How should you approach pediatric dosing when standing orders specify weight-based dosing?

• A. Use adult dosing for all children
• B. Calculate based on patient weight and refer to the dosing chart; adjust as needed
• C. Use fixed doses by age only
• D. Guess dose based on appearance

Answer: (B)

In pediatric dosing, the dose is driven by weight rather than age or appearance. When standing orders specify weight-based dosing, you take the patient’s weight in kilograms, look up the recommended dose per kilogram on the dosing chart, and multiply by the weight to obtain the dose. Then you check the chart for any maximum or minimum limits and adjust as needed based on the formulation and route. This method accounts for the wide variation in sizes among children and helps prevent under- or overdosing.

Using adult doses ignores pediatric needs, fixed doses by age don’t account for weight differences, and guessing by appearance is unsafe; each of these can lead to inaccurate dosing.