TLO 2.6c Medication safety child

Question 1

9 rules of med administration to children

Answer 1

Never give choice
Do give choice that give child some control
never lie
Explanations simple/brief
Ok to be afraid/cry
Be positive/firm/assertive
Keep time between explanation and admin short
Obtain cooperation from family

Question 2

6 medication rights

Answer 2

Right:
pt
med
time
dosage
route
documentation

Question 3

Oral medications less than 5mL

Answer 3

Must be administered by an oral syringe designed for oral medications
**larger amounts, use calibrated medicine cup (up to 30mL)

Question 4

Suitable foods you can mix with medication

Answer 4

Apple sauce
Pudding
Jelly

Question 5

Which foods to avoid mixing medicine with?

Answer 5

Essential foods
Formula
Honey
Why? they can alter the foods taste, the child may refuse further intake of that food

Question 6

Why honey is not used with children?

Answer 6

Can cause infant botulism

Question 7

IM injection- infant/toddler
size
gauge
degree
amount

Answer 7

1/2-1.5" needle
22-25 gauge
90 degrees
Infant: 1mL=vastus lateralis
Toddler: 0.5mL=deltoid, 1mL=ventrogluteal, 1-1.5mL vastus lateralis

Question 8

Injection in deltoid.
How old?
Why?

Answer 8

Deltoid can only be used in toddlers (over 13 mo+) due to the deltoid is not fully developed and is a small muscle. Vastus lateralis is the preferred site for any child under 13 mo.

Question 9

Max amount of medication and site for IM injection:
Young child (3-6 years)

Answer 9

Deltoid: 0.5-1mL
Ventrogluteal: 1.5mL
Vastus lateralis: 1.5-2mL

Question 10

Max amount of medication and site for IM injection:
Older child (6-14 years)

Answer 10

Deltoid: 0.5-1mL
Ventrogluteal: 1.5-2mL
Vastus lateralis: 1.5-2mL

Question 11

Max amount of medication and site for IM injection:

Adolescent (15+ years)

Answer 11

Deltoid: 1mL
Ventrogluteal: 2-3mL
Vastus lateralis: 2-3mL

Question 12

Intradermal injections

• gauge
• sites
• syringe/amount
• position

Answer 12

25-27 gauge
3/8-5/8"
Forearm or upper back
0.1mL max amount
5-15 degree angle

Question 13

Rectal Meds

• when they are used
• what kinds of meds
• what age will have difficulty
• how administered

Answer 13

Used: child is unable to drink/eat, N/V
Meds: fever, prompting defecation
Age: preschoolers, fears of body entry
Admin: pinky <3yr, index finger >3 yr.
Use water soluble lube!!

Question 14

Otic meds admin

pinna position for <3 yr and >3 yr

Answer 14

<3 yr: pull pinna down and back

>3 yr: pull pinna up and back

Question 15

Ophthalmic med admin

-if eye can be opened

Answer 15

Position head lower than body
Child close eyes
Nurse rests hand with dropper on forehead
Retract lower lid
Instill in lower lid
Pt maintain position for 1 min.

Question 16

Ophthalmic med admin

-if eye CAN’T open

Answer 16

Drop med into inner canthus
Hold slight pressure over nasolacrimal duct, few min.
Blot excess med

Question 17

Instilling ophthalmic ointment

• technique
• when is it appropriate

Answer 17

Prior to admin, discard small amount onto sterile gauze.
Place ribbon of ointment on inside edge of lower lid.
Remind child vision will be blurry

Question 18

What ophthalmic med is administered first:

Drops or ointment?

Answer 18

Drops should always be admin before ointment

Question 19

Metered Dose Inhaler (MDI)

Directions

Answer 19

Sit at 90 degrees or stand
shake inhaler
take deep breath and exhale
place inhaler into mouth
press down to deliver medication
inhale medication slowly
hold breath for 10 seconds
exhale slowly

Question 20

Powdered Dose Inhaler

Directions

Answer 20

remove cover
do NOT shake
prepare medication as directed
exhale
place inhaler to mouth
inhale deeply and forcefully
hold breath 5-10 seconds
exhale slowly

Question 21

Why use a spacer with MDI?

Answer 21

Spacers help the medication get straight to the lungs with less medication ending up in your mouth and throat where it can lead to irritation or infection