dosage question

[Nina96]

My question is when a provider orders a weight based medication for a pediatric patient should the mg per dose be rounded to the tenth or the hundredth? Example a doctor orders omnicef 14 mg per kg per dose for 5 year old who weighs 45 pounds. When I use DA my answer comes out to 286.3636 mg. I just want to know if the doctor is ordering the dose by mg would the order be 286.4 mg per dose or 286.36 mg per dose?

[PeakRN]

The physician should not be ordering a medication without a weight, and with rare exception (almost exclusively critical care medications) drugs should be ordered with fixed dose rather than one where the nurse needs to calculate based on a current weight.

The school answer is to ask your instructor and/or clinical site for their practice. Likely the would have you calculate out to mL before you round, which in a 250mg/5mL concentration would be 5.2727(repeating) and likely your program would have you round to 5.3 mL for oral meds.

The real life answer in this case is that the provider will almost always order 250, 275, or 300 mg (depending on provider preference) as the parent will probably be administering the same medication at home and it is much easier for a parent to measure out 5, 5.5, or 6 mL.

[NotReady4PrimeTime, RN]

Because this subject has been discussed MANY times already, I'm closing this thread. If you're still confused about how to caluclate pediatric dosages, please use the search bar and read the myriad other threads.