Medication Safety
What is the most important piece of information to verify before calculating a weight-based pediatric medication dose?
What is verify the child’s current weight in kilograms?
(pg 855)
What is one of the earliest signs of respiratory distress in an infant or young child?
What is tachypnea (increased respiratory rate), nasal flaring, retractions, and increased work of breathing?
When assessing a critically ill or injured child, what should the nurse assess and address first?
What is Airway and breathing, following the pediatric ABC approach?
Identify and treat immediate threats to oxygenation and ventilation.
A child is prescribed acetaminophen 240 mg PO. The medication is available as 160 mg/5 mL. How many mL should the nurse administer?
What is 7.5 mL?
A 6-month-old has a red, irritated diaper area. What nursing intervention is most appropriate to help prevent worsening of diaper dermatitis?
What is keep the diaper area clean and dry, change diapers frequently, gently cleanse the skin, and apply a moisture-barrier product as indicate?
Allow the child to go diaper-less to air out.
A nurse prepares a medication for a 4-year-old and notices the prescribed dose is significantly higher than the recommended pediatric dose. What should the nurse do?
What is hold the medication and clarify the order with the provider/pharmacist before administering it?
A child with croup develops a harsh, barking cough and inspiratory stridor. What position should the nurse encourage to help improve the child's breathing?
What is positioning the child upright, allowing them to assume a position of comfort?
Keeping the child calm is also important because agitation can worsen airway obstruction
A parent reports that their child may have swallowed a household cleaning product. What should the nurse instruct the parent not to do unless specifically directed by Poison Control?
What is do not induce vomiting?
The child should be evaluated, and Poison Control should be contacted for specific instructions.
A child weighs 20 kg. The provider orders amoxicillin 25 mg/kg/dose PO. How many mg should the child receive per dose?
What is 500 mg/dose?
A child sustains a minor thermal burn to the arm. What is the recommended initial nursing intervention?
What is cool the burn with cool water as soon as possible. Avoid ice because it can cause additional tissue injury.
A pediatric nurse is preparing to administer an oral medication. The child spits out part of the medication immediately after administration. What should the nurse do?
What is do not automatically repeat the dose. Determine approximately how much medication was retained, assess the situation, and consult the provider for guidance before administering additional medication.
(pg 857)
A child experiencing acute asthma exacerbation has wheezing and increased work of breathing. Which medication would the nurse expect to administer for rapid relief?
What is Albuterol, a short-acting beta₂-agonist (SABA) used as a rescue bronchodilator?
(pg 1064)
A child who is experiencing shock has cool, pale skin, delayed capillary refill, tachycardia, and weak peripheral pulses. What type of shock is most commonly associated with significant fluid loss?
What is hypovolemic shock?
A child weighs 18 kg. The provider orders cefazolin 25 mg/kg/dose IV. The medication is available as 500 mg/5 mL. How many mL should the nurse administer?
What is 4.5 mL?
A hospitalized child has limited mobility and is at increased risk for pressure injury. Which intervention is most important for maintaining tissue integrity?
What is frequently reposition the child and relieve pressure from vulnerable areas, while keeping the skin clean, dry, and protected from moisture.
What is a spacer used for?
A spacer helps the child receive more of the medication into the lungs by slowing and holding the medication after it is released, making coordination between pressing the inhaler and inhaling easier. It also reduces medication deposited in the mouth and throat.
An infant with bronchiolitis has copious nasal secretions and difficulty feeding. What nursing intervention should be performed before attempting to feed the infant?
What is suction the infant's nose/upper airway, typically with a bulb syringe or appropriate suction device, to help clear secretions and improve breathing and feeding?
A child who experienced a head injury becomes increasingly sleepy, develops repeated vomiting, and has a worsening headache. What should the nurse suspect?
What is increasing intracranial pressure (ICP) or a significant intracranial injury?
The child requires immediate evaluation.
A child weighs 24 kg and is prescribed cefazolin 30 mg/kg/dose IV every 8 hours. The medication is prepared as 1,000 mg in 100 mL NS and must infuse over 30 minutes. How many mL should the nurse administer per dose, and what should the IV pump be set at in mL/hr?
720 mg = 72 mL per dose
IV pump = 144 mL/hr
A school-aged child has multiple small, red lesions around the nose and mouth that have developed honey-colored crusts. What infection should the nurse suspect, and what is an important teaching point for the family?
What is Impetigo? It is highly contagious, so the family should emphasize hand hygiene, avoiding scratching/touching the lesions, and not sharing towels or personal items.
When administering an intramuscular (IM) medication to a pediatric client, why is the amount of medication injected into the muscle important?
What is the volume must be limited because a child's muscle mass is smaller, increasing the risk of tissue injury and poor medication absorption.
(pg 859)
A child with respiratory distress initially has tachypnea and retractions. The child suddenly becomes lethargic, has decreasing respiratory effort, and develops bradycardia. What does this indicate, and what is the nurse's priority?
What is these are signs of impending respiratory failure?
The nurse should immediately support the airway and breathing and activate emergency assistance, providing oxygen and preparing for assisted ventilation as needed.
A small child is found unresponsive and is not breathing normally. The nurse checks for a pulse and finds a heart rate of 50/min with signs of poor perfusion despite effective ventilation. What is the priority intervention?
What is begin CPR with chest compressions because a heart rate is less than 60/min with signs of poor perfusion despite adequate oxygenation and ventilation is an indication for chest compressions in pediatric resuscitation.
A pediatric client weighs 25 kg. The provider prescribes maintenance IV fluids using the Holliday-Segar method. What is the child's hourly maintenance IV fluid rate?
What is 65 mL/hr?
The 4-2-1 rule:
A school-aged child has an intensely itchy scalp, and the nurse observes small, oval nits firmly attached to the hair shafts close to the scalp. What condition should the nurse suspect, and what is an important teaching point for the family?
What is head lice (pediculosis capitis). The family should use the prescribed or recommended pediculicide as directed and a fine-toothed nit comb to remove nits, while avoiding sharing combs, brushes, hats, or other hair accessories. Clothing and bedding used recently should be appropriately laundered.