Module 2: Chapter 6: Life span: Children

Question 1

The textbook defines a pediatric patient as what

Answer 1

less than 16 years of age and under 50kg

Question 2

what % of drugs regularly prescribed to children in the US have never been labeled for use in any pediatric population

Answer 2

75

Question 3

is it now considered ethical or unethical to exclude children from drug studies

Answer 3

unethical

Question 4

what must nurses be aware of until all drugs have been tested and labeled for sue in children?

Answer 4

off-label use that will occur

Question 5

what are most pediatric doses based on

Answer 5

the childs weight in kilograms

Question 6

what is used to determine the dosage in pediatric patients if a child dose is not specified

Answer 6

can be determined from the adult dose based on the body SA of the child

Question 7

what can be used to determine a childs surface area to determine dosing

Answer 7

nomogram

Question 8

True or false a drugs mechanism of action is the same in all individuals regardless of age

Answer 8

true

Question 9

true of false in very young children immature organ systmes have less than optimal functioning

Answer 9

true

Question 10

true or false a childs age, growth and maturation can affect how the body absorbs, distributes, metabolizes and excretes a drug

Answer 10

true

Question 11

what can a nurse do regarding adverse and therapeutic effects

Answer 11

maximize therapeutic effects and minimize adverse effects

Question 12

what can be done with dosages to account for immature or impaired body systems in neonates and infants

Answer 12

lowered

Question 13

what can have an effect on pediatric drug absorption

Answer 13

age
disease process
dosage form
route 
foods and drugs present in the childs body

Question 14

is an infants GI tract more or less acidic than an adults

Answer 14

less acidic

Question 15

compared to adults do infants have a higher or lower body SA

Answer 15

higher

Question 16

what are fat and water levels like in children compared to adults

Answer 16

children have higher concentrations of water

lower concentrations of fat

Question 17

does a neonates liver produce more or less plasma proteins then adults

Answer 17

fewer

Question 18

what is the difference in the blood brain barrier in children compared to adults

Answer 18

at birth the blood-brain barrier is not full developed

Question 19

immaturity of the nonatal and infant liver results in _____ or ___ metabolism of many drugs

Answer 19

decreased or incomplete

Question 20

a child with an immature or compromised liver fn is at risk for what

Answer 20

drug toxicity

Question 21

why are drugs that require oxidation for metabolism frequently more rapidly metabolized in children than adults

Answer 21

because children ahve a faster resting respiratory rate

Question 22

immaturity of the nonatal and infant liver results in ____ or _____ metabolism of many drugs

Answer 22

decreased or incomplete

Question 23

in children with impaired renal fn, drug dosages should be _____ to acheive and maintain therapeutic drug levels

Answer 23

alterered

Question 24

the neonate, especially the preterm infant, has immature kindeys so renal excretion of the drug is

Answer 24

slow

Question 25

true or false: many drugs excreted through the bilary tree into the intestinal tract

Answer 25

false: few drugs

Question 26

is biliary drug flow increased or decreased during the first few days of life

Answer 26

increased

Question 27

are most drugs prescribed to children prescribed for their labeled use or off labeled use

Answer 27

off labeled

Question 28

are drugs that are dangerous for children labelled as such?

Answer 28

obviously

Question 29

T or F: some adverse effects on body systems occur only at specific phases of development

Answer 29

yes

Question 30

what is the effect diarrhea can have on drug absorption

Answer 30

decrease intestinal transit time and therefore decrease the time available for drug absorption

Question 31

does constipation decrease drug absorption

Answer 31

no, it increases it as it slows down the motility in the GI tract allowing more of the drug to be absorbed

Question 32

what considerations are especially important when communicating with a child

Answer 32

developmental considerations

Question 33

what is the age range for infants

Answer 33

birth to 12 months

Question 34

why may infants willingly swallow a pleasant-tasting liquid drug through a bottle nipple

Answer 34

well-developed sucking reflex

Question 35

what is the preferred injection site for children and infants up to 3 years

Answer 35

vastus lateralis

Question 36

what age group is considered toddlers

Answer 36

13 months to 3 years

Question 37

can toddlers chew oral drugs

Answer 37

yes

Question 38

what can ease a toddlers anxiety when administering drug therapy

Answer 38

having a parent nearby

Question 39

why are toddles likely to be anxious or uncooperative druing administration of rectal suppositories

Answer 39

because of their experiences with toilet training and sphincter control

Question 40

what are the IM injection sites of choice for toddlers

Answer 40

vastus lateralis and rectus femoris

Question 41

are scalp veins still appropriate for toddlers?

Answer 41

yes, up till 18 months

Question 42

why are scalp veins not the first choice for IV access

Answer 42

because of the anxiety it causes parents

Question 43

what age group are preschoolers

Answer 43

3-5 years

Question 44

are preschoolers usually cooperative in drug administration

Answer 44

no

Question 45

what is a strategy for getting a preschooler to be cooperative during drug administration

Answer 45

offer choices

Question 46

what can be used to reduce pain when administering an IM injection to a preschooler

Answer 46

use of topical anesthetic cream to numb the site

Question 47

what are the common sites for IM injections in preschoolers

Answer 47

vastus lateralis rectus femoris ventrogluteal sites

Question 48

what age are school-aged children

Answer 48

6-12 years

Question 49

are school aged children cooperative

Answer 49

very

Question 50

how can you allow a school aged child to exercise control during drug administration

Answer 50

offer choices

Question 51

what age group can begin to swallow pills

Answer 51

school-aged children

Question 52

what is the site recommended for administering an IM injection to a school-aged child

Answer 52

ventrogluteal

Question 53

what should you offer adolescents whenever possible

Answer 53

control so that they can make their own choices

Question 54

what are adolescents particularly sensitive about

Answer 54

their bodies and their independence

Question 55

routes of administration for adolescents are similar to what

Answer 55

adults

Question 56

what is the preferred IM injection sites for adolescents

Answer 56

same as adults

Question 57

what is an infants primary food intake

Answer 57

milk and formula, these substances decrease gastric acidity and thus increase gastric pH

Question 58

what should you assess for in school-aged children

Answer 58

use and abuse of substances such as caffeine, alcohol, tobacco and street drugs

Question 59

what should you question the parent of a school-aged child

Answer 59

the use of herbal therapy in their child

Question 60

what should you also consider for patients

Answer 60

the economic circumstances of the family

Question 61

what do children receving drug therapy at home need to have

Answer 61

a parent or gaurdian responsible for ensuring that he child receives the prescribed therapy

Question 62

what is an important question to ask the parent or caretaker when sending a child home with a perscription

Answer 62

if there is a safe place to store prescription and non-prescription drugs

Question 63

a families beliefs can greatly affect the child in what way

Answer 63

childs attitude and adherence to the therapeutic regimen

Question 64

what must be considered quite seriously when planning drug therapy for a child

Answer 64

cultural background and heritage

Question 65

what is the desired outcome for delayed growth and development in children

Answer 65

patient will achieve normal growth and development during growth and development

Question 66

what is the desired outcome for ineffective family therapeutic regimen management

Answer 66

family members will master effective management strategies of the patients drug regimen

Question 67

what is the desired outcome for the nursing diagnosis caregiver role strain

Answer 67

patient and family will develop effective coping skills to avoid, reduce, or relieve stress on family caregivers

Question 68

administering drugs safely and effectively to children requires an understanding of what 3 things

Answer 68

pediatric anatomy and physiology developmental and cognitive levels diagnosis and prognosis

Question 69

what are the 6 situations medication errors are most likely to occur

Answer 69

``` children younger than 2 in ICU emergency departments children receiving cehmo children receiving IV meds children whose weight was not documented ```

Question 70

what are strategies for preventing medication errors

Answer 70

always weigh the child before administering any medications standardize as much as possible use computerized drug order entry systems use reliable drug information cources double-check each calculated dose for accuracy measure and deliver oral medications via oral syringes only invovle the family communicate the drug therapy plan clearly when different nurses will be caring for the patient

Question 71

what are some ways of reducing psychological stress and anxiety

Answer 71

consider age-related emotional needs adress feelings and discuss and answer questions as simply and honestly as possible play therapy reduces anxiety and promotes understanding of drug therapy for preschoolers and school-aged chilrdren take care to explore the childs experiences with the health care system