Use nightly or HS for bedtime. Every other day. Use every other day. Every evening at 6 PM. Mistaken as every 6 hours. Use daily at 6 PM or 6 PM daily. Sliding scale regular insulin Sliding scale insulin. Mistaken as 3 times a day or twice in a week Mistaken as 2 times a day. Use 3 times weekly Use 2 times weekly.
Miscellaneous Abbreviations Associated with Medication Use. Baby boy A twin Baby girl B twin. Mistaken as IV or intrajugular. Use injection. Period following abbreviations e. Use mg, mL, etc. Drug Name Abbreviations. Antiretroviral medications e. Use complete drug names. ARA A. Use complete drug name. Mistaken as azithromycin, aza THIO prine, or aztreonam.
Mistaken as tincture of opium. Mistaken as hydrocortisone e. Mistaken as magnesium sulfate. Na at the beginning of a drug name e.
Sodium bicarbonate. Mistaken as no bicarbonate. Mistaken as patient-controlled analgesia. Pitocin oxytocin. Mistaken as Purinethol mercaptopurine. Mistaken as liothyronine, which is sometimes referred to as T3. TAC or tac. Use complete drug names Avoid drug regimen or protocol acronyms that may have a dual meaning or may be confused with other common acronyms, even if defined in an order set.
TPA or tPA. Mistaken as TPA tissue plasminogen activator. Mistaken as morphine sulfate. IV vanc. Intravenous vancomycin. Mistaken as Invanz. Neo-Synephrine, a well known but discontinued brand of phenylephrine. Mistaken as neostigmine. Specific ingredients compounded together. Dose Designations and Other Information. Doses expressed as Roman numerals e. Use only Arabic numerals e.
Lack of a leading zero before a decimal point e. Mistaken as 5 mg if the decimal point is not seen. Trailing zero after a decimal point e. Mistaken as 10 mg if the decimal point is not seen.
Do not use trailing zeros for doses expressed in whole numbers. Mistaken as propranolol mg Mistaken as TEG retol mg. Place adequate space between the drug name, dose, and unit of measure.
Numerical dose and unit of measure run together e. Place adequate space between the dose and unit of measure. Use commas for dosing units at or above 1, or use words such as thousand or 1 million to improve readability Note : Use commas to separate digits only in the US; commas are used in place of decimal points in some other countries.
Dram Minim. Symbol for dram mistaken as the number 3 Symbol for minim mistaken as mL. Administer once. Administer for 1 day. Use explicit words e. Increase and decrease. Use increase and decrease. Use per rather than a slash mark to separate doses. Mistaken as the number 2. Use at. Plus or and. Mistaken as the number 4. Use plus, and, or in addition to.
Mistaken as a zero e. Zero, null sign. Mistaken as the numbers 4, 6, 8, and 9. Use 0 or zero, or describe intent using whole words.
Use the metric system kg or g rather than pounds Use lb if referring to pounds. Apothecary or Household Abbreviations. Grain s. Mistaken as gram. Use the metric system e. Minim s. Mistaken as minutes. Teaspoon s.
Mistaken as tablespoon s. Contradictory Meanings. Breast, brain, or bladder. So, how do we check that? This means that the child should get mg of the drug for every kg they weigh. So, for example, if they weighed 10 kg, they should get mg per day, and if they weighed 15 kg, they should get mg per day; however, we must be careful, because if they weight over 20 kg, they should only receive " mg to mg q.
So, if there are supposed to be four doses a day notice that the label says q. Likewise, the 15 kg child who will get mg per day should have that divided into 4 equal doses , so we should divide mg by 4 to get mg per dose. So, to check and see if the above order for "ampicillin susp. Let's suppose this child weighs 16 kg.
We write down the important information below: Example: Is the following order safe for a 6 kg child? Order: Principen mg p.
We want our answer to be in mg, because our goal is to calculate the safe dosage and compare it to the given order , which measures the drug in mg. So we begin by writing:. Now we need to find something to put on the right side of the equation that will help us determine a safe dosage for this patient.
Since the dosage range depends on the patient's weight, we begin by putting 6 kg to the right of the equals sign, because we need to find the number of mg we need for a 6 kg patient:. We can put 6 kg over 1 without changing it: 6 kg 1. If we look at the label, we see that it says that the safe dosage is mg per kg per day.
Because this safe dosage is given per day , we should label our calculations "Safe dosage per day":. Now we want to get rid of the kg on the top of the right side of the equation, and we notice that we can write mg per kg as a fraction: mg 1 kg.
In a safe dosage, mg and 1 kg should be equal; we can multiply our equation by mg 1 kg , because: The top of this fraction will be equal to the bottom in a safe dosage. This fraction has kg on the bottom, which will cancel out the kg we want to get rid of on the top. None of the numbers will cancel, but we can cancel units that appear on both the top and the bottom to get:.
Is the following order safe for a 43 lb child? This child has a moderate infection. Order: Kefzol mg IM q. Since the dosage range depends on the patient's weight, we begin by putting 43 lb to the right of the equals sign, because we need to find the number of mg we need for a 43 lb patient:.
We can put 43 lb over 1 without changing it: 43 lb 1. Since the patient's weight is in lb and we want to use metric as a general rule, we need to convert lb to kg. If we look at the label, we see that it says that the safe dosage is 25 to 50 mg per kg per day. We choose this concentration instead of the others listed on the label because it is the one the label says we should use when This child has a moderate infection.
Because this safe dosage is given per day , we should label our calculations "Safe dosage per day", and because the safe dosage given is a range , our answer must be a range , too, with a minimum safe amount, and a maximum safe amount:.
Now we want to get rid of the kg on the top of the right side of the equation, and we notice that we can write mg per kg as two different fractions: 25 mg 1 kg and 50 mg 1 kg.
In a minimum safe dosage, 25 mg and 1 kg should be equal and in a maximum safe dosage, 50 mg and 1 kg should be equal; we can multiply our equation for the minimum by 25 mg 1 kg and our equation for the maximum by 50 mg 1 kg , because: The top of these fractions will be equal to the bottom in a safe minimum or maximum dosage.
Both fractions have kg on the bottom, which will cancel out the kg we want to get rid of on the top of each equation. Now we need to get rid of the decimal in 2. If we multiply 2. Now we notice that we can divide both 10 and 22 by 2, so we can reduce the right side of our equations by dividing 10 on the top and 22 on the bottom by The ordered amount is safe , because the ordered amount of mg is within the safe range per dose mg. Is the following order safe for a lb child? Order: Mithracin mcg IV q.
We want our answer to be in mcg, because our goal is to calculate the safe dosage and compare it to the given order , which measures the drug in mcg. Since the dosage range depends on the patient's weight, we begin by putting lb to the right of the equals sign, because we need to find the number of mcg we need for a lb patient:. We can put lb over 1 without changing it: lb 1. If we look at the label, we see that it says that the safe dosage is 25 to 30 mcg per kg per day.
Now we want to get rid of the kg on the top of the right side of the equation, and we notice that we can write mcg per kg as two different fractions: 25 mcg 1 kg and 30 mcg 1 kg. In a minimum safe dosage, 25 mcg and 1 kg should be equal and in a maximum safe dosage, 30 mcg and 1 kg should be equal; we can multiply our equation for the minimum by 25 mcg 1 kg and our equation for the maximum by 30 mcg 1 kg , because: The top of these fractions will be equal to the bottom in a safe minimum or maximum dosage.
The ordered amount is unsafe , and we should check with the physician who wrote the order and should not give the patient this dose, because the ordered amount of mcg is not within the safe range per dose mcg.
Is the following order safe for a 35 lb child? Order: Velocef mg IV q. Since the dosage range depends on the patient's weight, we begin by putting 35 lb to the right of the equals sign, because we need to find the number of mg we need for a 35 lb patient:.
We can put 35 lb over 1 without changing it: 35 lb 1. If we look at the label, we see that it says that the safe dosage is 50 to mg per kg per day. Now we want to get rid of the kg on the top of the right side of the equation, and we notice that we can write mg per kg as two different fractions: 50 mg 1 kg and mg 1 kg. In a minimum safe dosage, 50 mg and 1 kg should be equal and in a maximum safe dosage, mg and 1 kg should be equal; we can multiply our equation for the minimum by 50 mg 1 kg and our equation for the maximum by mg 1 kg , because: The top of these fractions will be equal to the bottom in a safe minimum or maximum dosage.
Is the following order safe for a 33 kg child? This child has bacterial meningitis. Order: Zinacef 2. We want our answer to be in g, because our goal is to calculate the safe dosage and compare it to the given order , which measures the drug in g. Since the dosage range depends on the patient's weight, we begin by putting 33 kg to the right of the equals sign, because we need to find the number of g we need for a 33 kg patient:.
We can put 33 kg over 1 without changing it: 33 kg 1. If we look at the label, we see that it says that the safe dosage is to mg per kg per day. We choose this concentration instead of the others listed on the label because it is the one the label says we should use when This child has bacterial meningitis. Now we want to get rid of the kg on the top of the right side of the equation, and we notice that we can write mg per kg as two different fractions: mg 1 kg and mg 1 kg.
In a minimum safe dosage, mg and 1 kg should be equal and in a maximum safe dosage, mg and 1 kg should be equal; we can multiply our equation for the minimum by mg 1 kg and our equation for the maximum by mg 1 kg , because: The top of these fractions will be equal to the bottom in a safe minimum or maximum dosage.
Now we notice that the units we have on the top right of our equation are mg, but we need our answer to be in g. The ordered amount is safe , because the ordered amount of 2.
Calculating Dosages Based on Body Surface Area Sometimes using a person's weight to determine how much of a drug they receive isn't the best method. For example, someone who is 4 ft 10 in tall and someone who is 6 ft 4in tall might both be lbs, but they may need more or less of a drug, depending on what portion of their weight is fat, or muscle, or retained fluid, etc.
Some ways of dealing with this might include determining a person's dosage not on their actual weight, but on their "ideal" body weight - the weight that would be healthy for someone of their height and build; a hospital should have a chart that would allow us to calculate what this is.
However, another way to address this issue is to determine how much drug a person should get by their body surface area, rather than their weight. The body surface area is precisely what it sounds like: the surface area of a person's body. You have probably calculated the surface areas of more regular shapes, like cubes and balls and pyramids in a previous math class.
A person's surface area would be the area that the skin would take up if we could lay it out flat. Obviously this would be difficult to measure, as people are made up of a lot of irregular shapes, so to determine a person's body surface area , or BSA , we use formulas or charts based on their height and weight. The book gives two formulas to determine a person's BSA.
If we know someone's height and weight in the metric system in kg and cm we use this formula:. If we know someone's height and weight in lb pounds and in inches we use this formula:. Notice that our BSA is always in square meters , no matter which formula we use. The BSA of a person will always be below 3 m 2.
The BSA of a child will generally be below 1. We will always round BSA to the nearest hundredth. Let's look at a few examples that will show us how to calculate BSA:.
Because this question gives us the height and weight in lb and in , we must use the formula for these units:. Because this question gives us the height and weight in kg and cm , we must use the formula for these units:.
We use BSA just like weight when we want to calculate a dosage. Notice how similar these examples are to the ones we had for dosages calculated by weight:. Is the following order safe for a 0.
This is the child's fifth dose. Order: vinblastine sulfate 3. Before we can calculate anything, we must first calculate the patient's BSA.
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