Peds Pharm. PRCC.
What type of fluid calculation would you use on the pt. with moderate or severe dehydration?
1 1/2 maintenance fluid
Explain how you calculate 24hr maintenance fluid:
100ml/kg for the first 10kg of pt.s weight 50ml/kg for the next 10kg of pt.s weight 20ml/kg for the remainder of pt.s weight
What's the capacity of a buretrol control pump?
120-150ml
What gage needle would you select for older children?
20-22g.
What gage needle would you select for an IM on an infant?
23g.
What gage needle would you select for an IM injection on a neonate?
25g.
gr 1= ____mg
60mg
How are oral medications filtered & excreted?
filtered through the kidneys & liver. excreted by urine.
What should you do after administering medication via NG tube?
flush tube w/ water; about 20ml of water.
What does a digitalizing dose mean?
loading dose.
How do you calculate for 24hr fluids for 1 1/2 times maintenance?
maintenance total times 1.5
How often is NG output measure?
q 4hrs
How are Sub Q medications absorption affected in children?
any decreased perfusion = decreased absorption.
What are common IV sites in peds pts.?
arm hand feet scalp
Where is the best place to administer an IM injection on a baby?
vastus lateralis.
How to prevent fluid overload?
-know what IV rate is -hrly recording of IV fld. intake -calculate flds used to administer IV meds into the hrly fld amount
T or F: Peds pt.s have a high risk of fluid overload.
TRUE.
T or F: Children over 50 kg use adult dose reference.
TRUE. (slide 14 in pharm powerpoint)
How do you determine BSA?
1. measure child's height. 2. determine child's weight. 3. using nomogram draw a line connecting the height & weight. 4. where the line intersects the middle column is your BSA number.
gr 1/4= ____mg
15mg
How many ml in 5 tsps?
15ml
How long should the pt. remain in position after administering ear drops?
2-3 mins.
gr 3/4= _____mg
45mg
1 Tbsp= ____ml
5 ml
T or F: In pediatrics there are standard amounts/doses of a drug given based on the age of the child.
FALSE. (standard doses/drugs are based on weight in kg)
Which medication route is the MOST traumatic?
IM.
T or F: You calculate the fluids used to flush tubes/lines into the daily fluid intake.
TRUE. (slide 63 in pharm powerpoint)
20 lbs. 5 oz. = ________kg
9.2 kg
Used on IV's to control volume of fluids?
-buretrol -syringe pump -IV pump
1 milliunit= ____ unit(s)
1 unit
gr 1/2= _____mg
30mg
1 oz.= ____ml
30ml
1 tsp= ____ml
3ml
Amoxicillin 200mg/5ml is prescribed for a pt. On hand is Amoxicillin 250mg/5ml. How much would the nurse administer?
4ml.
What does BSA mean?
Body Surface Area.
Which route of administration is the route of choice when drugs must be delivered rapidly?
a. oral b. intravenous c. intramuscular d. topical correct answer: b. intravenous
The nurse is administering Amoxicillin orally to an infant with a bacterial infection. Which physical factors might affect the absorption of this medication?
a. slower gastric emptying b.vasomotor instability c. decreased perfusion d. lower percentage of body water correct answer: a. slower gastric emptying
Which of these provide atraumatic care when administering medications? SELECT ALL THAT APPLY
a. using comforting positions b. using an 18g needle c. using topical anesthetic prior to injections d. educating the child & parents e. getting mom to assist in holding the pt. down correct answers: a,c,d
Amoxicillin 215mg PO tid for a child who weighs 36 pounds. Available is Amoxicillin 250mg/5ml suspension. Drug reference: Amoxicillin PO (children) <40kg (6.7 to 13.3 mg/kg q8hrs) a. Is ordered dose of 215mg a safe dose? b. If order is safe, how much would you prepare to give?
a. yes. (low range: 109.9 high range: 218.1) b. 4.3ml
What should you ask the mother/caregiver before administering a toddler medication?
ask parent how the child normally takes medications at home.
What are the factors affecting distribution of medication in children vs. adults?
children: - have higher percent of body water than adults - more rapid extracellular fld exchange - decreased body fat - live immaturity, altering first-pass elimination - decreased amounts of plasma proteins available for drug binding - immature blood-brain barrier, esp neonate, allowing movement of certain medications into CSF
How is the absorption of intramuscular medications affected in children?
decreased due to smaller muscle mass, muscle tone, perfusion, & vasomotor instability.
Where is the best injection site to administer an IM medications on a pt. 10 years and older?
deltoid.
What factors affect absorption?
gastrointestinal rectal intramuscular topical/transdermal intraocular
What's the benefit of using IV buretrol?
if the IV pump malfunctions or the pt.s mess with the machine, the pt. will only receive the volume that's inside the buretrol already.
Absorption of topical medications are increased in children, why?
increased due to greater body surface area & greater permeability of infants skin.
Why do we NOT administer otic medications cold?
increases pain causes vomiting
What part of the eye do you instill the eye drops in?
into the conjunctival sac.
What determines if a dose of medication is safe?
it must fall w/in the safe range as listed in a Drug Handbook or other reliable drug reference.
Explain NG- ml/ml replacement.
just means that for every ml that comes out the pt. in 4 hrs, must be replaced back into the pt. w/in 4 hrs.
You have just administered ophthalmic medication to your pt., what should you instruct them to do after?
keep eye closed for 1 min.
What position will you place the pt. in when administering rectal medication?
left lateral position.
What type of fluid calculation would you implement on a pt. with mild dehydration?
maintenance fluid
Glomerular filtration & tubular secretion are ____________ at birth.
reduced
What is 1 1/2 times maintenance used for?
rehydration.
Gradual increase in ____________ _______________ to adult level (1-2 yrs).
renal function
How do you mix/warm up otic medications?
rotate within hands.
What's good for unclogging NG tubes?
soda.