Paediatric Medication Administration PDF

Administration of Pediatric Medication  Introduction  Administration of medication is the most important nursing responsibility.  Since paediatric dose is often small in comparison with adult dose , a slight mistake in the amount of the administered drug represents a greater...

Administration of Pediatric Medication  Introduction  Administration of medication is the most important nursing responsibility.  Since paediatric dose is often small in comparison with adult dose , a slight mistake in the amount of the administered drug represents a greater error. Why Medication Errors ??? Causes of such errors include  Ignorance of appropriate dosage schedules  carelessness in calculating the dose  poor writing in prescription  failure to administer the correct drug. Failing to apply the drug administration rights  To a void further errors  adhere to the Rights  check the order to be sure that the information is correct , Note the Allergies  Always double check medication calculation before administration & be sure of the child’s Wt accurately  Documentation.  Safety Measures in Administration of Drugs  Each child has the 5 rights during administration of medication to prevent medication errors: 1. The Right patient 2. The Right Drug 3. The Right Dose 4. The Right Rout 5. The Right Time  some Rights has been added  The Right to Know (right information)  The Right to Refuse (Parents).  Routes of administration  Topical administration : this preparations may be applied to the skin , mouth , nose , ear , rectum …etc  This type of drug administered in forms of creams , ointments , gels , lotions , powders , patch's , suppositories and sprays. Oral administration : Because the oral route is the most convenient ,safest and least expensive, it is the one most often used. oral preparations forms may be :  solid (tablets , capsules & powders ).  Or in a liquid (solutions , suspensions & syrups).  Parenteral administration The Parenteral route is when a drug is injected or infused into the body , it includes  interadermal  subcutaneous  intramuscular  intravenous  interathecal (into space around the spinal cord).  IM Injection  Preferable IM sites in children 1. Vastaus lateralis ,Ventrogluteal , rectus femoralis are good choice for children under 3years 2. Dorsogluteal + previous sites (3-6 years) 3. Deltoid + previous sites (6-14years)  Rectus Femoralis Vastaus lateralis  Ventrogluteal Dorsogluteal +Deltoid  Routes of administration Ear , Nose & Eye drops : may be frightening , explain & position the child :  Nose drops : with head lowered.  Eye drops : with low head , instil into the bottom eyelid.  Ear drops :hold the auricle down & outwards. Drug calculations for children  Children'sdoses may be calculated from adult doses by using age, body-weight, or body-surface area  Body-weight may be used to calculate doses expressed in mg/kg.  Liquid doses calculation to calculate liquid doses we use the following formula :- Required dose stock volume ----------------- x -------------- = volume to be given Stock dose 1  Example  A child is ordered 90 mg of oral paracetamol. the bottle contains 120 mg in 5 ml. How many milliliters will you administer ?  Answer 90 x 5 = 3.75ml 120  Example A 34 kg child is ordered Erythromycin 40mg/kg/day, in 4 doses per day , how many mg/dose will you give ?  Answer= 40mg x 34 kg = 1360 mg 1360 = 340 mg per dose 4 doses  Ali is have 15 mg of Gentamycin IV injection. (80mg in 2 ml) How many milliliters will you administer ?  Answer 15 x 2 = 0.37ml (0.4ml) 80 How to Calculate IV Flow Rate  it may be measured as ml/hour or liter/hour or drops/min  The dropper of the drip set can give number of drops /ml (the drop factor) ( check the manufactures for drop factor)  Common drops factors are : 1. 10drops/ml = blood set 2. 15drops/ml = regular set 3. 60 drops /ml = microdropper  Metric Conversions 1 kilogram = 1000grams  1 gram = 1000 milligrams  1 milligram = 1000 micrograms  1 litre = 1000 millilitres  Metric Conversions 5 ml = 1 teaspoon  1 kg = 2.25 pound  1 ml = 1 cc  1 gram = 1 ml  Calculate IV Flow Rate (drops/min)  The formula : Volume (ml) x drop factor(drops/ml) time(min) = drops/min  1.5liter of saline is ordered over 12hrs using 15 drops/ml (drop factor), how many drops/min needed to be delivered ?  Answer = 1500(ml) x 15(drops/ml) 12 x60(total min) = 31 drops/min  The Dr ordered 500 ml of 1/5 dextrose saline for Ali over 8 hours , how many drop/min will you give by regular drip set ?  Answer = 500 (ml) x 15 (drops/ml) 8 x60 (total min) 15.6 = 16 drops/min Calculate IV Flow Rate (ml /hrs) Formula : ( using infusion or syringe pump) Volume (ml) time(hrs) = ml/hr  1 liter to be given for 24hrs ,how many ml to be infused /hr?  Answer = 41.6ml/hr  Tablet Dose calculation Required dose Stock dose = tablets to be given e.g :1 mg of oral diazepam is ordered for Amal is. 2mg tablets are available , how tablets will you give? Answer : 1/2 = ½ tablet  0.5 mg of Digoxin is ordered for Ahmed. 250 microgram tablets are available. How many tablets will you give ?  Answer : 0.5mg x 1000 =500 micrograms 500 = 2 tablets 250  Rights of medication administration 1. Right drug /medication 2. Right client or patient 3. Right route 4. Right dose 5. Right frequency /time 6. Right assessment 7. Right approach  Rights of medication administration continue 8. Right education 9. Right evaluation 10. Right documentation 11. Right to refuse 12. Right principle of care 13. Right prescription 14. Right nurse clinician Thanks