Unit 11 Pediatric Veriations Flashcards
What are the factors affection absorption of medication in children? Oral. IM. SQ. Topical.
Oral medications- slower gastric emptying*, increased intestinal motility, a proportionately larger small intestine surface area, higher gastric ph
IM- Smaller muscle mass, tone, and perfusion
SQ- decreased perfusion
Topical- Increased absorption due to greater body surface area and greater permeability of infant’s skin
What are the factors affecting distribution of medication in children?
- Higher percentage of body water than adults
- Decreased body fat
- Liver immaturity, altering first-pass elimination (more Rx staying in the system)
- Immature blood-brain barrier, especially neonates, allowing permeation of certain medications
What are the factors affecting metabolism of medication in children?
- Increased metabolic rate
- Immature liver means mess Rx is broken down so more stays in system.
What affects excretion of Rx in children?
-Immature kidney function
What are the forms of oral medications?
Liquids
-elixirs (can have alcohol), syrups (sugar), suspensions(shake & mix)
Powders
Tablets
Capsules
Why should a tablet not be crushed and mix with a child’s formula or essential foods?
-The child may associate the bitter taste with the good and later refuse it. Instead mix with a small amount of applesauce or nonessential food
What are the guidelines for pediatric oral medications?
- Administer using appropriate calibrated equipment (oral syringe, med cup)
- Administer appropriate to age
- SIDE OF MOUTH
- Don’t mix in bottle
- Can mix in small amount of applesauce,etc.
How would you administer med in a Gtube or Jtube?
Water, Rx, Water BY GRAVITY
How would you improve absorption feeds?
- Use pacifier during alternative feeds (non-nutritive sucking improves digestion)
- Quiet calm environment
- Consistent feeding techniques by caregiver/family members
Describe when rectal Rx’s would be necessary and the procedure.
-Necessary with: N/V & Diarrhea NPO Seizing (can be seen given in IBD when enemas are given)
Procedure:
side-lying, well-lubricated, above anal sphincter, use index or pinky finger, depending on child size, hold buttocks together, check BM for suppository
*invasive and upsetting/embarrassing for child
Describe administering Ophthalmic (eye) Medications for kids.
Age-appropriate explanation
Keep eyes closed until administration
Med at room temperature
Position to control head
Not when child is crying
Med in conjunctival sac
Describe administering otic (ear) medication for children.
< 3years old, pinna down and back
> 3years old, pinna up and back
Med room temp
Side-lying
Don’t contaminate dropper
Remain in position
What are the appropriate IM injection spots for the child age groups? and what would you not aspirate when injecting?
Vastus lateralus (thigh) all ages, especially infant
Deltoid > 3 years
Ventro gluteal (side upper leg) > 7 months
With vaccines DO NOT ASPIRATE for kids!
What are ways to provide atraumatic care when administering medications?
- Using comforting positions (might be parents lap)
- Using topical anesthetic prior to injections, vapocoolant spray
- Educating child and the parents
- Distraction!
**cold is a distraction
What are principles of atraumatic care for managing IV therapy?
- Gather equipment before approaching child
- Select hand rather than wrist or upper arm veins
- Ensure adequate pain relief
- Allow anesthetic to prepared site to dry
- If needed, use a device to transilluminate the vein
- Only two attempts to gain access
- Secure line with minimal amount of tape
- Protect site from bumping
