1. Pediatric Intravenous Medications
Chapter 21
Pediatric Intravenous Medications

2. Pediatric IV Medications
Children incompletely developed physiologically
Especially under age four
Makes drug tolerance, absorption, and excretion ongoing concerns

3. Pediatric IV Medications
Infants and acutely ill children have narrow range of tolerance for hydration
IV medications diluted for administration
Check facility policy to determine inclusion of medication volume in total dilution volume

4. Pediatric Patients
Require frequent and careful IV site inspection for inflammation and infiltration due to:
Fragility and size of veins
Irritating nature of many medications
Including antibiotics

5. Inflammation
Redness
Heat
Swelling
Tenderness/Pain

6. Infiltration
Swelling
Coolness
Tenderness/Pain
Lack of blood return

7. Inflammation/Infiltration
Presence of inflammation and/or infiltration necessitates:
Immediate discontinuance of IV
Restart at new site

8. IV Medication Guidelines
Always use to determine drug dosages, dilutions, and administration rates

9. IV Medication Guidelines
May be administered either:
Over several hours
As intermittent infusions
Should be administered using volumetric infusion pump

10. Steps for Adding IV Medication to Solution
Locate type and volume of IV solution prescribed
Measure dosage of medication to be added
Use strict aseptic technique to add drug to solution bag through medication port and mix drug thoroughly in solution

11. Steps for Adding IV Medication to Solution
Label IV solution bag with name and dosage of medication added
Add initials with time and date medication added
Hang IV and set flow rate for infusion
Document administration when completed

12. Flushing Medications
Regardless of method of intermittent administration, medication infusion routinely should be flushed following infusion to be sure that:
Medication cleared from tubing
Total dosage administered

13. Calculating IV Medication
Dosage of 250 mg in 15 mL of D5/0.45% NS to be infused in 30 min
Follow medication infusion with 5 mL fluid of D5/0.45% NS
Total volume = 15 mL
Infusion time = 30 min

14. Using DA

15. Flush
After medication infusion complete, infuse 5 mL flush at 30 mL/hr

16. Comparing IV Dosages Prescribed with Safe Ranges
Dosages of IV medications calculated on basis of kg of body weight or BSA
Average dosage ranges used to assess dosages prescribed

17. Calculating Safe Range
Child weighing 22.6 kg prescribed to receive 500 mg of medication in 100 mL of D5W every 12 hours
Normal/Safe dosage range 40 to 50 mg/kg/day
Determine if dosage prescribed is within normal/safe range

18. Calculating Safe Range
Calculate safe daily dosage range

19. Calculating Safe Range
Calculate dosage infusing in 24 hours
500 mg in 12 hr = 1000 mg in 24 hours
500 mg in 12 hours is within 904 to 1130mg/day range