N2715 Dosage Calculation Made Easy Rounding Rules for Pediatrics: Round to the hundredth place for weights

and dosage amounts. Round to the tenths for IV rates. *Do not round until your final answer. This worksheet takes you step by step through three sample problems. Example #1: Order: clindamycin 220 mg IVPB every 6 hours. Recommended: 25-40 mg/kg/day in divided doses every 6 to 8 hours to be administered over 60 minutes. Supplied: 18 mg/mL. Patient wt.: 50 lbs. If this is a safe dose, how many mL will you administer per dose? (Round answer to the nearest hundredth.) Example #2: Order: ceftriaxone 700 mg IVPB once daily. Recommended: 50-75 mg/kg/day in divided doses every 12 to 24 hours to be administered over 20 minutes. Supplied: 40 mg/mL. Patient wt.: 23 lbs., 3.4 oz. If this is a safe dose, at what rate would you set the IV pump? (Round answer to the nearest tenth.) Example #3: Ordered: digoxin 20 mcg/kg PO daily. Recommended dose: 20 mcg/kg daily. Supplied: 0.05 mg/mL. Patient weight: 5 pounds, 12 oz. If this is a safe dose, how many mL will you administer? (Round answer to the nearest hundredth.)

Step one: Determine the weight in kilograms (round to hundredths) and

clear calculator.

Step two: Determine the dose. Is it written as per kg dosing? Step three: Determine the recommended range. Is it per day or per dose? Step four: Determine if the dose is safe. Are you comparing apples to
apples?

Step five: Answer the question in mL or mL/hr or state that the dose is not
safe.

Step six: Review your work. Does the answer make sense? Did you round
correctly?

Example #1: Order: clindamycin 220 mg IVPB every 6 hours. Recommended: 25-40 mg/kg/day in divided doses every 6 to 8 hours to be administered over 60 minutes. Supplied: 18 mg/mL. Patient wt.: 50 lbs. If this is a safe dose, how many mL will you administer per dose? (Round answer to the nearest hundredth.)

Step one: Determine the weight in kilograms (round to hundredths) and

clear calculator. 50 lbs 50 lbs 2.2 lbs/kg = 22.72727272 kg would be rounded to 22.73 kg

Step two: Determine the ordered dose. Is it written as per kg dosing? Is it

per day or per dose? The dose is 220 mg IVPB every 6 hours so you write it as 220 mg/dose.

Step three: Determine the recommended range. Is it per day or per dose?
Low: 25mg x 22.73 kg/day = 568.25 mg/day High: 40 mg x 22.73 kg/day = 909.2 mg/day

Step four: Determine if the dose is safe. Are you comparing apples to
apples? NOTICE: The dose is in mg/dose but the range is in mg/day. To compare apples to apples, you either have to get both of them in mg/day or both in mg/dose. Here is how you would do it both ways. mg/day: Because the dose is given every 6 hours, it is given 4 times per day. Therefore, the patient will be getting 220 mg x 4 doses/day = 880 mg/day Now you can compare this to the recommended 568.25 - 909.2 mg/day and determine that the dose falls safely within the recommended range. mg/dose: To do it this way, you need to get your recommended range in mg/dose. 568.25 mg/day 4 doses = 142.0625 mg/dose 909.2 mg/day 4 doses = 227.3 mg/dose Now you can compare this dose range to the 220 mg/dose order and determine that the dose falls safely within the recommended range.

Step five: Answer the question in mL or mL/hr or state that the dose is not
safe.

In this case, the dose is safe and the question asks how many mL should be administered. 220 mg x 1 mL = 12.222222 mL 18 mg Rounds to 12.22 mL

Step six: Review your work. Does the answer make sense? Did you round
correctly? Can you administer 12.22 mL? Is it rounded to the hundredths as the question requested? Example #2: Order: ceftriaxone 715 mg IVPB once daily. Recommended: 50-75 mg/kg/day in divided doses every 12 to 24 hours to be administered over 20 minutes. Supplied: 40 mg/mL. Patient wt.: 23 lbs., 3.4 oz. If this is a safe dose, at what rate would you set the IV pump? (Round answer to the nearest tenth.)

Step one: Determine the weight in kilograms (round to hundredths) and

clear calculator. 23 lbs, 3.4 oz. First: Get oz into lbs 3.4 oz 16 oz/lb = .2125 lbs Second: Add for total lbs 23 lbs + .2125 lbs = 23.2125 lbs (NOTICE: no rounding yet) Last: Convert lbs to kg 23.2125 lbs 2.2 lbs/kg = 10.551136 kg rounded to 10.55 kg

Step two: Determine the ordered dose. Is it written as per kg dosing? Is it

per day or per dose? The dose is 715 mg IVPB daily so you write it as 715 mg/day.

Step three: Determine the recommended range. Is it per day or per dose?
Low: 50 mg x 10.55 kg/day = 527.5 mg/day High: 75 mg x 10.55 kg/day = 791.25 mg/day

Step four: Determine if the dose is safe. Are you comparing apples to
apples? NOTICE: The dose is in mg/day and the range is in mg/day. You are comparing apples to apples. You determine that the dose of 715 mg/day falls safely within the recommended range of 527.5 to 791.25 mg/day

Step five: Answer the question in mL or mL/hr or state that the dose is not
safe. In this case, the dose is safe and the question asks at what rate you would set the IV pump.

715 mg x 1 mL = 17.875 mL 40 mg

No rounding needed.

Now you need to figure out how you will set the IV pump in mL/hr to deliver dose over 20 minutes. 17.875 mL x 60 min = 53.625 mL/hr 20 min 1 hr Rounded to 53.6 mL/hr

Step six: Review your work. Does the answer make sense? Did you round
correctly? Can you administer medication at 53.6 mL/hr? Is it rounded to the tenths as the question requested?

Example #3: Ordered: digoxin 20 mcg/kg PO daily. Recommended dose: 20 mcg/kg daily. Supplied: 0.05 mg/mL. Patient weight: 5 pounds, 12 oz. If this is a safe dose, how many mL will you administer? (Round answer to the nearest hundredth.)

Step one: Determine the weight in kilograms (round to hundredths) and

clear calculator. 5 lbs, 12 oz. First: Get oz into lbs 12 oz 16 oz/lb = .75 lbs Second: Add for total lbs 5 lbs + .75 lbs = 5.75 lbs Last: Convert lbs to kg 5.75 lbs 2.2 lbs/kg = 2.6136 kg rounded to 2.61 kg

Step two: Determine the ordered dose. Is it written as per kg dosing? Is it

per day or per dose? The dose is 20 mcg/kg IVPB daily so you have to figure out how many total mcg you will give per dose. 20 mcg x 2.61 = 52.2 mcg Because this is a daily dose, you would write your dose as 52.2 mcg/day

Step three: Determine the recommended range. Is it per day or per dose?
There is nothing to calculate in this part of the problem because the ordered dose is exactly the recommended range so the dose is safe.

Step four: Determine if the dose is safe. Are you comparing apples to
apples? NOTICE: The dose is in mcg/kg/day and the recommended range is in mcg/kg/day. You are comparing apples to apples. You determine that the dose of 52.2 mcg/day is the recommended dose.

Step five: Answer the question in mL or mL/hr or state that the dose is not
safe. In this case, the dose is safe and the question asks at what rate you how many mL you would administer. 52.2 mcg x 1 mg x 1 mL = 1.044 mL 1000 mcg 0.05 mg Rounded to 1.04 mL.

Step six: Review your work. Does the answer make sense? Did you round
correctly? Can you administer 1.04 mL? Is it rounded to the hundredth as the question requested?