SECTION 5

Dosage Calculation from Body Weight and

Body Surface Area

CHAPTER 13
Adult and Pediatric Dosages Based on Body Weight
CHAPTER 14
Adult and Pediatric Dosages Based on Body Surface Area

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 CHAPTER 13 ADULT AND PEDIATRIC DOSAGES BASED ON BODY WEIGHT 117

CHAPTER 13
Adult and Pediatric Dosages Based on Body Weight

Objectives
The learner will:
1. convert body weight from lb to kg.
2. convert body weight from kg to lb.
3. calculate dosages using mcg/mg per kg, or per lb.
4. determine if dosages ordered are within the normal range.

Suggested Review Questions

1. Why is body weight a factor considered by the prescriber when ordering medication
dosages?
2. What are the nurse’s responsibilities when medications are prescribed by weight?
3. How is weight in pounds (lb) converted to weight in kilograms (kg)?
4. How can dimensional analysis be used to calculate medication dosages of mg/kg when the
patient’s weight is given in lbs?

Answers to Review Questions

1. Body weight is one of the factors that influences an individual’s response to a dose of
medication. Other factors include the amount of the dose and route of drug administration,
as well as the individual’s age, general health status, hepatic and renal function, drug
history, presence of allergies, etc. Weight is especially important when considering drug
dosage for infants and neonates since their ability to metabolize drugs is decreased due to
organ immaturity. Drug doses for children in general are frequently prescribed by body
weight because of the wide variation in weight and development in children of similar age.
2. As with all medication orders, when a medication dose is prescribed based on body
weight, it is the nurse’s responsibility to prepare the prescribed dose correctly as well as
verify that the order is safe. For medications prescribed by weight, the safe dose is
determined by comparing the ordered dose and frequency of administration with the

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118 SECTION 5 DOSAGE CALCULATION FROM BODY WEIGHT AND BODY SURFACE AREA

recommended total daily dose as noted on the drug label, package insert, or a reliable
reference, e.g., PDR. The recommended total daily dose is usually noted as the number of
micrograms (mcg) or milligrams (mg) per kilogram (kg) of body weight. Occasionally,
doses for adults may be noted as micrograms (mcg) or milligrams (mg) per pound (lb) of
body weight.
3. There are 2.2 lb in one kg, so to convert weight in lbs to weight in kg, divide the number of
lbs by 2.2. Stress that fractions of lbs are always noted as decimals and, in children, the
number of kg needs to be exact; that is, ounces cannot be rounded to the nearest quarter lb.
4. The medication calculation problem is set up in the same manner as described in Chapter
12, with the conversion for lbs to kg noted in the equation written to the right of the equal
(=) sign. Here is an example:
A 48 lb child has an order for cefaclor 45 mg/kg PO every 12 h. Using the information on
the label in Figure 13-1, how many milliliters are needed per dose?
The problem would be set up as follows:
5 mL 45 mg 1 kg 45 lb 10,800
mL = × × × = = 39.27 rounded to nearest tenth = 39.3 mL/dose
125 mg 1 kg 2.2 lbs 1 275
Ranbaxy Pharmaceuticals Inc.
Used with permission from

Figure 13-1

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 CHAPTER 13 ADULT AND PEDIATRIC DOSAGES BASED ON BODY WEIGHT 119

Name ____________________________________________ Date ____________________

Chapter 13: Adult and Pediatric Dosages Based on Body Weight

Additional Practice Problems

Convert the following body weight to kg or lb as directed below. Round weights to nearest
tenth.

1. 25 lb = ___________ kg

2. 62.5 lb = ___________ kg

3. 115 lb = ___________ kg

4. 15.25 lb = ___________ kg

5. 156 lb = ___________ kg

6. 252 lb = ___________ kg

7. 58.2 kg = ___________ lb

8. 13.5 kg = ___________ lb

9. 5.4 kg = ___________ lb

10. 23.6 kg = ___________ lb

Determine the amount of medication needed based upon physician orders and patient’s
weight. When available, read the label to determine how the medication is supplied. Work
problems using dimensional analysis when appropriate. Calculate doses to nearest tenth.
Calculate safe dose when requested.

11. A patient with rheumatoid arthritis is ordered azathioprine (Imuran®)

twice a day. The label reads: recommended dose 1 mg/kg/day
in 2 divided doses. The patient weighs 145 lbs. How many mg
should the patient get with each dose? ________________ mg

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120 SECTION 5 DOSAGE CALCULATION FROM BODY WEIGHT AND BODY SURFACE AREA

12. You are to administer furosemide (Lasix®) 2 mg/kg to a child

weighing 45 lbs. The furosemide available is 8 mg/mL. ________________ mL

13. You are to give digoxin 15 mcg/kg to a child weighing

15 kg. The digoxin available is 0.1 mg/mL. ________________ mL

14. Clindamycin 100 mg/kg/day is ordered for an infant weighing

6 lb 4 oz. Refer to the package information shown in Figure 13-2.
You are to give this in divided doses 12 hours apart.
How many mL will be given for each dose? ________________ mL
Used with permission from Bedford

Boehringer-Ingelheim Company.
Laboratories, A Division of Ben
Venue Laboratories Inc. A

Figure 13-2

15. The physician orders 40 mg of gentamycin (Garamycin®) every

8 hours for a patient who weighs 20 kg. The recommended
safe range dose for gentamycin is 6 to 7.5 mg/kg/day in 3 to 4
divided doses. What is the safe dose range for this patient? ________________

Is the ordered dose within the safe range? ________________

16. A patient is to receive 20 mg/kg of nafcillin sodium (Nafcil®)

every 12 hours. The patient weighs 5 kg and the nafcillin label
reads 500 mg/mL. How many mL will you give? ________________ mL

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 CHAPTER 13 ADULT AND PEDIATRIC DOSAGES BASED ON BODY WEIGHT 121

17. A child who weighs 35 lb has been ordered amoxicillin 250 mg

po every 8 h. The label on the amoxicillin bottle reads: amoxicillin
250 mg/5 mL. How many mL are needed for each dose? ________________ mL

The label also reads: Usual Child Dosage: 20 to 40 mg/kg/day

in divided doses every 8 hrs. Is this dose safe for this patient? ________________

18. The physician orders ampicillin 5 mg/kg/day in 4 equally divided

doses for a child who weighs 70 lbs. How many mg are needed
for each dose? ________________ mg

19. Procainamide 0.5 mg/kg/day divided in 2 doses is ordered for

an adult patient weighing 198 lbs. How many mg are needed
for each dose? ________________ mg

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122 SECTION 5 DOSAGE CALCULATION FROM BODY WEIGHT AND BODY SURFACE AREA

Solutions to Additional Practice Problems

Convert the following body weight to kg or lb as directed below. Round weights to nearest
tenth.

1. 25 lb = 25 ÷ 2.2 = 11.36 rounded to nearest tenth = 11.4 kg

2. 62.5 lb = 62.5 ÷ 2.2 = 28.40 rounded to nearest tenth = 28.4 kg

3. 115 lb = 115 ÷ 2.2 = 52.27 rounded to nearest tenth = 52.3 kg

4. 15.25 lb = 15.25 ÷ 2.2 = 6.93 rounded to nearest tenth = 6.9 kg

5. 156 lb = 156 ÷ 2.2 = 70.90 rounded to nearest tenth = 70.9 kg

6. 252 lb = 252 ÷ 2.2 = 114.54 rounded to nearest tenth = 114.5 kg

7. 58.2 kg = 58.2 × 2.2 = 128.04 rounded to nearest tenth = 128 lb

8. 13.5 kg = 13.5 × 2.2 = 29.7 lb

9. 5.4 kg = 5.4 × 2.2 = 11.88 rounded to nearest tenth = 11.9 lb

10. 23.6 kg = 23.6 × 2.2 = 51.92 rounded to nearest tenth = 51.9 lb

Determine the amount of medication needed based upon physician orders and patient’s
weight. When available, read the label to determine how the medication is supplied. Work
problems using dimensional analysis when appropriate. Calculate doses to nearest tenth.
Calculate safe dose when requested.

11. kg = 145 ÷ 2.2 = 65.9 kg

mg = 1 mg × 65.9 kg = 65.9 mg/day divided into 2 equal doses = 32.95
rounded to nearest tenth = 33 mg/dose

1 mL 2 mg 1 kg 45 lb 45
12. mL = × × × = = 5.1 mL
8 mg kg 2.2 lb 1 8.8
4

1 mL 1 mg 15 mcg 15 kg 45
13. mL = × × × = = 2.25 rounded to nearest
0.1 mg 1000 mcg 1 kg 1 20
200

tenth = 2.3 mL

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 CHAPTER 13 ADULT AND PEDIATRIC DOSAGES BASED ON BODY WEIGHT 123

14. First convert 6 lb 4 oz to a decimal = 4 oz/16 oz in a lb = 0.25 + 6 lb = 6.25 lb.

1 mL 100 mg 1 kg 6.25 lb
mL = × × × remove the decimals
150 mg 1 kg 2.2 lb 1
2 125
1 mL 100 mg 1 kg 625 lb 250
mL = × × × = = 1.89 mL/day
150 mg 1 kg 220 lb 1 132
3 44

1.89 mL daily dose ÷ 2 = 0.94 rounded to nearest tenth = 0.9 mL/dose

15. Safe dose = 6 mg × 20 kg = 120 mg/day

7.5 mg × 20 kg = 150 mg/day
Safe dosage range is 120–150 mg/day.
Ordered is 40 mg every 8 hrs or 3 times a day, therefore daily dose = 40 mg × 3 = 120.
Yes, the ordered dose is within the safe dose range for this patient.

1 mL 20 mg 5 kg 5
16. mL = × × = = 0.2 mL
500 mg 1 kg 1 25
25

5 mL 250 mg 5
17. mL = × = = 5 mL/dose
250 mg 1 1
1

Ordered daily dose is 250 mg every 8 hours = 250 × 3 = 750 mg/day

Child’s weight in kg = 35 ÷ 2.2 = 15.9 kg
Safe dose = 20 mg × 15.9 kg = 318 mg/day
40 mg × 15.9 kg = 636 mg/day
The ordered 750 mg/day exceeds the safe dose range, therefore, the ordered dose is not
safe for this patient.

18. kg = 70 lbs ÷ 2.2 = 31.8 kg.

Daily dose = 5 mg × 31.8 kg = 159 mg/day divided in 4 doses = 159 ÷ 4 = 39.75 = 39.8

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124 SECTION 5 DOSAGE CALCULATION FROM BODY WEIGHT AND BODY SURFACE AREA

19. kg = 198 lbs ÷ 2.2 = 90 kg.

mg = 0.5 mg × 90 kg = 45 mg/day divided in 2 doses = 45 ÷ 2 = 22.5 mg/dose

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