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Pediatric Dosage Calculation Question

crissik crissik (New) New

Please calculate this for me:

Child weighs 28lb and you need to administer medication 75mg/kg/day.

I figured it out but the answer came up 952.5.

So would the answer be 952? 952.5 or 953.

I was not sure if I should round with children?

Thank YOu

9livesRN, BSN, RN

Has 2 years experience. Specializes in SNU/SNF/MedSurg, SPCU Ortho/Neuro/Spine.

Child weighs 28lb and you need to administer medication 75mg/kg/day.

28 lbs - 12.7kg (12.7 times 75)

952.5mg - depending on the rounding instructions you will change.

so 952.5 if says to round it will be 953, if it does not want you to round leave as 952.5

My clinical instructor told us that in pediatrics we are always to round to the hundreth, if applicable. 28 lbs/2.2=12.7272

75 mg x

1 kg 12.7272 kg =954.5454

At my clinical my answer would be 954.55 mg

I hope it helps and good luck :)

i need help with pediatric math

We were told in our class to not round up with pedi cases since the smallest amount can have an effect on the kid and you want to be more precise...unless it's a gtt and you can't cut a gtt in half lol

exit96

Has 3 years experience. Specializes in RN.

It depends on your school program. We are told to round to the nearest 10th...which in this case is a whole number> 953

Music in My Heart

Has 10 years experience. Specializes in being a Credible Source.

I wonder if the disregard for significant figures indicates a lack of understanding on the part of the instructors. I'm curious what an MD or RPh would say.

The *real* answer would be 950 mg... though your instructor may ask for a different approach to rounding.

Two significant figures in the problem statement... two significant figures in the answer.

Pneumothorax, BSN, RN

Specializes in Critical Care, Emergency Medicine, Flight.

we were taught to round up so it would be 953

Like others have said, my program specifically tells us to always round down, if you underdose the child you can give more, overdose poses more serious problems and children are very succeptible to the effects (good or bad) of even the smallest amount of medication. I would clarify with your instructor what is expected, but in general I would round down to be safe.

solneeshka, BSN, RN

Has 11 years experience. Specializes in PACU, Surgery, Acute Medicine.

This is an interesting theoretical discussion! I'd like to see someone try to actually provide 952.5 mg of *anything*! I don't think you could measure even water that precisely, let alone a pill. The *real* real answer is probably going to be "1 gram," maybe 950 mg if whatever the medication is happens to be something with a lot of volume where a person could even see the difference between 950 mg and 1000 mg. As for the answer your instructor is looking for, you have to go with whatever the rounding policy is that your school uses.

NicuGal, MSN, RN

Has 30 years experience. Specializes in NICU, PICU, PACU.

The answer above is wrong. Most peds meds come in liquid form or you are going to make a suspension out of it. You will be measuring things in small doses. In NICU, we give 0.05 of some oral and IV meds. The difference in 950mg and 1000mg would be an overdose. In adults, not so much, but peds is a whole different arena. Our pharmacy programs round to the nearest 10th for us.

For example.....you are to give 952.5mg of oral whatever. It comes 100mg/ml. You would then draw up 9.5ml to give. Make sense?

You have a 1.5kg baby and you have to give .15mg of Morpine. Comes in a 1mg/ml solution, you will give 0.15ml. If you round that up to 0.2 there is the possibility that that kid is going to go apneic on you. Might not seem like a lot, but to someone that is small it is.

I hope that helped :)

solneeshka, BSN, RN

Has 11 years experience. Specializes in PACU, Surgery, Acute Medicine.

My point is that if someone is getting 952.5 mg of something, then whether you round to 953 mg or 952 mg is immaterial, even in peds. At that volume, even rounding all the way up to 1,000 mg, the difference is only 4.8% of the amount of medication being given. Completely different from the morphine example, where the difference between a 0.15 mg dose and a 0.2 mg dose is 25%. And I did say that if your volume of medication were large enough, then you might be able to round to 950 mg. But there isn't anything you'd be giving where you would distinguish between 952.5 mg and 953 mg.

NicuGal, MSN, RN

Has 30 years experience. Specializes in NICU, PICU, PACU.

In peds, you would never round up from 952 to 1000, that is my point. Even sometimes that small amount can make the difference in a peds population.

melmarie23, MSN, RN

Specializes in L&D/Maternity nursing.

I think most are over thinking this. I think the point of the problem is to practice the math, not so much about the specifics of how the dose is administered (though that too is important to know, but for the purpose of dosage calcs, its to practice the math). I think the best piece of advice is to ask the professor/teacher what they'd like the answer to be rounded to.

Music in My Heart

Has 10 years experience. Specializes in being a Credible Source.

you have a 1.5kg baby and you have to give .15mg of morpine. comes in a 1mg/ml solution, you will give 0.15ml. if you round that up to 0.2 there is the possibility that that kid is going to go apneic on you. might not seem like a lot, but to someone that is small it is.
exactly... two significant figures in the given data, two significant figures in the calculated answer.
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