Okay, I feel rather dumb that I am asking this, but just wanted to hear others' perspectives.
You have a profoundly emaciated pediatric patient- semi-normal height/length for their actual age, but extremely, profoundly underweight- truly skeletal.
Normally of course, Tylenol is dosed 15 mg/kg q4hrs, and Motrin is dosed 10 mg/kg q6hrs. My thinking is that, whatever the patient's weight is, even if it is extremely low for their age and height, you have to base your dose on that weight. But the pt's fever in this scenario is responding very little to weight-based doses of these meds (several doses spaced out over several hours).
(Setting aside the fact that the pt obviously has underlying issues causing this fever and likely needs antibiotics or other therapies.) Regarding the Tylenol and Motrin specifically, because of being so emaciated will they need a higher dose by weight of these medications since their organs are possibly closer to the same size as their same-age counterparts, even though their overall weight is not? Or is that not a factor at all? I feel like I'm being an idiot even asking this.
(If this question doesn't make a lot of sense, please ask me to clarify, too- sometimes I can think I'm being very clear but then people look at me and say "what??"