NUR 232 Pharm EAQ - Chapter 10: Drug Therapy in Pediatric Patients

Which factors may contribute to unintentional nonadherence? Select all that apply.

1.) Forgetfulness 2.) Inability to pay for medications. 3.) Failure to comprehend instructions.

According to the U.S. Food and Drug Administration (FDA) Pregnancy Risk categories, which category represents the greatest risk for fetal harm?

D

The nurse prepares to administer a newly prescribed medication to a 22-year-old woman. The insert in the medication package states, "Pregnancy Category X." Select the nurse's best action.

Ask the patient, "When was your last menstrual period?"

Which of these is not an example of age-related adverse drug effects?

Toxicity

Which statement by a patient about the use of aspirin during pregnancy indicates a need for further learning?

"Aspirin can be used to relieve pain during pregnancy."

Knowing that neonates and infants have a lower binding capacity for medications, the nurse anticipates that the healthcare provider will order which adjustment when prescribing drugs that are highly protein bound?

A decrease in the dosage of drug.

When preparing a teaching session for residents at an assisted living facility, what should the nurse include?

The importance of taking the full prescribed dose.

The nurse is administering medication to an older adult with altered renal function. This patient's renal system will likely have which effect on the medication?

The medication will be excreted more slowly.

The nurse is caring for an older adult patient. The laboratory reports reveal decreased liver function. How does this change affect the drug action?

Reduced metabolism.

The nurse is concerned that an older patient's adverse drug reactions are due to reduced renal excretion. Which laboratory result should the nurse closely monitor?

Creatinine clearance.

The safety or potential harm of drug therapy during pregnancy relates to which factor?

Drug properties.

Why would the nurse consult the Beers list when administering drugs?

It lists drugs with a high likelihood of causing adverse effects in older adults.

Which statement regarding adverse reactions during pregnancy is false?

One in five children is born with a malformation related to drug use during pregnancy.

A pregnant woman admits taking a friend's left-over antibiotics for a sore throat. The nurse will need to verify that the antibiotic is void of what kind of effects?

Teratogenic effects.

Why are infants especially sensitive to drugs that affect central nervous system (CNS) function?

The blood-brain barrier is not fully developed at birth.

The drug prescribed for an older adult patient is renally excreted. How should the nurse assess the patient's renal function to administer this drug safely?

Creatinine clearance.

When does gastric emptying time reach adult values in infants?

At 6 - 8 months.

For medications that do not have established pediatric doses, the most common method of extrapolating the appropriate dose is based on which measurement?

Body surface area.

When assessing for drug effects in the older adult, which phase of pharmacokinetics is the greatest concern?

Excretion

In which gestational period is drug therapy associated with a greater incidence of drug-induced developmental defects in the newborn?

First trimester.

Which is not a reason for the decline in hepatic drug metabolism with age?

Poor diet.

Which statement is true regarding drug absorption in infants versus adults?

When a drug is administered intravenously, levels decline more slowly in the infant than in the adult.

Which statement about drug use among older adults is true?

Drug use among older adults is disproportionately high.

Which statement about renal excretion in infants is true?

Adult levels of renal function are achieved by 1 year.

When teaching a pregnant patient about the effects of medication on the fetus, the nurse should recognize that the greatest harm from maternally ingested medications occurs during which time period?

First trimester.

A mother of a 1-month-old infant calls the clinic and asks the nurse if the medication she is taking can be passed to her infant during breast-feeding. What is the appropriate response for this patient?

"Drugs can cross from mother to infant in breast milk, so it will depend on the drug you are taking."

A 3-year-old child has been started on a new medication to be given as needed. What is the most important information to convey to the parents?

"Observe the child for potential adverse effects of the medication."

The nurse is teaching young parents about medication administration in their child. Which statements are appropriate to include in the teaching plan? Select all that apply.

1.) "This calibrated spoon will help your child get an accurate dose." 2.) "Guard against spills and spitting to ensure that your child gets an accurate dose." 3.) "Keep a medication record to make sure you do not give more than one dose at a time."

A pregnant woman has taken a medication that is a known teratogen. What steps should the nurse take to identify risks for malformation? Select all that apply.

1.) Determine exactly when the pregnancy began. 2.) Determine exactly when the medication was taken. 3.) Determine the frequency of when the medication was taken.

How can the nurse enhance effective medication use in an older adult? Select all that apply.

1.) Explain the purpose and importance of each drug. 2.) Educate the patient about the side effects of each drug. 3.) Develop a chart that includes the time to take each drug. 4.) Encourage family members to monitor the patient's drug regimen.

Older adult patients are at high risk for adverse drug reactions (ADRs). Which measures can reduce the incidence of ADRs? Select all that apply.

1.) Helping patients avoid prescriptions for drugs on the Beers list. 2.) Regularly monitoring patients for drug-drug and drug-nutrient interactions. 3.) Taking a thorough drug history, including over-the-counter (OTC) medications. 4.) Monitoring clinical response and laboratory results to help determine proper dosage.

According the Food and Drug Administration (FDA) Pregnancy and Lactation Labeling Rule, which content is considered part of the clinical considerations subsection? Select all that apply.

1.) Labor or delivery. 2.) Maternal adverse reactions. 3.) Fetal or neonatal adverse reactions. 4.) Disease-associated maternal and/or embryo or fetal risk. 5.) Dose adjustments during pregnancy and the postpartum period.

How can healthcare providers promote medication adherence for children? Select all that apply.

1.) Providing a calibrated medicine spoon for measuring liquid medications. 2.) Taking extra time with parents to help ensure conscientious and skilled participation. 3.) Mixing oral drugs with small amounts of food or juice (when allowed) to improve palatability. 4.) Selecting the most convenient dosage form and dosing schedule when using over-the-counter drugs.

Which statements accurately describe results of drug research in children? Select all that apply.

1.) Traditionally, the pediatric population is subdivided into six groups: premature infants, full-term infants, neonates, infants, children, and adolescents. 2.) About 30% of drugs cause unanticipated side effects, some of them potentially lethal, in the pediatric population.

Which statement is true regarding pharmacokinetics in children 1 year and older?

By age 1 year, most pharmacokinetic parameters in children are similar to those in adults.

What should the nurse do when administering medications to a pregnant patient who has asthma?

Give the asthma medications because they improve their outcomes.

The nurse is caring for a group of older adult patients who are all receiving multiple medications. Which statement represents a physiologic change that can alter pharmacodynamics in these patients?

Renal function declines with age, leading to decreased drug excretion.

The dosage of a certain drug is reduced when administered to a pregnant woman with liver impairment. Which other clinical situation requires reduction in the dosage of most drugs administered during pregnancy?

Renal impairment.

The breast-feeding patient with epilepsy takes anticonvulsant therapy. What guideline should the nurse follow to minimize risk to the baby?

Request an order for drugs that have a shorter half-life.

A teratogenic drug, such as methotrexate, is most likely to cause learning deficits during which phase of fetal development?

Second and third trimesters.