Principles of Medication Administration

1. Administering Medications To Children Principles of Medication Administration Click on the image to start your review Drip Rates NOT YET ACTIVE Grains to milligram conversion

2. Grains to Milligram Conversions Click on the image to start your review 65 When to use 65 mg per grain? The difference between 60-65 mg per grain 60 When to use 60 mg per grain? Practice Calculations

3. Apothecary System of Measurement The apothecary system was used in ancient times for trade and is still used today. The grain that is referenced to in this system refers to a grain of wheat. A grain of wheat varies in weight depending on the size of the grain and the amount of moisture. When converting from apothecary to metric there may be anywhere from 60-65 mg per grain.

4. When to use 65 mg per grain? • ALWAYS when the medication that is ordered is either: (Acetaminophen) Click the image to go to the Tylenol homepage Click the image for a history of aspirin Practice Calculation

5. When to use 60 mg per grain? When the ordered dose ends in a zero, e.g. grains 10 As a default • Remember the “0” in both 10 and 60 Practice Calculation

6. Practice Calculation • The physician orders grain V (5) of Tylenol to be administered every 4 hours as needed for pain. The Tylenol comes in 325 mg tablets. How many tablet(s) will the nurse administer? ½ tablet 1 tablet 1 ½ tablets 2 tablets • The physician orders grain ½ of Phenobarbitol to be administered every 6 hours. The Phenobarbitol is packaged in a vial labeled 60 mg per 1 cc. How many cc(s) will the nurse administer per dose? 0.5 cc 1 cc 1.5 cc 2 cc

7. Practice Calculation • The physician orders grain V (5) of Tylenol to be administered every 4 hours as needed for pain. The Tylenol comes in 325 mg tablets. How many tablet(s) will the nurse administer? ½ tablet try again 1 tablet 1 ½ tablets 2 tablets Back to Practice Calculation

8. Practice Calculation • The physician orders grain V (5) of Tylenol to be administered every 4 hours as needed for pain. The Tylenol comes in 325 mg tablets. How many tablet(s) will the nurse administer? ½ tablet 1 tablet 1 ½ tablets 2 tablets Back to Practice Calculation

9. Practice Calculation • The physician orders grain V (5) of Tylenol to be administered every 4 hours as needed for pain. The Tylenol comes in 325 mg tablets. How many tablet(s) will the nurse administer? ½ tablet 1 tablet 1 ½ tablets try again 2 tablets Back to Practice Calculation

10. Practice Calculation • The physician orders grain V (5) of Tylenol to be administered every 4 hours as needed for pain. The Tylenol comes in 325 mg tablets. How many tablet(s) will the nurse administer? ½ tablet 1 tablet 1 ½ tablets 2 tablets try again Back to Practice Calculation

11. Practice Calculation • The physician orders grain ½ of Phenobarbitol to be administered every 6 hours. The Phenobarbitol is packaged in a vial labeled 60 mg per 1 cc. How many cc(s) will the nurse administer per dose? 0.5 cc 1 cc 1.5 cc 2 cc Back to Practice Calculation

12. Practice Calculation • The physician orders grain ½ of Phenobarbitol to be administered every 6 hours. The Phenobarbitol is packaged in a vial labeled 60 mg per 1 cc. How many cc(s) will the nurse administer per dose? 0.5 cc 1 cc try again 1.5 cc 2 cc Back to Practice Calculation

13. Practice Calculation • The physician orders grain ½ of Phenobarbitol to be administered every 6 hours. The Phenobarbitol is packaged in a vial labeled 60 mg per 1 cc. How many cc(s) will the nurse administer per dose? 0.5 cc 1 cc 1.5 cc try again 2 cc Back to Practice Calculation

14. Practice Calculation • The physician orders grain ½ of Phenobarbitol to be administered every 6 hours. The Phenobarbitol is packaged in a vial labeled 60 mg per 1 cc. How many cc(s) will the nurse administer per dose? 0.5 cc 1 cc 1.5 cc 2 cc try again Back to Practice Calculation

15. Principles of Pediatric Medication Administration Click on the image to start your review Dose is based on weight Rounding rules Where to give an injection Practice Calculations

16. Infant Injection Click on the button to start your review Diagram of VastusLateralas Principles- basic information every nurse must know about giving injections to infants Practice Calculation

17. Infant Injection site • Use the vastuslateralas muscle until the age of 1 year • Do not inject more than 1 cc at a time • Rotate sites, R and L, if more than 1 cc or more than 1 injection at a time

19. Rounding Rules • When calculating a pediatric dose, NEVER round up • Truncate- which means to drop off the numbers at the appropriate decimal point Click the ball to practice pediatric rounding Practice Calculation

20. Rounding Rules Practice Click on the ball for the answer • 1.532 would round to: • 0.5382 would round to: • 2.4984 would round to:

21. 1.532 would round to 1.5 cc • This medication would be delivered in a 3 cc syringe • A 1 cc syringe is calibrated to the 0.1 cc or the tenths place • The number is truncated at the 1.5

22. 0.5382 would round to 0.53 • This dose would be delivered in a 1 cc syringe • A 1 cc syringe is calibrated to the 0.01 cc or the hundredths place • The number is truncated at the 0.53

23. 2.4984 would round to 2.4 cc • This medication would be delivered in a 3 cc syringe • A 1 cc syringe is calibrated to the 0.1 cc or the tenths place • The number is truncated at the 2.4

24. Weight based dose • Nurses must accurately calculate the dose based on the child’s weight • Remember there is 2.2 pounds per kilogram • If the pharmacist calculates and fills the order, nurses must double check the calculation • The final responsibility remains with the person who delivers the medication, or in other words: thenurse Practice Calculation

25. Practice Calculations • The physician orders Ampicillin 100mg/kg/day for a child with a weight of 34 pounds, and to be administered 4 times a day. How many mg will the nurse deliver in one dose? 386 mg try again 386.3636 mg 386.4 mg 387 mg Back to Practice Calculation

26. Practice Calculations • The physician orders Ampicillin 100mg/kg/day for a child with a weight of 34 pounds, and to be administered 4 times a day. How many mg will the nurse deliver in one dose? 386 mg 386.3636 mg 386.4 mg 387 mg Back to Practice Calculation

27. Practice Calculations • The physician orders Ampicillin 100mg/kg/day for a child with a weight of 34 pounds, and to be administered 4 times a day. How many mg will the nurse deliver in one dose? 386 mg 386.3636 mg 386.4 mg try again 387 mg Back to Practice Calculation

28. Practice Calculations • The physician orders Ampicillin 100mg/kg/day for a child with a weight of 34 pounds, and to be administered 4 times a day. How many mg will the nurse deliver in one dose? 386 mg 386.3636 mg 386.4 mg 387 mg try again Back to Practice Calculation

29. Practice Calculations • The order is for Ampicillin 420 mg per dose to be administered 4 times a day. The Ampicillin suspension label reads 125 mg/5 ml. How many ml will the nurse deliver in one dose? 16 ml try again 16.5 ml 16.8 ml 17 ml Back to Practice Calculation

30. Practice Calculations • The order is for Ampicillin 420 mg per dose to be administered 4 times a day. The Ampicillin suspension label reads 125 mg/5 ml. How many ml will the nurse deliver in one dose? 16 ml 16.5 ml try again 16.8 ml 17 ml Back to PracticeCalculation

31. Practice Calculations • The order is for Ampicillin 420 mg per dose to be administered 4 times a day. The Ampicillin suspension label reads 125 mg/5 ml. How many ml will the nurse deliver in one dose? 16 ml 16.5 ml 16.8 ml 17 ml Back to Practice Calculation

32. Practice Calculations • The order is for Ampicillin 420 mg per dose to be administered 4 times a day. The Ampicillin suspension label reads 125 mg/5 ml. How many ml will the nurse deliver in one dose? 16 ml 16.5 ml 16.8 ml 17 ml try again Back to Practice Calculation

33. Practice Calculations • The physician orders Ampicillin 100mg/kg/day for a child with a weight of 34 pounds, and to be administered 4 times a day. How many mg will the nurse deliver in one dose? 386 mg 386.3636 mg 386.4 mg 387 mg • The order is for Ampicillin 420 mg per dose to be administered 4 times a day. The Ampicillin suspension label reads 125 mg/5 ml. How many ml will the nurse deliver in one dose? 16 ml 16.5 ml 16.8 ml 17 ml