Ch 38 Peds

A nurse has just given otic medication instructions to the parents of a 12-year-old child. Which statement would indicate that the parents need further education concerning the medication?

"I will pull the outer ear down and back before administering the medication."

A 12-month-old child weighing 11 lb has an order for gentamycin sulfate 13 mg IM q 36 hour. The pharmacy has 20 mg/2 mL on hand. How may milliliters would the infant receive, and what is the best site for the injection?

1.3 mL; vastus lateralis

A child with HIV, weighing 25 kg (55.1 lbs), is about to receive an infusion of IVIG. The recommended dose is 400 mg/kg/dose. The medication is available in a concentration of 50 mg/mL. What is the proper amount of infusion that the child will receive?

200 mL

The nurse is caring for a preschooler who has become dehydrated due to an intestinal virus. Which approach to replace the fluid loss is initially anticipated?

Oral rehydration

A 12-year-boy is being discharged from the hospital after major surgery. The boy will be taking two medications at home for an extended period. The nurse who is discharging the patient should provide medication teaching specifically to

Both the boy and his mother regarding all medication issued.

The nurse is caring for a child and unable to obtain intravascular (IV) access. The health care provider prescribes ceftriaxone intramuscularly (IM). Which nursing considerations are discussed with the health care provider before administering? Select all that apply.

Children do not have sufficient muscle mass. IM injections often are painful.

A child is prescribed multiple intravenous medications. Which nursing action demonstrates the best practice to maintain medication safety?

Flush the intravenous line between each medication.

The nurse is teaching a parent how to administer medications to her young child. Which instructions are appropriate? Select all that apply.

Gently restrain the child's head and arms. Have the parent administer the medication. Hold the child against the body with the head raised.

A toddler is ordered amoxicillin for bilateral otitis media. The mother complains that the child refuses to take the oral medication. The nurse knows that more education is needed when the mother states:

I will shake the medication well, and draw up the medication to the top of the syringe. My husband and I will hold the child down and force the medication down his throat.

A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to

Immature liver and kidney function in infants and children.

A child is having difficulty swallowing pills. What is the best action for the nurse to take to help this child swallow medications?

Place the pills in a bite of ice cream or applesauce.

The nurse is administering otic medication to a 30-month-old with a diagnosis of otitis media. Which nursing action ensures that the medication is distributed appropriately?

Pull the pinna down and back

A child with gastroenteritis has been unable to keep oral medication down. What nursing intervention would be appropriate for this client?

Request an intravenous form of the medication.

After the RN has initiated intravenous (IV) therapy on the child in the pediatric unit, the newly licensed LPN is caring for the child. Which of the following is the LPN responsible for related to the IV therapy? Select all that apply.

The LPN monitors the IV site for redness. The LPN monitors the IV site for pain. The LPN monitors the IV flow rate. The LPN monitors the site for swelling

A nurse is assigned to a pediatric unit for an 8 hour shift. When administering medications to a pediatric patient rather than an adult, which does the nurse consider? (Select all that apply.)

The child's developmental level The child's weight The child's developing body systems The child's smaller size

The nurse is administering medications to a 10-year-old child who takes medications at home for a chronic condition. The child's parent is at the bedside. What are appropriate guidelines for medication administration to this client? Select all that apply.

The nurse compares the child's ID band with the medication record. The nurse carefully reads the label on the side of the medication bottle. The nurse documents the medication administration after giving the medication.

The nursing student identifies which technique as the correct one to use when giving oral medications to an infant?

Use a dropper and slowly inject the liquid into the side of the infant's mouth.

Using the West nomogram scale, the nurse needs to calculate the safe dosage of a medication for a child. The child is 50 inches tall and weighs 76 lb. The normal dosage of the medication for an adult is 300 mg. Which of the following is the correct way to use the West nomogram scale?

Use the scale to locate the child's height and weight. Use a straight edge to align these numbers with the scale indicating the surface area, divide that by the average adult body surface area, and multiply the resulting number by the adult dose.

The charge nurse is assisting the new graduate nurse in administering eye drops to a child. The charge nurse would stop the new graduate if which action was observed?

holds the eyelids apart for about 30 seconds

The nurse is preparing an emergency IV site for a child who has been admitted to the hospital with burns on his arms, legs, and torso. Which IV site would be most appropriate?

intraosseous

The nurse is assigned to administer medications to 8 pediatric clients from age 6 weeks to 16 years old. What two key factors does the nurse consider which influence pharmacokinetics in children?

Age and size