CH 20 Drugs for the Pediatric Patient Flashcards
- Which of the following is the branch of medicine pertaining to diseases and disorders of infants and children?
Obstetrics
Geriatrics
Pediatrics
Reproductive medicine
Pediatrics
Pediatrics is the branch of medicine pertaining to the diseases and disorders of infants and children.
- Which of the following terms describes a physician trained in caring for infants and children?
Obstetrician
Geriatrician
Pediatrician
Gynecologist
Pediatrician
A pediatrician is a physician trained in caring for infants and children.
- Which of the following terms describes the period extending from birth to the end of the first year of life?
Childhood
Toddler
Infancy
Preschooler
Infancy
Infancy is the period extending from birth to the end of the first year of life.
- Which of the following terms describes the period of life extending from infancy to puberty?
Childhood
Toddler
Infancy
Preschooler
Childhood
Childhood is the period of life extending from infancy to puberty.
- Which of the following terms describes a period of accelerated growth rate and sexual development generally occurring around age 12 in girls and age 14 in boys?
Childhood
Puberty
Postinfancy
Toddler
Puberty
Puberty is the period of accelerated growth rate and sexual development generally occurring around age 12 in girls and age 14 in boys.
- Infants and small children do not have fully developed bodies and are not able to metabolize and excrete drugs like an adult would. As a result, infants and children require _____________ doses of medication.
larger
smaller
more frequent
less frequent
smaller
Infants and small children do not have fully developed bodies and are not able to metabolize and excrete drugs like an adult would. As a result, infants and children require smaller doses of medication.
- Which of the following statements about the physiological alterations in the pediatric patient is NOT true?
Infants have immature enzyme systems in the liver. Infants have lower plasma concentrations of protein for binding with drugs.
Infants have kidneys that function immaturely.
Infants have a metabolic capacity similar to adults.
Infants have a metabolic capacity similar to adults.
Infants and children do not have fully developed bodies and are not able to metabolize and excrete drugs like an adult would.
- Which of the following methods should be used to administer medications that are irritating when tracked into the subcutaneous tissue?
Oral
Inhalation
Z-track
Topical
Z-track
Z-track is the method of injection administration to be used when the medication is irritating.
- Which of the following is NOT a common site for subcutaneous medication administration?
Upper arm
Abdomen
Anterior thigh
Deltoid
Deltoid
The most common sites for subcutaneous medication administration are the center third of the lateral aspect of the upper arm or abdomen, or the center third of the anterior thigh.
- Which of the following drugs should be avoided in most children and teenagers because of Reye’s syndrome, which is a potentially life-threatening disorder?
Aspirin
Ibuprofen
Acetaminophen
Diphenhydramine
Aspirin
Avoid administer aspirin to children and teenagers because of Reye’s syndrome a life threatening condition.
- Which of the following allows fluid to remain in a syringe and needle after the plunger is completely pushed forward?
Hub space
Dead space
Plunger space
Barrel space
Dead space
Dead space is the space that allows fluid to remain in a syringe and needle after the plunger is completely pushed forward.
- Which of the following is an example of a medication that children beyond infancy will need a larger dose of, although still not equivalent to an adult dose?
Antibiotics
Pain control
Antiemetics
Immunizations
Pain control
Children beyond infancy may metabolize drugs faster and will need larger doses of pain control medications, but still not equivalent to those of an adult.
- Which of the following is the most successful strategy for the administration of oral and liquid medications to a pediatric patient?
Have the medical assistant administer the medication. Allow the doctor to administer the medication.
Observe the parent administer the medication.
Require that the nurse administer the medication.
Observe the parent administer the medication.
The most successful strategy for the administration of oral and liquid medications to a pediatric patient is to observe the parent administer them
- Which of the following is the preferred route of medication administration in pediatric patients?
Oral
Nasal
Rectal
Parenteral
Oral
Oral is the preferred medication administration route for pediatric patients.
- When administering solid medications, which of the following is a concern if the child is fussy or crying?
Vomiting
Choking
Adverse reaction
Resistance
Choking
Choking is a concern when administering solid medications if the child is extremely fussy or crying.
- Which of the following is the standard conversion of teaspoons to milliliters?
1 tsp = 5 mL
½ tsp = 5 mL
½ mL = 1 tsp
5 tsp = 1 mL
1 tsp = 5 mL
The standard conversion is 1 tsp (teaspoon) = 5 mL (milliliters).
- Which of the following is a very accurate method of administering a drug with a dose of less than 1 mL?
Teaspoon
1 mL syringe
Dropper
Medicine cup
1 mL syringe
A TB syringe is a very accurate method of administering a drug with a dose of less than 1 mL.
- Which of the following is the correct position to place a child in when administering an oral medication?
Upright
Supine
Prone
Sims
Upright
Place the child in an upright position when administering an oral medication
- Which of the following is the injection method is most commonly used in the administration of immunizations?
Oral
Subcutaneous
Intravenous
Otic
Subcutaneous
Subcutaneous administration is the injection method used for live vaccine immunizations.
- Which of the following may be administered in the home for a child who is vomiting or running a fever?
Suppository
Troche
Liniment
Thin strip
Suppository
A suppository may be administered in the home for a child who is vomiting or running a fever.
- How should a child under the age of three have his or her ear positioned for the administration of ear drops?
Pulled upward and back
Pulled downward and back
Pushed back against the head
Pulled straight out from the head
Pulled downward and back
When administering ear drops in children under the age of three years, the external auditory canal should be straightened by pulling the pinna downward and straight back.
- When administering nose drops, the child should be instructed to remain in the instillation position for:
30 seconds.
1 minute.
2 minutes.
5 minutes.
1 minute.
When administering nose drops, the child should be instructed to remain in the installation position for 1 minute.
- Which of the following is the maximum amount of parenteral medication given to a pediatric patient?
0.5 mL
1 mL
2 ml
3 mL
1 mL
The maximum amount of parenteral medication given to a child is 1 mL.
- Which of the following is the preferred route of medication administration in a child who has poor absorption, diarrhea, vomiting, dehydration, or peripheral vascular collapse?
SC
IM
PO
IV
IV
The intravenous route (IV) is the preferred route of medication administration in a child who has poor absorption, diarrhea, vomiting, dehydration, or peripheral vascular collapse.
- The period of life extending from infancy to puberty is called __________________.
childhood
Explanation: Childhood is the period of life extending from infancy to puberty.
- The branch of medicine pertaining to the diseases and disorders of infants and children is _________________.
pediatrics
Explanation: Pediatrics is the branch of medicine pertaining to the diseases and disorders of infants and children.
- ____________ is the period extending from birth to the end of the first year of life.
Infancy
Explanation: Infancy is the period extending from birth to the end of the first year of life.
- _______________ is the period of accelerated growth rate and sexual development.
Puberty
Explanation: Puberty is the period of accelerated growth rate and sexual development.
- Puberty occurs around age ________ in girls.
12
Explanation: Puberty occurs around age 12 in girls.
- Puberty occurs around age _______ in boys.
14
Explanation: Puberty occurs around age 14 in boys.
- Infants and children do not have fully developed bodies and are not able to _______________ and ___________ drugs like an adult would.
metabolize; excrete
Explanation: Infants and children do not have fully developed bodies and are not able to metabolize and excrete drugs like an adult would.
- Infants and children require __________ doses of medication than adults.
smaller
Explanation: Infants and children require smaller doses of medication.
- The processes of ________________, distribution, biotransformation, and excretion may significantly alter the effects of drugs on a pediatric patient.
absorption
Explanation: The processes of absorption, distribution, biotransformation, and excretion may significantly alter the effects of drugs on a pediatric patient.
- The processes of absorption, distribution, biotransformation, and excretion may significantly alter the _____________ of the drug on a pediatric patient.
effects
Explanation: The processes of absorption, distribution, biotransformation, and excretion may significantly alter the effects of the drug on a pediatric patient.
- Children beyond infancy may metabolize drugs ___________ and need larger doses.
faster
Explanation: Children beyond infancy may metabolize drug faster and need larger doses.
- Infants have immature enzyme systems in the liver, lower plasma concentrations of protein for binding with drugs, and kidneys that function immaturely. All of these factors make them more vulnerable to the _____________ effects of drugs.
harmful
Explanation: Infants have immature enzyme systems in the liver, lower plasma concentration of protein for binding with drugs, and kidneys that function immaturely. All these factors make them more vulnerable to the harmful effects of drugs.
- When administering a(n) ________________ to an infant older than four months of age, the needle gauge would be 25G, the needle length, 1 inch, and the location, the vastus lateralis muscle.
immunization
Explanation: The vastus lateralis muscle of the upper outer thigh is the preferred site for infant immunizations. A 25G, 1-inch needle would assure the medication would reach the proper site with minimum pain.
- Infants have immature enzyme systems in the liver, lower plasma concentrations of protein for binding with drugs, and ____________ that function immaturely. All of these factors make them more vulnerable to the harmful effects of drugs.
Kidneys
Explanation: Infants have immature enzyme systems in the liver, lower plasma concentrations of protein for binding with drugs, and kidneys that function immaturely. All these factors make them more vulnerable to the harmful effects of drugs.
- When administering immunizations to a preschooler or school-aged child, the ___________ muscle is the preferred site to use.
deltoid
Explanation: When administering immunizations to a preschooler or school-aged child, the deltoid muscle is the preferred site to use. It can absorb 1 mL of fluid
- Infants and small children cannot tell you that they are experiencing symptoms that may be a(n) ________ of a drug; for example, a preverbal child cannot verbalize dizziness or ringing in the ears.
side effect
Explanation: Infants and preverbal children cannot verbalize symptoms that may be a side effect of a drug.
- A potential problem for children who are ill is _______________. In an ill child, water requirements and losses are both increased with the fluid intake decreased.
dehydration
Explanation: A potential problem for children who are ill is dehydration. In an ill child, water requirements and losses are both increased with the fluid intake decreased.
- Because of an altered ability in a pediatric patient to excrete drugs, toxic drug _______________ may occur.
accumulation
Explanation: Because of an altered ability in a pediatric patient to excrete drugs, toxic drug accumulation may occur.
- With the pediatric patient population, perhaps more than any other, administrating an accurate _________ of a drug cannot be emphasized enough.
dose
Explanation: With the pediatric patient population, perhaps more than any other, administrating an accurate dose of a drug cannot be emphasized enough
- When an oral medication is given nasogastrically, this means that the medication is administered through a(n) ___________ that runs from the patient’s nose to the stomach.
tube
Explanation: Liquid medications may be inserted through a nasogastric tube that runs from the patient’s nose to the stomach.
- Checking the dose of a medication is a shared responsibility between the physician _____________ the drug and the person _______________ the drug.
ordering; administering
Explanation: Checking the dose of a medication is a shared responsibility between the physician ordering the drug and the person administering the drug.
- Because both healthy and ill infants and children are particularly sensitive to the effects of drugs, you must know the __________________ for drug dosing.
safe range
Explanation: Because both healthy and ill infants and children are particularly sensitive to the effects of drugs, you must know the safe range for drug dosing.
- Because you are ____________ responsible for the safe administration of a drug, you may need to refuse to administer the drug if you are uncomfortable with a dose outside the safe range.
legally
Explanation: Because you are legally responsible for the safe administration of a drug, you may need to refuse to administer the drug if you are uncomfortable with a dose outside the safe range.
- As a result of an unpredictable response to a drug, ____________ the drug with another person is advised.
double-checking
Explanation: Because of an unpredictable response to a drug, double-checking the drug with another person is advised.
- Drugs doses should be double-checked because the _________________ may make the difference between life and death. There is a significant difference in administering a microgram and a milligram. A milligram is a thousand times larger than a microgram.
decimal point
Explanation: The incorrect placement of a decimal could mean overdosing or underdosing a patient.
- Acetaminophen and antiemetics may be administered rectally via a(n) ______________ for a child who is vomiting or running a fever.
suppository
Explanation: Acetaminophen, and antiemetics may be administered rectally via a suppository for a child who is vomiting or running a fever.
- It is essential that the nurse realize that children are ____________ sources of information.
unreliable
Explanation: It is essential that the nurse realize that children are unreliable sources of information. The only reliable method of drug administration is to check the child’s hospital identification band with the medication label. Toddlers and preschoolers may answer to any name, and older children may deny their identity to avoid administration of the medication.
- A child should never be asked his or her identity. Infants are not able to state their identity. Toddlers and preschoolers may answer to _________ name..
any
Explanation: A child should never be asked his or her identity. Infants are not able to state their identity. Toddlers and preschoolers may answer to any name
- A child should never be asked his or her identity. School-age children may _____ their identity to avoid administration of the medication.
deny
Explanation: A child should never be asked his or her identity. School-age children may deny their identity to avoid administration of the medication. The only reliable method of drug administration is to check the child’s hospital identification band with the medication label.
- Because all parents have administered a drug to their children, they may provide helpful information and offer _________ that may assist you in the successful administration of the drug.
techniques
Explanation: All parents have administered a drug to their children, so they may provide helpful information and offer techniques that may assist you in the successful administration of the drug.
- Perhaps the most successful strategy would be for the ___________ to administer oral and liquid drug forms. The child who has medication administered this way may feel safer and be less likely to fuss.
parent
Explanation:
The most successful strategy would be for the parent to administer oral and liquid drug forms. The child who has medication administered this way may feel safer and be less likely to fuss.
- Whenever possible, the _______ route of medication administration is preferred in pediatric patients.
oral
Explanation: Administering medications using the parenteral route is painful and presents a safety risk. The preferred route of medication administration in pediatric patients is the oral route.
- Dissolved or suspended medications are preferred to solid medications because of a decreased risk of aspiration or ____________.
choking
Explanation: Because of a decreased risk of aspiration or choking, liquid medications are preferred to solid medications.
- Because many oral drugs are ordered in teaspoons, and teaspoons are inaccurate devices, the measurements should be converted to ____________.
milliliters
Explanation: The teaspoon is a household system of measurement. Because of the need to standardize the dose of medication, particularly in the pediatric patient, measurement should be converted to milliliters
- The standard conversion from teaspoon to milliliter is ______ tsp (teaspoon) equals _______ mL (milliliters).
1; 5
Explanation: Five mL equal one tsp.
- A very accurate method of administering a drug with a dose of less than 1 mL is a(n) _____________ syringe.
tuberculin
Explanation: Because they provide greater accuracy, tuberculin syringes are used to measure and administer doses of less than 1 mL.
- Never place a child on his or her back or side for oral medication administration because this could result in ________________.
aspiration
Explanation: A child who is placed on his or her back or side for oral medication administration is at risk for aspirating the medication.
- When administering pediatric intramuscular injections, very small volumes of less than 1 mL should be administered in a (n) ________ syringe to ensure accuracy.
low-dose
Explanation: Low-dose syringes are designed to increase the accuracy of medication administration and should be used when administering doses of less than 1 mL.
- Low-dose syringes with specially designed needles decrease the chance of administering inaccurate doses because of a(n) _____________, which allows fluid to remain in the syringe and needle after the plunger is completely pushed forward.
dead space
Explanation: Low-dose syringes with specially designed needles decrease the chance of administering inaccurate doses because of a dead space, which allows fluid to remain in a syringe and needle after the plunger is completely pushed forward.
- Medications such as iron, diphtheria, and tetanus toxoid are specifically irritating and may result in irritation when tracked into the subcutaneous tissue; they should be administered by ______________.
Z-track
Explanation: Medications such as iron, diphtheria, and tetanus toxoid are specifically irritating and may result in irritation when tracked into the subcutaneous tissue; they should be administered by Z-track. The skin is pulled to the sides when the needle is inserted and after the medication is injected and the needle withdrawn, the skin is allowed to fall back into place. This closes the channel that the needle created and prevents irritating medication from being tracked into the subcutaneous tissue.
- Because the response to an injection is unpredictable, it is recommended that someone assist you to _________ the child.
hold
Explanation: Because the response to an injection is unpredictable, it is recommended that someone assist you to hold the child.
- The maximum amount of drug that can be given to infants and children using the parenteral route is _______ mL.
1
Explanation: The maximum amount of drug that can be given to infants and children using the parenteral route is 1 mL.
- If one-half of a suppository is ordered, it is recommended to cut it ________________ and not in half.
lengthwise
Explanation: When one-half of a suppository is ordered, it is recommended to cut it lengthwise and not in half.
- It is recommended to administer an eye ointment before a nap because the child’s vision will most likely be ______________.
blurred
Explanation: It is recommended to administer an eye ointment before a nap because the child’s vision will likely be blurred.
- When administering ear drops in children under three years of age, the external auditory canal should be straightened by pulling the pinna _____________ and straight back.
downward
Explanation: When administering ear drops in children under the age of three years, the external auditory canal should be straightened by pulling the pinna downward and straight back.
- When administering ear drops in children over the age of three years, the external auditory canal should be straightened by pulling the pinna _____________ and straight back.
upward
Explanation: The pinna is pulled upward and back in children over the age of three.
- An alternative technique to administering an oral medication in a liquid preparation is to ask the physician or pharmacist for another __________ of the drug, such as a chewable troche or lozenge.
form
Explanation: An alternative technique to administering an oral medication in a liquid preparation is to ask the physician or pharmacist for another form of the drug, such as a chewable troche or lozenge.
- Tylenol and Triaminic have developed forms of medication that will _______ on the child’s tongue.
melt
Explanation: Tylenol and Triaminic have developed forms of medication that will melt on the child’s tongue
- Digoxin, heparin, insulin, opioids, and sedatives are examples of drugs that must be __________________ before being administered.
double-checked
Explanation: Digoxin, heparin, insulin, opioids, and sedatives are examples of drugs that must be double-checked before being administered.
- The only reliable method of drug administration is to check the child’s hospital _____________________ with the medication label.
identification band
Explanation: The only reliable method of drug administration is to check the child’s hospital identification band with the medication label.
- Parents may provide helpful information and offer techniques that may assist you in successful administration of a drug. A parent may also inform you of the child’s known ____________.
allergies
Explanation: Because parents know their children’s medical history best, they are a good source of information concerning drug allergies.
- Drops and teaspoons may be the prescribed dose for some medications, leaving room for error. As long as the drug is administered by the dropper supplied with the drug, it is considered _______________. administered
accurate
Explanation: Healthcare workers and parents should be instructed to use the dropper supplied with the medication to ensure an accurate dose is being
- Avoid putting a liquid drug in a medicine cup because some of the drug would adhere to the sides of the cup and result in a (n) ________________ dose.
inaccurate
Explanation: Avoid putting a liquid drug in a medicine cup because some of the drug would adhere to the sides of the cup and result in an inaccurate dose.
- When using a tuberculin syringe to measure and administer a liquid medication, place the syringe in the child’s ____________ to ensure the child receives the complete dose.
mouth
Explanation: The proper way to administer medication using a tuberculin syringe is to place the syringe in the child’s mouth. This ensures that the child receives all of the medication and the proper dose.
- If a drug comes only in tablet or capsule form, it should be ____________ and mixed with 1 teaspoon of a sweetened substance.
crushed
Explanation: If a drug comes only in tablet or capsule form, it should be crushed and mixed with 1 teaspoon of a sweetened substance.
- To avoid ____________________ and administration of other medications, always wash and completely dry the pill crusher.
cross-contamination
Explanation: When using a pill crusher, you should wash the crusher after use to avoid cross-contamination and administration of other medications.
- When administering oral medications, it is critical to have the parent hold the child in an ____________ position, with one of the child’s arms firmly secured against the parent’s side, and the child’s other hand held with the parent’s free hand.
upright
Explanation: When administering oral medications, it is critical to have the parent hold the child in an upright position, with one of the child’s arms firmly secured against the parent’s side, and the child’s other hand with the parent’s free hand.
- Blowing a small puff of air in the face of an infant up to 11 months of age or gently stroking the throat will stimulate the _________ reflex and facilitate the administration of an oral medication.
sucking
Explanation: Blowing a small puff of air in the face of an infant up to 11 months of age or gently stroking the throat will stimulate the sucking reflex and facilitate the administration of an oral medication.
- Low-dose syringes have specially designed needles that decrease the chance of administering inaccurate doses because of a dead space that allows fluid to remain in the syringe after the _____________ is completely pushed forward.
plunger
Explanation: Low-dose syringes have specially designed needles that decrease the chance of administering inaccurate doses because of a dead space that allows fluid to remain in the syringe after the plunger is completely pushed forward.
- When mixing two drugs in the same syringe, such as insulin, it is recommended to always draw up the two drugs in the same ______________.
order
Explanation: When mixing two drugs in the same syringe, such as insulin, it is recommended to always draw up the two drugs in the same order.
- The volar surface of the forearm is the preferred site for administering a(n) _______________ injection.
intradermal
Explanation: The volar surface of the forearm is the preferred site for administering an interdermal injection.
- When administering a subcutaneous injection, the ___________ side of the arm should be avoided because the skin is more sensitive.
medial
Explanation: A subcutaneous injection should be administered on the lateral side of the arm because the medial side is more sensitive.
- The _________________ route is the preferred route for children who have poor absorption, diarrhea, vomiting, dehydration, or peripheral vascular collapse.
intravenous
Explanation: The intravenous route is the preferred route for children who have poor absorption, diarrhea, vomiting, dehydration, or peripheral vascular collapse.
- It cannot be stressed enough that because the effect of intravenous administration is immediate, it is critical that the dose be ___________ because of life-threatening complications that can arise from administering too much of a drug.
accurate
Explanation: The intravenous route is one of the fastest delivery methods for medications. It is critical that the dose be accurate because of life-threatening complications that can arise from administering too much of a drug.
- IV administration may be used for children who need fluid _______________ and can tolerate extra fluid.
replacement
Explanation: IV administration may be used for children who need fluid replacement and can tolerate extra fluid.
- For very small children, or children who need the drug administered intravenously but cannot tolerate extra fluids, a special delivery system such as a(n) ____________________ may be used.
syringe pump
Explanation: A syringe pump is a special delivery system that is used when a child cannot tolerate extra fluids but needs a drug administered intravenously.
- A major disadvantage of administering medication through a feeding tube is the clogging of the tube by ________ solutions. The most important intervention to prevent this complication is to flush the tube after giving the medication.
thick
Explanation: The healthcare worker should maintain the integrity of feeding tubes by flushing the tubes to prevent clogging.
- There aren’t many differences in the optic, otic, or nasal administration of drugs between a child and an adult. The biggest consideration is the child’s ability to _______________.
cooperate
Explanation: The biggest consideration in administering drugs to a child is his or her ability to cooperate.
- The proper needle length to use when administering a parenteral medication in an infant or child ranges from _________ to _______ inch.
5/8; 1
Explanation: Infants and children have poorly developed muscles. Because of this, a needle with a length no longer than 5/8 to 1 inch should be used.
- When administering an immunization to an infant or child, a needle with a gauge (G) of ______ should be used.
25
Explanation: Because children have small muscles and little subcutaneous tissue, a small needle, gauge 25, should be used when administering immunizations.
- When administering drugs to infants and children using the parenteral route, a needle with a gauge (G) of ___________ should be used.
23
Explanation: Because children have poorly developed muscles, a needle with a small gauge, such as 23, should be used to administer drugs.
- A small infant must be held much like a(n) _____________ to administer nose drops.
football
Explanation: A small infant must be held much like a football to administer nose drops.
- A child should remain in the instillation position for _____ minute(s) after the administration of otic or nasal medications.
one
Explanation: A child should remain in the installation position for one minute after administration of otic or nasal medications.
- When instilling nose drops, a small pillow may be placed under the child’s shoulders to aid in the flow of the medicine through the ___________ passage.
nasal
Explanation: When instilling nose drops, a small pillow may be placed under the child’s shoulders to aid in the flow of the medicine through the nasal passage.
- After instilling an otic medication, the child should be instructed to lie on the ________ side for one minute.
opposite
Explanation: After instilling an otic medication, the child should be instructed to lie on the opposite side for one minute.
