Pediatric medication administration Flashcards
What percentage of water makes up a pre-term infant, full term infant, and adult?
85%
80%
60%
How does intracellular water change in toddlerhood?
Intracellular water increases
How do ECF, ICF, and TBF change over time?
ECF decreases
ICF increases
TBF decreases
Which is lost faster in children: ECF or ICF?
ECF
How does the loss of ECF affect infants and children?
Electrolyte imbalances show twice as fast as in adults
How do you calculate daily maintenance fluid requirements for children?
100ml/kg for the first 10kg
50ml/kg for the second 10kg
20ml/kg for each additional kg of body weight
Divide by 24 to obtain cc/hr
How do children physiologically process medications differently from adults?
Neonates have less plasma albumin
Infants have more rapid gastric emptying
Infants have immature renal function
Metabolic rate of a child is 2-3x greater than the adult
How does a child’s metabolic rate affect them?
More rigorous
Greater caloric needs
Greater MBR
Increased H20 need to make up for normal fluid losses
Who has a greater BSA: children or adults?
Children
Pound per pound, kids have a greater surface area than adults
When do the kidneys reach full renal function?
Latter part of the first year
How does the child’s immature buffer system affect them?
They are at a greater risk for acid/base imbalances
How are the majority of pediatric meds given?
Orally
What factors influence the absorption in infants and children?
Irregular peristalsis
pH
Enzyme activity
How does the immature liver affect drug metabolism?
Immature liver cannot conjugate molecules with glucoronide to permit excretion by the liver
Deadly blood levels can accumulate
When does the BBB mature?
~2 years old
What can an immature BBB cause?
Encephalopathy
Dysfunction of the brain
Coma
What percentage of muscle mass makes up an infant/adult?
25%
50%
Why can an IM injection be bad for children?
Little muscle tissue available
May have erratic blood flow to muscle tissue -> decrease medication absorption
Infants need _________ doses of water soluble medication because of increased H20
Increased
Infants need _________ doses of fat soluble medication because of decreased body fat
Decreased
What percentage of body fat is in an infant, 1 year old, preschooler, and adult?
16%
23%
8-12%
15%
How long should a child be walking before using a dorsogluteal site?
One year
What are the best IM site choices in kids?
Ventrogluteal - Free of impt nerves and vascular structures - Easily ID - Thinner layer of subq tissue here - Less painful than vastus lateralis Vastus lateralis - Large, well-developed muscle - Can tolerate larger quantities of fluid - No impt nerves or blood vessels
What should you never do when administering medications to kids?
Mix with food or formula
Mix with child’s favorite food
Pretend you’re giving them something else
Use medication as a reward
How should you administer nose drops?
Position the head extended over the bed or pillow
Administer drops and hold for 1 min
How should you administer ear drops?
Pull pinna back and down for child <3
Pull pinna back and up for child >3
How should you administer eye drops?
Pull lower lid down
Squeeze drops into sac
