Hatfield: Introductory Maternity and Pediatric Nursing #31
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.
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.
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 nurse is choosing a vein to insert a peripheral IV for a 2-year-old child. Which sites would be appropriate? Select all that apply.
Peripheral IV therapy sites commonly include the hands, feet, and forearms. In infants up to about the age of 9 months, the scalp veins may be used. Central IV therapy usually is administered through a large vein, such as the subclavian, femoral, or jugular vein or the vena cava.
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 nurse has just given otic medication instructions to the parents of a 12-year-old child. 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."
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."
The nurse is providing teaching for parents on how to administer ointment to their son's eyes. Which response indicates a need for further teaching?
"We should stand or sit behind him as he lies down."
A nurse is caring for a child who requires intravenous maintenance fluid. The child weighs 30 kg. Calculate the child's daily maintenance fluid requirement in milliters. Record your answer using a whole number.
1,700 mL.... The child requires 100 mL/kg for the first 10 kg, plus 50 mL/kg for the next 10 kg, plus 20 mL/kg for each kg more than 20 kg. This equals the number of milliliters required for 24 hours. (10 x 100) + (10 x 50) + (10 x 20) = 1,700.
The nurse is preparing to administer an oral dose of antibiotics to a 10-year-old child who weighs 70 lb (31.75 kg). The prescription reads cephalexin 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 794 mg per dose....Use the client's weight in kilograms. Calculate the low dose by multiplying 31.75 kg by 25 mg to equal 793.75 mg per day. This must be further divided by 4, the amount of times it is given in a 24-hour period (per day): 795 mg divided by 4 is 198.4, rounded up to 199 mg per dose. The high dose is calculated by multiplying 31.75 kg by 100 mg to equal 3,175 mg per day. This must be further divided by 4 because it is being given every 6 hours: 3,175 mg divided by 4 is 793.75, rounded up to 794 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 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.
To give eardrops to a 4-year-old child, what would be the best technique to use?
Pull the pinna of the ear up and back.
Which technique should the nurse use to administer ear drops to a 4-year-old child?
Pull the pinna of the ear up and back.
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 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
An infant is to have a scalp-vein intravenous infusion begun. What is an advantage of this insertion site?
The scalp veins are easily visualized.
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 site most often used when administering a medication using the intradermal route is the:
forearm
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 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 (31.75 kg). The prescription reads cephalexin 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 794 mg per dose... Use the client's weight in kilograms. Calculate the low dose by multiplying 31.75 kg by 25 mg to equal 793.75 mg per day. This must be further divided by 4, the amount of times it is given in a 24-hour period (per day): 795 mg divided by 4 is 198.4, rounded up to 199 mg per dose. The high dose is calculated by multiplying 31.75 kg by 100 mg to equal 3,175 mg per day. This must be further divided by 4 because it is being given every 6 hours: 3,175 mg divided by 4 is 793.75, rounded up to 794 mg per dose.
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...Multiply 0.8 mg by 18.2 kg, which equals 14.6 mg per day for the client's weight. Then, divide 14.6 mg by 4, the number of doses per day day, to arrive at 3.65 mg per dose.
The nurse enters the room to give a subcutaneous injection of insulin to a 6-year-old female who is diabetic. What is the best method of medication administration?
Ask her where she would like to have the nurse give the injection.
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.
The pediatric nurse is bringing the prescribed medication for a child but notes that the identification band is missing. The parents are at the bedside holding the child. What is the bestmethod for identifying the child?
Ask the parents to tell you his or her name and date of birth.
The nurse enters the room to give a subcutaneous injection of insulin to a 6-year-old female diabetic client. Which of the following would be most appropriate for the nurse to do?
Ask the patient where she would like to have the nurse give the injection
A child is prescribed multiple intravenous medications. Which nursing action demonstrates the best practice to maintain medication safety?
Flush the intravenous line between each medication.
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
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.
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...the largest muscle mass in the groups
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?
To calculate the does, use the client's weight in kilograms. Multiply 0.8 mg by 18.2 kg, which equals 14.6 mg per day for the client's weight. Then, divide 14.6 mg by 4, the number of doses per day day, to arrive at 3.65 mg per dose.
The nurse is caring for a child who weighs 42 lb (19 kg). The medication prescribed for the child has a therapeutic dosage range of 33 mg/kg/day to 48 mg/kg/day. The medication prescribed is to be given 3 times per day. Which dosage would be appropriate for the nurse to administer to this child in one dose?
Use the child's weight in kilograms. The low dose of this medication would be 19 kg × 33 mg/kg/day = 627 mg, divided by 3 times per day equals 209 mg per dose. The high dose of this medication would be 19 kg × 48 mg/kg/day = 912 mg/day divided by 3 times per day equals 304 mg per dose. Halfway between these two dosages (304 mg - 209 mg = 95 mg, 95 mg ÷ 2 = 47.5 mg), equates to a dose of 250 mg per dose being appropriate.
The nurse is working to gain a preschooler's cooperation to swallow an oral medication. What would be the nurse's best approach?
ask if the child would like to take the medicine in a cup or through an oral syringe
The nurse is giving ophthalmic medication to a 7-year-old male client. Which of the following approaches is the best for the nurse to use?
Have the child hold his head back and close his eyes, drop the medication on the inner canthus, then have him open his eyes.
A health care provider has written several prescriptions for a 7-pound newborn with jaundice. Which prescription does the nurse need to question?
IV normal saline 20 mL/hour
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.
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:
Reread the armband
The nurse is caring for a toddler diagnosed with iron deficiency anemia and prescribed an iron supplement. What would the nurse include in the educational plan for the parents? Select all that apply.
1. Iron supplements may cause dark stools, so monitor for this as an expected finding 2. Give the iron suppleiment with a liquid or food high in vitamin C (such as orange juice/oranges)
A toddler is ordered amoxicillin for bilateral otitis media. The mother complains that the child refuses to take the oral medication. The nurse knows that more education is needed when the mother states:
I will shake the medication well, and draw up the medication to the top of the syringe. My husband and I will hold the child down and force the medication down his throat.
A father believes his 2-year-old son is frightened by seeing an intramuscular (IM) medication injected into his thigh and requests that the child's "butt" be used. What will be the nurse's response?
"The muscle in his butt is not well enough developed to receive this injection until he has walked for 1 year."
The nurse is teaching a parent how to administer medications to her young child. Which instructions are appropriate? Select all that apply.
1. Gently restrain the child's head and arms. 2. Have the parent administer the medication. 3.Hold the child against the body with the head raised.
The nurse is administering medications to a 10-year-old child who takes medications at home for a chronic condition. The child's parent is at the bedside. What are appropriate guidelines for medication administration to this client? Select all that apply.
1. The nurse compares the child's ID band with the medication record. 2. The nurse carefully reads the label on the side of the medication bottle. 3. The nurse documents the medication administration after giving the medication.
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...For IM injections in infants, the mandatory site for administration is the vastus lateralis muscle of the anterior thigh
A pediatric client who weighs 33.4 kilograms is prescribed a medication in which the safe dose range is 15 to 20 mg/kg/day in q 12 hours divided doses. What is the highest single dose, in milligrams, that a nurse can administer in the safe dose range? Record your answer using a whole number.
334... The highest dose is 20 mg × 33.4 kg = 668 mg/day. 668 mg ÷ 2 doses = 334 mg/dose
