Pediatric rounding rules

  1. Yes I'm new nursing student and I'm in dosage calculation class. I'm working through some pediatric math involving weight based problems in some text it shows to round KG to nearest tenth and others to nearest hundredth I'm curious which is correct? Also for some pediatric oral liquid medication in some text the final answer is rounded to nearest tenth of an ML and and other text rounded to nearest hundredth of an ML which is correct?
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  2. 15 Comments

  3. by   chare
    In practice, I complete all calculations and then round the final result. If I am only calculating the weight, I round based on the following:
    • >5 kg: 1 decimal place
    • 1 – 5 kg: 2 decimal places
    • <1 kg: 3 decimal places

    Rounding volume for medication administration, both enteral and parenteral, I use the following:
    • >1 2mL: 1 decimal place
    • <1 mL: 2 decimal places
  4. by   RNSAINT41
    I was told to round kg to nearest tenth for all weights regardless of age to nearest 10th kg before before proceeding with weight based dose calculation is that correct?
  5. by   RNSAINT41
    Although I do not use deminsional analysis so maybe that's why we are taught to round kg to nearest tenth on all problems before proceeding
  6. by   llg
    There is no one right, correct answer. Different facilities may have different policies. Do whatever you employer or school instructor wants you to do.
  7. by   RNSAINT41
    Ok that's I just find it odd there isn't just a standard way it should be done everywhere
  8. by   meanmaryjean
    This too: You cannot measure oral meds to the 1/100th of an mL. An oral syringe is not calibrated thusly.
    Last edit by meanmaryjean on Sep 21 : Reason: Yeah, I used the word 'thusly'. Deal
  9. by   Calalilynurse
    Ask your professor what rounding rule they prefer for grading. In real word peds its sometimes guess work. I can't give a baby 2.345 ml of Tylenol I give as close as I can usually 2.4 or as close to between 2.3 or 2.4 as I can depending on the syringe.
  10. by   meanmaryjean
    Quote from Calalilynurse
    Ask your professor what rounding rule they prefer for grading. In real word peds its sometimes guess work. I can't give a baby 2.345 ml of Tylenol I give as close as I can usually 2.4 or as close to between 2.3 or 2.4 as I can depending on the syringe.

    Then there's the whole "How do I account for what they just spit at me" factor...
  11. by   RNSAINT41
    The way we were taught you would administer 2.3ml
  12. by   RNSAINT41
    So for pediatric patient if an oral liquid medication called for 4.68 ml I would round to nearest tenth but I've seen books put the answer
    4.6ml why is that
  13. by   KelRN215
    Quote from RNSAINT41
    I was told to round kg to nearest tenth for all weights regardless of age to nearest 10th kg before before proceeding with weight based dose calculation is that correct?
    That could be a huge difference for a NICU baby who is weighed in grams...

    If a baby's weight is entered in the system as 2.548 kg, that is what I would use for dosage calculation and then round at the end.
  14. by   Julius Seizure
    Quote from RNSAINT41
    Ok that's I just find it odd there isn't just a standard way it should be done everywhere
    Real world:

    Most syringes will only have markings to then 1/10th of an ml. Pretty tough to accurately dose more specifically than that. Likewise, its difficult to accurately give 1/5th of a tablet. (Yes I have seen that ordered.)

    As for weight, infant scales measure to 3 decimal points. Bed scales usually measure to just one decimal point. I would use whatever amount of data I had (so use as many decimal points as the scale will give you).

    School world:

    Best to check with your instructor, who may want non-real-world. When in doubt, use every decimal possible and then round at the end if necessary.

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