ch 5: pediatric considerations Flashcards
what determines the degree and rate of absorption for pediatric patients?
- health status
- age
- weight
- route of administration
what influences drug absorption of oral drugs?
- gastric acidity
- gastric emptying
- gastric motility
- GI surface area
- enzyme levels
- intestinal flora
what is the gastric pH at birth? 2 to 3 years?
- alkaline
- reaches adult levels of gastric acid secretion
what absorption does low pH favor? high pH?
- acidic drugs
- alkaline drugs
what age does gastric emptying and GI motility reach adult level?
between 6 to 8 months
at what age does intestinal surface area reach adult level?
20 weeks
what does a decreased amount in production of bile salts and pancreatic enzymes lead to?
reduced absorption of lipid-soluble drugs
what is the skin like on infants and children?
thinner than adults
what percent of the body is water in neonates and infants? adults?
- 75%
- 60%
what does the greater fluid volume in the body mean related to drug concentration?
greater fluid volume = lower drug concentration
until the age of 2 how does the dosage need to be for water-soluble drugs?
higher dosage
what drugs are able to cross the cell membrane?
free or unbound
what is the level of protein binding sites in neonates and infants? how does this relate to dosages?
- lower amounts of protein binding sites
- lower dosages because more of the drugs is able to cross the cell membrane instead of being binded
what is the blood brain barrier like in infants? what does this increase the risk of?
- relatively immature
- allows drugs to pass through more easily into CNS
- increased risk for toxicity
what organ carries out metabolism?
liver
at what age does drug-metabolizing enzymes reach adult level?
11
at what age does GFR reach adult level?
12 months
how does a nurse determine the amount of drug in a patient’s body?
using plasma or serum drug levels
how are drugs ordered for a pediatric patient?
- weight in kg
- body surface area
what is the major reason for drug sensitivity?
small body size
what is family-centered care?
- essential to ensuring safety during and after health care interventions
- teaching is directed towards both family and patients
how do you go about giving a toddler medication?
- make it a game
- simple explanations
- they may act violently
how do you go about giving a preschooler medication?
- they are fairly cooperative
- allow some level of choice
how do you go about giving a school-age child medication?
- often cooperative
- may fear bodily injury
- need more control and information
