Health Care Adaptations for the Child and Family

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Questions and Answers

What must be presented for treatments provided to a child upon their admission to the pediatric unit?

A consent form signed by the healthcare team

An oral agreement from the child

A written informed consent from the parent or guardian (correct)

A verbal explanation of the procedure

Which identification method is the preferred practice for identifying a child in a pediatric unit?

Parent's name

ID bracelet (correct)

Birthdate

Room number

Which of the following is NOT a recommended safety measure in the pediatric unit?

Documenting the child's weight in kilograms

Keeping crib sides up and locked when the child is unattended

Inspecting toys for sharp edges

Placing cribs near electrical outlets (correct)

How should nurses ensure safety when administering medications to children?

Identify the child using their ID bracelet Signup and view all the answers

What is one of the main reasons accidents occur among infants and children in the healthcare setting?

Failure to implement safety regulations Signup and view all the answers

Which of the following is a safe practice regarding crib safety?

The mattress must fit securely into the crib. Signup and view all the answers

What is the recommended procedure to prevent choking in small children?

Supervising them closely during feeding times. Signup and view all the answers

Which statement about transporting children in a hospital is true?

Younger children should be transported in their cribs or wagons. Signup and view all the answers

Which measure is essential to prevent cross-infection in a hospital setting?

Keeping toys and materials specific to each patient. Signup and view all the answers

Which safety measure is important for supervising children in bathing facilities?

Remaining present when a child is using the bathtub or shower. Signup and view all the answers

What is the correct method for obtaining an accurate weight measurement for an infant?

Using a weight measurement that is accurate in kilograms. Signup and view all the answers

When assessing blood pressure in children, which blood pressure reading indicates elevated blood pressure?

Blood pressure readings at or above the 90th to 95th percentile. Signup and view all the answers

Which of the following statements regarding the assessment of a child’s temperature is true?

Fever is compared to a standard of the rectal temperature. Signup and view all the answers

What is the recommended approach to perform a head-to-toe assessment for pediatric patients?

Perform the assessment once each shift or clinic visit, regardless of the reason for the visit. Signup and view all the answers

Which of the following is NOT an appropriate method of collecting a urine specimen from an infant?

Forcing the infant to urinate in a bucket. Signup and view all the answers

What method is recommended for obtaining a stool specimen from an infant?

Scraping from the diaper with a tongue depressor Signup and view all the answers

What is a critical consideration during a lumbar puncture procedure for a child?

The child should be positioned with knees flexed and head close to knees. Signup and view all the answers

Which of the following factors affects drug absorption in neonates?

Timing of medication in relation to feedings Signup and view all the answers

What should be monitored at the site of blood specimen collection?

Presence of bleeding after the procedure Signup and view all the answers

What is a common characteristic of the stratum corneum in pediatric patients?

Allows for faster absorption of topical medications Signup and view all the answers

Why is it important to understand the metabolism of medications in infants and children?

Liver enzymes function at a mature level until 2 to 4 years of age. Signup and view all the answers

What is a unique consideration for the administration of codeine in certain ethnic groups?

Deficiencies in the required metabolizing enzyme can affect pain relief. Signup and view all the answers

What is the primary reason that infants less than 1 year of age may experience altered responses to medication?

Immature kidney function impairs drug excretion. Signup and view all the answers

Which technique is NOT recommended when administering medications to infants and children?

Mixing medication with formula or food. Signup and view all the answers

What should be done to minimize pain during injections in children?

Positioning the child properly to reduce muscle tenseness. Signup and view all the answers

When administering nose drops to small children, what is a recommended technique?

Restrain the child using a mummy restraint if necessary. Signup and view all the answers

Which statement about subcutaneous and intramuscular injections in children is true?

Subcutaneous absorption is faster when the extremity is exercised immediately after the injection. Signup and view all the answers

What is the maximum volume of medication that can be administered intramuscularly to an infant?

0.5 mL Signup and view all the answers

Which technique is recommended for ensuring compliance when administering medications to children?

Using a sweet-tasting liquid to mask medication flavors. Signup and view all the answers

Why is it important to document medication administration in children?

To prevent forgetting doses or administering double doses. Signup and view all the answers

What is the most appropriate site for intramuscular (IM) injections in infants?

Vastus lateralis muscle Signup and view all the answers

What is NOT a recommended practice for giving oral medications to children?

Dividing unscored tablets to adjust dosage. Signup and view all the answers

Which of the following describes infiltration in an IV site?

Leakage of IV fluid into surrounding tissue Signup and view all the answers

What is the primary benefit of using a Saline Lock for pediatric patients?

It allows children to be more mobile and free from tubing. Signup and view all the answers

What should a nurse do to assess the patency of an IV site in a pediatric patient?

Observe hourly for signs of redness or inflammation. Signup and view all the answers

Which technique should be used when administering oral medications to an infant?

Insert medication along the side of the mouth. Signup and view all the answers

When should a nurse notify the registered nurse (RN) during intravenous administration?

Upon noticing leakage or cool, blanched skin around the IV site. Signup and view all the answers

What is recommended for preschoolers when administering medication?

Involve parents in the administration process. Signup and view all the answers

What is necessary for adolescents regarding their healthcare information?

They need time to process information and ask questions. Signup and view all the answers

What should be done when a toddler is resisting medication administration?

Allow the child to explore an empty medicine cup beforehand. Signup and view all the answers

Study Notes

Pediatric Patient Safety

Documentation of Treatments: Upon admission to the pediatric unit, a detailed record of treatments provided to the child must be documented. This is crucial for continuity of care.
Preferred Identification Method: The preferred method for identifying children in a pediatric unit is utilizing a wristband with two identifiers (e.g., name and date of birth). This helps ensure accurate identification, especially in a busy healthcare setting.
Unsafe Practice: One unsafe practice in the pediatric unit is leaving infants and young children unattended on examination tables. This poses a significant risk of falls or injury.
Medication Safety: To ensure medication safety for children, nurses must double-check the medication order, patient's identification, and dosage calculation before administering any medication. Utilizing electronic medication administration records (eMARs) is crucial for double-checking orders and minimizing errors. Utilizing a "five rights" approach (right patient, right medication, right dose, right route, right time) helps ensure accuracy.
Accident Causes: Accidents among infants and children in healthcare settings are often due to inappropriate supervision and lack of proper safety measures (e.g., crib safety, choking prevention).
Crib Safety: An essential crib safety practice is keeping crib rails raised and ensuring the mattress fits snugly, preventing the infant from falling or getting trapped.
Choking Prevention: For small children, keeping small objects out of reach and thoroughly inspecting toys for choking hazards are crucial to prevent choking.
Transporting Children: When transporting children in a hospital setting, a parent or guardian should accompany them whenever possible to minimize anxiety and provide reassurance.
Infection Prevention: A crucial measure to prevent cross-infection in hospitals is consistent and thorough hand hygiene by all healthcare personnel, including the use of alcohol-based hand rubs when necessary.
Bathing Supervision: When supervising children in bathing facilities, never leave them unattended to prevent drowning or injury.
Infant Weight Measurement: An accurate infant weight measurement is achieved by using a digital scale, weighing the infant in a diaper only, and double-checking the reading.
Elevated Blood Pressure: In children, a blood pressure reading above the 95th percentile for their age, gender, and height is considered elevated.
Child Temperature Assessment: The rectal route is considered the most accurate method for measuring temperature in infants and young children.
Head-to-Toe Assessment: When performing a head-to-toe assessment on pediatric patients, nurses should utilize the age-appropriate approach: observe and assess from head to toe in a systematic way, considering developmental milestones.
Infant Urine Specimen Collection: Using a urine bag with adhesive tabs is not a preferred method for collecting a urine specimen from an infant. This method can lead to contamination and inaccurate results.
Infant Stool Specimen Collection: When collecting a stool specimen from an infant, the recommended method is using a clean, dry container and obtaining the sample from the diaper while avoiding contamination.
Lumbar Puncture Considerations: During a lumbar puncture procedure for a child, it's vital to ensure the child is positioned appropriately and minimize pain during the process.
Neonate Drug Absorption: Drug absorption in neonates is influenced by immature gastrointestinal function, different enzyme activity, and reduced gastric emptying, making it critical to carefully consider appropriate drug dosages and monitoring responses closely.

Pediatric Medication Administration

Blood Specimen Monitoring: After blood specimen collection, it's crucial to monitor the site for bleeding, bruising, and any other signs of complications.
Stratum Corneum: The stratum corneum, the outermost layer of skin, is thinner and more permeable in pediatric patients, meaning topical medications are absorbed more readily compared to adults.
Metabolism Importance: Understanding medication metabolism in infants and children is critical because their liver enzymes are still developing, potentially leading to variable drug clearance rates and different responses to medications.
Codeine Considerations: Certain ethnic groups, particularly those of Asian descent, may exhibit altered metabolism of codeine, leading to increased levels of its active metabolite, potentially causing adverse effects.
Infant Medication Responses: Infants less than 1 year of age may experience altered responses to medications primarily due to their immature liver function and altered metabolic pathways, leading to slower medication clearance and potential accumulation.
Medication Administration Technique Avoid: It is NOT recommended to ever force medication administration, as it can lead to negative psychological associations and resistance in children.
Minimizing Injection Pain: Minimizing pain during injections in children can be achieved through distraction techniques, applying a topical anesthetic (e.g., EMLA cream), and utilizing smaller-gauge needles.
Nose Drop Technique: When administering nose drops to small children, it's important to position the child with their head tilted back and ensure drops are instilled in each nostril to maximize effectiveness.
Subcutaneous/ Intramuscular Injections: Subcutaneous and intramuscular injections in children often require smaller needle sizes and lower injection volumes than adults, due to smaller muscle mass and thinner skin.
Infant Intramuscular Volume: The maximum volume of medication that can be administered intramuscularly to an infant is generally 1.0 mL.
Medication Compliance: To ensure compliance when administering medications to children, engage the child in the process (e.g., let them choose a flavor if available), provide positive reinforcement, and use clear and age-appropriate language. Educating the child and caregiver about the medication, as well as answering any questions, is crucial.
Medication Documentation: Documentation of medication administration in children is essential for ensuring proper dosing, tracking medication side effects, and preventing medication errors.
Infant IM Injection Site: For infants, the vastus lateralis muscle is generally considered the safest and most preferred intramuscular injection site.
Oral Medication Practices: It is NOT recommended to ever mix medication with formula or juice without consulting with a physician as this can alter the effectiveness of the medication.
IV Infiltration: Infiltration at an IV site is characterized by swelling, redness, and pain around the insertion site, and usually indicates that the IV fluid is leaking into surrounding tissues.
Saline Lock Benefit: Using a Saline Lock for pediatric patients offers the advantage of allowing for intermittent medication administration while maintaining an open IV line, which is particularly useful for children who require frequent medications but may be more comfortable with less frequent IV access procedures.
IV Site Patency Assessment: To assess IV patency in a child, nurses should observe for good blood flow, absence of swelling or redness around the site, and easy flushing of the IV line.
Infant Oral Medication Technique: When administering oral medication to an infant, the recommended techniques are using a syringe, drawing the medication into the syringe, and placing the syringe in the infant's cheek, allowing them to swallow naturally.
IV Administration Notification: During intravenous administration, a nurse should notify the RN if any complications arise (e.g., infiltration, redness, pain at the site), if the flow rate is slow or stopped, or any other signs of adverse reaction.
Preschooler Medication Administration: When administering medication to preschoolers, engaging them in a playful and interactive approach can make the process more comfortable.
Adolescent Healthcare Information: Adolescents have the right to privacy and confidentiality regarding their healthcare information, so it's important for them to be involved in discussions regarding their treatment choices. Whenever possible, the parent or caregiver should be present.
Toddler Medication Resistance: When a toddler resists medication administration, it's critical to maintain a calm and reassuring demeanor, use distraction techniques, and involve the caregiver in the process to make it more positive.

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Description

Test your knowledge on essential safety measures and practices in pediatric healthcare settings. This quiz covers topics such as identification methods, medication safety, and accident prevention. Perfect for nursing students or healthcare professionals working with children.