Module 2: Chapter 6: Life span: Children Flashcards
The textbook defines a pediatric patient as what
less than 16 years of age and under 50kg
what % of drugs regularly prescribed to children in the US have never been labeled for use in any pediatric population
75
is it now considered ethical or unethical to exclude children from drug studies
unethical
what must nurses be aware of until all drugs have been tested and labeled for sue in children?
off-label use that will occur
what are most pediatric doses based on
the childs weight in kilograms
what is used to determine the dosage in pediatric patients if a child dose is not specified
can be determined from the adult dose based on the body SA of the child
what can be used to determine a childs surface area to determine dosing
nomogram
True or false a drugs mechanism of action is the same in all individuals regardless of age
true
true of false in very young children immature organ systmes have less than optimal functioning
true
true or false a childs age, growth and maturation can affect how the body absorbs, distributes, metabolizes and excretes a drug
true
what can a nurse do regarding adverse and therapeutic effects
maximize therapeutic effects and minimize adverse effects
what can be done with dosages to account for immature or impaired body systems in neonates and infants
lowered
what can have an effect on pediatric drug absorption
age disease process dosage form route foods and drugs present in the childs body
is an infants GI tract more or less acidic than an adults
less acidic
compared to adults do infants have a higher or lower body SA
higher
what are fat and water levels like in children compared to adults
children have higher concentrations of water
lower concentrations of fat
does a neonates liver produce more or less plasma proteins then adults
fewer
what is the difference in the blood brain barrier in children compared to adults
at birth the blood-brain barrier is not full developed
immaturity of the nonatal and infant liver results in _____ or ___ metabolism of many drugs
decreased or incomplete
a child with an immature or compromised liver fn is at risk for what
drug toxicity
why are drugs that require oxidation for metabolism frequently more rapidly metabolized in children than adults
because children ahve a faster resting respiratory rate
immaturity of the nonatal and infant liver results in ____ or _____ metabolism of many drugs
decreased or incomplete
in children with impaired renal fn, drug dosages should be _____ to acheive and maintain therapeutic drug levels
alterered
the neonate, especially the preterm infant, has immature kindeys so renal excretion of the drug is
slow
true or false: many drugs excreted through the bilary tree into the intestinal tract
false: few drugs
is biliary drug flow increased or decreased during the first few days of life
increased
are most drugs prescribed to children prescribed for their labeled use or off labeled use
off labeled
are drugs that are dangerous for children labelled as such?
obviously
T or F: some adverse effects on body systems occur only at specific phases of development
yes
what is the effect diarrhea can have on drug absorption
decrease intestinal transit time and therefore decrease the time available for drug absorption
does constipation decrease drug absorption
no, it increases it as it slows down the motility in the GI tract allowing more of the drug to be absorbed
what considerations are especially important when communicating with a child
developmental considerations
what is the age range for infants
birth to 12 months
why may infants willingly swallow a pleasant-tasting liquid drug through a bottle nipple
well-developed sucking reflex
what is the preferred injection site for children and infants up to 3 years
vastus lateralis
what age group is considered toddlers
13 months to 3 years
can toddlers chew oral drugs
yes
what can ease a toddlers anxiety when administering drug therapy
having a parent nearby
why are toddles likely to be anxious or uncooperative druing administration of rectal suppositories
because of their experiences with toilet training and sphincter control
what are the IM injection sites of choice for toddlers
vastus lateralis and rectus femoris
are scalp veins still appropriate for toddlers?
yes, up till 18 months
why are scalp veins not the first choice for IV access
because of the anxiety it causes parents
what age group are preschoolers
3-5 years
are preschoolers usually cooperative in drug administration
no
what is a strategy for getting a preschooler to be cooperative during drug administration
offer choices
what can be used to reduce pain when administering an IM injection to a preschooler
use of topical anesthetic cream to numb the site
what are the common sites for IM injections in preschoolers
vastus lateralis
rectus femoris
ventrogluteal sites
what age are school-aged children
6-12 years
are school aged children cooperative
very
how can you allow a school aged child to exercise control during drug administration
offer choices
what age group can begin to swallow pills
school-aged children
what is the site recommended for administering an IM injection to a school-aged child
ventrogluteal
what should you offer adolescents whenever possible
control so that they can make their own choices
what are adolescents particularly sensitive about
their bodies and their independence
routes of administration for adolescents are similar to what
adults
what is the preferred IM injection sites for adolescents
same as adults
what is an infants primary food intake
milk and formula, these substances decrease gastric acidity and thus increase gastric pH
what should you assess for in school-aged children
use and abuse of substances such as caffeine, alcohol, tobacco and street drugs
what should you question the parent of a school-aged child
the use of herbal therapy in their child
what should you also consider for patients
the economic circumstances of the family
what do children receving drug therapy at home need to have
a parent or gaurdian responsible for ensuring that he child receives the prescribed therapy
what is an important question to ask the parent or caretaker when sending a child home with a perscription
if there is a safe place to store prescription and non-prescription drugs
a families beliefs can greatly affect the child in what way
childs attitude and adherence to the therapeutic regimen
what must be considered quite seriously when planning drug therapy for a child
cultural background and heritage
what is the desired outcome for delayed growth and development in children
patient will achieve normal growth and development during growth and development
what is the desired outcome for ineffective family therapeutic regimen management
family members will master effective management strategies of the patients drug regimen
what is the desired outcome for the nursing diagnosis caregiver role strain
patient and family will develop effective coping skills to avoid, reduce, or relieve stress on family caregivers
administering drugs safely and effectively to children requires an understanding of what 3 things
pediatric anatomy and physiology
developmental and cognitive levels
diagnosis and prognosis
what are the 6 situations medication errors are most likely to occur
children younger than 2 in ICU emergency departments children receiving cehmo children receiving IV meds children whose weight was not documented
what are strategies for preventing medication errors
always weigh the child before administering any medications
standardize as much as possible
use computerized drug order entry systems
use reliable drug information cources
double-check each calculated dose for accuracy
measure and deliver oral medications via oral syringes only
invovle the family
communicate the drug therapy plan clearly when different nurses will be caring for the patient
what are some ways of reducing psychological stress and anxiety
consider age-related emotional needs
adress feelings and discuss and answer questions as simply and honestly as possible
play therapy reduces anxiety and promotes understanding of drug therapy
for preschoolers and school-aged chilrdren take care to explore the childs experiences with the health care system
