ch 35 key pediatric interventions Flashcards
the nurse caring for a 6 year old client enters the room to administer an oral medication in the form of a pill. the dad at the bedside looks at the pill and tells the nurse that his daughter has a hard time swallowing pills. what is the best response by the nurse?
call the pharmacy and ask if the pills can be crushed
the nurse is administering acetaminophen PRN to a 9 year old child on the pediatric ward of the hospital. which answers reflect nursing actions that follow the rules of the rights of pediatric medication administration? select all that apply.
-the nurse checks the documented time of the last dosage administered
-the nurse calculates the dosage according to the child’s weight
-the nurse explains the therapeutic effects of the medication to the child and parents
the nurse is teaching the student nurse the factors that affect the pharmacodynamics of the medications being administered. what is a factor affecting this property of medication in children?
immature body systems
when describing the differences affecting the pharmacokinetics of drugs administered to children, which would the nurse include?
topical drugs are absorbed more quickly in young children than adults
the nurse is providing teaching for the mother of an infant who receives all of his nutrition through a nasogastric feeding tube. the nurse is reviewing interventions to promote growth and development. which response from the mother indicates a need for further teaching?
we need to keep feeding time very quiet
the nurse is preparing to administer oral ampicillin to a child who weighs 40 kg. the safe dose for children is 50-100 mg/kg/day divided in doses administered every 6 hours. what would be the low single safe dose and high singe safe dose per day for this child?
500 to 1,000 mg per dose
the nurse is preparing to administer a medication to a 5 year old who weighs 35 lbs. the prescribed single dose is 1 to 2 mg/kg/day. which is the appropriate dose range from this child?
16 to 32 mg
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 nurse is preparing to administer medication to a child with a gastrostomy tube in place. what is a recommended guideline for this procedure? select all that apply.
-verify proper tube placement prior to instilling medication
-crush tablets and mix with warm water to prevent tube occlusion
-open up capsules and mix the contents with warm water
-flush the tube with water after administering medications
the nurse is administering immunizations to children in a neighborhood clinic. what is the most frequent route of administration?
intramuscular
the nurse is preparing to administer insulin to a diabetic child. which would be the recommended route for this administration?
subcutaneous
the nurse is caring for an 8 year old 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.
the nurse is providing teaching on how to administer nasal drops. which response by the parents indicates a need for further teaching?
she needs to remain still for at least 10 minutes after administration
the nurse is administering a liquid medication to a 3 year old using an oral syringe. which action would be the most appropriate?
allow the child time to swallow the medication in between amounts
after administering eye drops to a child, the nurse applies gentle pressure to the inside corner of the eye at the nose for which reason?
to ensure the medication stays in the eye
the nurse is preparing to administer an intramuscular injection to an 8 month old infant. which site would the nurse select?
vastus lateralis
the nurse is caring for children who are receiving iv therapy in the hospital setting. for which children would a central venous device be indicated?
a child who is receiving chemotherapy for leukemia
the nurse is determining the amount of iv fluids to administer in a 24 hour period to a child who weighs 40 kg. how many milliliters should the nurse administer?
1,900 ml
a nurse has just administered medication via an orogastric tube. what is the priority nursing action following administration?
flush the tube
a nurse is caring for a 14 year old with a gastronomy tube. the girl has skin breakdown and irritation at the insertion site. which would be the most appropriate method to clean and secure the gastronomy tube?
if any drainage is present, use a pre split 2 x 2 and place it loosely around the site
the nurse is explaining to the student nurse the therapeutic effects of total parenteral nutrition (TPN). what accurately describes the use of TPN?
it is a highly concentration solution of carbohydrates, electrolytes, vitamins, and minerals
the nurse is caring for a 6 year old child who has multisystem trauma due to a motor vehicle accident. the child is receiving total parenteral nutrition (TPN). what is a recommended nursing intervention for children on TPN?
initially, check blood glucose levels frequently, such as 4-6 hours to evaluate from hyperglycemia
the nurse is caring for a child who is receiving total parenteral nutrition (TPN) for failure to thrive. which nursing action might the nurse take to prevent complications from this therapy?
use occlusive dressings and chlorohexidine-impregnated sponge dressings
a healthcare provider orders a medication dosage that is above the normal dosage. the nurse administers the medication without questioning the dosage. what error did the nurse make?
the nurse violated one of the rights of medication administration
the nurse notes that a child with a swallowing difficulty is receiving a continuous tube feeding. the child is very active, and the feeding frequently get interrupted because the tube becomes disconnected. what should the nurse discuss with the healthcare provider about the tube feeding?
-the nurse should ask the healthcare provider if the client could receive bonus rather than continuous tube feedings
-the nurse should ask the healthcare provider if the client could receive the tube feedings during the night rather than continuously during all hours.
the parents of a child receiving total parenteral nutrition ask the nurse why their child must have their blood glucose monitored so frequently since they are not diabetic. what is the best response by the nurse?
it is important to monitor the blood glucose level because the solution has a high concentration of carbohydrates that convert to glucose
the student nurse is preparing to administer eye drops to a 2 year old child. which actions indicate the need for additional instruction? select all that apply.
-the nurse holds the medication bottle 3 inches from the child’s nose during administration
-the child is instructed to look down during the instillation of the medication in the eyes
-the child is turned so the medication flows toward the outer corner of the eye
the nurse is monitoring the output for a 10 year old child. the medical record indicates that the child weighs 78 lbs (35kg). how much using can be anticipated for this child for a 12 hour period?
420-840 ml
the nurse is checking placement of a child’s feeding tube. when the pH is checked, it is 5.3. what action by the nurse is indicated?
contact the health provider
the nurse will be administering a medication to a child that is primarily excreted by the kidney. the nurse is aware that this action is especially dangerous until the child reaches what age? record your answer in years.
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