NUR-227 PEDS Test 2 (Medication Administration (Sherpath))
The nurse is ordered to administer a stat IV medication to a 3-month-old patient. The parent asks, "Why can't you just give this medication by mouth; it'll take some time to start working anyway?" What is the best response by the nurse? "IV medications will begin to take effect immediately." "Oral medications are not absorbed as well as IV medications." "The healthcare provider ordered the medication IV, so I have to give it that way." "I can request the health care provider change the medication to be given orally."
"IV medications will begin to take effect immediately." IV medications have a rapid onset of action, and this is a stat medication. This would be the preferred method, and the most accurate and best response by the nurse to the parent's query.
The nurse is preparing medication for an 8-month-old infant by mixing it with applesauce. The infant's parent asks why the medication should not be mixed into the infant's breast milk, since that is what the infant prefers. What is the appropriate response from the nurse? "Breastmilk may alter the effectiveness of the medication being administered." "It may result in the child refusing to drink breast milk, an essential food for an 8-month-old." "Using nonessential food provides you with better options for timing of the delivery of the medication." "The medication should be mixed with nonessential foods like pudding so your child will more readily take it."
"It may result in the child refusing to drink breast milk, an essential food for an 8-month-old." A medication may alter the taste of a food which could result in the child refusing to eat that food. By using a nonessential food the medication may be administered using different foodstuffs that the child may enjoy.
An 8-year-old child is prescribed a medication that must be delivered by injection. Which statements should the nurse make to prepare the child for administration of this medication? Select all that apply. "This may sting a bit but should not last very long." "This medication is necessary to help your body function properly." "This medication is going to help you and you did not do anything wrong." "I am going to ask your parents to leave briefly while I administer your medication." "You may feel a warm sensation at the injection site, but it is normal and will only last a few minutes."
"This may sting a bit but should not last very long." Preparing the child for what to expect will help him process the situation and encourage his involvement in the process. "This medication is necessary to help your body function properly." The nurse should explain the reason for the injection and help the child understand that the medication will help with her illness. This will help the child remain calm if she understands that it is for her benefit. "This medication is going to help you and you did not do anything wrong." Helping the child to understand that the injection will help her feel better is an important aspect of increasing the child's confidence in the procedure. The nurse should help the child understand that the injection in NOT a punishment. "You may feel a warm sensation at the injection site, but it is normal and will only last a few minutes." The nurse should explain the length of time sensations associated with the injection should last when preparing the child for an injection. If the child knows what to expect then he or she is more likely to be cooperative.
The nurse is preparing to administer an oral medication to a child who is reporting nausea and frequent vomiting. Which action should the nurse take to ensure successful delivery of the medication? Withhold the medication until the patient is no longer vomiting. Ask the health care provider to prescribe the medication for inhalation. Ask the health care provider to prescribe the medication rectally or by injection. Ask the health care provider to prescribe the medication as a topical application.
Ask the health care provider to prescribe the medication rectally or by injection. An alternative administration route such as rectal, intravenous, or intramuscular, should be requested so the patient doesn't go without the needed medication.
When preparing a suspension or elixir that specifies dosage in milligrams (mg), what should the nurse do to ensure the patient receives the correct amount of the medication? Use a tablespoon to administer the oral medication. Weigh the bottle of liquid on a scale and then weigh the dose. Draw an amount of liquid equal to the number of milligrams prescribed. Calculate the dose based on the number of mg/mL in the suspension.
Calculate the dose based on the number of mg/mL in the suspension. Prescriptions will often state the dosage in mg—and not mL—for liquids; care must be given to calculate the correct liquid dose.
The nurse is performing patient teaching prior to discharge for a child with type I diabetes. What information should the nurse provide the child regarding administration of a subcutaneous insulin injection? Select all that apply. Change the site of injection Massage the site of injection Track the location of injection sites Injection of insulin should cause a bleb Administer the insulin injection in their abdomen
Change the site of injection The systematic rotation of injection site helps facilitate consistent drug absorption. Track the location of injection sites By encouraging the child to track injection locations the nurse helps to empower the child. Additionally, tracking helps the child perform injections in different sites regularly. Administer the insulin injection in their abdomen The abdomen is the preferred location for children who require frequent subcutaneous injections, like type 1 diabetics.
An 8-year-old pediatric patient was prescribed a topical medication. What steps should the nurse take to prepare for the application of the medication? Select all that apply. Cleanse the skin allow it to dry. Examine the skin for abnormalities. Teach the child to not touch treated areas. Assist the child in applying the medication. Use tie-down restraints to restrain the child.
Cleanse the skin allow it to dry. In preparing the skin for the application of a topical medication the skin should be cleansed to remove exudates, scales, and other residue. This preparation will allow proper penetration of the topical medication. Examine the skin for abnormalities. The presence of bruises, abrasion, and irritation would affect the absorption of topical medications and, therefore, should not be present at the site of application. Teach the child to not touch treated areas. The child should avoid manipulating the treated area once the topical medication has been applied. Manipulation of the treated area could alter the perfusion of the area, which would change the absorption characteristics of the medication. Assist the child in applying the medication. Children should be involved in their own care as much as is appropriate for the child's development.
The nurse is caring for a child who is experiencing an acute asthma attack. What approach should the nurse use to administer a bronchodilator? Encourage the child to continue to breathe rapidly. Supply the medication using a metered-dose inhaler. Use a spacer to aid the child in inhalation of the dose. Deliver the nebulized medication with supplemental oxygen.
Deliver the nebulized medication with supplemental oxygen. Using oxygen with the nebulizer allows both the medication and oxygen to be delivered to the lungs. The delivery of oxygen is independent of the nebulized medication because oxygen transfer occurs in the alveoli and nebulized medication will not travel into the alveoli.
A nurse has been asked to administer an intramuscular injection to a 1-year-old child. How does the nurse choose the appropriate needle to use? Select all that apply. The nurse may contact a colleague to obtain information about the correct needle to use. Determine the shortest length needle according to the selected muscle. Choose the needle length by taking into account the amount of body fat on the child. Determine the appropriate gauge needle for the type of medication to be administered. Look up the last intramuscular injection that was given to see what size was used before.
Determine the shortest length needle according to the selected muscle. The nurse should choose the shortest-length needle for the administering of an IM injection based upon the selected muscle for administration. This will help prevent the injection from penetrating too deeply. Choose the needle length by taking into account the amount of body fat on the child. The amount of body fat on the child would influence the correct needle choice by requiring a longer needle when the child is carrying a higher amount of body fat. Determine the appropriate gauge needle for the type of medication to be administered. The nurse should choose the smallest-gauge needle, based on the site and viscosity of the medication, when administering an IM injection. Using the smallest-gauge needle will help reduce the pain associated with intramuscular injection and increase the child's cooperation during the procedure.
The nurse is assessing the IV site of a pediatric patient and notes yellow drainage. What action should the nurse take? Apply EMLA cream to the infiltrated site. Wrap the site tightly to reduce the drainage. Reduce the infusion rate and notify the health care provider. Discontinue the infusion and the IV catheter and notify the health care provider.
Discontinue the infusion and the IV catheter and notify the health care provider. If drainage is noticed by the nurse at the IV site of a child the IV infusion should be immediately discontinued, the IV catheter removed, and the health care provider notified.
A 7-year-old child is admitted to the hospital to receive an intravenous antibiotic. The child's parent is concerned about injury to the child's arm because this is the child's first IV infusion. How does the nurse ensure patient safety while placing the IV catheter? Select all that apply. Do not allow the parents to hold the child. Reduce pain using topical pharmacological agents. Have the parent leave the room during the IV insertion. Obtain help from a colleague to hold the child and the extremity. Tell the child to imagine his or her favorite activity while guiding the catheter.
Do not allow the parents to hold the child. The parents should be allowed to therapeutically hold the child during the IV insertion if they are comfortable with the position and the procedure. Reduce pain using topical pharmacological agents. The use of EMLA cream will reduce the pain associated with the insertion of an IV catheter and encourage more cooperation from the child helping to prevent injury. Obtain help from a colleague to hold the child and the extremity. Therapeutic holding of a child may be a necessary step for the insertion of an IV catheter. Insertion of an IV catheter can be a traumatic event for a child. Restraint of the child will reduce the length of time the child is in the stressful situation. Tell the child to imagine his or her favorite activity while guiding the catheter. The nurse should help the child imagine positive images when preparing them for the insertion of an IV catheter. This imagery will help the child feel in control of the situation and improve cooperation.
The nurse is caring for a pediatric patient and is implementing orders to infuse an IV medication at a rate of 50 mL/hr. The nurse returns to the room 15 minutes after initiating the IV medication and finds the pump set to 75 ml/hr. What action should the nurse take? Select all that apply. Double check the prescribed rate. Check the infusion site for edema. Disconnect the infusion and flush the site. Verify the medication that is to be infused. Stop the infusion and contact the health care provider.
Double check the prescribed rate. The nurse should verify the ordered rate of the IV medication. If it was administered incorrectly, stop the infusion and notify the health care provider. Check the infusion site for edema. The nurse should check the IV site for signs of edema, infection, and infiltration, a medication instilled at an incorrect higher rate may cause edema or infiltration at the IV site. Disconnect the infusion and flush the site. The nurse should stop the infusion and flush the site if the rate prescribed is not the same as the rate that is set on the infusion pump. This will prevent a continuing medication error. Stop the infusion and contact the health care provider. After stopping the infusion, the nurse contacts the health care provider to inform him or her of the increased rate of medication administration and to receive further orders.
The nurse is caring for a pediatric patient who is to receive oral pain medication. The patient's parents indicate that the patient has had trouble swallowing capsules in the past. Which forms of medication may the nurse request? Select all that apply. Elixir Tablet Injection Suspension Chewable tablet Sprinkle (powder)
Elixir If a child is unable to swallow a capsule, then an elixir is an acceptable alternative form for medication administration. An elixir is a liquid and is easily swallowed compared with a capsule. Suspension If a child is unable to swallow a capsule, then a suspension is an acceptable alternative form for medication administration. A suspension is a liquid form of medication which is easily swallowed. Chewable tablet If a child is unable to swallow a capsule, then a chewable tablet is an acceptable alternative form for medication administration. Chewable tablets allow the child to break down the medication into a size that may be swallowed. Sprinkle (powder) If a child is unable to swallow a capsule, then a sprinkle (powder) is an acceptable alternative form for medication administration. A powder can be placed in a food such as applesauce, which will allow the child to ingest the medication.
A pediatric patient cannot swallow pills. The medication order is for an enteric-coated medication. How should the nurse proceed? Notify the health care provider. Crush tablet for administration. Ask the child to chew the tablet. Administer the medication as a liquid.
Notify the health care provider. The nurse should notify the ordering provider and request the medication be changed to a different form. Medication that is enteric-coated cannot be crushed or chewed without hindering the effectiveness of the medication.
The nurse is preparing to insert an IV catheter in a pediatric patient. What actions should the nurse take when applying eutectic mixture of local anesthetics (EMLA) cream? Select all that apply. Remove gloves to ensure accurate application. Apply over a surface area twice the size of the chosen site. Place on the skin site and cover with a transparent dressing. Leave in place for a minimum of 1 hour prior to catheter insertion. Rub the medication into the skin and cover with an occlusive dressing.
Place on the skin site and cover with a transparent dressing. The EMLA cream should be placed on the skin and covered with an occlusive, transparent dressing to allow absorption time and prevent the medication from being removed. Leave in place for a minimum of 1 hour prior to catheter insertion. The EMLA cream should be left in place for at least 1 hour but should be removed within 4 hours after placement.
A child is brought to the allergist's office for frequent congestion and watery eyes. The health care provider orders a series of allergens to be administered subcutaneously to determine the child's allergies. When the nurse administers these subcutaneous injections, which steps should be taken? Select all that apply. Massage the site of injection. Release the tissue and inject the medication. Gently pinch the subcutaneous tissue from the muscle. Insert the needle at a 45-degree angle with the bevel up using a dart motion. Apply gentle pressure to the site using dry gauze after removing the needle.
Release the tissue and inject the medication. Releasing the tissue before injecting the medication will remove pressure from the tissue allowing the medication to be safely injected. Gently pinch the subcutaneous tissue from the muscle. The nurse should pinch the child's skin to raise the subcutaneous tissue from the muscle underneath. This will help prevent the needle from being inserted too deeply into the patient. Insert the needle at a 45-degree angle with the bevel up using a dart motion. Inserting the needle at a 45-degree angle with the bevel up is used for subcutaneous injections in most cases. The nurse would use a dart-like motion to decrease the time of skin penetration, thereby reducing the pain felt by the patient with a subcutaneous injection. Apply gentle pressure to the site using dry gauze after removing the needle. Applying gentle pressure will help stimulate clotting and prevent the medication from leaking out of the needle site.
The nurse is preparing to administer a subcutaneous injection to a pediatric patient. Which skin abnormality would cause the nurse to avoid that site? Select all that apply. Scarring Excess fat Ecchymosis An open wound Presence of body hair
Scarring Scarring at the site of injection would indicate increased connective tissue, which would impair circulation. Impaired circulation would reduce the diffusion of the medication into the circulatory system and limit its effectiveness by decreasing the concentration in the blood. Ecchymosis Bruising at the site of injection would alter the vascular bed and would be contraindicated for subcutaneous injection. An open wound An infection at the site of injury would alter the vascular bed and would be contraindicated for subcutaneous injection.
The nurse is providing patient teaching to the family of a young child with asthma. The nurse would instruct the parents on the correct use of which piece of equipment to increase the effectiveness of a metered-dose inhaler? Mask Spacer Nebulizer Flutter valve
Spacer The use of a spacer can increase the effectiveness of administration with a metered dose inhaler because it allows the child time to deeply inhale the medication.
The nurse is preparing to administer an intramuscular injection to a pediatric patient. What information does the nurse require to accurately determine which site is best to administer the injection? Select all that apply. The child's age. The child's height. The child's weight. The volume of medication. The child's body surface area.
The child's age. The child's age is a factor that should be used to determine the site for an intramuscular injection. For instance, a neonate should not be injected in the deltoid muscle, but that site is OK for a toddler. The child's weight. The child's weight should be considered when determining the site for an intramuscular injection. By evaluating the child's weight and overlying fat the nurse will be able to select a needle of the appropriate length. The volume of medication. The volume and properties of the medication must be considered when determining the site for an intramuscular injection. Certain sites are only able to contain a limited volume of injectable material.
The nurse is teaching the parent of an infant how to administer medication using an oral syringe. In what order does the nurse describe the appropriate steps? Assess the child's gag reflex and ability to swallow. Seat the infant in an upright or semi-upright position. Open the infant's mouth using gentle pressure to the chin or cheeks. Place the syringe along the side of the cheek. Gently dispense medication as the infant begins to suck.
The nurse should first assess the child's gag reflex and ability to swallow. Once it has been determined that the infant is able to safely ingest the medication orally, the infant should be held in an upright or semi-upright position. The nurse should then gently open the infant's mouth using gentle pressure and the syringe should be placed along the side of the cheek. With the syringe in this position the infant should be allowed to suck while the nurse gently dispenses the medication.
The nurse receives orders to administer eye drops to a young patient. What is the correct order for the steps involved? Wash hands and don gloves. Gently wipe the child's eye with a sterile gauze pad. Shake the medication. Instill drops into the conjunctival sac.
The nurse should first perform hand hygiene and don gloves. Next the nurse should remove any exudates from the child's eye with a sterile gauze pad. The nurse should use a different pad for each eye and move from the inner to outer canthus when wiping the eye. The suspensions should be mixed well before applying to eye. Finally, the eye drops will be instilled into the conjunctival sac of the child's eye.
An infant is prescribed nasal drops by the primary health care provider. Which actions should the nurse take to ensure proper delivery of the medication? Select all that apply. Hold the infant in a semi-upright position. Use a calm voice to help the infant relax. Obtain assistance in restraining the child. Remove any excess mucus with a bulb syringe. Hold the infant's nose after administration to ensure adequate delivery.
Use a calm voice to help the infant relax. Using a calm voice helps the baby know how to react to a disturbing event and can increase the likelihood that the infant remains still during administration. Obtain assistance in restraining the child. The restraining of a child is not always necessary, but may be necessary if efforts getting the child to cooperate fail. Remove any excess mucus with a bulb syringe. The removal of excess mucus from the nares is essential for preparing an infant to receive nasal medication because it will allow the medication access to the mucus membranes.
The nurse is preparing to administer prescribed oral medication to a 3-month-old patient. How should the nurse administer this medication? Place the infant on his or her back prior to administering medication. Hold the infant with the dominant hand to ensure the child does not move. Using a nipple, wait for the infant to begin sucking before adding the medication. Using a teaspoon, place the medication into the mouth along the side of the cheek.
Using a nipple, wait for the infant to begin sucking before adding the medication. The infant should be encouraged to begin sucking the empty nipple and only afterward should the medication be added. By waiting until the infant is sucking the nurse can ensure that the infant is able to feed.
A nurse receives an order that specifies IV bolus for a medication. What is the first step the nurse should take to administer this medication? Verify the administration rate for the medication. Verify the medication can safely be given as an IV bolus. Verify the medication compatibility with the IV solution being used. Verify the amount of flush needed following administration of the medication.
Verify the medication can safely be given as an IV bolus. The first step the nurse should take is to verify that the medication can be safely administered as an IV bolus. Some medications delivered via IV can be delivered as a bolus or intermittent infusion. It is important that the nurse verify the method of administration.
