A child is admitted with fever, weighs 15 kg, and has a prescription of PCM of 20 mg/kg body weight. Available dose 250 mg/5 ml. Calculate the required dose?

1. A

   5 ml

2. B

   5.5 ml

3. C

   6 ml

4. D

   4 ml

Appeared in: NORCET 6 mains-2024

Explanation

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• The calculation is a two-step process common in pediatric nursing.
• First, the total required dose in milligrams is determined by multiplying the child's weight by the prescribed dose per kilogram (15 kg × 20 mg/kg = 300 mg).
• Second, the volume to administer is calculated using the formula: (Desired Dose / Available Dose) × Quantity.
• Plugging in the values: (300 mg / 250 mg) × 5 ml gives the final answer of 6 ml.
• This ensures the child receives the precise amount of medication as prescribed by the physician.

Why Other Options Were Wrong

• Option A: Administering 5 ml would mean giving only 250 mg of the drug, which is less than the prescribed 300 mg. This error could occur if the nurse mistakenly assumes the required dose is exactly what is available in 5 ml, ignoring the weight-based calculation.
• Option B: 5 ml is an incorrect calculation. It does not correspond to the correct formula and would result in underdosing the patient (275 mg instead of 300 mg). This is likely a simple mathematical error.
• Option D: Administering 4 ml would deliver only 200 mg of the medication, which is a significant underdose compared to the required 300 mg. This might result from a calculation error, such as incorrectly calculating the total dose needed.

Related Visual

• Visual 1: Infographic - A clear visual breakdown of the dosage calculation formula: (Desired Dose / Dose on Hand) × Quantity = Amount to Administer. This helps in memorizing and applying the formula correctly.
• Visual 2: Diagram - A diagram showing a measuring cup or oral syringe being filled to the 6 ml mark, with labels indicating 'Child's Dose', reinforcing the final answer visually.

Clinical Relevance

• Nursing practice connection: Use the key finding related to Pediatric Dosage Calculation to guide bedside assessment, documentation, and the next nursing action.
• Accurate pediatric dosage calculation is a critical nursing skill to ensure patient safety and therapeutic effectiveness. Children are more vulnerable to medication errors due to their smaller body size and immature organ systems.
• This calculation is a core component of the 'Five Rights of Medication Administration': Right Patient, Right Drug, Right Dose, Right Route, and Right Time. Getting the dose right is paramount.
• What if the available dose was a pediatric drop formulation of 100 mg/ml? The total required dose remains 300 mg. The calculation would be (300 mg / 100 mg) × 1 ml = 3 ml. The nurse must always check the concentration of the available medication.

How to Approach the Question

• First, identify that this is an analytical or calculation-based question.
• Carefully read the problem and extract all the numerical values provided: child's weight (15 kg), prescribed dose (20 mg/kg), and available medication concentration (250 mg/5 ml).
• Follow a two-step process. Step 1: Calculate the total dose required in mg by multiplying the weight and the prescribed mg/kg dose.
• Step 2: Use the standard drug calculation formula (Desired/Have × Quantity) to find the volume in ml.
• Perform the multiplication and division carefully to arrive at the final answer.
• Finally, compare your calculated answer with the given options to select the correct one.

Concept Tested & Keywords

• Concept Tested: Pediatric Dosage Calculation
• Stem keywords: child, weighs 15 kg, PCM, 20 mg/kg, Available dose 250 mg/5 ml, Calculate dose
• Lead-in keywords: Calculate
• Clinical cues: Weight: 15 kg (This is a critical value for weight-based dosing).
• Clinical cues: Prescription: 20 mg/kg (This defines the specific dose required per unit of body weight).

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