Peds Chapter 31: PrepU
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
The nurse is planning to provide a preschool-age client with an oral medication. Which approach should the nurse use to gain the child's cooperation?
Ask the child if a cup or oral syringe is preferred to take the medicine.
A medical/surgical nurse has been floated to the pediatric unit. Which action by the float nurse would require the pediatric nurse to intervene?
Asking the child his or her name prior to giving medications
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?
Body surface area
A 6-year-old client is prescribed to receive an oral antibiotic. What should the nurse do before giving the child this medication?
Check to see if the child can swallow pills.
The nurse is preparing to administer a PO medication to a 6-year-old in the hospital for an exacerbation of asthma. The nurse notes that the child is due for an oral dose of lansoprazole in 1 hour. What is the most important action for the nurse to take before administering this medication to the client?
Clarify the order, since there is no apparent link between the client's diagnosis and the medication.
Mike, age 8, is going home on medication after surgery. The nurse is preparing to review the discharge instructions with the mother. What basic information and/or instructions should be given to her to continue the drug therapy at home? Select all that apply.
Description of the intended therapeutic drug effect Generic and trade names of drugs Schedule and duration of administration
A child is receiving intravenous fluids for dehydration. The nurse notes coarse breath sounds and increased pulse and blood pressure. What does the nurse do first?
Discontinue the IV infusion.
The nurse is giving discharge instructions to a mother of a 3-month-old infant who will be receiving oral medication at home. Which of the following would the nurse include in the teaching plan?
Give the medication with a syringe and squirt a small amount at a time beside the tongue while holding the infant upright.
The new graduate nurse is preparing to administer medication to a 4-year-old client. When would it be appropriate for the supervising nurse to intervene? The new graduate:
Had two whole tablets to administer to the child.
Prior to providing a preschool-age child with a prescribed dose of medication, the nurse is concerned that the child is underweight. Which should the nurse do at this time?
Measure the child's height and weight and check whether the dose is correct.
The nurse is administering a crushed tablet to an 18-month-old infant. What is a recommended guideline for this intervention?
Mix the crushed tablet with a small amount of applesauce.
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.
The nurse teaches the mother of a 2-year-old child how to instill antibiotic otic drops. The mother indicates understanding of the skill when she takes which action?
Pulls down and backward on the earlobe before instilling the drops.
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:
Read the child's armband.
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.
The nurse is preparing to administer regular insulin to a child following lunch. Which finding will cause the nurse to question administering the medication?
The client received insulin aspart 2 hours ago.
Parents question the necessity of moving their preschooler from her room to another place to insert her IV line. The nurse explains:
The importance of avoiding unpleasant experiences in the child's room and bed in order for both to remain safe places.
The nurse is instructing a parent on administering ear drops to a 6-year-old. Which parental action demonstrates an understanding of teaching?
The parent has the child sit down and pulls the pinna upward and back
A nursing student is administering medications to her client, Tommy, on a pediatric floor. What action by the student demonstrates a need for further instruction?
The student asks the client if he is Tommy before giving the medication.
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 ensure the medication stays in the eye
The nurse has prepared an IM injection to give a 13-year-old client. After some searching, the nurse locates the adolescent in the playroom in front of a video game. Which action by the nurse would be most appropriate?
Inform him that it is time for an injection. Explain why the injection is needed and have the patient move to the treatment room.
The nurse is caring for an 8-year-old girl who requires medication that is only available in an enteric tablet form. The nurse is teaching the mother how to help the girl swallow the medication. Which statement indicates a need for further teaching?
"I can pinch her nose to make it easier to swallow."
The nurse knows additional teaching is needed if a parent makes which comment?
"I keep the medications in a drawer under papers."
The nurse is preparing to give an oral medication to an 11-year-old client. Which of the following is the best approach for the nurse to take?
Allow independence from the parent in the process of medication administration.
A toddler is prescribed amoxicillin for bilateral otitis media. The parent reports that the toddler refuses to take the oral medication. The nurse knows that more education is needed when the parent makes which statement?
"I will shake the medication well, and draw up the medication to the top of the syringe. My spouse and I will hold our toddler down and force the medication down his throat."
The primary health care provider prescribed ketoconazole for a child with ringworm. Which statement by the parents indicates the nurse needs to provide additional teaching on the prescription?
"I will wrap the skin tightly after applying the medication."
The nurse enters the room of a 4-year-old patient to administer an oral medication. The child takes one look at the medication in the nurse's hand and yells "This is yucky!!" Which response by the nurse would be most appropriate?
"Let's hold our noses! It's medicine time!"
The nurse educator is teaching the class of nurses about infusion control in children. The nurse knows that more education is needed when the student nurse states:
"No special pumps are needed for the pediatric patient; I can use the same one that we use with adult patients."
The nurse is preparing to administer an oral dose of metoclopramide to a 5-year-old child who weighs 40 lb (18.2 kg). The prescription reads metoclopramide 0.8 mg/kg/day to be given in 4 oral doses. How many milligrams of metoclopramide would the nurse give per dose?
3.65 mg per dose
The nurse is administering a liquid medication to a 3-year-old using an oral syringe. Which action would be most appropriate?
Allow the child time to swallow the medication in between amounts.
A toddler requires 1.5 ml (.05 oz) of an antibiotic given intramuscularly (IM). How will the nurse administer this medication?
Divide the dose. Administer 0.75 ml (0.25 oz) IM in each vastus lateralis.
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
What is the most important reason for administering a medication at the correct time?
To maintain the desired blood level of 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.
A nurse is administering a liquid oral medication to a 5-month-old. Which nursing action provides the correct dosage? Select all that apply.
Using a medicine dropper Gently restraining the child's arms and head Administering the medicine such that it flows slowly into the child's mouth
The nurse is preparing to administer an IV antibiotic to a 10-year-old child. After calculating the recommended dose with the patient's weight, the nurse discovers the ordered dose exceeds the safe dose range in a pediatric drug reference. The medication has been given to the child at this dose for three days. Which of the following should the nurse's next action be?
Verify the dose with the prescribing practitioner
If a medication is being administered by the otic route, it will be administered in which way?
Warmed to room temperature and dropped into the ear
A nurse is preparing a dose of insulin to give Billy, an 11-year-old boy. Which of the following actions would be most appropriate for the nurse to do when giving this medication?
Double check the dose with another registered nurse before giving it.
A nurse is preparing a dose of insulin to give the client. Which action takes priority when preparing and administering this medication?
Double-check the dose with another RN before giving.
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?
"Use a dosing cap to measure the dosage."
A mother of a newborn brings her child to the well child clinic the week after birth. The mother asks the nurse if the child will get any "shots" at the next appointment. The best response from the nurse would be:
"Yes, your child will get 3 shots next time. They will be the polio vaccine (called IPV), Haemophilus influenza B vaccine (called Hib), and hepatitis B vaccine. They will be given in the thigh."
The nurse is preparing to administer an oral dose of antibiotics to a 10-year-old child who weighs 70 lb (31.8 kg). The prescription reads cephalexin 500 mg orally every 6 hours. The pediatric drug reference identifies the safe dosing as 25-100mg/kg/day in 2 to 4 divided doses. Which safe range per dose does the nurse calculate?
199 mg to 795 mg per dose
The nurse is preparing to give a 4-month-old an oral medication. Which technique demonstrates the nurse's accurate knowledge of the infant's developmental level?
Position the infant upright, offer the infant a bottle of formula, remove the bottle and squirt the medication on the side of the tongue toward the cheek, then offer the infant the bottle again.
