Pediatrics Safe Dosage
ORDER: Cefdinir 100 mg PO q12h
Child: 10 kg
Safe range: 7–14 mg/kg/24 hr
Calculate the safe 24-hour range.
Is this order safe?
Safe range = 70–140 mg/24 hr
Is it safe? No, 200 mg/24 hr is above the safe range
A 6-year-old child with dehydration is prescribed 1,000 mL of normal saline over 8 hours using an infusion pump.
What rate should the nurse set the pump to in mL/hr?
125 mL/hr
Carb ratio = 1:15
Sliding scale:
150–199 = +1 unit
200–249 = +2 units
Blood glucose = 180 mg/dL
Carbs eaten = 45 g
Total insulin dose?
4 units
ORDER: Azithromycin 120 mg PO daily
Child: 15 kg
Safe dose: 10 mg/kg/24 hr
Calculate the safe dose.
Is this order safe?
Safe dose = 150 mg/24 hr
Is it safe? Yes, 120 mg is below 150 mg, so this is safe
A postoperative patient needs 500 mL of Lactated Ringer’s over 4 hours. The IV tubing has a drop factor of 15 gtt/mL.
What is the infusion rate in gtt/min?
31 gtt/min
Carb ratio = 1:10
Sliding scale:
150–199 = +1 unit
200–249 = +2 units
250–299 = +3 units
Blood glucose = 220 mg/dL
Carbs eaten = 50 g
Total insulin dose?
7 units
ORDER: Ibuprofen 200 mg PO q6h PRN
Child: 20 kg
Safe dose: 10 mg/kg/dose
Calculate the safe single dose
Is this order safe?
Safe dose = 200 mg per dose
Ordered dose = 200 mg/dose
Is it safe? Yes
A 4-year-old child is receiving 750 mL of Lactated Ringer’s at 150 mL/hr for fluid replacement.
How many hours will it take for the infusion to complete?
5 hours
Carb ratio = 1:12
Sliding scale:
150–199 = +1 unit
200–249 = +2 units
Blood glucose = 140 mg/dL
Carbs eaten = 60 g
Total insulin dose?
5 units
ORDER: Vancomycin 300 mg IV q8h
Child: 18 kg
Safe range: 40–60 mg/kg/24 hr
Calculate the safe 24-hour range
Is this order safe?
Safe range = 720–1080 mg/24 hr
Is it safe? Yes, 900 mg/24 hr is within the safe range.
A pediatric patient weighing 20 kg is prescribed an IV medication: Heparin 25,000 units in 500 mL Dextrose 5% in Water, to infuse at 20 units/kg/hr.
What rate should the nurse set the infusion pump to in mL/hr?
8 mL/hr
Carb ratio = 1:8
Sliding scale:
150–199 = +1 unit
200–249 = +2 units
250–299 = +3 units
Blood glucose = 260 mg/dL
Carbs eaten = 64 g
Total insulin dose?
11 units
ORDER: Amoxicillin-clavulanate 500 mg PO q12h
Child: 25 kg
Safe range: 25–45 mg/kg/24 hr
Calculate the safe 24-hour range
Is this order safe?
Safe range = 625–1125 mg/24 hr
Is it safe? Yes, 1000 mg/24 hr is within the safe range.
A child is prescribed 240 mL of intravenous antibiotics to infuse over 90 minutes using microdrip tubing with a drop factor of 60 gtt/mL.
After 30 minutes of starting the infusion, the nurse finds that only 60 mL has infused.
To finish the medication on time, what should the nurse adjust the rate to in gtt/min?
180 gtt/min
Carb ratio = 1:15
Sliding scale:
<150 = 0 units
150–199 = +1 unit
200–249 = +2 units
Blood glucose = 135 mg/dL
Carbs eaten = 75 g
Total insulin dose?
5 units