Pediatric Medication Administration Guidelines Quiz

Oral Medication Administration

• Using a household teaspoon or tablespoon to measure medication can result in dosage errors due to their inaccuracy.
• To administer medication to an infant, depress the chin with the thumb, direct the medication towards the inner aspect of the cheek, and release the flow slowly.
• For infants, use a syringe or nipple; do not add medication to formula.
• For small children, mix medication with a small amount of juice or fruit and administer in a syringe or allow them to drink it at their own pace.
• Parents may give medication under the supervision of a nurse.

Intramuscular Medications

• Rarely used in acute settings, except for immunizations, antibiotics, and use of EMLA (local skin anesthetic).
• Inform the child it is okay to make noise or cry during the injection, and their job is to try not to move the extremity.
• Keep the needle out of the child's visual field and secure them before giving the injection.

Pediatric Medication Administration

• Giving medications to children is a serious responsibility, and half of medications on the market do not have documented safe use in children.
• Children are smaller than adults, and medication dosage must be adjusted.
• Children react more violently to medications, and drug reactions are not predictable.
• The impact on growth and development must be considered when giving medications to children.
• Double-checking is always best, especially for medications like Lanoxin, insulin, and heparin.

Pediatric Drug Administration

• Pediatric drug therapy should be guided by the child's age, weight, and level of growth and development.
• The nurse's approach should convey the impression that they expect the child to take the medication.
• Explanations regarding medications should be based on the child's level of understanding.
• The nurse must be honest with the child regarding the procedure.
• It may be necessary to mix distasteful medication or crushed tablets with honey, applesauce, or gelatin.
• Never threaten a child with an injection if they refuse an oral medication.

Ear Drops

• In children under 3 years, pull the pinna down and back to straighten the ear canal.
• In children over 3 years, pull the pinna up and back.

Nose Drops

• Position the child with their head hyperextended to prevent a strangling sensation.
• Nasal drops act as vasoconstrictors, and excessive use may be harmful.
• Discontinue use after 72 hours.
• Congested nose will impair an infant's ability to suck.
• Give nasal drops 20 minutes before feeding.
• Have kleenex available and keep the child's head below the level of their shoulders for 1-2 minutes after instillation.

Rectal Medications

• Usually used for sedatives and antiemetics.
• Use the little finger and insert beyond the anal sphincter.
• Apply pressure to the anus by gently holding the buttocks together until the desire to expel subsides.

Intravenous Medications

• IV route provides direct access into the vascular system.
• Adverse effects of IV medication administration include extravasation of the drug into surrounding tissue and immediate reaction to the drug.

IV Medication Administration

• Check your institution's policy on which drugs must be administered by a physician and which must be verified for accuracy by another nurse.
• Check for compatibilities with IV solution and other IV medications.
• Use a buretrol to control the amount of fluid to be infused and for administering IV antibiotics or medications that need to be diluted.

Central Venous Line

• A large-bore catheter inserted into the superior or inferior vena cava or umbilical line in neonates.
• Used for long-term administration of medications and total parental nutrition.
• Complications include infiltration, catheter occlusion, air embolism, phlebitis, and infection.

Complications

• Infiltration: fluid leaks into subcutaneous tissue, causing fluid to leak around the catheter site, coolness to the touch, and tenderness or pain.
• Catheter occlusion: fluid will not infuse or unable to flush, causing frequent pump alarms.
• Air embolism: IV pump will alarm when there is air in the tubing, causing fluid to slow or stop.
• Phlebitis: often due to chemical irritation, causing tenderness or pain.

Dose Measurement

• Doses are measured and administered by professional and paraprofessional personnel in institutional settings and by adults or parents in home settings.
• Household measures are not accurate, and calibrated droppers or metric measurements should be used instead.
• Case example: calculating the dose of a cough syrup to be safely administered dropwise to a child.