Pediatric Dosage Calculations...HELP!

Published

Specializes in CVICU, Education Dept., FNP Student.

I'm having such issues with dosing Pediatric patients appropriately. Does anyone have any shortcuts/pointers for the math portion?

Up Vote Up Vote ×
Specializes in NICU, PICU, adult med/surg, peds BMT.

Your question is so vague... Just look up each drug your giving for recommended dosing. Understand how todo the math....

Up Vote Up Vote ×
Specializes in CVICU, Education Dept., FNP Student.

Recommended dosages is not my problem. I get hung up on the math portion...I was just wondering if anyone had a quick tip to share.

Up Vote Up Vote ×
Specializes in NICU, PICU, adult med/surg, peds BMT.

Are you talking about figuring mg/kg/minute or something like that or how figure out 50mg/kg when you have a patient who is 10kg and the vial is 100mg/ml. I'm just not sure what types of tips you are looking for. I'd be glad to help I've done nicu PICU peds for a long time so it's something I do routinely.

Up Vote Up Vote ×
Specializes in CVICU, Education Dept., FNP Student.

Well, for example... You are prescribing Amoxicillan 90 mg/kg/day in divided doses for AOM in a child weighing 9 kg. I understand that you multiply 9x90 to get 810 mg/day and divide by 2 to get per dose (405 mg). It's provided in 400mg/5mls... So that's one tsp twice a day... I can figure this if I have time...But when I get in the clinical situation, I get stressed by the urgency of things and can't think on my toes...Just curious if anyone had any quick tips to offer...

Up Vote Up Vote ×
Specializes in NICU, PICU, adult med/surg, peds BMT.

It sounds like you have all the steps down. Perhaps someone else has advice but rest assured you more you do your job the easier and less stressful it becomes and these calcs will become second nature as well. Best of luck.

Up Vote Up Vote ×
Specializes in Peds Urology,primary care, hem/onc.

I have been a PNP for 5 years.... calculating the doses for meds is one of the most important things you do. You have to be very meticulous. It is ok that you are cautious and it takes you time.... I always tell parents, as I wip out my calculator I keep in my pocket at all times, " just give me two seconds, gotta do math to make sure get the dose perfect". They will appreciate you for that. They more you do it and you get used to perscribing certain meds regularly... the easier it becomes. Don't EVER feel you have to rush... just doing med pass when you were an RN, cannot rush because that is when you make mistakes.

Up Vote Up Vote ×
Specializes in General.
I have been a PNP for 5 years.... calculating the doses for meds is one of the most important things you do. You have to be very meticulous. It is ok that you are cautious and it takes you time.... I always tell parents, as I wip out my calculator I keep in my pocket at all times, " just give me two seconds, gotta do math to make sure get the dose perfect". They will appreciate you for that. They more you do it and you get used to perscribing certain meds regularly... the easier it becomes. Don't EVER feel you have to rush... just doing med pass when you were an RN, cannot rush because that is when you make mistakes.

i agree when you phrase it like that the parents really appreciate it, I am a new PNP and today I had a kiddo with a rash I was not sure what it was so I went back in with the derm book and explained to the parent that I wanted to be sure of what I was seeing and they really appreciated it rather than just saying oh its just contact dermatitis be patient it will come to you my collaborative md has been doing this for years and still calculates her meds

Up Vote Up Vote ×

When I started my very first NP job last summer (in peds) I made myself a card that I laminated to keep in my planner. I used the most commonly prescribed meds and appropriate dose for each weight range in pounds. So for Amox, I had from xx-xx lbs get 1 tsp of 400/5 bid, xx-xx get 1 1/2 tsp, etc. (sorry I am just being too lazy to refigure the weights! I calculated amox, augmentin, azithro, bactrim, and omnicef. For amox I just estimate the weight in kg and if it is a bit higher, I just use the 80mg/kg (remember high dose amox is 80-90kg so you have some wiggle room). So for a 35lb kiddo, I just estimate 17kg x 80mg= 1360 (1 3/4tsp bid) rather than actually figuring 15.9kg x 90=1431 (1 3/4tsp bid). Just remember that peds doses max out at usual adult doses (my first day I prescribed Amox 400/5 3tsp bid-luckily the pharmacist called to tell me that was too much!)

I agree with the others. I have never had a parent complain or even look concerned when I say that I need just a second to double check my math as I want to make extra sure I am giving the appropriate dose, etc. Actually, at my peds clinical in school, the NP carried a planner with her prescription pad and a multitude of resources. I have done the same and take my day-timer with pda, scripts, and some references I use. My favorites are comparisons of low, medium, and high dose inhaled steroids by age (I think it is from the Fitzgerald review) and a comparison of strength for various topical steroids, etc. I also have the two sided Tylenol/Motrin dose chart as I always review proper dose with parents at the WCC.

Good luck and I bet once you stop being stressed about taking the time you need to perform the calculation it will seem easier!

Up Vote Up Vote ×

OOooooh where did you get the two sided tylenol/motrin dosage chart?

Up Vote Up Vote ×

I just graduated so have not actually started working yet. But all the preceptors I worked with always did their assessment and then told the parents they would be back in a few minutes. They would then leave the room and go to their office to do the calculations and write the prescriptions then take them back to the room. So they weren't all stressed out doing calculations right there in front of the parents.

Up Vote Up Vote ×
Specializes in CVICU, Education Dept., FNP Student.

Thanks Everyone for the reassurance!! I think that I just need to focus on the calculation and stop focusing on how long it takes me.

Up Vote Up Vote ×
+ Join the Discussion