Pediatric Medication Dosage Calculation and Administration Guidelines

Safe dosages (based on body weight) should always be calculated prior to the administration of medications ordered for children. Dosage information based on the child’s weight in kilograms is available for most medications in current medication manuals. If no information is available for a specific medication, the body surface area is sometimes used to calculate dosages. The calculation method is as follows:

1. Use a nomogram to calculate body surface area (see Figs. 1–26 and 1–27).
2. Divide the surface area in meters by 1.7.
3. Multiply the quotient from step 2 by the adult dose.

Tips for Administrating Medications

1. Never ask a child if he or she will take the medicine. Tell the child it is time to take the medicine.
2. Give choices when possible. Example: Ask which medicine he or she wants to take first or what he or she wants to drink with the medicine.
3. Infants will frequently suck medication from a nipple.
4. A syringe may be used to administer liquid medicine to an infant. Gently squeeze the infant’s cheeks to prevent medicine from being pushed from the mouth, and administer small amounts into the side of the child’s mouth. (Medicine placed on top of the tongue is likely to be pushed from the mouth.)
5. Do not add medication to the infant’s formula.
6. Never blow into a child’s face or pinch his or her nose closed in an attempt to make him or her swallow medication, as this may cause the child to gasp and aspirate medicine into the airway.
7. When giving IM medications, be sure to have assistance in holding the child. Be honest about pain, and finish the procedure as quickly as possible.