[Exam 3] Chapter 35 – Key Pediatric Nursing Interventions Flashcards
(169 cards)
1
Q
Medication Administration - Difference In Pharmacodynamics and Pharmacokinetics: What is Pharmacodynamics?
A
Behavior of the medication at the cellular level
2
Q
Medication Administration - Difference In Pharmacodynamics and Pharmacokinetics: What can affect the drugs pharmcokinetics (movement of drugs throughout the body via absorption, distrubtion, metabolism, adn excretion)
A
Child’s age, weight, body surface, and body composition
3
Q
Medication Administration - Difference In Pharmacodynamics and Pharmacokinetics: In infants and young adults , absorption of orally administered med affected by?
A
slower gastric emptying, increased intestinal motility, a larger small intestine surface area, higher gastric pH, and decreased lipase and amylase secretion.
4
Q
Difference In Pharmacodynamics and Pharmacokinetics: IM injections in infants and young children affected by what?
A
amount of muscle mass, muscle tone and perfusion, and vasomotor instability
5
Q
Medication Administration - Difference In Pharmacodynamics and Pharmacokinetics: How does topical absorption affect infants/children?
A
Increased due to greater BSA. Also increased because of permebility of infants skin
6
Q
Medication Administration - Difference In Pharmacodynamics and Pharmacokinetics: Distrubtion in children affected by what?
A
Higher percentage body water
More rapid ECF exchange
Decreased body fat
Liver immaturity
Decreased amounts of plasma proteins
Immature blood-brin barrier
7
Q
Difference In Pharmacodynamics and Pharmacokinetics: Immaturity of kidneys until 1-2 years affects what?
A
Renal blood flow, glomerular filtration, and active tubular secretions. Means longer half-life and increases potential for toxicity of drugs
8
Q
Med Admin - Developmental Issues/Concerns: What explanations should be given to child before administering medications?
A
Why drug is needed, what they will experience, what is expected of child, and how parents can support their child
9
Q
Med Admin - Developmetnal Issues/Concerns: What must we assure child about when meds need to be administered with needle?
A
Let them know that this is not a consequence of their behavior
10
Q
GROWTH AND DEVELOPMENT ISSUES RELATED TO PEDIATRIC MEDICATION ADMINISTRATION: Infants issue?
A
Development of trust, which is fostered by consistent care. Development of stranger anxiety later in infancy
11
Q
GROWTH AND DEVELOPMENT ISSUES RELATED TO PEDIATRIC MEDICATION ADMINISTRATION: Toddler issue?
A
DEvelopment of autonomy with displays of negativisml rituals and routines maintian control
12
Q
GROWTH AND DEVELOPMENT ISSUES RELATED TO PEDIATRIC MEDICATION ADMINISTRATION: Preschooler issue?
A
Development of initiative, which is fostered when they sense they are helping
13
Q
GROWTH AND DEVELOPMENT ISSUES RELATED TO PEDIATRIC MEDICATION ADMINISTRATION: School-aged child issue?
A
Development of industry, benefiting from being part of their care; generally very cooperative
14
Q
GROWTH AND DEVELOPMENT ISSUES RELATED TO PEDIATRIC MEDICATION ADMINISTRATION: Adolescent issue?
A
Development of identity, benefiting from much more control over their care
15
Q
Determination of Correct Dose: At what weight is adult dose prescribed?
A
Once they reach 40-50 kg
16
Q
Determination of Correct Dose by BSA: This dosage takes what into account?
A
Child’s metabolic rate and growth, and need a nomogram
17
Q
Determination of Correct Dose by BSA: What is a nomogram?
A
Divided into three columns: Height (left column) surface area (middle column) and weight (right column)
18
Q
Determination of Correct Dose by BSA: How to determine BSA?
A
Measure height
Determine weight
Using nomogram, draw a line to connect the two
Determine point where line intersects surface area column
19
Q
Oral Admin: Why are children younger than 5/6 at risk for aspiration?
A
Because they have difficulty swallowing tablets/capsules. Must be crushed or mixed with pleasant-tasting liquid or food like applesauce
20
Q
Oral Admin: What should you never crush or open?
A
Enteric-coated or time-release tablet or capsule
21
Q
Oral Admin: What to know about liquid medications?
A
Shake the bottle to ensure even drug distribution
22
Q
Oral Admin: When using a dropper, direct the liquid where?
A
Toward the posterior side of the mouth , while giving the drug slowly and allowing child to swallow before more medication placed.
23
Q
Oral Admin: What angle should children always be palcced in?
A
45 degrees to avoid aspiration
24
Q
Oral Admin: How can medication be given is they have a gastric tube placed?
A
The meds can be given via the devices present . Allows for meds to be placed directly into stomach
25
Rectal Administration: How are these meds typically supplied?
In the form of suppositories
26
Rectal Administration: Why is this route not preferable?
Because drugs absorption may be erratic and unpredictable and the method is invasive
27
Rectal Administration: When would this route be used?
When the child is vomiting or receiving NPO.
28
Rectal Administration: What should you do to suppository and how is child positioned?
Make sure its lubricated. Place child is side-lying position. Used a gloved finger and insert above anal sphincter.
29
Rectal Administration: How do you prevent expulsion?
Hold the buttocks together for several minutes or until teh child loses urge to defecate.
30
Ophthalmic Admin: Usually provided in what form?
Drops or ointment
31
Ophthalmic Admin: How is this administered?
Retrct the lower eyelid and place the medication in the conjunctival sac.
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Ophthalmic Admin: How do you apply ointment?
Apply the meidcation in a thin ribbon from the inner canthus outward without touching the eye or eyelashes
33
Ophthalmic Admin: What to do if child's eyes are closed?
Apply 1-2 drops on inner canthus and then instruct child to open their eyes and drops will enter their eye
34
Otic Administration: Medications are in what form?
Ear drops.
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Otic Administration: Often receives this medication why?
For an earache.
36
Otic Administration: How to explain cooperation in younger and older child?
Younger: Explain in terms that they'll understand
Older: Explain purpose of medication
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Otic Administration: How to administer pediatric ear drops?
Pulling the pinna down and back if younger than 3
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Otic Administration: How to administer ear drops to child who is 4 years and older
nurse should pull the pinna up and back
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Otic Administration: What can happen if cold ear drops used?
Can cause pain and possibly veertigo or vomit when they rech the eardrum
40
Otic Administration: What should child do after medication administered?
Should remain in the same posiiton for several minutes to ensure that the medication stays in the ear camel. `
41
Nasal Administration: Nasnally administered meds are typiclaly what
drops and sprays
42
Nasal Administration: How should child be positioned for nose drops?
Position child supine with head hyperextended to ensure that drops will flow back into nares.
43
Nasal Administration: What to do after it is adminsitered?
Maintain childs head in hyperextension for at least 1 minute to ensure drops have contact with nasal membranes
44
Nasal Administration: How should child be positioned for nasal sprays?
Position child upright with head tilted slightly back and place the tip of the spray bottle just inside the nasal opening and tilted toward the back. Hold one nostil closed and instruct to take deep breath.
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Intramuscular Admin: What determined IM injection sites?
Muscle development and amount of fluid to be injected
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Intramuscular Admin: What determines needle size?
by the size of the muscle adn the viscosity of the medication.
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Intramuscular Admin: Preferred injection site for infants less than 7 months ?
Vastus lateralis muscle
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Intramuscular Admin: Site for those infants and children greater than 7 months?
Ventrogluteal site
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Intramuscular Admin: Dorsogluteal site is not recommended for those younger than ?
5 years old
50
Intramuscular Admin: Deltoid muscle is used for those older than ?
3 years old
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Intramuscular Admin: Solution amount and location for infant?
Vastus Lateralis , 0.5 mL
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Intramuscular Admin: Needle should be inserted at what angle?
90-degree angle.
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Subcutaneous and Intradermal Admin: This distibuted medication into where?
Faty layers of teh body.
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Subcutaneous and Intradermal Admin: This is primarily used for what?
insulin, heparin, and certain immunization like MMR
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Subcutaneous and Intradermal Admin: Preferred sites include?
Anterior thihg, lateral upper arms, and abdomen
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Subcutaneous and Intradermal Admin: What size needle is used?
3/8 - 5/8 inch, with 23-25 gaguge nedle
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Subcutaneous and Intradermal Admin: What should you do to skin for admin?
Pinch the skin to isolate tissue from the muscle or pull it taut.
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Subcutaneous and Intradermal Admin: Needle inserted at what angle?
45-90 degree angle. , release skin if pinched, and inject the medication.
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Subcutaneous and Intradermal Admin: Intradermal admin deposits medication where?
Just under the epidermis .
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Subcutaneous and Intradermal Admin: Usual site for ID admin?
Forearm
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Subcutaneous and Intradermal Admin: ID Admin usually used for what?
TB Screening and Allergy Testing
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Subcutaneous and Intradermal Admin: What size is used for ID Admin?
1 mL syringe with 5/8 inch, 25-27 gauge.
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Subcutaneous and Intradermal Admin: How is ID Admin? Specificially the needle.
Insert the needle, with bevel up, at 5-15 degree angle
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IV Admin: Primary method for IV med admin is what?
Syringe pump.
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IV Admin: If pump is unavailable, med may be administered via what?
Volume control device.
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IV Admin: Direct IV Push is reserved for what?
Emergency situations and when therapeutic blood levels must be reached quickly.
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Providing Atraumatic Care: How can you decrease discomfort and painf ro child who is to receive an injection?
Apply a topical anesthetic such as local anesthetic cream or vapocoolant spray to site before injection
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Providing Atraumatic Care: Research supports children experience less paina dn decreased fear if they are in what position?
Siting versus lying down
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Educating Child/Parents: Ways to prevent med errors includes?
Confirm childs wt accurate
Always weight in kg
Double check med calculations
Utilize medication ordering and dispensing systems
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Intravenous Therapy - Sites: IV Therapy may be administerd via what
Peripheral vein or central vein
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Intravenous Therapy - Sites: Peripheral IV therapy sites include
hands, feet and forearms
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Intravenous Therapy - Sites: When selecting an IV site in an extremity, always chose what site
the most distal site. Prevents injury to veins superiro to site
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Intravenous Therapy - Sites: Central IV Therapy is usually administered where?
LArge veins, such as subclavian, femoral, or jugular vein or vena cava.
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Intravenous Therapy - Sites: Where does a device lie for CEntral IV Therapy?
Lies in the superior vena cava at entrace of right atrium.
75
Intravenous Therapy - Equipment, Peripheral Access Devices: Devices used here include?
Over-the-needle catheters or winged-infusion sets, such as butterflies or scalp vein needles.
76
Intravenous Therapy - Equipment, Peripheral Access Devices: How are the devices inserted here?
Vein and then connected to IV solution via tubing to provide a continuous infusion of fluid
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Intravenous Therapy - Equipment, Peripheral Access Devices: Needle size here?
21-25 gauge, dpending on childs size
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Intravenous Therapy - Equipment, Peripheral Access Devices: Rule of thumb for needle size?
Use the smallest-gauge catheter with the shortest length possible to prevent traumatizing childs fragile veins.
79
Intravenous Therapy - Equipment, Peripheral Access Devices: Typically, this is used for how long?
Short-term therapy, averaging 3-5 days.
80
Intravenous Therapy - Equipment, Peripheral Access Devices: When are midline catheters recommended?
If therapy is to exceed longer than 6 days. Remain outside central vein and can stay up to 2 months.
81
Intravenous Therapy - Equipment, Peripheral Access Devices: Where are midline catheters positioned?
Deep in the cephalic or basilic veins
82
Intravenous Therapy - Equipment, Central Access Devices: How long are they used for?
Moderate-to- long-term therapy
83
Intravenous Therapy - Equipment, Central Access Devices: When are these devices recommended?
When child lacks suitable peripehral access, requires IV fluid or medication for a prolonged period of time, or to receive specific treatments.
84
Intravenous Therapy - Equipment, Central Access Devices: Why is this advantageous?
Provides vascular access without need for multiple IV starts, thus decreasing discomfort and fear.
85
Intravenous Therapy - Equipment, Central Access Devices: Associated with complications, such as?
Infection at the site, sepsis due to direct access to central circulation and thrombosis.
86
Intravenous Therapy - Equipment, Central Access Devices: What is done after placement?
Chest X-Ray to verify proper placement
87
Intravenous Therapy - Equipment, Infusion Control Devices: Why would these be used?
To ensure accurate fluid administration
88
Intravenous Therapy - Equipment, Infusion Control Devices: How often is the IV solution bag filled?
Every 2 hours, as it avoids accidental fluid overload.
89
Intravenous Therapy - Inserting Peripheral IV Access Devices: What is done prior to insertion?
Review childs diagnossi adn medical hx for information that may affect site selection.
90
Intravenous Therapy - Inserting Peripheral IV Access Devices: What extremity is often used?
Nondominant extremity
91
Intravenous Therapy - Inserting Peripheral IV Access Devices: How to properly insert IV therapy device?
Use hand veins to reduce risk for phlebitis.
Ensure adequte pain releif.
Allow antiseptic used to prepare site.
Use a barrier such as gauze or washcloth.
92
Intravenous Therapy - IV Fluid Administration: Amount of fluid to be adminsitered in a day determined by
childs weight
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Intravenous Therapy - IV Fluid Administration: How many mL per kg for first 10 kg?
100 mL
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Intravenous Therapy - IV Fluid Administration: How many mL per kg for next 10 kg?
50 mL
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Intravenous Therapy - IV Fluid Administration: How many mL per kg for remainder of body weight in kilograms
20 mL
96
Intravenous Therapy - Maintaining IV Fluid Therapy: Expected urine output for children adn adolescents?
1-2 mL/kg/hour
97
Intravenous Therapy - Maintaining IV Fluid Therapy: What to do when recording output for infant who is not potty trained?
Weigh the diaper to determine the output . 1g = 1 mL
98
Intravenous Therapy - Maintaining IV Fluid Therapy: Why may flushing the IV line be necessary?
To maintain patency, such as before/after med administered or after obtaining blood speciments.
99
Intravenous Therapy - Maintaining IV Fluid Therapy: What to know about saline adn flushing?
Found to be more compatible with the numerous solutions adn medications adminsitered IV, and is less expensive and less irritating to the vein
100
Intravenous Therapy - Maintaining IV Fluid Therapy: If done via a central venous access device, what should you do cleaning wise?
Provide site care using sterile technique and flush device according to agency policy. Note the exit site for signs of infection.
101
Intravenous Therapy - Preventing Complications: How often should site be inspected?
Every 1-2 hours for inflammation or infiltration.
102
Intravenous Therapy - Preventing Complications: signs of infiltration include?
Cool, blanched or puffy skin
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Intravenous Therapy - Preventing Complications: How often is the IV site changed in adults?
Every 72-96 hours when integrity of system has been co mprimised
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Intravenous Therapy - Preventing Complications: How often should IV site be changed in children?
Only when clinically indicated.
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Intravenous Therapy - Preventing Complications: CDC recommends changing adminsitration sets that are continuously used how often?
No more frequently than 72-96 hours but at leasy every 7 days
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Intravenous Therapy - Preventing Complications: What may be used to prevent infection in children older than 2 months of age?
Chlorhexidine-impregnated sponge
107
Intravenous Therapy - Discontinuing IV Device: Atraumatic care can be practiced how?
Use water to loosen tape
If transparent, gently lift off dressing by pulling opposite corners
Avoid using scissors
Turn off infulsion solution and pump
108
Intravenous Therapy - Discontinuing IV Device: What to do if IV site was in the arm or near AC speace?
Apply pressure until the bleeding stops.
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Providing Nutritional Support: What is enteral nutrition?
Delivery of nutrition into GI tract via a tube
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Providing Nutritional Support: What is parenteral nutrition?
IV delivery of nutritional substances
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Enternal Nutrition: The tube may be inserted how here?
Inserted via nose or mouth or through an opening in abdominal area, with tube ending in stomach or small intestine
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Enternal Nutrition: What are gavage feedings?
Nasogastric or orogastric tube feedings, a tube from the nose to the stomach or from the mouth to the stomach, respectively
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Enternal Nutrition: This is indicated for who?
Children who have a functioning GI tract but cannot ingest enough nutrients orally
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Enternal Nutrition: What conditions may warrant this?
Failure to thrive
Abnormalities of the throat
REspiratory distress
GERD
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Enternal Nutrition - Inserting Nasogastric or Orogastric Feeding Tube: For infants who are nose breathers, how will it be inserted?
Via the mouth
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Enternal Nutrition - Inserting Nasogastric or Orogastric Feeding Tube / Determining Length: How is length typically determined?
Measureing from the nose to ear to mid-xiphoid to umbilicus. (NEMU)
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Enternal Nutrition - Inserting Nasogastric or Orogastric Feeding Tube / Checking Tube Placement: What is the best way to check tube placement?
Radiologic confirmation of tube placement is considered most accurate method, but risk with repeated radiation exposure.
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Enternal Nutrition - Inserting Nasogastric or Orogastric Feeding Tube / Checking Tube Placement: What are some alternative methods to check for placement?
Bilirubin, trypsin, CO2 monitoring.
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Enternal Nutrition - Inserting Nasogastric or Orogastric Feeding Tube / Checking Tube Placement: How to make sure gavage feeding tube remain in place?
Secure it to the child's cheeck.
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Enternal Nutrition - Inserting Nasogastric or Orogastric Feeding Tube / Checking Tube Placement: Gastric secretions will have a pH of what?
Less than 5
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Enternal Nutrition - Inserting Nasogastric or Orogastric Feeding Tube / Checking Tube Placement: Small intestine secretions will have pH of what?
Greater than 6
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Enternal Nutrition - Inserting Nasogastric or Orogastric Feeding Tube / Checking Tube Placement: How to gastric secretions often appear?
Grassy green or clear and colorless and can have off-white mucous shreds
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Enternal Nutrition - Inserting Nasogastric or Orogastric Feeding Tube / Checking Tube Placement: Intestinal secretionsd have what color?
Bile strianed, light golden to yellowish to brownish green
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Enternal Nutrition - Administering Enteral Feedings: How often can these be given?
Continuously or intermittently
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Enternal Nutrition - Administering Enteral Feedings: What are bolus feedings?
Intermittent feedings. Specified amount of feeding solution given at specific intervals, usually over a short period of time of 15-30 mins.
126
Enternal Nutrition - Administering Enteral Feedings: How are bolus feedings given?
Via a syringe, feeding bag, or infusion pump, bolus feedings
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Enternal Nutrition - Administering Enteral Feedings: Rate for continuous feedings?
Given at a slower rate over a longer period of time.
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Enternal Nutrition - Administering Enteral Feedings: What should you do daily with these feedings?
For gastrostomy and jejunostomy tubes, ensure calibration present. Measure length of tube daily. Assess the abdeomen for distentsion and bowel sounds.
129
Enternal Nutrition - Administering Enteral Feedings: How do you check for gastric residual?
By aspirating the gastric contents with a syringe, measuring it, and then replacing the contents. Check every 4-6 hours and before every feedings.
130
Enternal Nutrition - Administering Enteral Feedings: How do you begin the feeding?
Place child in a supine position with the head and shoulders elevated approximately 30 degrees so that feeding will remain in the stomach area.
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Enternal Nutrition - Administering Enteral Feedings: How do you prevent occlusion?
Flushing the tube with a small amount of water.
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Enternal Nutrition - Administering Enteral Feedings: Temperature for the feedings?
At room temperature
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Enternal Nutrition - Administering Enteral Feedings: Intermittent feedings lasts how long?
15-30 minutes,
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Enternal Nutrition - Administering Enteral Feedings: What must you do once the feeding is complete?
Flush the tube with water. AS water leaves teh syringe or tubing, clamp the tube to prevent air from entering stoamch
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Enternal Nutrition - Administering Enteral Feedings: What to do if child vomits?
Stop the feeding immediately and turn the child onto their side or sit them up
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Enternal Nutrition - Administering Enteral Feedings: How is feeding performed if child has gastrostomy button?
Open the cap and conect adaptor. Feeding solution container connected to the extension tubing or adaptor.
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Enternal Nutrition - Administering Enteral Feedings: What must you make sure you do for an infant?
Burp the infant, while also positioning the child on their right side with head slightly elevated 30 degrees for about 1 hour after feeding
138
Enternal Nutrition - Administering Enteral Feedings: How does venting help child?
Helps relieve gas. Removes excess air and can be helpful if the child is bloated or the abdomen is distended.
139
Enternal Nutrition - Providing Skin/Insertion Site Care: How to prevent irritation from occuring?
Keep the skin clean and dry.
140
Enternal Nutrition - Providing Skin/Insertion Site Care: How often must the skin be cleaned?
At least once a day.
141
Enternal Nutrition - Providing Skin/Insertion Site Care: Routine skin care includes?
Gentle cleansing with sterile water or saline for newly placed tubes. or soap and water for established tubes.
142
Enternal Nutrition - Providing Skin/Insertion Site Care: Why should you not rotate jejunal or gastrojejunal tube?
Because it can cause kinking
143
Enternal Nutrition - Providing Skin/Insertion Site Care: What would signs of infection look like?
Erythema, induration, foul drainage , or pain
144
Enternal Nutrition - Providing Skin/Insertion Site Care: What does normal drainage look like?
Small amount of clear or tan drainage , which can be covered with a dressing
145
Enternal Nutrition - Providing Skin/Insertion Site Care: How often should you check volume of the balloon?
With a balloon-tipped device once or twice a week, and reinflate balloon to the initial volume if needed. Tube should be able to move slightly.
146
Enternal Nutrition - Providing Skin/Insertion Site Care: Why should you rotate sites where the tube is secured to the abdomen?
TO prevent tension on the stoma or skin breakdown
147
Enternal Nutrition - Providing Skin/Insertion Site Care: Measure and record the lengthof the tube how?
FRom the exit site of the abdominal wall to the end of the wall
148
Enternal Nutrition - Promoting Growth and DEvelopment: How do you help infants avoid losing desire to eat by mouth?
Using a pacifier helps avoid this, allows infant to associate niple in their mouth with feeding
149
Enternal Nutrition - Promoting Growth and DEvelopment: What does sucking motion help with?
Exercise the jaw and promote flow of feedings
150
Enternal Nutrition - Promoting Growth and DEvelopment: What promotes an active feeding time?
Talking with children, playing music, or reading a story
151
Enternal Nutrition - Promoting Growth and DEvelopment: How do you allow child to participate in feedings?
By gathering suplies and administering the actual feeding so that child may experience independence
152
Enternal Nutrition - Educating Family: What topics have to be covered for home enteral nutrition?
Type/Size of Tube
Rationale for Therapy
Duration of Therapy
Feeding Solution/Equipment
PRocedure for Flushing Tube
Frequency of weighing child
153
Parenteral Nutrition: What is total parenteral nutrition (TPN)?
Parenteral nutrition given via a central venous access device
154
Parenteral Nutrition - Administering TPN: How is concentration and components of TPN solution determined?
With thorough assessment of child's status, including the results of lab testing.
155
Parenteral Nutrition - Administering TPN: What is done at the start of TPN?
CEntral venous access is inserted and secured, if one is not already in place.
156
Parenteral Nutrition - Administering TPN: Solution should be hung for how long
No longer than 24 hours.
157
Parenteral Nutrition - Administering TPN: How quickly is this infused?
Initiated at a slow rate and then gradually increases.
158
Parenteral Nutrition - Administering TPN: What happens if its given too rapidly?
Since they are highly concentrated glucose solutions can cause hyperglycemia
159
Parenteral Nutrition - Administering TPN: What is done to make sure essential fatty acids met?
Fat emulsions are administered periodically to meet the child's needs
160
Parenteral Nutrition - Administering TPN: How often should blood glucose be monitoring?
Every 4-6 hours to evaluate for hyperglycemia.
161
Parenteral Nutrition - Administering TPN: What happens if blood glucose is elevated?
SQ administration of insulin may be needed. And then assess blood glucose levels every 8-12 hours.
162
Parenteral Nutrition - Administering TPN: What to do if TPN infusion is interrupted or stops?
BE prepared to begin an infusion of 5-10% dextrose solution at same infusion rate as the TPN. Prevents rebound hypoglycemia
163
Parenteral Nutrition - Administering TPN: What cycle can this be administered on?
Continuously over a 24-hour period or after initiation may be given on a cycle basis, over a 12-hour period during night..
164
Parenteral Nutrition - Preventing Complications: Key measures to reduce complications inlcude?
Monitor VSs, Adhere to stritch aseptic technique
Ensure the system remains a closed system at all times
Use occlusive dressings. Biopatch dressings may be used.
Assess intake/output
Monitor blood glucose levels
165
Parenteral Nutrition - Promoting Growth/Development: Why should you run TPN over the night?
TO allow the child to participate in developmentally appropriate activites during the day
166
A 3-year-old child is to receive a medication that is supplied as an enteric-coated tablet. What is the best nursing action?
Crush the tablet and mix it with apple sauce.
Dissolve the medication in the child’s milk.
Place a pill in the posterior part of the pharynx and tell the child to swallow.
Check with the prescriber to see if an alternative form can be used.
Check with the presciber to see if an alternative form can be used
167
The nurse is caring for an infant who weighs 8.2 kg and is NPO and receiving IV fluid therapy. What rate does the nurse calculate as meeting the child’s daily fluid requirements?
82 mL per hour
41 mL per hour
34 mL per hour
22 mL per hour
41 mL per hour
168
When administering ear drops to a 2-year-old, which action would be most appropriate?
Tell the child that the drops are to treat his infection.
Pull the pinna of the child’s ear down and back.
Have the child turn his head to the opposite side after giving the drops.
Massage the child’s forehead to facilitate absorption of the medication.
Pull the pinna of the child's ear down and back
169
An infant is to receive intermittent gavage feedings via a nasogastric tube every 6 hours. The feeding tube was inserted with a previous feeding and remains in place. The nurse is preparing to administer the next scheduled feeding. Place the events in the proper sequence.
Check the placement of the feeding tube.
Position the infant on his right side with the head of the bed slightly elevated.
Allow the feeding to come to room temperature.
Flush the tube with water.
Clamp the tube to prevent air from entering the stomach.
Pour the solution into the barrel of the syringe.
C, A, F, D, E, B
