| Course | NR 328 Pediatric Nursing |
|---|---|
| Week | 4 |
| Paper type | Weight-based dosage calculation set |
| Length | About 1,130 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 328 Week 4
Weight-Based Dosage Set: Five Orders for an 11-Year-Old at 47.6 kg With Community-Acquired Pneumonia, One of Them Past the Adult Ceiling and One to Query
Student Name
College of Nursing, Chamberlain University
NR 328: Pediatric Nursing
Instructor Name
Month Day, Year
Weight-Based Dosage Set: Five Orders for an 11-Year-Old at 47.6 kg With Community-Acquired Pneumonia, One of Them Past the Adult Ceiling and One to Query
The Child and the Weight
Maya is 11 years old, admitted overnight with community-acquired pneumonia and poor oral intake; details have been changed. She was weighed this morning, 0615 on the unit scale, without shoes, at 47.6 kilograms. Her clinic weight from four months ago was 44.9 kilograms, which is why the older figure is not used: it belongs to a smaller child, and every dose below would have been 6% low.
Each item gives the order, the dose the order works out to per kilogram, the band published for that drug at that weight, and a verdict of give, hold or query. Where an item rests on a guideline, the guideline is cited. Where it rests on the unit's pediatric dosing reference, that is stated. The calculations were checked by a second student and by the nurse assigned to Maya.
Item 1: Ampicillin, Intravenous
Order. Ampicillin 2,000 mg IV every 6 hours.
Order in mg/kg. 2,000 mg x 4 doses = 8,000 mg a day; 8,000 / 47.6 = 168 mg/kg/day.
Published band. 150 to 200 mg/kg/day divided every 6 hours for a fully immunized child admitted with pneumonia (Bradley et al., 2011). At 47.6 kg: 7,140 to 9,520 mg a day, or 1,785 to 2,380 mg a dose.
Verdict. Give. The ordered dose sits inside the band.
What is given. The dose arrives from pharmacy prepared as a small-volume infusion; the nurse checks the label against the order and the weight before hanging it.
Item 2: Maintenance Intravenous Fluid
Order. 5% dextrose in 0.9% sodium chloride at 85 mL an hour.
Calculation. By the Holliday and Segar (1957) method: 100 mL/kg for the first 10 kg = 1,000 mL; 50 mL/kg for the next 10 kg = 500 mL; 20 mL/kg for each kg above 20 = 27.6 x 20 = 552 mL. Total 2,052 mL a day, or 85.5 mL an hour.
Verdict. Give. The order matches the calculated maintenance rate.
What is given. 85 mL an hour on the infusion pump. The rate is reviewed as her oral intake improves, since she will not need full maintenance by vein once she is drinking.
Item 3: Acetaminophen, Oral
Order. Acetaminophen 650 mg by mouth every 6 hours as needed for fever or pain.
Order in mg/kg. 650 / 47.6 = 13.7 mg/kg a dose. Maximum use in a day, four doses, is 2,600 mg, or 54.6 mg/kg.
Published band. The unit's reference gives 10 to 15 mg/kg a dose, capped at 75 mg/kg in 24 hours or 4 g, whichever is lower. At 47.6 kg: 476 to 714 mg a dose, and a daily ceiling of 3,570 mg.
Verdict. Give. The dose and the maximum daily total both sit inside the band.
What is given. Two 325 mg tablets. Maya says she swallows tablets, which avoids measuring 20.3 mL of the 160 mg per 5 mL liquid.
Item 4: Ibuprofen, Oral
Order. Ibuprofen 600 mg by mouth every 6 hours as needed for pain.
Order in mg/kg. 600 / 47.6 = 12.6 mg/kg a dose. Four doses a day would be 2,400 mg, or 50.4 mg/kg.
Published band. The unit's reference gives 5 to 10 mg/kg a dose, no more than 40 mg/kg a day. At 47.6 kg: 238 to 476 mg a dose, and 1,904 mg a day.
Verdict. Query. The single dose is above the per-kilogram band, and so is the daily total if every dose is given. 600 mg is a common adult dose, which may be why it was written, but Maya has not reached the size at which the adult dose applies.
What happens. The nurse holds this dose and phones the prescriber with the figures: "Ibuprofen 600 is 12.6 mg per kg for Maya at 47.6 kilograms; our reference band is up to 10. Would you like to change the order?" The nurse does not reduce the dose independently, because choosing the dose is the prescriber's decision.
Item 5: Amoxicillin, Oral, at Discharge
Order. Amoxicillin 2,000 mg by mouth twice a day to complete the course at home.
Calculation without a ceiling. The oral dose for pneumonia in the same guideline is 90 mg/kg/day in two doses, with a maximum of 4 g a day (Bradley et al., 2011). At 47.6 kg: 90 x 47.6 = 4,284 mg a day, or 2,142 mg a dose.
Where the rule stops. 4,284 mg a day is above the 4,000 mg maximum. At her size, the per-kilogram rule has reached its ceiling, and the ceiling is the dose: 4,000 mg a day, or 2,000 mg twice a day.
Verdict. Give. The order equals the capped dose. If the order had been written from the per-kilogram figure alone, 2,142 mg twice a day, it would have looked correct by the rule and still been above the maximum.
What the family measures. The 400 mg per 5 mL suspension would be 25 mL a dose, which the pharmacy's 10 mL oral syringe cannot measure in one fill and a marked cup measures poorly. Maya's mother and the pharmacist agreed on four 500 mg capsules a dose, which Maya can swallow, with a written schedule for 0800 and 2000.
What the Set Shows
Four of the five orders were safe to give as written. One, the ibuprofen, was held and queried rather than corrected. One, the amoxicillin, was correct only because the prescriber had applied the adult maximum, and the set shows the calculation that proves it. In a child of Maya's size, the per-kilogram rule and the adult ceiling meet, and both have to be checked on every order: the first to catch a dose that is too large for her, the second to catch one that is too large for anyone.
The weight check at the top of the set was worth doing even though it changed no verdict here. At her clinic weight of 44.9 kilograms, the maintenance fluid would have come to about 83 mL an hour instead of 85, and the ibuprofen order would have been 13.4 mg/kg instead of 12.6, a larger overshoot. In a younger child, where the same four months can add a tenth of body weight, the older figure could move a dose out of its band entirely. That is why the set begins with a weight taken this morning and says so.
References
Bradley, J. S., Byington, C. L., Shah, S. S., Alverson, B., Carter, E. R., Harrison, C., Kaplan, S. L., Mace, S. E., McCracken, G. H., Moore, M. R., St Peter, S. D., Stockwell, J. A., & Swanson, J. T. (2011). The management of community-acquired pneumonia in infants and children older than 3 months of age: Clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clinical Infectious Diseases, 53(7), e25-e76. https://doi.org/10.1093/cid/cir531
Holliday, M. A., & Segar, W. E. (1957). The maintenance need for water in parenteral fluid therapy. Pediatrics, 19(5), 823-832. https://doi.org/10.1542/peds.19.5.823
Reading the NR 328 Week 4 instructions
The Week 4 assignment presents pediatric medication orders and asks you to calculate whether each dose is safe for the child's weight. Course materials usually specify the weight in kilograms, the calculation for each order, comparison with a recommended range, a decision to give, hold or clarify, and nursing actions, with references. Confirm the weight and its source before anything else. Convert to milligrams per kilogram for each dose and each day. Compare the result with a named reference, not memory. Check adult maximums whenever the child is large. Give a plain verdict for each item and say what the nurse does next. Convert the final dose into something that can be measured.
How this NR 328 Week 4 example is built
The paper starts with Maya's weight on the unit scale at 0615 and explains why the four-month-old clinic weight was not used. Item 1 works ampicillin to 168 mg/kg/day against Bradley and colleagues' 150 to 200 band. Item 2 calculates maintenance fluid at 2,052 mL a day, matching the 85 mL hourly order. Item 3 places acetaminophen at 13.7 mg/kg with a safe daily total. Item 4 finds ibuprofen 600 mg above the 10 mg/kg limit, holds it and scripts the call to the prescriber. Item 5 shows amoxicillin at 90 mg/kg reaching 4,284 mg a day, above the 4 g maximum, so the capped 2,000 mg twice daily is correct. The last section reviews the set.
Reading the NR 328 Week 4 grading rubric
Dosage calculation rubrics usually assign points to correct conversion and weight, accurate calculations shown step by step, comparison with a safe range, a correct decision for each order, appropriate nursing action and references. Accuracy and safety decisions carry the most points, so every item ends with two numbers and a verdict. Calculations earn credit when each step is visible, including the daily total. The safe range row is met by naming the source of each band. Nursing action scores when a query is made to the prescriber with figures rather than a quiet dose change, as with ibuprofen. Checking amoxicillin against the adult maximum shows the critical thinking the rubric rewards. Bradley and colleagues and Holliday and Segar support the bands.
Common NR 328 Week 4 mistakes, and how to avoid them
The heaviest point loss in this set is computing a dose and comparing it with nothing, which leaves arithmetic without a safety judgment. Weight left in pounds causes the next most errors, because every later figure inherits the mistake. Students also forget to check the daily total as well as the single dose, or adjust an unsafe dose themselves instead of contacting the prescriber. Large children catch many students out, because the per-kilogram dose can pass the adult maximum. A final dose that cannot be measured with the device at hand is another common miss. Round only at the end. If your set uses different drugs or weights, send the orders and an NR 328 calculation set can be worked through with you.
Get a NR 328 Week 4 example written to your instructions
Send the Week 4 problem set with whatever rounding and referencing rules your classroom publishes, and a fully worked version returns inside 24-48h, the first at no cost. Tell us which drug reference your section marks against, because the published band is half of every answer here and two references do not always agree with each other.
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NR 328 Week 4 questions, answered
Which reference should the safe range come from?
Whichever one your classroom marks against, named on the page. Published bands differ between drug handbooks and between editions, so an answer quoting a range without saying where it came from cannot be checked and sometimes disagrees with the marker's copy for reasons the writer could never have fixed. Name the source once at the top of the set and hold to it throughout.
What do I do when the calculated dose comes out unsafe?
Say so and stop. The finished item names the discrepancy, states that the dose would be held and the prescriber contacted, and leaves the figure exactly as the order produced it. Adjusting the order so the figure fits is not yours to do, and a marker reads it as the writer stepping into somebody else's role. Recognizing the problem and naming who owns it is the entire point of the item.
Do fluid calculations belong in the same set?
Often, and they behave the same way. Maintenance volumes here are derived from the child's size in bands rather than looked up, so the working stays visible for the same reason the drug items do, and the result gets the same treatment: an hourly figure, a device that could deliver it, and a sentence on what would make somebody question it. Check your instructions, since some sets keep the two apart.
Where can I find a free NR 328 Week 4 sample paper?
This page has the complete Week 4 dosage set for Maya at 47.6 kilograms, all five items with calculations, bands and verdicts, the closing review and both references.
Why is the ibuprofen order queried in the NR 328 Week 4 set?
At 600 mg it works out to 12.6 mg/kg a dose, above the reference band of 5 to 10 mg/kg, so the nurse holds it and calls the prescriber with the figures instead of changing it.