Acetaminophen (Tylenol) 120 mg PO stat for a fever of 102.6 F is ordered for an infant weighing 12 lb (5.5 kg). The recommended dose is 10-15 mg/kg. What action should the nurse take?

• A. Discuss the order with the physician
• B. Give the medication as ordered
• C. Administer 2/3 of the prescribed dose
• D. Give ½ of the dose bid

Answer: (A)

Dosing in pediatrics is based on weight, so it's essential to calculate mg/kg to ensure safety. For acetaminophen, the typical dose is 10–15 mg per kilogram every 4–6 hours as needed. This infant weighs 5.5 kg, so the safe per-dose range is 55 mg (5.5 kg × 10 mg/kg) to 82.5 mg (5.5 kg × 15 mg/kg). The ordered 120 mg is about 22 mg/kg, which is well above the safe per-dose maximum and poses a risk of overdose and hepatotoxicity. Because the dose is outside the recommended range, the nurse should discuss the order with the physician to verify or adjust the dose before giving anything. If the physician approves a safe dose, administer within 55–82.5 mg per dose (every 4–6 hours as needed, per guidelines).