Question

Determine the normal dosage range for the following problems to the nearest tenth. State your course of action. A child weighing \(23 \mathrm{~kg}\) has an order for \(500 \mathrm{mg}\) of a medication in \(100 \mathrm{~mL}\) D5W q12h. The normal daily dosage range is 40 to \(50 \mathrm{mg} / \mathrm{kg}\). Determine if the dosage ordered is within normal range, and state your course of action.

Short answer

The dosage of 1000 mg/day is within the normal range of 920 to 1150 mg/day, so no changes are needed.

Step-by-step solution

Determine Daily Dosage Ordered

The child is receiving 500 mg of medication every 12 hours, which means the total daily dosage is: \[ 500 \text{ mg} \times 2 = 1000 \text{ mg per day} \]

Calculate Weight-Based Dosage Range

The normal daily dosage range is given as 40 to 50 mg/kg. Thus, for a child weighing 23 kg, the appropriate dosage should be:- Lower range: \[ 40 \text{ mg/kg} \times 23 \text{ kg} = 920 \text{ mg/day} \]- Upper range: \[ 50 \text{ mg/kg} \times 23 \text{ kg} = 1150 \text{ mg/day} \]

Evaluate Dosage Ordered Against Normal Range

The ordered dosage is 1000 mg per day, which should be compared against the calculated range of 920 mg/day to 1150 mg/day. The ordered dosage of 1000 mg/day falls between the lower and upper limits of the normal range.

Determine Course of Action

Since the ordered dosage (1000 mg/day) is within the normal dosage range, and no other contraindications or adjustments were specified, the medication order is appropriate, and no changes are necessary.

Key concepts

Weight-Based Dosage

Weight-based dosage is a fundamental concept in pediatric medication management. Unlike adults, children vary greatly in size, which makes a single standard dosage inappropriate for all. To ensure safety and efficacy, dosages are calculated based on a child's weight. In this context, the weight-based dosage helps adjust the medication amount to fit the child's physical characteristics. The formula for calculating weight-based dosage involves multiplying the child's weight by the recommended dosage range. For instance, for a child weighing 23kg, the lower range would be calculated as \(40 \, \text{mg/kg} \times 23 \,\text{kg} = 920\, \text{mg/day}\), and the upper range as \(50 \, \text{mg/kg} \times 23 \,\text{kg} = 1150\, \text{mg/day}\). This calculation ensures the medication is neither under nor overdosed.

Normal Dosage Range

The normal dosage range refers to the safe and effective amount of a medication that should be administered within a day. This range assures that the medication exerts its intended effects without causing adverse reactions. For the scenario provided, the normal dose range is between 40 to 50 mg per kilogram per day. Understanding and calculating this range is critical for evaluating any medication order. It serves as a benchmark to compare the ordered dosage. Thus, a healthcare professional evaluates if a prescribed dose of 1000 mg/day fits into the established dosage parameters of 920 mg/day to 1150 mg/day. If the prescribed dosage fits within this range, it is considered safe to proceed with the administration.

Medication Administration

Medication administration is the process of preparing and providing the medication to the patient. It involves multiple steps ensuring accuracy and safety. In pediatric settings, administration should be approached with extra caution, often involving precise calculations to match the child's weight and closely monitoring for adverse effects. Practitioners follow specific guidelines and confirm that doses correspond to the weight-specific range. They also ensure the medication form and concentration, here provided in 100 mL D5W (dextrose 5% in water), is suitable for the prescribed frequency (every 12 hours in this case). Safe medication administration results from correctly interpreting the dosage calculations and comparing them against the child's needs.

Course of Action

The course of action refers to the steps a healthcare professional takes in response to evaluating medication orders. Once the calculated dosage aligns with the normal range, as it does in the given exercise (1000 mg/day fits within 920 to 1150 mg/day), the professional assesses further steps. Common actions include: - Approving and proceeding with the current medication regimen. - Monitoring the child for therapeutic effects and side effects. - Adjusting the dosing if any signs of adverse effects emerge. This ensures that not only is the medication safe, but it is also effective for the treatment's specific goals.

Medication Order Evaluation

Medication order evaluation involves a critical assessment of the physician's prescription to ensure that it is appropriate for the patient's needs. This step is essential in preventing medication errors and promoting patient safety. The evaluation process involves checking different components: - Verification of the patient's age, weight, and health condition. - Assessment of the dosage prescribed against the established weight-based dosage range. - Confirmation that the frequency and duration of administration are appropriate. In the scenario discussed, evaluating these aspects confirms that the ordered dosage of 1000 mg/day is correct and safe, thus warranting no adjustments.