ANSWERS TO PRACTICE MATH/MED TEST PEDIATRICS 1) Jordyn is a 15 Kg 2 ½ yr old with a fever and is ordered to receive Acetominophen 200 mg po Q 4 hr for a fever >101. The SDR for Acetominophen is 10-15 mg/Kg/dose Q 4hrs. Calculate the SDR for this child. SDR = 15(10) – 15 (15) = 150-225 mg / dose. 2) The Acetominophen you are going to give to Jordyn comes in multiple forms. The liquid form concentration is 160mg/5ml. How many ml’s will you prepare to deliver the correct dose of 200mg? 200/160 x 5 = 6.25 ml. 3) For discharge instructions, convert the dose in #2 from ml’s to teaspoons. 6.25 ml / x = 5 ml/ 1 tsp ; 6.25/5 = 1.25 tsp. 4) Benjamin is a 4 yr old with asthma who needs an Albuterol Neb. For wheezing, bronchospasm and an O2 sat of 88%. The physician has ordered Albuterol 2.5 mg via neb Q 4 hrs. The concentration of the Albuterol is 5.0 mg/1 ml. How many ml.’s will Benjamin receive? 2.5 mg/ 5.0 x 1ml = 0.5 ml 5) George is a 35 Kg 8 yr old who is ordered to receive Ancef 1 Gram IV Q 8hrs. The SDR for Ancef is 50-100mg/Kg/day. Determine the SDR for George. 35 ( 50 ) - 35 ( 100 ) mg / day ; 1750 - 3500 mg/ day Or per dose = 1750 / 3 = 583.3 - 1166.6 mg/ dose 6) Is George’s dose of Ancef within SDR? Pt recvs 3000mg or 3 Gm / day which is within the SDR / day Pt recvs 1000mg or 1 Gm / dose which is within the SDR / dose 7) What is your nursing action? Give the dose. 8) Mary is a 40 Kg 10yr old receiving D5 ½ with 20 mEq KCL @ 60 ml/hr. Determine the rate for the IV pump in ml/hr using a pediatric microdripper. Set the pump to 60 ml / hr. 9) Kara is a 12yr old who is ordered to receive Percocet i tab po Q 4-6hr for post-op pain. Kara weighs 45 Kg. [Children weighing < 50 Kg are considered within the pediatric safe dose range. Over 50Kg is considered adult dosing.] Since Percocet tab is a combination drug containing Oxycodone 5 mg and Acetominophen 325mg, you have to compute the SDR for both: Oxycodone SDR for children = 0.05-0.15 mg/kg/dose 45 ( 0.05) - 45 ( 0.15) mg/ dose 2.25- 6.75 mg / dose Acetominophen SDR for children = 10-15 mg/kg/dose 45 (10) – 45 ( 15 ) = 450 – 675 mg / dose 10) Are both the Oxycodone and the Acetominophen within SDR? Oxycodone 5 mg is within the SDR of 2.25 – 6.75 mg / dose Acetominophen 325 mg is actually below the SDR of 450 -675 mg/dose. 11) What is your nursing action? Give the drug but let the physician know that the Acetominophen dose is below therapeutic range. Keep this in mind when you reassess the child’s pain ½ to 1 hr after the pain med is given. 12) Will is a 30Kg 6yr old who is ordered to receive Gentamicin 80 mg IV Q 8hr. Using your PDA, determine the SDR for Gentamicin for this child. Calculate the SDR for Will. Gentamicin SDR for children = 6-7.5 mg / kg / day divided Q 8 hr 30 ( 6 ) = 180 mg / day ; 30 ( 7.5 ) = 225 mg / day Q 8 hr. 180 – 225 mg / day or 60 – 75 mg / dose Will’s dose is a little high. Let the physician know. Check the gentamicin Peak and trough levels to determine if they are within therapeutic range. 13) Gentamicin comes in a concentration of 80mg/30 ml. How many ml’s will you give Will? Give 30 ml. 14) Using your PDA, determine what length of time you will run this dose of Gentamicin. 30 min without kidney disease. 15). Determine the rate at which you will run the pump (microdripper). Set the pump to 60 ml / hr to deliver 30 ml over 30 min.