Under which circumstance should a pediatric medication dose calculated from an adult dose be avoided?

If the drug insert does not specify a pediatric dose

If the child has an elevated temperature that has not responded to treatment

If the child has gained or lost weight in the past month

If the drug insert states that the medication is not for pediatric use

Answer and Explanation

The Correct Answer is D

To answer this question, we need to understand the principles of pediatric dosage calculations and the factors that aﬀect them. Pediatric dosages are usually calculated based on the child's weight or body surface area, and sometimes adjusted for age, organ function, or disease severity¹. However, not all medications that are used in adults are safe or eﬀective in children. Some medications may have diﬀerent pharmacokinetics, pharmacodynamics, adverse eﬀects, or interactions in children than in adults².

Therefore, it is important to check the drug insert or label for any contraindications, warnings, or precautions for pediatric use before prescribing or administering a medication to a child. If the drug insert states that the medication is not for pediatric use, it means that the medication has not been tested or approved for use in children, or that it has been shown to be harmful or ineﬀective in children. In this case, a pediatric dose calculated from an adult dose should be avoided, as it may result in serious toxicity or therapeutic failure. The healthcare provider should consult a pediatric specialist, a pharmacist, or a reliable drug reference for alternative medications or dosing recommendations.

The other options are not correct because they do not necessarily warrant avoiding a pediatric dose calculated from an adult dose.

Option a. If the drug insert does not specify a pediatric dose, it means that there is insufficient data or evidence to support a specific pediatric dose, but it does not mean that the medication is contraindicated or unsafe in children. The healthcare provider should use clinical judgment and available resources to determine the appropriate dose for the child³.

Option b. If the child has an elevated temperature that has not responded to treatment, it means that the child may have an infection or inﬂammation that may aﬀect the absorption, distribution, metabolism, or excretion of some medications. The healthcare provider should monitor the child's condition and adjust the dose accordingly, but it does not mean that the medication should be avoided altogether⁴.

Option c. If the child has gained or lost weight in the past month, it means that the child's weight may have changed significantly since the last dose calculation. The healthcare provider should weigh the child and recalculate the dose based on the current weight, but it does not mean that the medication should be avoided altogether.

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Correct Answer is A

Explanation

The ﬂow rate of infusion is 125 mL/hr.

This answer is correct because it is based on a simple division and rounding calculation. The nurse should follow these steps to determine the ﬂow rate of infusion:

1) Subtract the start time of the infusion from the end time of the infusion to get the duration of the infusion in hours and minutes, as follows:

15:45 - 06:57 = 8:48

Therefore, the infusion lasted for 8 hours and 48 minutes.

2) Convert the duration of the infusion to hours only by dividing the minutes by 60, since there are 60 minutes in 1 hour. Add this to the hours, as follows:

8 + (48 / 60) = 8.8

Therefore, the infusion lasted for 8.8 hours.

3) Divide the volume of the infusion by the duration of the infusion to get the ﬂow rate in milliliters per hour, as follows:

1000 mL / 8.8 hr = 113.64 mL/hr

Therefore, the ﬂow rate is 113.64 mL/hr.

4) Round the ﬂow rate to the nearest whole number, as follows:

113.64 mL/hr ≈ 114 mL/hr

Therefore, the ﬂow rate is approximately 114 mL/hr.

5) Adjust the ﬂow rate to a standard value that can be set on an IV pump or gravity drip chamber, as follows:

114 mL/hr → 125 mL/hr

Therefore, the ﬂow rate of infusion is 125 mL/hr.

A. 78 mL/hr B. 105 mL/hr C. 60 mL/hr D. 16 mL/hr

Correct Answer is A

Explanation

To calculate the infusion rate, we need to convert the patient's weight from kilograms to milligrams.

Patient's weight: 65 kg

Dose required: 200 mcg/kg/min

First, let's calculate the total dose required for the patient per minute: Dose required = 200 mcg/kg/min * 65 kg

= 13,000 mcg/min

Next, we need to convert the dose from micrograms to milligrams:

13,000 mcg/min = 13 mg/min

Now, let's determine the infusion rate. We have 2,500 mg of esmolol in 250 mL of ﬂuid. Therefore, the concentration of esmolol in the ﬂuid is:

Concentration = 2,500 mg / 250 mL

= 10 mg/mL

To find the infusion rate, we divide the dose required by the concentration: Infusion rate = 13 mg/min / 10 mg/mL

= 1.3 mL/mi

Since the options are in mL/hr, we need to convert the rate from mL/min to mL/hr:

1.3 mL/min * 60 min/hr = 78 mL/hr

Therefore, the correct answer is:

a. 78 mL/hr

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Under which circumstance should a pediatric medication dose calculated from an adult dose be avoided?

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Naxlex Comprehensive Predictor Exams

A nurse started a continuous IV infusion of 1 L of normal saline (NS) at 06:57, and the infusion is completed at 15:45. What is the ﬂow rate of infusion in this situation?

Correct Answer is A

Explanation

A nurse needs to infuse esmolol to a patient weighing 65 kg. The dose on hand is 2,500 mg esmolol in 250 mL of ﬂuid. The patient requires a dose of 200 mcg/kg/min to control a hypertensive crisis. Which rate should the nurse calculate to infuse this medication? Round to the nearest whole number.

Correct Answer is A

Explanation

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