i am taking my very last class-peds. i have no problem doing the calculations but i am tired of my instructor changing her mind whether we round off or not when doing the calculations. please let me know how you guys do it in the real world. thank you!!
the problem she gave us today (we can't use a calculator):
child weighs 15.8 lbs
dr. orders: gentamicin 18 mg iv q8h in 10ml d5½ ns
reference: 2.5 mg/kg/dose q8h
stock: if safe: 40 mg/ml. give?
okay i know i need to convert 15.8 lbs to kilogram, which is 7.18 kg
7.18 kg x 2.5 mg = 17.95 mg/dose. now, is the original order 18 mg safe even though i got 17.95 mg? mind you, my instructor said anything that is above the recommended dose is not safe.
okay here is my second problem. if i had rounded off the 7.18 kg to 7.2 kg instead, i would get this
7.2 kg x 2.5 mg = 18 mg. and this would make the md order safe. then
i would give [18 mg/40 mg x 1 ml] = 0.45 ml
so what do you think? do i round off or not? and if the dr's order is alittle bit over the recommended dose, is it still safe or not? like what i said, a couple of students had already asked her to clarify yet she keeps giving different answers.
In the real world I would give that dose. It is not very much at all different from the recommended dose; if he was dehydrated with an admission weight, by the time he has gotten to my floor and gotten a couple of boluses, he would weigh enough to get that dose. (This is another good reason for daily weights on pediatric patients.)
Maybe I'm wrong but that is definitely how we do it on my floor, and how my preceptors taught me.
perfectbluebuildings, BSN, RN
1,016 Posts
In the real world I would give that dose. It is not very much at all different from the recommended dose; if he was dehydrated with an admission weight, by the time he has gotten to my floor and gotten a couple of boluses, he would weigh enough to get that dose. (This is another good reason for daily weights on pediatric patients.)
Maybe I'm wrong but that is definitely how we do it on my floor, and how my preceptors taught me.
In the nursing school world don't give it.