hundredths.
Round your answers to the nearest hundredth (100th) for medication
calculation
Show all work when calculating drug dosage.
Label all answers.
Always know if the drug is safe/unsafe before giving the drug. If unsafe let
your instructor know in pre-conference
Keep a calculator in your pocket at all times
Always know why your patient is getting the drug.
Study the drug labels and practice tests in your Learning Packet, as well
as your drug calculation text from NUR 131.
Always be prepared with your medications and DO NOT give a drug
without the knowledge of the instructor
KNOW COMMON CONVERSIONS:
1 teaspoon = 5ml
3 teaspoons = 1 tablespoon
30 ml = 1 ounce
1000 mcg = 1 mg
1000 mg = 1 Gm
1 kg = 2.2 lbs
1 inch = 2.5 cm
2
DIRECTIONS FOR CALCULATION OF PEDIATRIC MEDICATIONS
Purpose:
To verify if the doctors order is safe to give
A. Determining RSD by patient’s age- Least accurate criterion.
Step 1:
Determine age of the child
Step 2:
Look up medication and determine the recommended safe pediatric
dose for that age group.
Step 3:
Compare dosage recommended for that age group with the
doctor’s order
If recommended safe dosage (RSD) is equal to or exceeds doctor’s
order= safe to give. If doctor’s order exceeds RSD = unsafe to
give.
Step 4:
Example:
Step 1:
Dimetapp 1 tsp by mouth four times a day for a patient that is 1
year old
Step 2:
PDR states that recommended safe dosage is:
Dimetapp elixir (7 mos-2 years) = ½ tsp 4 times a day.
Step 3:
Order: 1 tsp four times a day
RSD: ½ tsp
Step 4:
Doctor’s order exceeds RSD; therefore, ordered dose is unsafe
B. Using the patient’s weight to determine dosage.
-- Most pediatric medication dosages are recommended according
to the patient’s weight in kilograms (kg).
Step 1:
Determine the weight of the child.
Step 2:
Look up medication to determine the safe recommended dosage
for your patient’s weight.
Step 3:
Convert pounds to kilograms if necessary.
Step 4:
If RSD is equal to or exceed doctor’s order, then safe to give.
If doctor’s order exceeds the RSD, then the medication is unsafe to
give.
3
Example:
Step 1:
Novahistine Elixir ½ tsp by mouth four times a day for an infant
weighing 8 kg
Step 2:
PDR states the recommended safe dosage for Novahistine elixir is
½ tsp four times a day for infants and children weighing less than
15 kg.
Step 4;
Order: ½ tsp four times a day
RSD: ½ tsp four times a day
Safe to give
Drug Calculations:
1.
2.
3.
Determining recommended safe dose (RSD)
Converting lbs/ounces to Kg
Reading drug labels
Converting lbs and ounces to Kg: Round to the nearest hundredth
1.
2.
3.
1 kg = 2.2 lbs
Child weighs 22 lbs; divide by 2.2 to get the number of kg (= 10 kg)
Child weighs 14 lbs 4 oz; change ounces to lbs first by dividing 4 oz by
16 oz, then divide the whole weight by 2.2. For example, 14 lbs 4 oz =
14.25 lbs divided by 2.2 = 6.48 kg
Determining Recommended Safe Dosage (RSD)
1.
2.
In pediatrics, there is usually not a common safe dose strictly based on
age as is for adults.
The RSD must be determined for pediatric patients and compared to
the patient’s medication order to determine if the drug is safe to give.
Determining RSD Step by Step:
1.
Look up the medication to determine what the recommended pediatric
or adult dosage. You must also know why the patient is getting the
medication; because the RSD is different for different illnesses.
2.
(Example is 10 mg/kg/day)
Determine the patient’s weight in Kg by dividing by 2.2. Example is 16
lbs = 7.27 kg. Always round to the nearest hundredth.
3.
10 mg X 7.27 Kg = 72.7 mg/day
Kg/day
1
4
Comparison of Physician’s Order to the RSD
1.
When comparing the order to the RSD, make sure that the labels are
same measurement and the same time period, such as: mgs/day;
mgs every 6 hours; and mg’s four times a day
2.
If the RSD is equal to or greater than ordered dose, safe to give.
3.
If the RSD is less than the ordered dose, unsafe to give.
5
Reading Drug Labels
1.
2.
Essential for safely being able to determine the amount of drug to
withdraw from the bottle, vial, or ampule.
Essential for determining how much to reconstitute a medication
(powder to liquid)
What to Look for When Reading Drug Labels?
1.
Follow the 6 R’s:
a. Correct Route
b. Correct Drug – Can ordered dose be obtained from the bottle
c. Correct Dose – If the drug does not need to be reconstituted,
concentration or drug strength should be clearly indicated on the
label.
d. Correct patient
e. Correct time
f. Correct documentation
6
2.
Next, determine if the drug needs to be reconstituted. If the drug
comes in the form of a powder, you need to read the label to determine
the amount and type of diluent to mix to get the correct concentration.
(Diluents usually are Normal Saline and Sterile Water if given
parentally. If given orally, may use non-sterile water, unless the age is
infancy).
3.
Once the drug has been mixed, determine the concentration (drug
strength). (Example is 250 mg/5 ml)
4.
Then, multiply the order times the concentration of the drug.
Example: Ordered: 150 mg
Concentration is 250 mg/5 ml
150 mg X _5 ml__
1
250 mg
= 3 ml
Therefore, you will withdraw 3 ml out of the bottle.
Reading Drug Labels: Sample Problems
1.
The physician orders: Ceclor 220 mg by mouth every 8 hours. Using
the label below, how many ml’s will you give? (This is always based on
the ordered amount.)
2.
Concentration is 187 mg/ 5 ml.
3.
220 mg X 5 ml
= 5.88 ml
1
187 mg
100ml Bottle
CECLOR
CEFACLOR
FOR ORAL
SUSPENSION, USP
187 MG per 5 ml
7
1.
Order is Tegopen 175 mg by mouth every 6 hours. Using the label
below, how many ml’s will you give? (This is always based on the
ordered amount.)
2.
Concentration is 125 mg/5 ml
3.
175 mg
1
X
5 ml
125 mg
= 7 mls
100 ml Bottle
TEGOPEN
CLOXACILLIN SODIUM
FOR ORAL SOLUTION
EQUIVALENT TO
125 MG PER 5 ML
CLOXACILLIN
8
MIDLANDS TECHNICAL COLLEGE
NURSING PROGRAM
NURSING 263 - NURSING ACROSS THE LIFESPAN II
Drug Calculation Practice Test #1
ROUND OFF ANSWERS TO THE NEAREST HUNDRETH. LABEL ALL
ANSWERS. MUST SHOW WORK!
1.
Your patient is ordered the following on the MAR: Nafcillin 850 mg IV
every 8 hours. Using the label below, how many ml’s will you administer?
nafcilNAFCILLIN
SODIUM FOR INJECTION
EQUIVALENT TO
2.0 GM. Nafcillin
For IM or IV Use
When reconstituted with 6.6
ml Sterile Water for
injection, each vial contains
8 ml solution. Each ml of
solution contains nafcillin
sodium as the monohydrate
equivalent to 250 mg sodium
citrate.
ANS: _________________
2. The pediatrician orders Acetaminophen 2 ml by mouth every 4 – 6 hours
PRN for pain. Using the label below, how many mg’s will you administer
with each dose?
CHERRY FLAVORED SYRUP
TEMPRA
ACETAMINOPHEN
ANALGESIC
4 FL. OZ.
Each teaspoonful (5 ml) of
TEMPRA syrup contains
120 mg of acetaminophen
in 10% alcohol with a
delicious, naturallysweetened cherry flavor.
ANS: ________________
9
3.
Your pediatric patient has the following order on the MAR: Solumedrol
31.3 mg IM every 8 hours. The vial contains 80 mg/ 2 ml. How many ml's
will you give?
ANS: ________________
4.
Using the syringe below, indicate how many units of insulin are in the
syringe?
ANS: _________________
5.
A child weighing 32.4 lbs is receiving Digoxin 0.28 mg by mouth every 12
hours. Recommended safe dosage for Digoxin is 20 mcg/Kg/day. What
is the recommended safe dose in mgs of Digoxin that this child can
receive every 12 hours? Is this safe to give?
ANS: __________________
ANS: __________________
10
6.
The nurse practitioner orders for your patient to receive Augmentin 180
mg by mouth every 8 hours. Using the label below calculate how many
ml’s you will administer with each dose.
Directions for mixing: Tap
bottle until all powder flows
freely. Add approximately 1
teaspoon (5ml) of water. Shake
vigorously. When
reconstituted, each 5 ml will
contain 250 mg amoxicillin as
trihydrate and 62.5 mg
clavulanic acid as clavulanate
250mg/5ml
AUGMENTIN
AMOXICILLIN/CLAVULANATE
POTASSIUM
FOR ORAL SUSPENSION
1 X 5 ml (when reconstituted)
potassium.
ANS: __________________
7.
Your pediatric patient is in pain so you check the MAR to find what is
ordered. You find an order for Ibuprofen ½ tsp (120 mg/5 ml) by mouth
every 4 to 6 hours PRN for pain. On hand is Ibuprofen 40 mg/0.4 ml.
How many ml’s will you give?
ANS: ________________
8.
Amoxicillin oral suspension 400 mg by mouth every 12 hours is ordered
for a child weighing 43 lbs. The recommended safe dosage for Amoxicillin
is 50 mg/kg/day. What is the recommended safe daily dosage? Is the
ordered dose safe to give?
ANS: ___________
ANS: ___________
11
9.
The physician orders for your patient to receive Streptomycin 950 mg IM
now. Using the label below, how many ml’s will you add to the vial of
powder? How many ml’s will you give?
Add 9.0 ml of
diluent to vial to
give a final
concentration of
400 mg/ml
Streptomycin sulfate
Equivalent to 5.0 g of Streptomycin
Base
5.0 g
ANS: ______________
ANS: ______________
10.
The pediatrician orders Fer-in-sol drops 25 mg by mouth daily. Using the
label below, how many mls will you give?
DROPS
FER-IN-SOL
Iron supplement
For infants and children
under 4 years of age
1 ½ fl. oz. (50 ml)
15 mg/0.6 ml
ANS: ________________
12
MIDLANDS TECHNICAL COLLEGE
NURSING PROGRAM
NURSING 263 - NURSING ACROSS THE LIFESPAN II
Drug Calculation Practice Test #1 (Answers)
1.
Your patient is ordered the following on the MAR: Nafcillin 850 mg IM
every 8 hours. Using the label below, how many ml’s will you administer?
850 mg x 1 ml
250 mg
= 3.4 ml
ANS: 3.4 ml
2.
The pediatrician orders Acetaminophen 2 ml by mouth every 4 – 6 hours
PRN for pain. Using the label below, how many mg’s will you administer
with each dose?
2ml x 120 mg
5 ml
= 48 mg
ANS: 48 mg
3.
Your pediatric patient has the following order on the MAR: Solumedrol
31.3 mg IM every 8 hours. The vial contains 80 mg/ 2 ml. How many ml's
will you give?
31.3 mg x
2 ml =
80 mg
0.78 ml
ANS: 0.78 ml
13
4.
Using the syringe below indicate how many units of insulin are in the
syringe?
ANS: 28 units
5.
A child weighing 32.4 lbs is receiving Digoxin 0.28 mg by mouth every 12
hours. Recommended safe dosage for Digoxin is 20 mcg/kg/day. What is
the recommended safe dose in mgs of Digoxin that this child can receive
every 12 hours? Is the ordered dose safe?
32.4 lb x
1kg = 14.73 kg
2.2 lbs
20 mcg x 14.73 kg x 1mg
= 0.29 mg/day ÷ 2 = 0.145 mg or
kg/day
1
1000mcg
0.15 mg
RSD: 0.15 mg every 12 hours
Order: 0.28 mg every 12 hours, therefore not safe
ANS: 0.15 mg every 12 hours
ANS: No, Unsafe
6.
The nurse practitioner orders for your patient to receive Augmentin 180
mg by mouth every 8 hours. Using the label below calculate how many
ml’s you will administer with each dose.
180 mg x
5 ml
250 mg
= 3.6 ml
ANS:
3.6 ml__
14
7.
Your pediatric patient is in pain so you check the MAR to find what is
ordered. You find an order for Ibuprofen ½ tsp (120 mg/5 ml) by mouth
every 4 to 6 hours PRN for pain. On hand is Ibuprofen 40 mg/0.4 ml.
How many ml’s will you give?
½ tsp x 5 ml x 120 mg x 0.4ml
1 tsp
5 ml
40mg
= 0.6 ml
ANS:
8.
0.6 ml___
Amoxicillin oral suspension 400 mg by mouth every 12 hours is ordered
for a child weighing 43 lbs. The recommended safe dosage for Amoxicillin
is 50 mg/kg/day. What is the recommended safe daily dosage? Is the
ordered dose safe to give?
43 lbs x
RSD:
1kg
=
2.2 lbs
50 mg
kg/day
19.55 kg
x 19.55 kg =
977.5 mg/day
Order: 400 mg x 2 doses = 800 mg/day
Day
Order
RSD
800 mg/day < 977.5 mg/day , therefore safe
ANS: 977.5 mg/day
ANS: Yes, safe___
9.
The physician orders for your patient to receive Streptomycin 950 mg IM
now. Using the label below, how many ml’s will you add to the vial of
powder? How many ml’s will you give?
950 mg x
ml
=
400 mg
2.375 ml or 2.38 ml
ANS:
9 ml___
ANS:
2.38 ml_
15
10.
The pediatrician orders Fer-in-sol drops 25 mg by mouth daily. Using the
label below, how many mls will you give?
25 mg x
0.6 ml = 0.999 ml or 1 ml
15 mg
16
MIDLANDS TECHNICAL COLLEGE
ASSOCIATE DEGREE NURSING PROGRAM
NURSING 263 – NURSING ACROSS THE LIFE SPAN II
Drug Calculation Practice Test #2
ROUND ALL ANSWERS OFF TO THE NEAREST HUNDRETH!
ANSWERS. MUST SHOW ALL WORK.
1.
LABEL ALL
Your patient’s MAR has the following order: Motrin Elixer 6.2 ml PO every
6 hours PRN for pain. On hand is Motrin 100 mg / ½ tsp. How many mgs
of Motrin will your patient receive with each dose of 6.2 ml? Your patient
weighs 27 kg and the maximum recommended safe dosage is 10
mg/kg/dose. Is the order dose safe to give?
ANS: _________________
ANS: _______________
2.
The physician orders Amoxicillin 75 mg PO every 12 hours. The
recommended safe dose is 50 mg/kg/day. Child weighs 22 lbs 10 oz.
Calculate the recommended safe dosage per day? Is the ordered dose
safe to give?
ANS: ________________
ANS: _______________
17
3.
It is time for your patient to receive his antibiotic. You check the MAR and
it has the following order written: Erythromycin ¼ tsp (400 mg/5 ml) PO
every 6 hours. On hand is Erythromycin 250 mg/5 ml. How many ml's will
you give?
ANS: ________________
4.
A child weighing 45 lbs has orders for Ibuprofen Elixir PO for temperature
> 101°F. The directions for recommended safe dosage appear on the
label as follows:
Children (20-27 kg)..........................180 mg every 6 hours
Children (28-35 kg)..........................240 mg every 6 hours
What is the recommended safe daily dosage of Ibuprofen for this child?
ANS: ________________
5.
Your patient is ordered to receive Amoxicillin oral suspension 78 mg every
8 hours. Using the label below, how many ml’s will you give?
100 ml Bottle
Polymox
AMOXICILLIN FOR
ORAL SUSPENSION
EQUIVALENT TO
125 mg
Per 5 ml. Amoxicillin
ANS: ________________
18
6.
Your patient is complaining of nausea. You check the MAR and find the
following order: Compazine 1.3 mg IM every 6 hours PRN for nausea and
vomiting. Using the label below, how many ml’s will you give?
Each ml contains, in aqueous
solution, prochlorperazine, 5
mg, as the edisylate; sodium
biphosphate, 5 mg; sodium
tartrate, 12 mg; sodium
saccharin, 0.9 mg.
For deep IM or IV injection
Compazine 10ml
Multiple dose vial
Injection
5 mg/ml
ANS: _________________
7.
The pediatrician orders for your patient to receive Actifed Syrup 2.6 ml PO
every 6 hours. Using the label below, how many mgs of pseudoephedrine
hydrochloride is the child receiving per dose?
4 fl. Oz
ACTIFED
SYRUP
Each 5 ml (1 teaspoonful) contains:
Actidil brand Triprolidine
Hydrochloride ---------------------1.25 mg
Sudafed brand Pseudoephedrine
Hydrochloride --------------------- 30 mg
PRESERVATIVES: Sodium benzoate ---0.1%
Methylparaben ------0.1%
ANS: ________________
19
8.
You are working in the ED and the physician gives you a verbal order for
Atropine 0.26 mg Subcutaneously. Using the label below, how many ml’s
will you administer?
20 ML
ATROPINE
SULFATE
INJECTION, U.S.P.
4 mg/5 ml
ANS: _________________
9.
The physician orders 50 mcg IM stat of epinephrine. The child weighs 26
lbs 2 oz and the recommended dose is 0.001 milligram per kilogram. Is
this a safe dose for this child?
ANS: ______________
10.
The pediatrician orders Erythromycin drops 58 mg PO every 6 hours.
Using the label below, how many ml will you administer? Your patient
weighs 10 lbs. The recommended safe dosage for Erythromycin is 50
mg/kg/day divided every 6 hours. Is the ordered dose safe to give?
60 ml for Oral Suspension
(When mixed)
EryPed Drops
ERYTHROMYCIN
ETHYLSUCCINATE FOR
ORAL SUSPENSION, USP
100 mg per 2.5 ml
(dropperful)
ANS: ______________
ANS: _______________
20
11
Your 9-year-old patient is in pain following his tonsillectomy. You check
the MAR and find the following order: Codeine (15 mg/5 ml) 3.5 ml PO
every 6 hours as needed for pain. You remove the medication from the
medication pyxis and see a bottle of codeine with the label below. How
many mg’s of Codeine Phosphate is the child ordered per dose? The
maximum recommended safe dosage of codeine is 60 mg/day for children
6 – 12 years of age. Is the ordered dose safe to give?
500 ml
CODEINE
Phosphate
Oral Solution
15 mg per 5 ml
Each 5 ml contains: Codeine Phosphate 15 mg.
ALCOHOL AND SUGAR FREE FORMULA
ANS: _________________
ANS: _________________
12.
It is time for you to give your patient her antibiotic. The medication ordered
is Rocephin 370 mg IM every 24 hours. On hand is a vial with 500 mg of
Rocephin. The directions on the bottle state to add 1.8 ml of sterile water
to the vial to make a total of 2 ml and a concentration of 250 mg/ml. How
many ml's will you administer per dose?
ANS: _________________
13.
Amoxicillin oral suspension 220 mg PO every 12 hours is ordered for a
child weighing 43 lbs 4 oz. The recommended safe dosage for Amoxicillin
is 50 mg/kg/day. What is the recommended safe daily dosage for this
patient? Is the ordered dose safe to give?
ANS: _________________
ANS: _________________
21
14.
Your patient’s MAR has the following: Gentamicin 24.7 mg IV every 8
hours. The recommended safe dosage for Gentamicin is 7.5 mg/Kg/day
in 3 – 4 divided doses. Your patient weighs 22 lbs 5 oz. What is the
recommended safe daily dose for this patient? Is the ordered dose safe to
give?
ANS: _________________
ANS: _________________
15.
The pediatrician orders Penicillin G Benzathine 50,000 units/kg IM as a
single dose. Your patient weighs 17 lbs 6 oz. The medication strength is
600,000 units per ml. How many ml’s will you administer?
ANS: _________________
16.
Your patient is in pain. You check the MAR and find the following order:
Morphine 8 mg IV every 4 hours as needed. Using the label below, how
many ml’s will you administer?
20 ml
MORPHINE
SULFATE INJECTION, USP
15 mg/ml
FOR SUBCUTANEOUS, INTRAMUSCULAR
OR SLOW INTRAVENOUS USE
NOT FOR EPIDURAL OR INTRATHECAL USE
ANS: _________________
22
17.
The pediatrician writes an order for Cefaclor 23 mg/kg PO three times a
day. The child weighs 12 lbs 9 oz. Using the label below, how many
milliliters of this antibiotic will you prepare per dose?
75 ml Bottle
CECLOR
CEFACLOR
FOR ORAL
SUSPENSION, USP
125 mg
per 5 ml
ANS: ___________
18.
Vancomycin 95 mg PO every 6 hours is ordered for a child weighing 18
lbs 11 oz. The recommended safe dose (RSD) for Vancomycin is 44
mg/kg/day divided every 6 hours. What is the RSD for this child for 24
hours? Is the ordered dose safe to give?
ANS: ___________
ANS: ___________
19.
Your patient is diagnosed with congestive heart failure. The physician
orders the following: Digoxin Elixir 22 mcg PO daily. Using the label
below, how many ml’s will you give per dose?
2 fl oz
LANOXIN
DIGOXIN
ELIXER PEDIATRIC
Each ml contains
50 mcg (0.05 mg)
Digoxin
ANS: ________________
23
20.
Rocephin 624 mg IM daily is ordered for a child weighing 10 lbs 8 oz. The
recommended safe dose (RSD) for Rocephin is 75 mg/kg every 12 hours.
What is the safe daily dose for this child? Is the ordered dose safe to
give?
ANS: _____________
ANS: _____________
21
The pediatric surgeon orders the following in his post-operative orders:
Codeine elixir 1½ tsp PO every 4 - 6 hours PRN for pain. On hand is
12 mg/5 ml. The child weighs 37 lbs 5 oz. The recommended safe dose
for Codeine is 0.5 mg/kg every 4 hours. What is the recommended safe
dose in ml’s of Codeine to be given per dose? Is 1½ tsp safe to give?
ANS: _____________
ANS: ____________
22.
The physician orders Morphine 2.7 mg IV. On hand is Morphine
10 mg/ml. How many ml's will you give?
ANS: _________________
24
23.
The nurse practitioner orders Ampicillin 230 mg PO every 6 hours. You
reconstitute a 250 mg bottle of Ampicillin to 5 ml's. Based on the order,
how many ml's will you give? Your patient is 9 kg. The maximum
recommended safe dosage of Ampicillin is 100 mg/kg/day divided every 6
hours. Is the ordered dose safe to give?
ANS: _________________
ANS: _________________
24.
Your patient is ordered to receive Gentamicin 12.7 mg IV every 8 hours.
The vial contains 80 mg/ 2 ml. How many ml's will you give per dose?
ANS: _________________
25.
Your patient has Kawasaki Syndrome and is ordered to receive baby
aspirin 200 mg PO every 4 hours. You have on hand: baby aspirin
81 mg chewable tablets. How many tablets will you give?
ANS: _________________
26.
The pediatrician writes the following order: Bicillin L-A 500,000 units IM
now. On hand is Bicillin L-A 600,000 units/ ml. How many ml's will you
give?
ANS: _________________
25
27.
The physician assistant writes an order for 0.10 mg PO once a day. The
child weighs 20.5 kg. The recommended safe dose for Digoxin is 10 mcg/
kg PO daily. The bottle label reads 1 ml = 0.05 mg. How many ml's per
dose will you give based on the PA’s order? Is the ordered dose safe to
give?
ANS: _________________
ANS: ________________
28.
It is time to give your pediatric patient their antibiotic. The MAR has the
following: Septra 2.5 ml PO every 6 hours. Septra contains 2 drugs. The
recommended dosage is 8 mg/kg/day of trimethroprim (T), and 40
mg/kg/day of sulfamethoxazole (S). The patient weighs 10.4 lbs. What is
the safe daily dose for each drug?
T = ________________
S = ________________
29.
Your patient is ordered to receive Keflex 250 mg PO three times a day.
The recommended safe dose is 100 mg/kg/day. Child weighs 18 lbs 10
oz. Calculate the recommended safe dosage per day? Is the ordered
dose safe to give?
ANS: _________________
ANS: _________________
26
30.
Your patient with sickle cell is having a pain crisis. You check the MAR to
see what pain medication is ordered. You find the following order:
Morphine 3 mg IV every 4 hrs PRN pain. On hand is Morphine Sulfate
8 mg/ml. The child weighs 14 lbs 7 oz. The maximum recommended
safe dose of Morphine is 0.2 mg/kg/dose every 2 -4 hours. Based on the
order, how many ml's will you give? Is the ordered dose safe to give?
ANS: ________________
ANS: ________________
31.
The pediatrician orders Ampicillin 85 mg IM now. You reconstitute this vial
according to label directions. How many ml's will you administer?
EQUIVALENT TO
125 mg AMPICILLIN
STERILE AMPICILLIN
SODIUM, USP
For IM or IV Use
For IM use, add 1.2 ml diluent. Resulting
solution contains 125 mg ampicillin per ml.
Use solution within 1 hour. This vial contains
ampicillin sodium equivalent to 125 mg
ampicillin. Usual Dosage: Children – 25 to
50 mg/kg/day in equally divided doses at 6hour intervals.
ANS: _________________
27
32.
Your patient is having an allergic reaction. You page the pediatric resident
on call and she gives you a verbal order for Benadryl 5 ml PO every 6
hours as needed for pruritis. The recommended safe dose of Benadryl is
5 mg/kg/day divided every 6 hours. The medication is supplied 12.5 mg
per 5 ml. Determine the maximum recommended dosage in mg per day
for a child weighing 28.2 lbs? Is the ordered dose safe to give?
ANS: _________________
ANS: _________________
33.
Your infant patient has thrush and is ordered Mycostatin oral suspension
200,000 units PO every 8 hours. Using the label below, how many ml’s
will you give per dose?
60 ml
100,000 units per ml
MYCOSTATIN
ORAL SUSPENSION
Nystatin Oral
Suspension USP
ANS: _________________
28
34.
In reference to the above question (#33), select the appropriate syringe to
measure the medication and draw an arrow to the correct amount.
29
Answers:
1.
248 mg. Yes, safe to give based on RSD of 270 mg.
2.
RSD: 514 mg/day (based on 10.28 Kg)
Order: 150 mg/day; Safe to give
3.
2 ml’s
4.
720 mg/day (based on 20.45 Kg)
5.
3.12 ml’s
6.
0.26 ml
7.
15.6 mg
8.
0.33 ml
9.
RSD: 0.01 mg or 10 mcg (Based on 11.88 Kg)
Order is 0.05 mg or 50 mcg; therefore unsafe to give.
10.
1.45 ml’s. Not safe to give based on patient weight of 4.55 kg and RSD
of 227.5 mg/day or 56.88 mg/dose.
11.
10.5 mgs. Safe to give since order is 42 mg/day and RSD is 60 mg/day
12.
1.48 ml’s
13.
RSD: 983 mg/day (based on 19.66 Kg)
Order: 440 mg/day; therefore, safe to give
14.
RSD: 76.05 mg/day (based on 10.14 Kg)
Order: 74.1 mg/day; therefore safe to give
15.
0.66 ml (Based on 7.9 Kg)
16.
0.53 ml
17.
5.25 ml’s (based on 5.71 Kg and order of 131.33 mg)
18.
RSD: 373.56 mg/day (Based on 8.49 Kg)
Order: 380 mg/day; therefore unsafe to give
19.
0.44 ml
30
20.
RSD: 715.5 mg/day (Based on 4.77 Kg)
Order: 624 mg/day; therefore safe to give
21.
3.53 ml’s (based on 16.96 Kg)
Order is 18 mg and RSD is 8.48 mg; therefore order is not safe to give.
22.
0.27 ml
23.
4.6 ml. Not safe to give because order is 230 mg and RSD is 225 mg.
24.
0.32 ml
25.
2½ tablets
26.
0.83 ml
27.
2 ml; RSD = 205 mcg; Order = 100 mcg; therefore safe to give
28.
T = 37.84 mg/day (based on 4.73 Kg)
S = 189.2 mg/day
29.
RSD: 847 mg/day (Based on 8.47 Kg)
Order: 750 mg day; therefore safe to give
30.
0.38 ml
RSD: 1.31 mg per dose (Based on 6.56 Kg). The order is 3 mg per
dose; therefore, unsafe to give.
31.
0.68 ml
32.
RSD: 64.1 mg/day or 16.03 mg/dose (based on 12.82 Kg)
Order: 12.5 mg/dose or 50 mg/day, therefore safe to give
33.
2 ml
34.
31