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Discussion

Safe dosage calculation

I have a question when performing safe dosage calculation for a pediatric medication example amoxicillin. The patient weighs 25lb dr orders 30mg/kg/day in 2 divided doses how many mg per day and how many mg per dose should the patient receive? I came up with 340.909091mg per day and 170.454545 mg per dose. My question is should the mg per day be rounded before figuring out the mg per dose? And should the mg per dose be rounded?

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In my practice, I complete all calculations and round my final answer. This isn't based on anything other than personal preference. And when I do round, I base the number of decimal places or significant digits on the graduation marks of the syringe being used. If this is class related your instructor should explain her or his rounding expectations.

As for clinical significance, whether you round at each stage, and to how many decimal places makes little to no difference. In the example you provided I worked the problem 4 ways based on rounding the weight to 1, 2, 3, and 4 decimal places and the answers ranged less than 0.6 mg.

Best wishes.

ETA: If you haven't yet done so, you might consider reviewing the attachments on the first two posts in this thread; particularly the second post.

https://allnurses.com/pre-nursing-student/master-your-drug-1148937.html

  • Expert

In the real world you'll be using common sense, ie the oral syringe will have marks at 0.01 mL if it's a 1 mL syringe, at 0.1 mL if it's a 3 mL or 5 mL, and every 0.2 mL if it's a 10. Amoxicillin comes as 125 mg/5 mL (25 mg/mL) or 250 mg/5 mL (50 mg/mL). So your dose of 170.45 mg would be 6.818 mL of the first or 3.409 mL of the second. See where the problem lies? You could draw your dose up into multiple syringes in order to be infinitessimally accurate, but your employer is going to blow a screw at the expense. And you're going to have to get a child to open their mouth for more than one syringe...

However, if this is for class, then you can't go by anything that will happen in the real world, because nursing school is about as far from the real world as you can get. Your instructor(s) are the only ones who can tell you how many decimals they want you to go to.

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