Pharm EAQ 7

The nurse is responsible for dispensing medications to children. Which characteristics of pediatric children have significant impact on dosage of drugs? Select all that apply.

Lack of acid in stomach Immature liver and kidney function

The nurse is preparing to administer medication to a child. As part of the preparation, the nurse carefully considers developmental factors. To which step of the nursing process does this action most closely correspond?

Planning

The nurse is evaluating a student nurse's knowledge on the physiology of drug absorption in different age groups. Which statement by the student nurse indicates the need for further teaching?

"A 1-year-old infant will have effective absorption of low pH medications."

The nurse is teaching the parent of a child about the use of antibiotics. Which statement by the parent indicates effective learning?

"Antibiotics cannot treat all of my child's illnesses."

The student nurse is discussing pharmacokinetics in infants. Which statement of the student nurse indicates effective learning?

"The distribution of water-soluble medications is high in infants."

A lactating patient tells the nurse, "I have been taking an over-the-counter (OTC) analgesic medication for pain relief for two days." What is the appropriate response by the nurse in this situation?

"You should consult the primary health care provider."

A 5-year-old child with diarrhea has been prescribed 0.2 mg/kg of loperamide (Imotil). The child's weight is 15 kg. What dose of medication should the nurse administer to the child to ensure safety? Record your answer using a whole number. ________ mg

3

Knowing that the albumin in neonates and infants has a lower binding capacity for medications, the nurse anticipates that the health care provider will order which adjustment to minimize the risk of toxicity?

A decrease in the dosage of drug given

Which body components are involved in the excretion of medications? Select all that apply.

A,C,E

The nurse is caring for a child with a urinary tract infection. The nurse is preparing the child for the insertion of an intravenous catheter to facilitate the administration of intravenous (IV) antibiotics. What is the best nursing intervention in this situation?

Apply EMLA prior to the insertion of the intravenous catheter.

A child with croup who has been prescribed oral corticosteroids refuses to take medications. Which best nursing intervention would the nurse anticipate to facilitate medication administration?

Administer the medication via nasogastric tube.

The laboratory reports of an infant with jaundice indicate high serum bilirubin levels. The primary health care provider prescribes a medication that that is highly bound to albumin. Which intervention helps provide safe and effective treatment to the infant?

Administering a low dose of the drug to the infant

The nurse is caring for a child with diabetes mellitus who is on insulin therapy. Which nursing interventions help provide atraumatic care for the child? Select all that apply.

Applying an antiseptic lotion at the site of injection Spraying a vasocoolant at the site of the injection Applying eutectic local anesthesia at the injection site

The nurse is administering medications by mouth to a 2-year-old child who is belligerent. What action is the best strategy for the nurse to use?

Ask the parents to assist in calming the child.

The nurse begins a clinic appointment with a pediatric patient by recording age, weight, and height. To which step of the nursing process does this action most closely correspond?

Assessment

The nurse is caring for a 2-year-old child with a Streptococcus infection who is on oral antibiotic therapy. How does the nurse verify that the ordered dosage is safe? Select all that apply.

Based on the child's weight in pounds CorrectC Based on the child's body surface area CorrectD Based on the child's weight in kilograms

Which factors affect the distribution of medications in the body? Select all that apply.

Body fluid composition Body tissue composition Protein-binding capability

The parent of an 8-month-old infant tells the nurse, "While administering the medication to my child, I add a small amount of honey to mask the bitter taste." Which condition is this infant at risk for due to this method of medication administration?

Botulism

Which parameters may impede the absorption of medications administered via the intramuscular route? Select all that apply.

Dehydration Low body temperature Alterations in cardiac status

The nurse is caring for a 1-month-old infant with diarrhea who has been prescribed an antidiarrheal medication. Upon checking the composition of the medication, the nurse finds that the active ingredient is an alkaline and fat-soluble substance. Which pharmacokinetic variation does the nurse expect to find in the child when compared to an adult?

Enhanced drug absorption

The nurse is caring for a toddler who reacts violently during medication administration. Which intervention may be therapeutic when preparing to administer medication to a toddler? Select all that apply.

Giving storybooks to the toddler CorrectB Providing dolls and toys to the toddler CorrectC Instructing the toddler in a firm voice

A 6-year-old child with a gastrointestinal infection is prescribed enteric-coated antibiotic medications. On the follow-up visit, the nurse finds no improvement in the child's health and suspects that the child's parents are not administering the medications properly. Which statements of the child's parents support the nurse's assumption? Select all that apply.

I dissolve the tablet in water before giving it to my child." CorrectD "I crush the tablet into small pieces before giving it to my child." CorrectE "I place the tablet between my child's upper and lower molar teeth

The nurse assesses the patency of the intravenous site before administering intravenous medication to a patient. What complications of intravenous therapy is the nurse assessing for? Select all that apply.

Infiltration Extravasation

Which organ is primarily involved in the metabolism of medications?

Liver

The nurse writes the following notation on a pediatric patient: "Delayed growth and development related to physiological factors." To which step of the nursing process does this action most closely correspond?

Nursing diagnosis

The nurse uses an appropriate drug reference to obtain drug parameters prior to administration of a medication. To which step of the nursing process does this action most closely correspond?

Nursing intervention

A drug given by which route is altered by the first-pass effect?

Oral

The nurse is preparing a preschooler for the administration of the Bacillus Calmette-Guerin (BCG) vaccine (TheraCys BCG). The nurse observes that the child is afraid of needles and is therefore afraid of the injection. Which nursing interventions does the nurse expect to be beneficial in reducing anxiety in this situation? Select all that apply.

Suggesting the child cough while injecting the medication Using hypnosis to provide pain relief for the child

While assessing the cognitive skills of an adolescent patient, the nurse finds that the patient is in the concrete operational stage. Which action of the patient supports the nurse's conclusion?

The patient is unable to comprehend potential drug implications.

The nurse is preparing a child for the administration of a hepatitis B vaccine (Engerix-B). The nurse applies a eutectic mixture of local anesthetics (EMLA) at the site of administration and covers it with a transparent dressing before administering the vaccine. What is the reason for this intervention?

To increase containment of the drug

The nurse is caring for a 7-month-old infant who is receiving intravenous antibiotic therapy. The nurse frequently evaluates the infant's hydration status. What is the rationale behind this nursing intervention?

To prevent drug toxicity in the child

The nurse is caring for an infant who has been prescribed ranitidine (Zantac) syrup. While administering the medication, the nurse avoids pointing the oral syringe directly towards the back of the infant's mouth. What is the rationale behind this intervention?

To prevent the risk of gagging or choking

The nurse is preparing to administer intravenous antibiotics to a child with pneumonia. On entering the child's room, the nurse discovers that the child is sleeping. The nurse awakens the child and administers the medication. What is the rationale behind this intervention? Select all that apply.

To promote trust with the child To promote sleep and rest

After administering an intravenous medication to a preschooler, the nurse places a decorative bandage at the site of injection. What is the rationale for this intervention?

To relieve anxiety

Which actions will the nurse perform to ensure that the medication dose for a pediatric patient is correct? Select all that apply.

Use a current drug reference to determine usual dosage per 24 hours. Correct3 Determine the dose parameters by multiplying the weight by the minimum and maximum daily doses of the drug (the safe range). Correct4 Determine the total amount of the drug to administer per dose and per day. Correct5 Compare the drug dosage prescribed with the calculated safe range. Correct6 If the drug dosage prescribed varies from recommended reference range, notify the provider.

Which patient identification method does the nurse find to be safe and effective for administering medications to children?

Using an automated computerized system

The student nurse is caring for a child who has fever and diarrhea. The primary health care provider prescribes oral and intravenous medication for the child. Which instruction would the nurse provide the student nurse to ensure safe and effective medication administration? Select all that apply.

Verify the dose calculation with the registered nurse. Teach the dosage calculation to the child's parents. Calculate the dose of drug according to the child's weight.

What should a pediatric nurse do prior to administering acetaminophen (Tylenol) to a pediatric patient?

Verify the name of the drug to be administered on the prescription