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**39: Pediatric Medication Administration
**

PRACTICE QUESTIONS

1. Penicillin V (Veetids), 250 mg orally every 8 hours, is prescribed for a child with a respiratory infection. The child’s weight is 45 pounds. The safe pediatric dosage is 25 to 50 mg/kg/day. The nurse determines that: 1. The dose is too low. 2. The dose is too high. 3. The dose is within the safe dosage range. 4. There is not enough information to determine the safe dose. Answer: 3 Rationale: Convert pounds to kilograms by dividing by 2.2. Pounds to kilograms: 45 lb divided by 2.2 lb/kg = 20.45 kg Dosage parameters: 25 mg/kg/day ×20.45 kg = 511.25 mg/day 50 mg/kg/day ×20.45 kg = 1022.5 mg/day Dose frequency: 250 mg ×3 doses (every 8 hours) = 750 mg/day The dose is within the safe dosage range. Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for the safe dosage range for medication. Change pounds to kilograms. Calculate the dosage parameters using the safe dose range identified in the question and the child’s weight in kilograms. Use a calculator to verify the answer and remember to determine the total daily dosage before selecting an option. Review pediatric medication calculations if you had difficulty with this question. Level of Cognitive Ability: Comprehension Client Needs: Physiological Integrity Integrated Process: Nursing Process/Planning Content Area: Child Health Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, pp. 234-236. 2. A physician has prescribed phenobarbital sodium (Luminal Sodium), 25 mg orally twice daily, for a child with febrile seizures. The medication label reads “phenobarbital sodium, 20 mg/5 mL.” The nurse has determined that the dose prescribed is a safe dose for the child. The nurse administers how many milliliters per dose to the child? 1. 2 mL 2. 4.5 mL 3. 6.25 mL 4. 7 mL Answer: 3 Rationale: Use the medication calculation formula.

Silvestri, 3/e, ISBN 1-1460-0052-6 Chapter 039 (edited file)—"Pediatric Medication Administration " 10/14/08, Page 2 of 7, 3 Figure(s), 0 Table(s), 6 Box(es)

Formula: Desired 25 mg __________ ×volume = ________ ×5 mL = 6.25 mL/dose Available 20 mg Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for milliliters per dose. Use the formula to determine the correct dosage and use a calculator to verify the answer. Review pediatric medication calculations if you had difficulty with this question. Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Child Health Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, p. 134. 3. Cloxacillin (Tegopen), 100 mg orally every 8 hours, is prescribed for a child with an elevated temperature who is suspected of having a respiratory tract infection. The child weighs 17 pounds. The safe pediatric dosage is 50 mg/kg/day. The nurse determines that: 1. The dose is too low. 2. The dose is too high. 3. The dose is within the safe dosage range. 4. There is not enough information to determine the safe dose. Answer: 3 Rationale: Convert pounds to kilograms by dividing by 2.2. Pounds to kilograms: 17 lb divided by 2.2 lb/kg = 7.72 kg Safe dose parameter: 50 mg/kg/day ×7.72 kg = 386 mg/day Dosage frequency: 100 mg ×3 doses (every 8 hours) = 300 mg/day The dose is within the safe dosage range. Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for the safe dose of the medication. Change pounds to kilograms. Calculate the dosage using the safe dose identified in the question and the child’s weight in kilograms. Use a calculator to verify the answer, and remember to determine the total daily dosage prior to selecting an option. Review pediatric medication calculations if you had difficulty with this question. Level of Cognitive Ability: Comprehension Client Needs: Safe, Effective Care Environment Integrated Process: Nursing Process/Planning Content Area: Child Health Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, pp. 234-236. 4. Sulfisoxazole (Gantrisin), 1.0 g orally four times daily, is prescribed for an adolescent with a

Silvestri, 3/e, ISBN 1-1460-0052-6 Chapter 039 (edited file)—"Pediatric Medication Administration " 10/14/08, Page 3 of 7, 3 Figure(s), 0 Table(s), 6 Box(es)

urinary tract infection. The medication label reads “500-mg tablets.” The nurse has determined that the dose prescribed is safe. The nurse administers how many tablets per dose to the adolescent? 1. 0.5 tablet 2. 1 tablet 3. 2 tablets 4. 3 tablets Answer: 3 Rationale: Change grams to milligrams, knowing that 1000 mg = 1 g. When converting from grams to milligrams (larger to smaller), move the decimal point three places to the right. Therefore, 1.0 g = 1000 mg. Then, use the medication calculation formula. Formula: Desired 1000 mg _________ ×tablet = _______ ×1 tablet = 2 tablets Available 500 mg Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for tablets per dose. Change grams to milligrams first. Then, use the formula to determine the correct dosage. Remember to verify the answer using a calculator. Review pediatric medication calculations if you had difficulty with this question. Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Child Health References: Asperheim, M. (2005). Introduction to pharmacology (10th ed.). Philadelphia: Elsevier/Saunders, p. 15. Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, p. 22. 5. Diphenhydramine hydrochloride (Benadryl), 25 mg orally every 6 hours, is prescribed for a child with an allergic reaction. The child weighs 25 kg. The safe pediatric dosage is 5 mg/kg/day. The nurse determines that: 1. The dose is too low. 2. The dose is too high. 3. The dose is within the safe dosage range. 4. There is not enough information to determine the safe dose. Answer: 3 Rationale: Use the formula for calculating a safe dosage range. Safe dose parameter: 5 mg/kg/day ×25 kg = 125 mg/day Dosage frequency: 25 mg ×4 doses (every 6 hours) = 100 mg/day The dose is within the safe dosage range. Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for the safe dose of the medication. Calculate the dosage parameters using the safe dose identified in the question and the child’s weight in kilograms.

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Use a calculator to verify the answer, and remember to determine the total daily dosage prior to selecting an option. Review pediatric medication calculations if you had difficulty with this question. Level of Cognitive Ability: Comprehension Client Needs: Safe, Effective Care Environment Integrated Process: Nursing Process/Planning Content Area: Child Health Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, pp. 234-236. 6. Penicillin G procaine (Wycillin), 1,000,000 units intramuscular, is prescribed for the child with an infection. The medication label reads “1,200,000 units/2 mL.” The nurse has determined that the dose prescribed is safe. The nurse administers how many milliliters per dose to the child? 1. 0.8 mL 2. 1.2 mL 3. 1.44 mL 4. 1.66 mL Answer: 4 Rationale: Use the medication calculation formula. Formula: Desired 1,000,000 _________ ×volume = ________ × 2 mL = 1.66 mL/dose Available 1,200,000 Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for milliliters per dose. Use the formula to determine the correct dose, and verify the answer with a calculator. Review pediatric medication calculations if you had difficulty with this question. Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Child Health Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, p. 80. 7. Morphine sulfate, 2.5 mg, is prescribed for a child with cancer. The safe pediatric dose is 0.05 to 0.1 mg/kg/dose. The child weighs 50 kg. The nurse determines that: 1. The dose is too low. 2. The dose is too high. 3. The dose is within the safe dosage range. 4. There is not enough information to determine the safe dosage range. Answer: 3 Rationale: Use the formula for calculating a safe dosage range. Dosage parameters: 0.05 mg/kg/dose ×50 kg = 2.5 mg/dose

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0.1 mg/kg/dose ×50 kg = 5 mg/dose The dose is within the safe dosage range. Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for the safe dosage range of the medication. Calculate the dosage parameters, using the safe dosage range identified in the question and the child’s weight in kilograms. Verify the answer using a calculator. Review pediatric medication calculations if you had difficulty with this question. Level of Cognitive Ability: Comprehension Client Needs: Safe, Effective Care Environment Integrated Process: Nursing Process/Planning Content Area: Child Health Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, pp. 234-236. 8. Morphine sulfate, 2.5 mg subcutaneously, is prescribed for a child postoperatively. The medication label reads “1/15 grains/mL.” The nurse has determined that the dose is safe. The nurse administers how many milliliters to the child? 1. 0.62 mL 2. 0.82 mL 3. 1.35 mL 4. 1.62 mL Answer: 1 Rationale: Convert grains (gr) to milligrams (mg) and then use the medication calculation formula. 1 gr = 60 mg 1/ gr ×60 mg = 4 mg 15 Formula: Desired 2.5 mg _________ ×volume = _______ ×1 mL = 0.62 mL Available 4 mg Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for milliliters per dose. Begin by converting grains to milligrams. Then, use the formula to determine the correct dose, and verify the answer using a calculator. Review pediatric medication calculations if you had difficulty with this question. Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Child Health Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, p. 80. 9. A physician’s order reads “ampicillin (Omnipen), 125 mg intramuscular every 6 hours.” The medication label reads “1 gram and reconstitute with 7.4 mL of bacteriostatic water.” The nurse draws up how many milliliters to administer one dose? 1. 0.54 mL

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2. 0.92 mL 3. 1.1 mL 4. 7.4 mL Answer: 2 Rationale: Convert grams to milligrams. In the metric system, to convert larger to smaller, multiply by 1000 or move the decimal three places to the right. Then, use the medication calculation formula: 1 g = 1000 mg Formula: Desired _______ ×volume = mL/dose Available Test-Taking Strategy: Identify the key components of the question and what the question is asking. In this case, the question asks for milliliters per dose. Convert grams to milligrams first. Next, use the formula to determine the correct dosage, knowing that 1000 mg = 7.4 mL. Verify the answer using a calculator. Review pediatric medication calculations if you had difficulty with this question. Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Nursing Process/Planning Content Area: Fundamental Skills References: Asperheim, M. (2005). Introduction to pharmacology (10th ed.). Philadelphia: Elsevier/Saunders, p. 15. Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, p. 22. 10. A pediatric client with ventricular septal defect repair is placed on a maintenance dosage of digoxin (Lanoxin) elixir. The safe dosage is 0.07 mg/kg/day, and the client’s weight is 7.2 kg. The physician orders the digoxin to be given twice daily. The nurse prepares how much digoxin to administer to the client at each dose? 1. 0.25 mg 2. 0.37 mg 3. 0.5 mg 4. 2.5 mg Answer: 1 Rationale: Calculate the dosage by weight first; therefore, 0.07 mg/day ×7.2 kg = 0.5 mg/day. Next, note that the physician orders digoxin twice daily; therefore, two doses in 24 hours will be administered; 0.5 mg/day divided by 2 doses = 0.25 mg for each dose. Test-Taking Strategy: Identify the key components of the question and what the question is asking. Read the question carefully, noting the key words, twice daily and each dose. Calculate the dosage by weight first and then determine the milligrams per each dose. Verify the answer using a calculator. Review pediatric medication calculations if you had difficulty with this question. Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation

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Content Area: Child Health Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, pp. 234-236. <AQ>11. Atropine sulfate, 0.2 mg intramuscular, is prescribed for a child preoperatively. The medication label reads “0.4 mg per mL.” A nurse has determined that the dose prescribed is safe. The nurse prepares to administer how many milliliters to the child? Answer: 0.5 Rationale: Use the formula for calculating medication dosage. Formula: Desired 0.2 mg _______ ×volume = ________ ×1 mL = 0.5 mL Available 0.4 mg Test-Taking Strategy: Identify what the question is asking. In this case, the question asks for the milliliters to be administered. Use the formula to determine the correct dose and use a calculator to verify your answer. Review this formula if you had difficulty with this question. Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Child Health Reference: Kee, J., & Marshall, S. (2004). Clinical calculations: With applications to general and specialty areas (5th ed.). Philadelphia: W.B. Saunders, pp. 22-23.

- Silvestri Chapter 35 Ed#55F
- Silvestri Chapter 36 Ed#560
- Silvestri Chapter 37 Ed#561
- Silvestri Chapter 38 Ed#562
- Silvestri Chapter 40 Ed#564
- Silvestri Chapter 41 Ed#565
- Silvestri Chapter 42 Ed#566
- Silvestri Chapter 43 Ed#567
- Silvestri Chapter 56 Ed#574
- Silvestri Chapter 57 Ed#575
- Silvestri Chapter 58 Ed#576
- Silvestri Chapter 59 Ed#577
- Silvestri Chapter 60 Ed#578
- Silvestri Chapter 61 Ed#579
- Silvestri Chapter 62 Ed#57A
- Silvestri Chapter 63 Ed#57B
- Silvestri Chapter 64 Ed#57C
- Silvestri Chapter 65 Ed#57D
- Silvestri Chapter 66 Ed#57E
- Silvestri Comp Exam Edi#57F
- Silvestri001-100
- Silvestri1001-1100
- Silvestri101-200
- Silvestri1101-1200

- 6574189 Silvestri Chapter 11 Ed547
- Silvestri Chapter 37 Ed#561
- Silvestri Chapter 10 Ed#546
- Silvestri Chapter 36 Ed#560
- Silvestri Chapter 35 Ed#55F
- Silvestri Chapter 38 Ed#562
- Silvestri Chapter 29 Ed#559
- Silvestri Chapter 27 Ed#557
- Silvestri Chapter 60 Ed#578
- Silvestri Chapter 41 Ed#565
- Silvestri Chapter 40 Ed#564
- Silvestri Chapter 09 Ed#545
- Silvestri Chapter 30 Ed#55A
- Silvestri Chapter 61 Ed#579
- Silvestri Chapter 64 Ed#57C
- Silvestri Chapter 28 Ed#558
- Silvestri Chapter 21 Ed#551
- Silvestri Chapter 25 Ed#555
- Silvestri Chapter 07 Ed#543
- Silvestri Chapter 08 Ed#544
- Silvestri Chapter 65 Ed#57D
- Silvestri Chapter 15 Ed#54B
- Silvestri Chapter 20 Ed#550
- Silvestri Chapter 42 Ed#566
- Silvestri Chapter 51MM
- Silvestri Chapter 31 Ed#55B
- Silvestri Chapter 12 Ed#548
- Silvestri Chapter 59 Ed#577
- Silvestri Chapter 45 Ed#569
- Silvestri Chapter 43 Ed#567
- Silvestri Chapter 39 Ed#563

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