Perform Mensuration and Calculation

In calculating dosages for pediatric patients keep these in mind:

•Children are completely different from adults.•Inaccurate dosage is more likely to harm a child that of an adult.•Children are more sensitive than adults to medication because of their weight, height, physical condition, immature systems, and metabolism.

Administering Pediatric Oral Drugs

•Infants and young children are given oral drugs in the form of liquid.•In some cases wherein liquid medicines are not available, tablet may be crushed and mixed it with a little amount of liquid.•The child will not get the entire dose if the medication is mixed in a large amount of liquid.

Devices used in giving out pediatric oral drugs

•Cup – It can be used by children.•Dropper – It is usually used for infants.•Syringe – it is usually used for infants.•Hollow-handle spoon – it is usually used for toddlers.

Methods to Calculate Pediatric Doses

1.Body Surface Area (BSA)- Also called as the dosage-per-kilogram-

of-body weight method.- most accurate and safest method in

calculating pediatric dose.- A nonogram is a graphical calculating

device, a two-dimensional diagram designed to allow the approximate graphical computation of a function to determine the child’s BSA.

Formula for computing child’s dose

Child’s dose in mg=average adult dose( )Child’s BSA in m2

average adult BSA

NOTE: Average adult BSA is equal to 1.73 m2

Example:Compute the child’s dose who weighs 40 lbs. and 36 inches tall. What is the safe drug dose if the average adult dose is 500 mg? Using the nomogram, the child’s BSA is 0.72 m2

Solution:Child’s dose= 500mg

Child’s dose = 500mgChild’s dose = 210 mg

( )0.72m2

1.73m2

(.42)

Try this:Compute the child’s dose who weighs 20 lbs. and 30 inches tall. What is the safe drug dose if the average adult dose is 500 mg? Using the nomogram, the child’s BSA is 0.47 m2

NOTE: Average adult BSA is equal to 1.73 m2

( )

Solution:Child’s dose= 500mg

Child’s dose = 500mgChild’s dose = 135 mg

( )0.47m2

1.73m2

(.27)

Methods to Calculate Pediatric Doses

2. Clark’s Rule- It uses child’s weight to calculate

approximate dosage.- It uses weight in lbs., Never in kg.

Formula:Approximate child’s dose=average adult dose ( )Child’s weight

150 lbs

Example:Compute for a 2-year old child’s dose who weighs 28 lbs. wherein the adult dose is 500 mg.

Solution:Approximate child’s dose =

500mg

Approximate child’s dose = 500mg (.19)Approximate child’s dose = 95 mg

( )28 lbs.150 lbs

Try this:Compute for a 3-year old child’s dose who weighs 68 lbs. wherein the adult dose is 500 mg.

Formula:Approximate child’s dose=average adult dose( )

Child’s weight

150 lbs.

Solution:Approximate child’s dose =

500mg

Approximate child’s dose = 500mg (.45)Approximate child’s dose = 225 mg

( )68 lbs.150 lbs

Methods to Calculate Pediatric Doses

3. Young’s Rule-It normally applies to children who are

two years of age and above.- the word “young” refers to the age.

Formula:Approximate child’s dose = adult dose

[ ]Child’s age in the year(child’s age in the year + 12)

Example:Compute for a 2-year old child’s dose who weighs 28 lbs. wherein the adult dose is 500 mg. Note that the weight has no bearing using Young’s Rule.

Solution:Approximate child’s dose =

500mg

Approximate child’s dose = 500mg

Approximate child’s dose = 500mg (.14)Approximate child’s dose = 70 mg

[ ]2(2+12) ( )2

14

Try this:Compute for a 5-year old child’s dose who weighs 68 lbs. wherein the adult dose is 500 mg.

Formula:Approximate child’s dose = adult dose

[ ]Child’s age in the year(child’s age in the year + 12)

Solution:Approximate child’s dose =

500mg

Approximate child’s dose = 500mg

Approximate child’s dose = 500mg (.29)Approximate child’s dose = 145 mg

[ ]5(5+12) ( )5

17

Methods to Calculate Pediatric Doses

4. Fried’s Rule -It calculates doses for children who are

two years of age and less.- It uses age in months.

Formula:Approximate child’s dose = adult dose

[ ]Child’s age x 12 months150

Example:Compute for a 2-year old child’s dose who weighs 28 lbs. wherein the adult dose is 500 mg.

Solution:Child’s dose= 500mg

Child’s dose = 500mg

Child’s dose = 500 mg (.16)Child’s dose = 80 mg

[ ] 2 x 12150

[ ]24150

Try this:Compute for a 1 1/2-year old child’s dose who weighs 68 lbs. wherein the adult dose is 500 mg.

Formula:Approximate child’s dose = adult dose

(Child’s age x 12 month)[ ]150

Solution:Child’s dose= 500mg

Child’s dose = 500mg

Child’s dose = 500 mg (.12)Child’s dose = 60 mg

[ ] 1.5 x 12150

[ ]18150

Administering Medicine to the patient

•A caregiver or a home nurse should read the doctor's prescription.• A prescription is a written instruction of the doctor on the preparation and use of medicine.

Doctor's code in prescribing the time intervals to observe

in the administration and use of medicine

•- qd = once a day -q4h = every 4 hrs.•- bid = twice a day -q6h = every 6 hrs.•- tid = thrice a day -q8h = every 8 hrs.•- qid = 4x a day -pc = after meals•- ac = before meals -hs = at bedtime

Things that should be remembered when

administering medicines:1. The right medicine2. The right amount of medicine3. The right approach4. At the right time5. Right route6. Right patient

Expiration of MedicinesMedicine's effectivity lasts only up to a certain period of time.A medicine that has reached its expiration should no longer be administered, it is no longer safe and may cause serious harm.

Disposal of Medicines Medicines that are expired or no longer

needed must be discarded by:-flushing down the toilet-washing down the drain

• Syringe• -wrap it and the needle in a piece of

paper, plastic/container• -place in a puncture proof container

before putting in a tash can

The Generics Law