Pends Chapter 35 Key Pediatric Nursing
Interventions, Pends Chapter 36- Nursing
Care of the Child with an Alteration in
Comfort-Pain Assessment and Management
The nurse caring for a 6-year-old patient enters the room to administer an oral
medication in the form of a pill. The dad at the bedside looks at the pill and tells the
nurse that his daughter has a hard time swallowing pills. Which of the following is the
best response by the nurse?
A)Ask the child to try swallowing the pill and offer a choice of drinks to take with it.
B)Crush the pill and add it to applesauce.
C)Request that the physician prescribe the medication in liquid form.
D)Call the pharmacy and ask if the pill can be crushed. - Ans:D
The father is the best source of knowledge on medication administration for the child.
The pharmacy should be called to determine if the pill might be crushed. Asking the
child to try swallowing the pill disregards the information the father has just given.
Requesting that the physician order the medication in liquid form is not necessary at this
point.
The nurse is administering acetaminophen PRN to a 9-year-old child on the pediatric
ward of the hospital. Which answers reflect nursing actions that follow the rules of the
'eight rights' of pediatric medication administration? Select all that apply.
C)The nurse checks the documented time of the last dosage administered.
D)The nurse calculates the dosage according to the child's weight.
E)The nurse explains the therapeutic effects of the medication to the child and parents.
- Ans:C, D, E
Following the 'right patient' rule, the nurse checks the documented time of the last
dosage administered. For the 'right dose,' the nurse calculates the dosage according to
the child's weight. For the 'right to be educated,' the nurse explains the therapeutic
effects of the medication to the child and parents. To ensure the 'right patient,' the nurse
confirms the child's identity and then checks with the caregivers for further identification.
To administer at the 'right time,' the nurse gives the medication within 20 to 30 minutes
of the ordered time, and to protect the child's 'right to refuse,' the nurse respects the
child's or parents' option to refuse.
, When describing the differences affecting the pharmacokinetics of drugs administered
to children, which would the nurse include?
A)Oral drugs are absorbed more quickly in children than adults.
B)Absorption of intramuscularly administered drugs is fairly constant.
C)Topical drugs are absorbed more quickly in young children than adults.
D)Absorption of drugs administered by subcutaneous injection is increased. - Ans:C
Topical absorption of drugs is increased in infants and young children because the
stratum corneum is thinner and well hydrated. The absorption of oral drugs is slowed by
slower gastric emptying, increased intestinal motility, a proportionately larger small
intestine surface area, high gastric pH, and decreased lipase and amylase secretion.
The absorption of drugs given intramuscularly or subcutaneously is erratic and may be
decreased.
The nurse is preparing to administer oral ampicillin to a child who weighs 40 kg. The
safe dose for children is 50 to 100 mg/kg/day divided in doses administered every 6
hours. What would be the low single safe dose and high single safe dose per day for
this child?
A)50 to 100 mg per dose
B)100 to 500 mg per dose
C)500 to 1,000 mg per dose
D)1,000 to 5,000 mg per dose - Ans:C
To calculate the dosage, the nurse would set up a proportion to calculate the low dose
as follows: 50 mg/1 kg = x mg/40 kg; solve for x by cross-multiplying: 1 × x = 50 × 40; x
= 2,000 mg divided by 4 doses per day = 500 mg. Then calculate the high safe dose
range using the following proportion: 100 mg/1 kg = x mg/40 kg; solve for x by cross-
multiplying: 1 × x = 100 × 40; x = 4,000 mg divided by 4 doses per day = 1,000 mg.
The nurse is preparing to administer a medication to a 5-year-old who weighs 35
pounds. The prescribed single dose is 1 to 2 mg/kg/day. Which is the appropriate dose
range for this child?
A)8 to 16 mg
B)16 to 32 mg
C)35 to 70 mg
D)70 to 140 mg - Ans:B
The nurse should convert the child's weight in pounds to kilograms by dividing the
child's weight in pounds by 2.2. (35 pounds divided by 2.2 = 16 kg). The nurse would
then multiply the child's weight in kilograms by 1 mg for the low end (16 kg × 1 mg = 16
mg) and then by 2 mg for the high end (16 kg × 2 mg = 32 mg).
Interventions, Pends Chapter 36- Nursing
Care of the Child with an Alteration in
Comfort-Pain Assessment and Management
The nurse caring for a 6-year-old patient enters the room to administer an oral
medication in the form of a pill. The dad at the bedside looks at the pill and tells the
nurse that his daughter has a hard time swallowing pills. Which of the following is the
best response by the nurse?
A)Ask the child to try swallowing the pill and offer a choice of drinks to take with it.
B)Crush the pill and add it to applesauce.
C)Request that the physician prescribe the medication in liquid form.
D)Call the pharmacy and ask if the pill can be crushed. - Ans:D
The father is the best source of knowledge on medication administration for the child.
The pharmacy should be called to determine if the pill might be crushed. Asking the
child to try swallowing the pill disregards the information the father has just given.
Requesting that the physician order the medication in liquid form is not necessary at this
point.
The nurse is administering acetaminophen PRN to a 9-year-old child on the pediatric
ward of the hospital. Which answers reflect nursing actions that follow the rules of the
'eight rights' of pediatric medication administration? Select all that apply.
C)The nurse checks the documented time of the last dosage administered.
D)The nurse calculates the dosage according to the child's weight.
E)The nurse explains the therapeutic effects of the medication to the child and parents.
- Ans:C, D, E
Following the 'right patient' rule, the nurse checks the documented time of the last
dosage administered. For the 'right dose,' the nurse calculates the dosage according to
the child's weight. For the 'right to be educated,' the nurse explains the therapeutic
effects of the medication to the child and parents. To ensure the 'right patient,' the nurse
confirms the child's identity and then checks with the caregivers for further identification.
To administer at the 'right time,' the nurse gives the medication within 20 to 30 minutes
of the ordered time, and to protect the child's 'right to refuse,' the nurse respects the
child's or parents' option to refuse.
, When describing the differences affecting the pharmacokinetics of drugs administered
to children, which would the nurse include?
A)Oral drugs are absorbed more quickly in children than adults.
B)Absorption of intramuscularly administered drugs is fairly constant.
C)Topical drugs are absorbed more quickly in young children than adults.
D)Absorption of drugs administered by subcutaneous injection is increased. - Ans:C
Topical absorption of drugs is increased in infants and young children because the
stratum corneum is thinner and well hydrated. The absorption of oral drugs is slowed by
slower gastric emptying, increased intestinal motility, a proportionately larger small
intestine surface area, high gastric pH, and decreased lipase and amylase secretion.
The absorption of drugs given intramuscularly or subcutaneously is erratic and may be
decreased.
The nurse is preparing to administer oral ampicillin to a child who weighs 40 kg. The
safe dose for children is 50 to 100 mg/kg/day divided in doses administered every 6
hours. What would be the low single safe dose and high single safe dose per day for
this child?
A)50 to 100 mg per dose
B)100 to 500 mg per dose
C)500 to 1,000 mg per dose
D)1,000 to 5,000 mg per dose - Ans:C
To calculate the dosage, the nurse would set up a proportion to calculate the low dose
as follows: 50 mg/1 kg = x mg/40 kg; solve for x by cross-multiplying: 1 × x = 50 × 40; x
= 2,000 mg divided by 4 doses per day = 500 mg. Then calculate the high safe dose
range using the following proportion: 100 mg/1 kg = x mg/40 kg; solve for x by cross-
multiplying: 1 × x = 100 × 40; x = 4,000 mg divided by 4 doses per day = 1,000 mg.
The nurse is preparing to administer a medication to a 5-year-old who weighs 35
pounds. The prescribed single dose is 1 to 2 mg/kg/day. Which is the appropriate dose
range for this child?
A)8 to 16 mg
B)16 to 32 mg
C)35 to 70 mg
D)70 to 140 mg - Ans:B
The nurse should convert the child's weight in pounds to kilograms by dividing the
child's weight in pounds by 2.2. (35 pounds divided by 2.2 = 16 kg). The nurse would
then multiply the child's weight in kilograms by 1 mg for the low end (16 kg × 1 mg = 16
mg) and then by 2 mg for the high end (16 kg × 2 mg = 32 mg).
