Medications 1
When an infant presents with suspected sepsis, what is the priority in treating that infant?
Antibiotics or Culture
Obtaining a blood culture when inserting a PIV sterilely and then administering antibiotics
What medications do you anticipate the provider ordering for a patient with suspected sepsis and why?
Ampicillin & Gentamicin - because these are our most common broad spectrum antibiotics
What are the 5 Rights of Medication Administration?
Right Patient, Right Drug, Right Dose, Right Route, Right Time
What resource should you refer to when you need to y-in a new fluid to your central line?
Kings Guide Compatibility Chart
How are transpyloric medications in the NICU administered?
They must be mixed in with 4 hours of feed and the syringe should be labeled to indicate a medication is infusing
During an admission, where can you go to find D10 and 0.9% NS fluid bags during an admission?
Clean supply or the IV cart
What bolus is most commonly ordered on admission for fluid replacement and BP management and what is the ordered dose?
0.9% NS
10mL/kg
What bolus is most commonly ordered on admission to treat hypoglycemia and what is the ordered dose?
D10
2mL/kg
What is the "Golden Hour" and how does it pertain to antibiotic administration in the NICU?
Golden hour is the first hour of a baby's life - antibiotics should be administered within the golden hour to promote best outcomes
When administering transpyloric medications, what resource should you reference to ensure proper precautions are taken?
Osmolality chart in teams
Your patient has an OG tube to vent the stomach and an OD tube for continuous feeds. You have multivit. +iron to give at your next care time. Which route would you use to administer this medication and why?
OD tube - because iron is only required to be given gastric when given with epogen. We rarely give epogen in the NICU anymore, so this medication can be given transpyloric. You should avoid giving this medication gastric because it is very harsh on an empty stomach and would prevent you from being able to vent the OG tube.
You have an order for a D10 bolus for your new admit whose blood glucose was 32. How will you administer this bolus?
Slow IV push (1-5 minutes)
Describe the mechanism of action of caffeine citrate in the treatment of apnea of prematurity.
It is a CNS stimulant
You are giving SMOF for the first time- what are you priority concerns and what resource can we use?
Compatibility
SMOF Cheat Sheet on Teams
You need to give a Vaccine-
How to give a vaccine?
What's the angle?
Do we aspirate to see if we are in the right spot?
IM
90 degrees
NO!
At what gestational age do we start to titrate Caffeine?
32 weeks
Why do we give Midazolam (Versed)?
Anesthesia induction for its sedative properties
When giving Midazolam (Versed) what do we need to monitor for?
Respiratory depression, Apnea and hypotension
Why do we give Phenobarbital?
Anti-convulsant to treat neonatal seizures
When giving an electrolyte rider what are the criteria for administration?
How long?
Access?
Running with other medications?
4-6 hours
Need to discuss central or peripheral access
Need to investigate compatibility
Why do we give Hydrocortisone?
Treatment of cortisol deficiency for hypotension babies who are cortisol deficient
Special consideration before giving Insulin
(hint- the tubing)
Tubing must be primed with insulin and sit for 10-15 minutes prior to starting infusion
You have NaCl to give- pt weight 1.84kg Dose 1mEq/kg Concentration 2.5mEq/mL
How many mLs are you giving?
.74mL (round to the hundredth)
Complete this med math to admin Iron: Pt weight 2.02kg Dose: 2mg/kg Concentration: 15mg/mL
0.27mL (rounded to hundredth place)
Med math to admin Fentanyl: pt weight 0.73kg dose: 1mcg/kg concentration: 5mcg/mL
0.15mL