Pediatric Intervention Concepts And Med Admin

Front 1

age of majority

Back 1

capable of giving consent; usually 18

Front 2

psychological preparation for procedures

Back 2

based on developmental characteristics

Front 3

deep sedation

Back 3

patient is not easily aroused

Front 4

Safety-bathwater

Back 4

not too hot; infant never left alone

Front 5

furniture

Back 5

safest when scaled to child's proportions, sturdy, well-balanced, securely strapped into car seats; baby walkers should not be used; crib sides up

Front 6

entrapment

Back 6

under electronically controlled bed when it is activated to descend

Front 7

Toy safety-choking hazards

Back 7

appropriate for age, condition, and treatment; nonallergenic, no small removable parts; latex balloons dangerous

Front 8

Falls-risk factors

Back 8

medication (postanesthesia or sedation), altered mental status, altered/limited mobility, postop children, history of falls, side rails down

Front 9

actions for those at risk for falls

Back 9

armband labeled "fall precautions", alter environment, educate patients, educate family members

Front 10

transportation of younger children

Back 10

crib, stretcher with high sides and safety belt, wagon with raised sides, wheelchair with safety belt

Front 11

therapeutic holding

Back 11

secure, comfortable, temporary holding position that provides close physical contact with parent/caregiver for 30 min or less

Front 12

jacket restraint

Back 12

keep child safe in chairs

Front 13

swaddle or mummy restraint

Back 13

short tern restraint for exam/treatment involving head/neck

Front 14

continued use of restraints must be....

Back 14

renewed every day; continuously observe and assess every 15 min

Front 15

arm and leg restraints should never be tied to...

Back 15

side rails

Front 16

elbow restraint

Back 16

prevent child from reaching head/face

Front 17

Positioning for femoral venipuncture

Back 17

supine; legs in frog position; only uncover side used to protect practitioner from urine; apply pressure to site to prevent oozing

Front 18

Positioning for extremity venipuncture

Back 18

child on parent's lap in straddle; arm on firm surface, partially stabilized, parent hugs child's body

Front 19

positioning for lumbar venipuncture

Back 19

side-lying; head flexed and knees drawn up toward chest

Front 20

bone marrow aspiration or biopsy-if posterior iliac crest used

Back 20

prone position; adequate analgesia/anesthesia

Front 21

urine clean catch

Back 21

obtained for culture after urethral meatus is cleaned and 1st few mLs of urine are voided before urine is collected (midstream)

Front 22

24 hr specimen

Back 22

collection bags for infants/small children; older children-special instruction about notifying some when they need to void; starts and ends w/ empty bladder

Front 23

Bladder catheterization

Back 23

used when specimen is urgently needed or when child is unable to void or produce adequate specimen

Front 24

stool collection

Back 24

ID parasites and other organisms that cause diarrhea, assess GI function, and check for occult; large

Front 25

Blood collection: venous

Back 25

venipuncture or aspiration from peripheral or CAD

Front 26

Blood collection: arterial

Back 26

radial, brachial, or femoral arteries, or deep heel puncture, or indwelling catheters

Front 27

What precaution is taken with indwelling catheters (arterial)?

Back 27

assess circulation adequacy; Allen test

Front 28

main complications with infant heel puncture

Back 28

necrotizing osteochondritis, infection, abcess

Front 29

Respiratory secretions collection

Back 29

sputum or nasal discharge for diagnosis of respiratory infections. ex. TB and RSV

Front 30

Teaching for older children about collecting respiratory secretions?

Back 30

need coughed specimen, not mucus cleared from throat

Front 31

How to collect for RSV

Back 31

nasal washings

Front 32

Respiratory secretion collection for infants and small children

Back 32

lavage-gastric washings

Front 33

determination of drug dosage

Back 33

BSA, age, weight; BSA is estimated from child's height and weight

Front 34

oral medication admin

Back 34

go slow to prevent aspiration; preferred; solid not recommended for small children

Front 35

plastic calibrated cups used for...

Back 35

1 tsp or more

Front 36

Tsp is ....

Back 36

inaccurate; therefore-5 mL /tsp

Front 37

dropper for oral meds

Back 37

only use if supplied with specific med

Front 38

small amts of oral med

Back 38

use disposable plastic syringe

Front 39

pills for small children

Back 39

crush if possible; can only 1/2 or 1/4 scored tablets; otherwise-mix in liquid

Front 40

IM-2 drugs

Back 40

always draw up in same order

Front 41

IM admin

Back 41

use same brand; 1-piece syringe unit to reduce effect of dead space; flushing is not advisable, especially with <1 mL drug; Z track preferred; smallest needle possible that will go through subQ and into muscle

Front 42

max amt of IM drug in single site to small children and infants

Back 42

1 mL

Front 43

IM: larger amt-->larger...

Back 43

muscle; avoid major blood vessels and nerves

Front 44

preferred site for IM injection in infants

Back 44

vastus lateralis or ventrogluteal femoris; do NOT use rectus femoris

Front 45

What can happen with repeated use of a single site for IM?

Back 45

fibrosis of muscle

Front 46

problem associated with IM injection near large nerves

Back 46

permanent disability

Front 47

where to look for blood aspiration in opaque preps

Back 47

top of syringe, near plunger

Front 48

precaution when using med from glass ampule

Back 48

use only needles with filter

Front 49

subQ admin precaution

Back 49

change needle if pierced rubber stopper

Front 50

subQ needles

Back 50

26- to 30-gauge

Front 51

subQ injection logistics

Back 51

small volumes; 90 degree angle preferred; common sites-center 1/3 lateral aspect of upper arm, abdomen, center 1/3 of anterior thigh

Front 52

IV uses

Back 52

children w/ poor absorption, who need high serum concentration of drug, continuous pain relief, etc

Front 53

need to consider what with IV

Back 53

dilution solution, IV tubing volume; KNOW minimum dilutions

Front 54

IV precautions

Back 54

check insertion site for potency, 1 antibiotic at a time; never admin med with blood products

Front 55

peripheral intermittent infusion device or lock

Back 55

used when access to vein is required w/o need for continuous fluid; choose site w/ minimal movement i.e. forearm

Front 56

CAD short-term/nontunneled catheter

Back 56

acute care, emergency, ICU; placed in large veins-ex. femoral; check placement with xray

Front 57

Long-term tunneled cath and implanted infusion ports

Back 57

may be multi lumen, med instilled through injection cap

Front 58

maintenance of long-term CAD

Back 58

dressing changes, flushing, prevention of occlusion/dislodgment

Front 59

implanted device-use only...

Back 59

noncoring Huber needles; changed every 5-7 days

Front 60

most common complications associated with implanted device

Back 60

infection and occlusion

Front 61

PICC

Back 61

short-term to moderate length therapy

Front 62

site for PICC

Back 62

antecubital area using median, cephalic, or basilic vein; threaded into SVC; midline-b/w insertion site and axilla

Front 63

advantage of NG, OG, gastronomy meds

Back 63

admin around the clock w/o disturbing child

Front 64

disadvantage of NG, OG, gastronomy meds

Back 64

risk of occluding/clogging tube, especially w/ viscous meds; flush adequately

Front 65

rectal admin technique

Back 65

insert quickly and gently beyond both rectal sphincters; buttocks held firmly together to relieve pressure on sphincter until urge to expel suppository has passed (5-10 min)

Front 66

What if drops and ointment are ordered?

Back 66

drops first, wait 3 min, then ointment

Front 67

pinna-ear meds

Back 67

<3 yrs-down and back; >3 yrs-up and back

Front 68

nose drops

Back 68

hyperextended head; infant-football hold; remain in position 1 min

Front 69

nasal spray dispensers

Back 69

insert into nare vertically and then angled nasally to avoid trauma to septum and direct med toward inferior turbinate

Front 70

when to measure I&O

Back 70

when ordered, receiving IV therapy, major surgery, receiving diuretic or corticosteroid meds, severe thermal burns or injuries, with renal disease or damage, with congestive HF, dehydration, DM, oliguria, respiratory distress, chronic lung disease

Front 71

1 g of wet diaper weight=

Back 71

1 mL of urine

Front 72

gavage feedings

Back 72

provide means of nonnutritive sucking during procedure to associate comfort of physical contact w/ feedings

Front 73

gastronomy feeding

Back 73

when NG or OG is contraindicated or impossible; avoid constant irritation of gastric tube in children who require tube feed for extended pd of time

Front 74

NG and OG

Back 74

weight can be used to predict insertion length in very-low-birth-weight infants

Front 75

care of gastronomy tube

Back 75

cleanse at least daily; keep area around it clean and dry; use antibiotic ointment

Front 76

skin level device requires...

Back 76

requires well-established gastronomy site; valve could become clogged; may require decompression to release air

Front 77

how should child lay after gastronomy feeding?

Back 77

right side or Fowler's

Front 78

How to improve absorption of feedings

Back 78

use pacifier during alternative feeds-improves digestion; quiet, calm environment; consistent feeding techniques