Peds chapter 31
The nurse is caring for a 12-year-old post-appendectomy client who weighs 86 pounds. The child has a temperature of 38.5ºC (101.3ºF). The nurse prepares to give the client a dose of oral acetaminophen. The order reads "Tylenol 15mg/kg/dose every 4 to 6 hours PO PRN for fever or pain." How many milligrams of Tylenol should the nurse give the client? - 1.3 milligrams - 147 milligrams - 587 milligrams - 1,290 milligrams
587 milligrams
A parent must administer a medication in syrup form to a 2-month-old infant. The nurse suggests: - placing the syrup in an medicine syringe. - mixing the syrup in a small amount of formula. - using a measured medicine spoon. - placing the syrup in a small amount of oat cereal.
placing the syrup in an medicine syringe.
The nurse is providing discharge education to the parents of a 2-year-old who will be taking amoxicillin orally at home. The nurse would include which statement in the teaching? • "Give the medication until your child has no symptoms." • "Use a dosing cap to measure the dosage." • "Mixing the medication with milk will help." • "Crush the pills and mix with applesauce when giving the medication."
"Use a dosing cap to measure the dosage."
The nurse is teaching parents of a 12-year-old child how to administer otic medication. Which statement by the parent indicates a need for further education? • "I will pull the outer ear down and back before administering the medication." • "After removing the medication from the refrigerator, I need to roll it gently in my palms to warm it." • "I will hold the dropper 0.5 in (1.25 cm) above the ear canal and be certain not to touch the ear with the dropper." • "After administering the drops, I will ask my child to remain side-lying for several minutes."
"I will pull the outer ear down and back before administering the medication."
When preparing to administer a vaccine to a 3-year-old child, what actions by the nurse are appropriate? Select all that apply. - Utilize a restraint board to help hold the child still. - Discuss with the child's parent the use of therapeutic hugging during the injection. - Chat with the child during the injection. - Require the child to remain silent during the injection. - Explain the procedure to the child in simple terms.
- Discuss with the child's parent the use of therapeutic hugging during the injection. - Chat with the child during the injection. - Explain the procedure to the child in simple terms.
The nurse is caring for a child who weighs 31 kg. A medication is ordered for this child with a dosage range of 20 to 40 mg per kg of body weight per dose. Which dosage would be appropriate for the nurse to administer to this child in one dose? - 12.4 mg per dose - 62.0 mg per dose - 124.0 mg per dose - 1,000 mg per dose
1,000 mg per dose
The nurse is preparing to administer hydrochlorothiazide to a 5-year-old child who weighs 35 lb (16 kg). The prescribed single dose is 1 to 2 mg/kg/day. Which is the appropriate dose range for this child? - 8 to 16 mg - 16 to 32 mg - 35 to 70 mg - 70 to 140 mg
16 to 32 mg
The nurse is preparing to administer the hepatitis B vaccine to a newborn shortly after birth. Which of the following would be most appropriate for the nurse to do? - Administer the medication in the infant's vastus lateralis with a 25-gauge needle. - Administer the medication in the vastus lateralis using a 20-gauge needle. - Administer the medication in the dorsogluteal site using a 25-gauge needle. - Administer the medication in the deltoid muscle with a 20-gauge needle.
Administer the medication in the infant's vastus lateralis with a 25-gauge needle.
The nurse is administering a liquid medication to a 3-year-old child using an oral syringe. Which action is most appropriate? - Direct the liquid toward the anterior side of the mouth. - Keep the child's hand away from the oral syringe when squirting the medication. - Give all of the drug in the syringe at one time with one squirt. - Allow the child time to swallow the medication in between squirts.
Allow the child time to swallow the medication in between squirts.
A nurse is preparing to administer a prescribed dose of medication to a preschool-aged child. Assessment reveals that the child is underweight. Which action would would the nurse do next? - Give the child the prescribed dose. - Give the child one-half the ordered dose. - Call the provider and alert to the dosage error. - Obtain the child's current height and weight and check the dose.
Obtain the child's current height and weight and check the dose
A 5 year-old client is prescribed an oral antibiotic. What should the nurse do when preparing to give the child this medication? - Assess if the child is able to swallow pills. - Give the medication with a small glass of water. - Plan the dose to be given before the next meal. - Inform the child that an injection will be used if they can't take the pill.
Assess if the child is able to swallow pills.
When considering the developmental pharmacokinetics of children, what accurately describes the factors that affect medication distribution in children? • Gastric pH is high in neonates; neonates and infants have increased skin permeability and decreased muscle oxygenation. • The liver and enzymes in a child are immature. • Glomerular filtration and tubular secretion are reduced at birth, and there is gradual increase in renal function, with adult values reached during the first 1 to 2 years of life. • Children have a higher proportion of total body water, a lower proportion of body fat, and an immature blood-brain barrier.
Children have a higher proportion of total body water, a lower proportion of body fat, and an immature blood-brain barrier.
A child reports pain at the IV insertion site. The nurse suspects infiltration based on which assessment finding? - The area is red and hot. - The vein feels hard on palpation. - The site has purulent drainage. - The area is cool to the touch.
The area is cool to the touch
A child is prescribed multiple intravenous medications. Which nursing action demonstrates the best practice to maintain medication safety? - Ensure that two nurses check the health care provider orders. - Flush the intravenous line between each medication. - Give the medications together to decrease administration time. - Use 5% dextrose in water (D5W) for medication administration.
Flush the intravenous line between each medication.
The nurse is giving discharge instructions to a parent of a 3-month-old infant. What is the best information to give the parent concerning oral medication administration? • Give the medication with a syringe and direct the liquid toward the posterior side of the mouth while holding the infant upright. • Mix the oral medication in a small amount of formula or breast milk in a bottle. • Lay the infant in a crib and, over time, use a syringe to squirt small amounts of medicine beside the tongue. • Hold the infant's nose while squirting the medication into the mouth.
Give the medication with a syringe and direct the liquid toward the posterior side of the mouth while holding the infant upright.
As the nurse prepares to administer a medication to a preschooler, the nurse realizes that the child is extremely underweight for age. What action would the nurse take? - Give the child one-half the prescribed dose. - Give the child the prescribed dose, because dose is determined by nomogram, not weight. - Measure the child's height and weight, and check whether the dose is correct for the child. - Call the child's health care provider and alert the provider to the dosage error.
Measure the child's height and weight, and check whether the dose is correct for the child.
A nurse is administering ear drops to a 7-year-old girl. What should the nurse do? - Pull the pinna of the ear up and back to straighten the external ear canal. - Warn the child that the drops will hurt. - Administer the medication while it is still cold from the refrigerator. - Hold the child's head in the sideways position while counting to 5 to ensure the medication fills the entire ear canal.
Pull the pinna of the ear up and back to straighten the external ear canal.
A child with gastroenteritis has been unable to keep oral medication down. What nursing intervention would be appropriate for this client? - Place the child on NPO status. - Hold all medications until the vomiting stops. - Request an intravenous form of the medication. - Give an antiemetic prior to giving oral medications.
Request an intravenous form of the medication.
A nurse is preparing to administer a prescribed medication to a hospitalized 4-year-old child. Which action would the nurse use to identify the child? - Scan the barcode on the child's armband. - Ask the child to tell the nurse their name and age. - Tell the child to state their address and nickname. - Say the child's name and ask if it is correct.
Scan the barcode on the child's armband.
The nurse is administering a PRN pain medication to a child. What is the highest priority for the nurse in this situation? - The nurse double-checks the medication calculation with another nurse. - The nurse checks the last time the medication was given. - The nurse asks the child to explain the pain the child is having. - The nurse documents the effect of the medication within 1 hour of administration.
The nurse checks the last time the medication was given.
The nurse is determining a pediatric dosage of medication using the West nomogram for estimating body surface area (BSA). Which two known factors are on the left and the right scales? - Use the height and milligrams of medication. - Use the weight and milliliters of medication. - Use the client's height and weight. - Use the milligrams and milliliters of medication.
Use the client's height and weight
The nurse is working to gain a preschooler's cooperation to swallow an oral medication. What would be the nurse's best approach? - offer to play a game with the child if the child takes the medicine - ask if the child would like to take the medicine in a cup or through an oral syringe - compare the taste of the medicine to a chocolate bar - leave the medicine on the night stand so the child can take it independently
ask if the child would like to take the medicine in a cup or through an oral syringe
The nurse is preparing a subcutaneous insulin injection for a preschooler. How and where should the nurse administer the insulin? - at a 45- to 90-degree angle into the elevated tissue of the upper arm - at a 45-degree angle into the deltoid of the upper arm - at a 90-degree angle into the vastus lateralis - at a 45- to 90-degree degree angle into the rectus femoris
at a 45- to 90-degree angle into the elevated tissue of the upper arm
David, age 2, is diagnosed with stomach flu and is suffering from vomiting and diarrhea. What is the most important factor in determining the correct dosage for his infection? - past experience - age - body surface area - adult dosage
body surface area
The nurse is identifying a diagnosis appropriate for a preschool-age child who began to cry after learning about needing intravenous fluid therapy. Which diagnosis should the nurse select to address this specific reaction? - fear related to intravenous infusion - discomfort related to intravenous infusion - health-seeking behavior by the child related to the intravenous infusion - deficient knowledge related to actions and effects of intravenous fluid therapy
fear related to intravenous infusion
The site most often used when administering a medication using the intradermal route is the: - forearm. - thigh. - abdomen. - deltoid.
forearm
The danger of fluid overload developing is a potential problem in the infant receiving an intravenous infusion. For which of the following would you observe? - increased pulse rate and increased blood pressure - increased pulse rate and decreased blood pressure - decreased pulse rate and decreased blood pressure - decreased blood pressure and swelling of the feet
increased pulse rate and increased blood pressure
The nurse is caring for a young child in the hospital who is receiving IV therapy. Part of the routine care for this child will involve monitoring the IV site as frequently as every hour. The nurse will assess the IV for which of the following? Select all that apply. • induration at the IV site • moisture at the IV site • whether the mother is at the bedside • the IV flow rate • swelling at the IV site
induration at the IV site - moisture at the IV site - the IV flow rate - swelling at the IV site
A 4-year-old child is admitted to the hospital for surgery. Before the nurse administers medicine, the best way to identify the child would be to: - call the child's name and see if he or she answers. - read the child's armband. - ask the child to state his or her name. - tell the child to state his or her nickname.
read the child's armband.
After administering eye drops to a child, the nurse applies gentle pressure to the inside corner of the eye at the nose for which reason? - to promote dispersion over the cornea - to enhance systemic absorption - to ensure the medication stays in the eye - to stabilize the eyelid
to ensure the medication stays in the eye
