Math Help? What is the correct answer.

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Can anyone tell me the answer to this problem.

The physician orders ceftriazone sodium 50 mg/kg of body weight, in divided doses every 12 hours for a child who weghs 66 poinds. Calculate the body weight, then determine how many milligrams will the child receive in each dose?

Thanks in advance

yep.. every 12 hours the chilld will rec 50 mg/kg.

Lets see what her instructor says.. then you can owe me lunch :D

I'm betting on Angie.

As for giving IM Rocephin, if you gave my 30-kg child 1500 mg IM every 12 hours, I'd be asking for another nurse.

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Specializes in NICU (Level 3-4), MSN-NNP.

I know this is a picky point, but could she have gotten it wrong because she did not write down the weight as well? It says to calculate the weight, then determine the mg, etc. At my school, I would have been marked incorrect if I had only written the (correct) 750 mg part, without listing the 30 kg. Just a thought...

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Specializes in Nursing assistant.

Take a little dip into my pool of ignorance...

I found this info on dosage:

The recommended dosage of ceftriaxone for the treatment of meningitis in children is 100 mg/kg/day in one daily dose or divided into two doses and given every 12 hours, up to a total daily dose of 2 grams. For other infections, the recommended dosage is 50 to 75 mg/kg/day. The usual dose in adults is 1 to 2 grams given once daily.

Ceftriaxone may be administered either intravenously or intramuscularly. For intravenous use, ceftriaxone should be diluted to a concentration of 10 to 40 mcg/mL and infused over 30 minutes. For intramuscular use, the manufacturer recommends that ceftriaxone be diluted to a concentration of 250 mg/ml or 350 mg/ml with sterile water, 5% dextrose solution, normal saline, or 1% lidocaine. The use of lidocaine as a diluent has been shown to reduce the pain associated with injection in children.

In an effort to reduce the volume of fluid injected in children and minimize the number of intramuscular injection sites, Bradley and colleagues have documented the stability of more concentrated ceftriaxone solutions. These authors found that ceftriaxone concentrations of up to 450 mg/ml, prepared with lidocaine, were stable and resulted in appropriate serum concentrations and clinical response.

Did the teacher specify mode of administration, and is she interested in the mg/ml? Also, she spelled the drug with a z instead of a x. Did she want her to question the doctors spelling (he he)?

And the doctor did ask for a split dose every 12 hrs, but is that a bit to hefty all at once, and should it be split into smaller increments?

So many questions, so little time....

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Specializes in OB.
I'm betting on Angie.

As for giving IM Rocephin, if you gave my 30-kg child 1500 mg IM every 12 hours, I'd be asking for another nurse.

obviously 750 was not the right answer, or she would have gotten it right...

as for asking for another nurse.. I verified my info, before posting.

Davis Drug Guide 2005.. page 184

Ceftriaxone IM IV children- most infections- 25-37.5 mg/kg q 12h.

110mg/kg q 24 hr or 50mg/kg q 12 for menegitis.

skin soft tissue infections- 50-75mg/kg q 24.

otitis media- 50mg/kg single dose.

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Specializes in ED.

The questions says "in divided doses" which means to me that the 50mg/kg is per day then divide into two doses which is given every 12 hours.

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obviously 750 was not the right answer, or she would have gotten it right...

as for asking for another nurse.. I verified my info, before posting.

Davis Drug Guide 2005.. page 184

Ceftriaxone IM IV children- most infections- 25-37.5 mg/kg q 12h.

110mg/kg q 24 hr or 50mg/kg q 12 for menegitis.

skin soft tissue infections- 50-75mg/kg q 24.

otitis media- 50mg/kg single dose.

I'm not talking about the dosage. I'm talking about shooting that much Rocephin into the muscle of a 30-kg child every 12 hours. Rocephin is one of the most painful meds to give and I would not put my child through that. A one-time dose, maybe. Every 12 hours? No way!

As for the right answer, it's been pointed out that she possibly got it wrong because of lack of complete info.

As for the dig about verification, I did look it up before I posted. I just didn't see the part about meningitis dosing. Do you have such a huge need to be right?

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The way this problem is worded is very, very typical. It's just that the /d or per day is left out. Without exception, in my med calc book, all the examples that have the words "divided doses" also have /d or per day and the answer would have been 750 mg.

I hope she gets back to us with an explanation about what they wanted.

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Specializes in Nursing assistant.
I'm not talking about the dosage. I'm talking about shooting that much Rocephin into the muscle of a 30-kg child every 12 hours. Rocephin is one of the most painful meds to give and I would not put my child through that. A one-time dose, maybe. Every 12 hours? No way!

As for the right answer, it's been pointed out that she possibly got it wrong because of lack of complete info.

As for the dig about verification, I did look it up before I posted. I just didn't see the part about meningitis dosing. Do you have such a huge need to be right?

Wonder if it was an example of a situation where the doctors orders should be verified.:sofahider

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Specializes in OB.
The question specifies the individual dose. The 50mg/kg has to be for a daily dose because otherwise it would come out to 1500mg per dose....way too much for a 30kg kid.

this is what I was referring to in my post with the info from the drug guide. You seem to be saying that 1500mg was too high of a dose of Rocephin for a 30kg child. My apologies, I must have read this incorrectly. Sorry

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this is what I was referring to in my post with the info from the drug guide. You seem to be saying that 1500mg was too high of a dose of Rocephin for a 30kg child. My apologies, I must have read this incorrectly. Sorry

That's what I was saying, but I admit I was wrong. I have never given that high a dose to a small child, but then again I only see them in the ER. No idea what happens when they're in house. My comment was directed at the idea of anyone giving that high a dose IM to a small child when it's more than one dose. A dose that high would have to be divided into at least two injections, meaning you poke the child twice each time or two nurses do a double whammy. That's just plain cruel when it's done every 12 hours.

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Ok according to my professor the answer is 1500 mg per dose. I did ask other nurses and instructors and they all seem to get 750 mg per dose as I did. I dont know what will be done about the situation. However I have a new question.

A 5 year old chold weighs 44 pounds. Zinacef 50 mg/kg/day IM q6h is ordered. Determine the total daily desired dose.

Anyone? Thanks again. I will update on the progress of the other answer with my other instructor.

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A 5 year old chold weighs 44 pounds. Zinacef 50 mg/kg/day IM q6h is ordered. Determine the total daily desired dose.

Anyone? Thanks again. I will update on the progress of the other answer with my other instructor.

1000mg/daily:250mg im q6h

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