Module 6: Parenteral Medications

Question 1

Pediatric Medication Formulas Needed

Answer 1

1 lb = 16 oz
1 fl oz = 30 ml

Question 2

Pediatric Maintenance Fluids

Answer 2

< 10 kg = 100 ml/kg/day
10-20kg = 1000 mls + 50 ml/kg/day > 10 kg
20-70k = 1500 mls + 20 ml/kg/day > 20 kg
Over 70kg = 2500 ml/day

Question 3

Pediatric Rounding Guidelines

Answer 3

Carry out all pediatric calculations to the 100th place.
Round final answer from the 1000th place.
If 1000th place number is > 5, round up 100th place number.
If 1000th place number is < 5, do not change 100th place number

Question 4

Parenteral Med Basics

Answer 4

Injected with a needle
 More quickly absorbed than oral medications
 Used when patients are vomiting, cannot swallow, or
are restricted from taking oral fluids or require
intravenous (IV) medications

 Four routes
* Subcutaneous: Injection just under the dermis
* Intramuscular (IM): Injection into a muscle
* Intradermal (ID): Injection just under the epidermis
* IV injection or infusion: Injection into a vein

Question 5

SQ Injection Techniques

Answer 5

Select an injection site where there is a body area where 2.5 cm (1 inch) of subcutaneous fat can be pinched.
* Pediatric patients will require different needles and lengths based on age.
* Use a ½- or 5⁄16-inch (28- to 31-gauge) needle,
perpendicular to pinched skin.
* If the patient is receiving a small dose (less than 5 units) of insulin, a pen injector should not be used, as there is a 50% chance of dose errors.
**Insulin is absorbed rapidly through the abdominal wall, so this should be the first choice for sites.

Question 6

IM Injections

Answer 6

Deposits medication into deep muscle tissue
 Faster absorption than the subcutaneous route
 Use clinical judgment to determine the site, depth,
needle, volume to use for a medication or vaccine
 Angle of insertion is 90 degrees
 Rotate IM injection sites
* Ventrogluteal
* Vastus lateralis
* Deltoid

Question 7

IV Bolus

Answer 7

Introduces a concentrated dose of a medication
directly into a vein by way of an existing IV access
 An IV bolus or “push” usually requires small volumes
of fluid, which is an advantage for patients who are at
risk for fluid overload
 Dangerous method to administer medications
because it allows no time to correct errors
 Verify the rate of administration of IV push medication
using agency guidelines or a medication reference
manual

Question 8

IV Meds via Piggyback or Syringe Pump

Answer 8

Small volumes (25–250 mL) of compatible IV
fluids infused over a desired time frame
 Piggyback
 Volume-control administration
 Syringe pump
 Needle safety