PEDs Medication EAQ
Which adverse effect on pediatric clients is associated with nalidixic acid?
Cartilage Erosion Nalidixic acid can cause cartilage erosion in pediatric clients. Sulfonamides can cause kernicterus. Chloramphenicol can cause Gray syndrome in neonates and infants. Fluoroquinolones can cause tendon rupture in pediatric clients.
Which statement is true regarding infant pharmacokinetics?
Drugs have relatively easy access to an infant's central nervous system (CNS). Because the blood-brain barrier is not fully developed in infants, drugs have relatively easy access to the central nervous system (CNS). Protein binding is low in infants. The capacity of the liver to metabolize many drugs approaches adult levels a few months after birth. Inulin is excreted entirely by glomerular filtration.
A 5-year-old child is being given dactinomycin and doxorubicin therapy after nephrectomy for Wilms tumor. What will the nursing care include?
Ensuring meticulous oral hygieneOral hygiene is essential, especially during the administration of medications that have a negative effect on the oral mucosa.Although pain may be present, aspirin is avoided because doxorubicin is also being used, and a side effect of this medication is thrombocytopenia.Aspirin is contraindicated for children because it is associated with Reye syndrome.Citrus juice will aggravate stomatitis, which is a common side effect of dactinomycin.Spicy foods may aggravate the stomatitis that occurs with chemotherapy. However, usually any food that the child requests is permitted.
A 5-month-old infant is admitted with a diagnosis of respiratory syncytial virus (RSV) infection. The infant's condition suddenly deteriorates, and a dose of epinephrine is prescribed to relieve bronchospasm. For what side effect of the medication should the nurse assess the infant?
Tachycardia
Allopurinol is prescribed for a 6-year-old child undergoing chemotherapy for cancer of the bone. When given the medication, the child asks, "Why do I have to take this pill?" What is the best response by the nurse?
"With the other medicines, it helps you get rid of the things that are making you sick." Telling the child it helps get rid of the things making the child sick is the most accurate and age-appropriate response to the child's question. Telling the child that the medicine protects the body from new problems is inaccurate, and not being truthful will interfere with the development of the child's trust in the nurse. Telling the child that it stops sick white cells from spreading is inaccurate and may instill more fear. Telling the child that it is needed because the healthcare provider says so is insensitive to the question and does not provide an explanation.
Which preparations use toxoids but not live viruses? Select all that apply. 1. Rotarix 2. Varivax 3. MMR II 4. PEDIARIX 5. DAPTACEL
4, 5, PEDIARIX consists of diphtheria and tetanus toxoids plus inactivated bacterial components of pertussis, inactive viral antigen of hepatitis B, and inactivated poliovirus vaccine. DAPTACEL is a preparation consisting of toxoids plus inactive bacterial and viral components of diphtheria and tetanus toxoids and acellular pertussis vaccine. Rotarix, Varivax, and M-M-R II are preparations containing live viruses
Calcium disodium edetate chelation therapy injections for lead poisoning can cause local discomfort. What is the most appropriate nursing intervention to lessen the discomfort?
Administering the injection with a local anesthetic A local anesthetic can lessen the pain that occurs with this deep intramuscular injection. A cool bath will prolong the discomfort by inducing vasoconstriction, which will slow the rate of absorption. Massaging the site will cause more discomfort because the area is tender. Movement will probably be difficult and will cause more discomfort.
Which strategies should be used to reduce pain during or after vaccination? Select all that apply.
Applying topical anestheticProviding tactile stimulationHolding the child upright during vaccination Application of topical anesthetics on the skin before the injection numbs the skin and reduces the pain at the time of injection. Tactile stimulation at the injection site before and during injection results in reduced pain. Holding the child in an upright position provides a sense of control, can decrease fear, and help reduce pain. Avoiding aspiration prior to intramuscular injection, rather than encouraging it, reduces the pain. Administration of analgesics and antipyretics is avoided before and after vaccination because they reduce the immune response.
A child being treated with cardiac drugs developed vomiting, bradycardia, anorexia, and dysrhythmias. Which drug toxicity is responsible for these symptoms?
Digoxin Digoxin helps improve pumping efficacy of the heart, but overdose can cause toxicity leading to nausea, vomiting, bradycardia, anorexia, and dysrhythmias. The side effects of nesiritide may include effects like headache, insomnia, and hypotension. Dobutamine does not cause nausea or vomiting but may cause hypertension and hypotension. Spironolactone may cause edema.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple choice items. If you are uncertain about a question, eliminate the choices you believe are wrong and then call on your
A 6-year-old child is about to have an intravenous catheter inserted. What is the nurse's best response when the child starts to cry?
Do you want the IV in your right or left arm? Giving the child a choice provides a sense of control over the fearful situation. Children need assistance in coping and should not be left alone when afraid. Six-year-old children fear bodily harm, especially disfigurement. Fears should be acknowledged, not minimized. The child is too fearful to care about the effect of the medication.
A nurse is caring for a first-grader receiving prednisone. What outcome does the nurse expect with adrenocorticosteroid therapy?
Suppressed inflammatory process Because of the suppression of the inflammatory process, the nurse must be alert to the subtle symptoms of infection, such as changes in appetite, sleep patterns, and behavior. Adrenocorticosteroid therapy delays, not accelerates, wound healing. Adrenocorticosteroid therapy may cause hypokalemia, not hyperkalemia, because of the accompanying retention of sodium and fluid. Adrenocorticosteroid therapy decreases, not increases, the production of antibodies.
What are the pharmacokinetic reasons for drug sensitivity in infants? Select all that apply.
Drug absorption Renal drug excretion Protein binding of drugs Hepatic drug metabolism
An infant who has undergone cardiac surgery for a congenital defect is to be discharged. What should the nurse emphasize to the parents regarding administration of the prescribed antibiotic?
Ensure that the antibiotic is administered as prescribed. Ensuring that the antibiotic is administered as prescribed is a priority because inadequate antibiotic therapy may predispose the infant to the development of bacterial endocarditis. Giving the antibiotic between feedings, shaking the bottle, and storing the medication in the refrigerator are not priority instructions because instructions often vary depending on the antibiotic.STUDY TIP: Focus your study time on the common health problems that nurses most frequently encounter.
The mother of a school-aged child with type 1 diabetes asks why it was recommended that her child use an insulin pump rather than insulin injections. What will the nurse tell the mother concerning the greatest advantage of the insulin pump?
Independence is fostered
An 8-year-old child with an influenza B viral infection was treated with aspirin and developed Reye syndrome. Which nursing intervention would be beneficial for this child?
Initiate hyperventilation Reye syndrome may cause increased intracranial pressure. Hyperventilation helps to reduce intracranial pressure by lowering carbon dioxide levels and increasing oxygen levels. The temperature should be controlled to prevent an increase in oxygen demands. The head of the bed should be elevated to prevent nausea and vomiting. The nurse should provide a quiet environment for early recovery.
A child is admitted to the hospital with a fever, headache, cough, and has had a sore throat for the past week. Three days later, a rash appears at the hairline and spreads rapidly all over the body. What disease does the child have?
Measles Measles is a highly contagious disease. Initial symptoms are fever, headache, cough, sore throat, and conjunctivitis. A rash appears at the hairline three days later and spreads to the rest of the body within 36 hours. Mumps is a viral disease commonly seen in children between the ages of 5 and 15. Symptoms include swelling of the parotid gland accompanied by local pain and tenderness. Rubella is a mild viral disease characterized by fever, sore throat, and swelling in the lymph nodes behind the ear and back of the neck. Later, a rash may appear and spread to the torso and arms. Pertussis is commonly seen in young children and is characterized by a whooping cough.
A child with acute lymphoid leukemia is started on a chemotherapy protocol that includes prednisone. What side effect of this medication does the nurse anticipate?
Mood swings may result from steroid therapy. Alopecia does not result from steroid therapy. An increased appetite, not anorexia, results from steroid therapy. Weight gain, not weight loss, results from steroid therapy.
A child recovering from a severe asthma attack is given oral prednisone 15 mg twice daily. What is the priority nursing intervention?
Preventing exposure of the child to infectionRationale: Prednisone reduces the child's resistance to certain infectious processes and, as an anti-inflammatory drug, masks infection. The child will self-limit activity depending on respiratory status. The eosinophil count is often consistently increased in children with asthma. The child will need adequate hydration to help loosen and expel mucus.
A nurse is caring for a 6-year-old child who has undergone craniotomy. The parents ask what effect mannitol has. The nurse responds that this medication is given to achieve what goal?
Relieve cerebral pressure Mannitol is an osmotic diuretic used to relieve cerebral edema. The bladder is a storage basin and is not involved with filtration; mannitol acts in the kidneys. Mannitol is an osmotic diuretic that affects neither the body's excretion of glucose nor peripheral edema.Test-Taking Tip: After you have eliminated one or more choices, you may discover that two of the options are very similar. This can be very helpful because it may mean that one of these look-alike answers is the best choice and the other is a very good distractor. Test both of these options against the stem. Ask yourself which one completes the incomplete statement grammatically and which one answers the question more fully and completely. The option that best completes or answers the stem is the one you should choose. Here, too, pause for a few seconds, give your brain time to reflect, and recall may occur.
A 4-year-old child is to be treated with intravenous immunoglobulin (IVIG) for Kawasaki disease. Before administration of the IVIG, what action(s) will the nurse take? Select all that apply.
Start an intravenous line., Have the parents sign permission for blood product administration.Rationale: IVIG is administered intravenously, so an IV line would be required. Because IVIG is a blood product, the parents will need to sign the appropriate permission form. The child does not need to be on nothing-by-mouth status. A cardiac monitor is not required. Common side effects include headache and kidney issues. Shortness of breath and back pain may be reported. IVIG is not an antibiotic. The parents should be asked about reactions to previously administered blood products
A 5-year-old child is given fluoroquinolones. Which potential adverse effect unique to pediatric clients should the nurse anticipate?
Tendon Rupture Fluoroquinolones may cause tendon rupture in children. Nalidixic acid can cause cartilage erosion, and tetracycline can cause staining of developing teeth. Hexachlorophene may cause central nervous system toxicity in infants.
A nurse is caring for a child with acute lymphoid leukemia who is undergoing chemotherapy. The parents ask why the child needs prednisone. How will the nurse respond?
it decreases inflammation Prednisone is a synthetic glucocorticoid that exerts an active antiinflammatory effect by stabilizing lysosomal membranes, thereby inhibiting proteolytic enzyme release. Prednisone does not affect the lymphocytes. Although prednisone increases the appetite and creates a sense of well-being, these are not the reasons it is administered. There is no indication the child is receiving radiation.