Pediatric Medication Practice Problems UNRS 314 Converting Pounds to Kilograms 1. 2. 3. 4. 5. 6. 7.

30 lb = _____________ 15 lb 5 oz = _________ 7 lb = ____________ 22 lb = _____________ 4 lb 5 oz = __________ 75 lb = _____________ 10 lbs = __________

Answers: 1. 13.63 kg 2. 15.31 lb = 6.95 kg 3. 7.25 lb = 3.29 kg 4. 10 kg 5. 4.31 lb = 1.95 kg 6. 34.09 kg 7. 6.5 lb or 2.95 kg NOTE DO NOT ROUND OR YOUR ANSWER WILL BE MARKED WRONG Problem 1 Child weighs 33 lbs Physician order: Augmentin 150 mg po q 8 hours Information from drug guide: children < 40 kg receive 6.7 to 13.3 mg/kg q 8 hours Convert 33 lbs to kg ________ Calculate low and high dose _______ low dose _______ high dose Is the dose in the safe range? ___________ The medication comes Augmentin 125 mg / 5 mL How many mL would you need to draw up to equal 150 mg? _________ Answer problem 1: 15 kg Low dose 100.5 mg (6.7 x 15 kg) High dose 199.5 mg (13.3 x 15 kg) Safe range (100.5 mg to 199.5 mg) 150 mg is a safe dose. You would give 6 mL Calculation 125 mg = 150 mg 5 mL x mL

750 125 x

Problem 2 Child weighs 16 lb 10 oz Physician order: Lasix 15 mg po bid Information from drug guide: The initial dose of Lasix (furosemide) for infants or children is 2 mg / kg / dose. If initial dose works dosage may be increased to 1 or 2 mg / kg / dose (maintenance dose). Doses greater than 6 mg / kg / day are not recommended. Convert 16 lb 10 oz to kg ________ Calculate initial and high dose _______ initial dose _______ high dose Is the dose in the safe range? ___________ The medication comes: Furosemide 10 mg/mL How many mL would you need to draw up to equal 15 mg? _________

Answer Problem 2 16.62 pounds to 7.556 kg or 7.56 kg Single dose of Lasix 7.56 kg x 2 mg = 15.12 mg/dose High range daily dose 7.56 kg x 6 mg = 45.36 mg/dose Is the dosage of 15 mg bid or 30 mg / day safe? = yes How many mL? 1.5 mL Calculation: 10 mg = 15 mg 1 mL x mL Problem 3 Child weighs 66 lbs Physician order: Epinephrine 0.3mg sub q x 1 dose for allergic reaction Information from drug guide: 0.01 mg/kg every 20 minutes as needed. Not to exceed 0.5 mg in a single dose. Convert 66 lbs to kg ________ Calculate low and high dose _______ low dose _______ high dose Is the dose in the safe range? ___________ The medication comes epinephrine 1 mg / mL How many mL would you need to draw up to equal the minimum or low dose? _________

Answer 3

Weight in kg: 30 kg Low dose 0.3 mg high dose 0.5 mg Is dose safe? Yes 0.3 mg = 0.3 mL NOTE: .3 mL would be marked wrong you need to always put zero before a decimal in drug calculations. Fluid Calculations 100 mL x 1st 10 kg 50 mL x 2nd 10 kg 20 mL x any additional kg Practice problems Weight 22 lb to ___________kg ___________ 24 hour maintenance fluids ___________ 1 times maintenance Weight 12 lb to ____________kg ____________ 24 hour maintenance fluids ____________ 1 times maintenance Weight 6 lb 4 oz ___________kg ____________ 24 hour maintenance fluids ____________ 1 times maintenance Weight 75 lb to ____________kg ____________ 24 hour maintenance fluids ____________ 1 times maintenance Weight 42 lb to ____________kg ____________ 24 hour maintenance fluids ____________ 1 times maintenance Answers: 22 lb to 10 kg (10 x 100 mL = 1000 mL) 1000 mL / 24 hour (1000 x 1.5 = 1500 mL) 1500 mL / 24 hour for 1 maintenance fluids. 12 lb to 5.45 kg (5.45 x 100 mL = 545 mL) 545 / 24 hour (545 x 1.5 = 818 mL) or 818 mL / 24 hour for 1 maintenance fluids. 6 lb 4 oz to 6.25 lb to 2.84 kg (2.84 x 100 mL = 284 ml) 284 mL / 24 hours (284 x 1.5 = 426 mL) 426 mL / 24 hour for 1 maintenance fluids.

75 lb = 34 kg 100 mL x 10 kg = 1000 mL 50 mL x 10 kg = 500 mL 20 mL x 14 kg = 280 mL 1780 mL / 24 hours or 74 mL / hour 1 times maintenance would be (1780 x 1.5 = 2670) 2670 mL / 24 hours or 112 mL / hour. 42 lb to 19.09 kg 100 mL x 10 kg = 1000 mL 50 mL x 9.09 kg = 454 mL 1454 mL / 24 hours or 61 mL / hour Parenteral Pediatric Medications 1. Order: ampicillin 100 mg IV q 6 hours Weight: 9 lbs 6 ounces Drug guide: safe dose 75 to 200 mg /kg/24 hours Concentration of IV use: 50 mg/mL over 10 to 30 minutes Supplied as: vial of powder 500 mg. Directions: add 1.8 mL of sterile water to makes 250 mg / mL Questions: Pounds to kg ___________ Safe dose: low range __________ high range _________ Dose q 6 hours ______________ mg Minimum safe dilution ____________ How many mL would you draw up from the re-constituted vial of ampicillin ________ Inject the ampicillin into the volutrol and fill to 10mL. What would you need to set the pump at to deliver the 10 mL of medication + the 20 mL of flush over 30 minutes? ____________________ Answers: 1. 9 lb 6oz = 4.259 or 4.26 kg Safe dose for 24 hours: low range (4.26 x 75 mg) 319.5 mg high range (4.26 x 200 mg) 852 mg Safe dose for q 6 hour: low range 319.5 / 4 = 79.8 mg high range 852 /4 = 214 mg 100 mg per dose would be a safe dose. Minimum safe dilution would be 100 / 50 = 2 mL How many mL would you draw up from the re-constituted vial of ampicillin?

250 mg = 100 mg 100 1mL x mL 250 x You would draw up 0.4 mL of solution from the vial to equal 100 mg of ampicillin. The ampicillin 0.4 mL would be injected into the volutrol and fill to 10 mL with IV solution. 10 mL of medication followed by 20 mL flush would equal to 30 mL to be infused over 30 minutes. The pump would need to be set at 60 mL/hr. 2. Infant 6 months; weight 17 lbs 6 oz Order: Cefuroxime 185 mg IV q 6 hr in 10 mL Drug Guide: Safe dose is 50 to 100 mg/kg/24 hours. Medication can be safely infused over 30 minutes. Medication supplied as: 750 mg vial of powder. Directions: dilute with 8 mL sterile water to 90 mg / mL. Weight in kg_____________ Safe range: low __________ and high _________________ Is this a safe dose? _______ How much medication do you need to draw up from the vial? __________ mL You put the cefuroxime in the volutrol with 10mL of IV solution. Remembering the 20 mL flush. What would you need to set the pump at mL/hr to get the medication and flush in over 30 minutes? _____________

Answer to question 2 Weight 17.375 lb = 7.89 kg Safe range: low range 394.5 mg high range 789 mg divided by 4 = low range 98 kg to high range 197.25 Safe dose? Yes Draw up 90 mg = 38 mg 185 1mL x mL 90x = 2.05 mL How fast would you set the pump to infuse medication followed by the flush in 30 minutes? 60 mL/hour NG cc/cc replacement every 4 hours. 1. NG output recorded by the night nurse is 176 mL. The maintenance IV is infusing at 90 mL/hour. How much fluid would you infuse over the next four hours _______ 2. NG output recorded over the next 4 hours is 125 mL. The maintenance IV is infusing at 90 mL/hour. How much fluid would you infuse over the next four hours _________. Answers:

1. 2.

176 divided by 4 = 44 mL. Add to 90 mL per hour rate to equal 134 mL/hr to infuse over the next 4 hours. 125 divided by 4 = 31.25 or 31. Add to 90 mL per hour rate to equal 121 mL/hr to infuse over the next 4 hours.

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