Medication Review KILOGRAMS TO POUNDS 1. How many pounds is 60kg? Remember: 1kg=2.2lbs. Set up proportion like this: 1kg_ = __60 kg__ 2.2lbs. X lbs. Solve by cross multiplying: (1 kg) x (X lbs.) = (2.2 lbs.) x (60kg) 1x= 132 Isolate X and solve. You divide 132 by 1 = 132 lbs POUNDS TO KILOGRAMS 2. How many kilograms is 225lbs? Remember same conversion 1kg=2.2lbs. Set up proportion like this: 1kg_ = __X kg__ 2.2lbs. 225 lbs. Solve by cross multiplying: (1 kg) x (225lbs.) = (2.2 lbs.) x (Xkg) 225=2.2x Isolate X and solve. You divide 225 by 2.2 = 102.27 kg. (Do not round, must carry out to 1 hundredth unit in pediatrics) POUNDS PLUS OUNCES TO KILOGRAMS 3. How many kg is a child that weighs 14 pounds 4 ounces? Remember 16 oz. are in 1 lb. First you need to convert ounces to pounds. __4 ounces_ = 0.25 pounds 16 Then add 0.25 pounds to 14 pounds and you get 14.25 pounds. Convert pounds to kilograms. Do this by dividing 14.25 by 2.2 to find the kilograms. __14.25 pounds_ = 6.48 kg 2.2 OUNCES TO MILLILITERS 4. How many ml are there in 4oz.? Remember: 8oz.=240ml. Set up a proportion like this: 8oz._ = __4oz.__ 240ml Xml Solve by cross multiplying: (240ml) x (4oz) = (8oz) x (Xml) 960=8x Isolate X and solve. You divide 960 by 8 = 120ml SAME version 2.1. - 1 Haspela 2004 MILLILITERS TO OUNCES 5. How many ounces is equal to 375ml? 1 oz = 30ml Divide 375 by 30 = 12.5 ounces GRAMS TO MILLIGRAMS 6. How many mg are there in 24 grams? Remember 1g=1000mg Set up a proportion like this: 1 gram_ = __24 grams__ 1000mg X mg Solve by cross multiplying: (1000mg) x (24grams)= (1gram)x (Xmg) 24000 = 1X Isolate X and solve. You divide 24000 by 1 = 24,000mg MILLILITER TO MILLIGRAM CONVERSION GIVEN A CONCENTRATION 7. How many mg are in 3ml if 1ml has 5mg? Set up a proportion like this: 1 ml_ = __3ml__ 5mg Xmg Solve by cross multiplying: (5mg) x (3ml) = (1ml) x (Xmg) 15=1x Isolate X and solve. You divide 15 by 1 = 15mg FIND MAXIMUM 24 HOUR DOSE 8. What is the maximum 24 hour dose for a child that weighs 21 pounds 6 ounces? The maximum amount of medication that can be given in 24 hours is 80mg/kg/day. Convert 6 ounces to pounds: 6/16 = 0.375 lbs. Then add 0.375 lbs. to 21 lbs. = 21.375 pounds. Convert lbs to kg: 21.375/2.2 = 9.716 kg Then multiply (80mg) x (9.716kg) x 1 day = 777.28mg per day DIVIDED DOSAGES 9. The child weighs 12 pounds 8 ounces. The medication is 30mg/kg/day given every 8 hours. What is the total mg that can be given for the whole day? How many mg should be given at each dose? Convert 8 ounces to pounds: 8/16 = 0.5 pounds Then add 0.5 lbs. to 12 lbs. = 12.5 pounds Convert lbs. to kg: 12.5/2.2 = 5.682 kg Then multiply (30mg) x (5.682kg) x 1 day = 170.46mg per day SAME version 2.1. - 1 Haspela 2004 There are 3 doses in a 24 hour period (every 8 hours) Divide 170.46 by 3 = 56.82mg administered at each dose THERAPEUTIC RANGES 10. An order asks you to administer 50mg of a medication to a 6 pound 2 ounce premature infant via a PEG tube. A drug reference book indicated that the safe medication range for this medication is 10-15mg/kg/day. Is 50mg a safe dose to give? Covert the weight to pounds: 2/16 = 0.125 then add 0.125 + 6 = 6.125 pounds Convert pounds to kilograms: 6.125/2.2 = 2.784 kg Calculate the minimum and maximum doses for the drug: Minimum: (2.784kg) x (10mg) = 27.84mg Maximum: (2.784kg) x (15mg) = 41.76mg The order asked you to administer 50mg. The dose is outside of the range allowed for this child. You may NOT administer this medication. Call the ordering MD to discuss modification to the order. 11. The child you are caring for has a lower respiratory tract infection. The doctor orders Cefprozil (Cefzil) 125mg/5ml. Administer 120mg PO Q12 hours for 10 days. The child’s weight is 17lbs. 10oz. and she is 7 months old. The pediatric dose for a child >6 months old is 15mg/kg/Q12 hours. How many mg will you administer for the whole day? How many mg at each dose? How many ml should be given at each dose? Is the dose ordered appropriate for this child? First and foremost, convert the weight to pounds: 10/16= 0.625lbs+17 = 17.625 Convert the weight to kg: 8.01kg What are the mg that are to be given at each dose? (15mg) x (8.01kg) = 120.15mg per dose Yes, the dose ordered is appropriate. What is the mg dosage for the entire day? Medication is ordered BID, so: 120.15 x 2 = 240.3mg/day Now determine the ml for each dose: Concentration __125mg__ 5ml Set up like a proportion with what you know is ordered: __125mg_ = __120mg__ 5ml Xmg Cross multiply: (125mg) x (Xmg) = (5ml) x (120mg) = 125x = 600 Solve for X: Divide 600 by 125 = 4.8ml per dose SAME version 2.1. - 1 Haspela 2004 The following are examples of how your physician orders need to be written: Suprax 100mg/5ml. Administer 6ml (120mg) per GB BID x 10 days. Phenobarbital elixir 20mg/5ml. Administer 10ml (40mg) via GB twice daily. Bisocodyl EC 5mg/tab. Administer 1 tab (5mg) per GB 8-12 hours before desired stool PRN constipation. (Give only if no stool in 24 hours, may increase to 2 tabs) **Make sure you indicate ml and mg on every single order** **Complete the physician’s name you received the order from, write your full name with credentials, complete the patient’s birthdate and Medicaid number** **If you are writing a PRN order, please indicate the reason for usage.** **Send the white copy to the office and keep yellow copy in the home. ** **If the order is for an antibiotic, immediately complete an infection control sheet and send it into the office.** SAME version 2.1. - 1 Haspela 2004

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