PN108 PrepU Chapter 31

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 administering a medication that is enteric-coated. Which nursing responsibility is the most important when administering this medication?

The nurse should not crush the medication.

A nursing student is administering medications to her patient, Tommy, on a pediatric floor. What action by the student demonstrates a need for further instruction?

The student asks the patient if he is Tommy before giving the medication.

Samuel, a 1-month-old baby, is severely ill and has been prescribed an injection as part of his drug therapy. What is the preferred injection site?

The vastus lateralis muscle site

The nurse is providing teaching for parents on how to administer ointment to their son's eyes. Which of the following responses indicates a need for further teaching?

"We should stand or sit behind him as he lies down."

The nurse is caring for a child who weighs 47 lbs. The medication ordered for the child has a therapeutic dosage of 3 mg/kg per day. The medication ordered is to be given every six hours. What is the total number of milligrams of medication the child will receive in one dose?

16 mg

The nurse is preparing to administer a medication to a 5-year-old who weighs 35 pounds. The prescribed single dose is 1 to 2 mg/kg/day. Which is the appropriate dose range for this child?

16 to 32 mg

The nurse is caring for a 13-year-old boy with cystic fibrosis. The nurse prepares and verifies several medications and brings them and the medication administration record to the client's room. The nurse observes that the client is not wearing an identification band. Which action is the correct one for the nurse to take?

Ask the client to recall their name and date of birth.

T/F: A nurse administering an injection to a preschool boy should tell him to not cry, as this will help him be brave.

False

A parent must administer a medication in syrup form to a 2-month-old infant. The nurse suggests:

placing the medicine in an empty nipple without an attached bottle.

A 4-year-old child is admitted to the hospital for surgery. Before you administer medicine, the best way to identify the child would be to

read the child's armband.

The nurse is choosing a vein to insert a peripheral IV for a 2-year-old child. Which of the following sites would be appropriate? Select all answers that apply.

Hand veins Feet veins Forearm veins

The clinical nurse educator who oversees the emergency department in a children's hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?

Having nurses check their math calculations with a colleague before administering a drug.

A nurse has just given otic medication instructions to the parents of a 12-year-old. Which statement would indicate that the parents need further education concerning the medication?

"I will pull the outer ear down and back before administering the medication."

Which of the following is the most important reason for administering a medication at the correct time?

To maintain the desired blood level of the medication.

When determining the correct therapeutic dose of most medications in children, which assessment would be most important for the nurse to make?

Weight

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."

A school-aged child will have an intravenous line inserted. His mother asks if he could have this placed in his left hand so that he can do homework. What is the nurse's best response?

"Let's take a look at the left hand first."

The nurse is preparing to administer an oral dose of antibiotics to a 10-year-old child who weighs 70 pounds. The order reads Cephalexin (Keflex) 500 mg orally every 6 hours. The pediatric drug book dosing reads 25 to 100 mg/kg/day in 2 to 4 divided doses. What is the safe range per dose if administering every 6 hours for this client?

199 to 795 mg per dose

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 guage needle

An infant is to receive a hepatitis B vaccine within a few hours after birth. What is the best approach for the nurse to take when giving this medication?

Administer the medication in the infant's vastus lateralis with a 25-gauge needle.

A mother is told that her child will receive total parenteral nutrition. She asks the nurse what this means. The nurse bases her response on knowledge that total parenteral nutrition is:

Administration of fluids, electrolytes, amino acids, lipids, dextrose, and minerals through an IV.

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.

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 nurse is preparing to administer a prescribed medication. Which of the following would the nurse do to correctly identify the child?

Check the name and birth date on the patient's wristband with the Medication Administration Record

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 Prevacid in one 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.

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 her client. Which action should the nurse take when giving this medication?

Double-check the dose with another RN before giving.

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.)

Generic and trade names of drugs. Schedule and duration of administration Description of the intended therapeutic drug effect

The nurse is giving discharge instructions to a mother of a 3-month-old infant. What is the best information to give the mother 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.

Intravenous therapy is most commonly administered in the pediatric patient for the following reasons. Select all that apply.

To maintain fluid and electrolyte balance To administer medications, antibiotics, and pain medication To administer blood or blood products To administer nutrients

Vascular access ports are small plastic devices that are implanted under the skin for long-term fluid or medication administration.

True

t/f: Vascular access ports are small plastic devices that are implanted under the skin for long-term fluid or medication administration.

True

A nursing student learning about medication administration for children identifies correctly that a medication labeled "otic" is given in the:

ear canal.

The nurse is caring for a 12-year-old post-appendectomy client who weighs 86 pounds. The child has a temperature of 38.5 ºC (101.3 ºF). The nurse prepares to give the client a dose of oral Tylenol. 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?

587 milligrams

A 5-year-old boy is receiving an analgesic intravenously while in the hospital. What should the nurse do to determine whether the drug is being properly excreted from this child?

Monitor the child's fluid intake and output.

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 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 The IV flow rate Swelling at the IV site

A nurse is administering intravenous medication to a 13-year-old boy. Which potential complication should the nurse be especially concerned about in this situation?

Infiltration into surrounding tissues

The nurse has prepared an IM injection to give a 13-year-old patient. After some searching, the nurse locates the 13 year old 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 has prepared an IM injection to give a 13-year-old. After some searching, the nurse locates the 13-year-old in the playroom in front of a video game. Which action is the best one for the nurse to take?

Inform the child that it is time for an injection. Explain why the injection is needed and have him move to the procedure room.

A child has been admitted to the hospital with a systemic infection in the blood. Which route will the nurse prepare for antibiotic administration for this patient?

Intravenous antibiotics

As the nurse prepares to administer a medication to a preschooler, she realizes that the child is extremely underweight for her age. What action would the nurse take?

Measure her height and weight, and check whether the dose is correct for her.

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.

The mother of a toddler tells the nurse that, when taking medication, her child always makes an awful face and then spits it out. She tells the nurse that she has tasted the medicine, and it is extremely bitter, so she understands why the baby does not like it. What would be the best suggestion for this mother?

Mix the medicine with a spoonful 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.

A nursing instructor knows that teaching has been effective when a student identifies the following as the correct way to administer ear drops to a 4-year-old?

Pull the pinna up and back.

The nurse is preparing to administer insulin to a diabetic child. Which would be the recommended route for this administration?

Subcutaneous

The nurse is administering a medication that is an elixir. Which of the following should the nurse be aware of when giving this form of medication?

The alcohol in the medication may cause choking and should be diluted.

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.

The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select?

Vastus lateralis

A nursing student is preparing to give an intramuscular (IM) injection to an infant. Which site does the nurse identify as mandatory for this administration?

Vastus lateralis muscle

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 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse's assessment?

Where the medications will be stored.

To gain a preschooler's cooperation to swallow an oral medication, your best approach would be to:

ask if he would like to take his medicine in a cup or through an oral syringe.