NUR 417- Pediatrics Exam 1 Questions
With Correct Answers
Discuss the difference(s) between infants and children in regard to absorption of
| | | | | | | | | | | |
medications. (Hint: gastric acid and pH, intestinal mobility, feedings) - CORRECT
| | | | | | | | | | |
ANSWER✔✔-Infants: |
-Decreased gastric acid secretion (babies do not have as much gastric acid)
| | | | | | | | | | |
-Irregular gastric emptying
| |
-Increased intestinal mobility
| |
-Frequent feedings (there is SLOW digestion and absorption b/c drugs are
| | | | | | | | | | |
competing with other things like food for absorption)
| | | | | | |
Children: |
-Gastric pH equal to adult by 2-3 y/o
| | | | | | |
Discuss the difference(s) between infants and children in regard to distribution of
| | | | | | | | | | | |
medications. (Hint: albumin, BB barrier, total body water) - CORRECT
| | | | | | | | | |
ANSWER✔✔-Infants:
-Limited binding of drugs to plasma protein due to LOW albumin (more drug is
| | | | | | | | | | | | | |
floating = toxicity)
| | |
-BB barrier is NOT fully developed until 1 year (free-floating medication can be
| | | | | | | | | | | | |
toxic to brain)
| |
-Infants total body water is 80% compared to adult of 50% (means more drug is
| | | | | | | | | | | | | | |
needed because the drug will be diluted)
| | | | | |
,Children: |
-Plasma protein levels at adults levels by age 1
| | | | | | | | |
-Skin and BB barrier are more effective
| | | | | |
Discuss the difference(s) between infants and children in regard to metabolism of
| | | | | | | | | | | |
medications. - CORRECT ANSWER✔✔-Infants: | | |
-Enzymes in the liver to metabolize drugs are immature, so drugs cannot be
| | | | | | | | | | | | |
broken down | |
Children: |
-Decreased basic metabolic rate after age 2, results in lowered effects of drugs
| | | | | | | | | | | |
Discuss the difference(s) between infants and children in regard to excretion of
| | | | | | | | | | | |
medications. - CORRECT ANSWER✔✔-Infants: | | | |
-Immature renal function requires smaller doses of drugs primarily excreted by
| | | | | | | | | | |
the kidneys
|
Children: |
-Adult levels of renal function are reached by age 2
| | | | | | | | |
Pathophysiological differences in infant - CORRECT ANSWER✔✔- | | | | | |
,Why is accurate dosing critical for the pediatric client? - CORRECT ANSWER✔✔-
| | | | | | | | | | |
Because of their smaller weight, LOWER blood volume, and physiologic
| | | | | | | | | |
immaturity
Dosing of medication for the pediatric client is based on WHAT? - CORRECT
| | | | | | | | | | | | |
ANSWER✔✔-Weight in kilograms | |
Where is the preferred site to give an IM to a child under 18 months? At what
| | | | | | | | | | | | | | | | |
angle do you inject? - CORRECT ANSWER✔✔-Vastus lateralis/thigh muscle
| | | | | | | | |
90 degrees
|
The deltoid muscle should be used for IM injections in children starting at what
| | | | | | | | | | | | | |
age? At what angle do you inject? - CORRECT ANSWER✔✔-18 months and up
| | | | | | | | | | | | |
45 degrees
|
What is the preferred route of administration for drugs, if possible? When
| | | | | | | | | | | |
explaining a medication, what should NEVER be said? - CORRECT ANSWER✔✔-
| | | | | | | | | |
Oral |
NEVER describe medication as candy or sugar liquid
| | | | | | |
How should liquid, oral medications be administered? Why? - CORRECT
| | | | | | | | | |
ANSWER✔✔-Insert the syringe into the CHEEK (not tongue) and SLOWLY | | | | | | | | | |
squeeze:
, -To the side to prevent aspiration
| | | | |
AND |
-To the back to prevent it from being spit out
| | | | | | | | |
What is the main risk of pills for the pediatric client? How should these be
| | | | | | | | | | | | | | |
administered? What form of pill should NOT be administered like this and why? -
| | | | | | | | | | | | | |
CORRECT ANSWER✔✔-Main choking risk if the child cannot swallow pills
| | | | | | | | |
Pills can be crushed and mix with something like apple sauce
| | | | | | | | | |
NEVER crush time-released meds because risk of OVERDOSE
| | | | | | |
When are suppositories used? If you only need half of a suppository, how do you
| | | | | | | | | | | | | | |
prepare the med? - CORRECT ANSWER✔✔-Used to prevent vomiting or when
| | | | | | | | | | |
oral route is contraindicated
| | |
ALWAYS cut length wise to make sure half is given (Remember: one side of
| | | | | | | | | | | | | |
suppository is curved to allow insertion into the rectum to be easy)
| | | | | | | | | | |
What is the difference between medication that is an elixir and one that is a
| | | | | | | | | | | | | | |
suspension? - CORRECT ANSWER✔✔-Suspension is something that does NOT
| | | | | | | | |
dissolve in material (Always need to Shaken)
| | | | | |
Elixir does dissolve in material (No need to be shaken)
| | | | | | | | |
With Correct Answers
Discuss the difference(s) between infants and children in regard to absorption of
| | | | | | | | | | | |
medications. (Hint: gastric acid and pH, intestinal mobility, feedings) - CORRECT
| | | | | | | | | | |
ANSWER✔✔-Infants: |
-Decreased gastric acid secretion (babies do not have as much gastric acid)
| | | | | | | | | | |
-Irregular gastric emptying
| |
-Increased intestinal mobility
| |
-Frequent feedings (there is SLOW digestion and absorption b/c drugs are
| | | | | | | | | | |
competing with other things like food for absorption)
| | | | | | |
Children: |
-Gastric pH equal to adult by 2-3 y/o
| | | | | | |
Discuss the difference(s) between infants and children in regard to distribution of
| | | | | | | | | | | |
medications. (Hint: albumin, BB barrier, total body water) - CORRECT
| | | | | | | | | |
ANSWER✔✔-Infants:
-Limited binding of drugs to plasma protein due to LOW albumin (more drug is
| | | | | | | | | | | | | |
floating = toxicity)
| | |
-BB barrier is NOT fully developed until 1 year (free-floating medication can be
| | | | | | | | | | | | |
toxic to brain)
| |
-Infants total body water is 80% compared to adult of 50% (means more drug is
| | | | | | | | | | | | | | |
needed because the drug will be diluted)
| | | | | |
,Children: |
-Plasma protein levels at adults levels by age 1
| | | | | | | | |
-Skin and BB barrier are more effective
| | | | | |
Discuss the difference(s) between infants and children in regard to metabolism of
| | | | | | | | | | | |
medications. - CORRECT ANSWER✔✔-Infants: | | |
-Enzymes in the liver to metabolize drugs are immature, so drugs cannot be
| | | | | | | | | | | | |
broken down | |
Children: |
-Decreased basic metabolic rate after age 2, results in lowered effects of drugs
| | | | | | | | | | | |
Discuss the difference(s) between infants and children in regard to excretion of
| | | | | | | | | | | |
medications. - CORRECT ANSWER✔✔-Infants: | | | |
-Immature renal function requires smaller doses of drugs primarily excreted by
| | | | | | | | | | |
the kidneys
|
Children: |
-Adult levels of renal function are reached by age 2
| | | | | | | | |
Pathophysiological differences in infant - CORRECT ANSWER✔✔- | | | | | |
,Why is accurate dosing critical for the pediatric client? - CORRECT ANSWER✔✔-
| | | | | | | | | | |
Because of their smaller weight, LOWER blood volume, and physiologic
| | | | | | | | | |
immaturity
Dosing of medication for the pediatric client is based on WHAT? - CORRECT
| | | | | | | | | | | | |
ANSWER✔✔-Weight in kilograms | |
Where is the preferred site to give an IM to a child under 18 months? At what
| | | | | | | | | | | | | | | | |
angle do you inject? - CORRECT ANSWER✔✔-Vastus lateralis/thigh muscle
| | | | | | | | |
90 degrees
|
The deltoid muscle should be used for IM injections in children starting at what
| | | | | | | | | | | | | |
age? At what angle do you inject? - CORRECT ANSWER✔✔-18 months and up
| | | | | | | | | | | | |
45 degrees
|
What is the preferred route of administration for drugs, if possible? When
| | | | | | | | | | | |
explaining a medication, what should NEVER be said? - CORRECT ANSWER✔✔-
| | | | | | | | | |
Oral |
NEVER describe medication as candy or sugar liquid
| | | | | | |
How should liquid, oral medications be administered? Why? - CORRECT
| | | | | | | | | |
ANSWER✔✔-Insert the syringe into the CHEEK (not tongue) and SLOWLY | | | | | | | | | |
squeeze:
, -To the side to prevent aspiration
| | | | |
AND |
-To the back to prevent it from being spit out
| | | | | | | | |
What is the main risk of pills for the pediatric client? How should these be
| | | | | | | | | | | | | | |
administered? What form of pill should NOT be administered like this and why? -
| | | | | | | | | | | | | |
CORRECT ANSWER✔✔-Main choking risk if the child cannot swallow pills
| | | | | | | | |
Pills can be crushed and mix with something like apple sauce
| | | | | | | | | |
NEVER crush time-released meds because risk of OVERDOSE
| | | | | | |
When are suppositories used? If you only need half of a suppository, how do you
| | | | | | | | | | | | | | |
prepare the med? - CORRECT ANSWER✔✔-Used to prevent vomiting or when
| | | | | | | | | | |
oral route is contraindicated
| | |
ALWAYS cut length wise to make sure half is given (Remember: one side of
| | | | | | | | | | | | | |
suppository is curved to allow insertion into the rectum to be easy)
| | | | | | | | | | |
What is the difference between medication that is an elixir and one that is a
| | | | | | | | | | | | | | |
suspension? - CORRECT ANSWER✔✔-Suspension is something that does NOT
| | | | | | | | |
dissolve in material (Always need to Shaken)
| | | | | |
Elixir does dissolve in material (No need to be shaken)
| | | | | | | | |