1. Pediatric medications and drug administration guidelines
Jennifer kean msn, rn, ccrn

2. Pediatrics vs. adults Drug dosages for children differ greatly
Different physiological differences
Neonates and infants
Immature kidney and liver function- delays absorption and elimination of meds
Slow gastric emptying
Decreased gastric secretions= decreased absorption
Lower concentration of plasma proteins
Less total body fat & more total body water
Affects water soluble and fat-soluble meds

3. Oral meds Requires use of a calibrated measuring device
Small plastic cup, oral dropper, measuring spoon

4. Oral meds
Can be drawn up with an oral syringe and transferred to cup for an older child
Meds should not be mixed in an infant’s or toddler’s bottle
Avoid giving meds to a fussy infant, who could aspirate
Some chewable MEDS ARE AVAILABLE FOR OLDER CHILDREN

5. INTRAMUSCULAR SITES CHOSEN ON BASIS OF AGE AND MUSCLE DEVELOPMENT
ALL INJECTIONS SHOULD BE GIVEN IN A MANNER THAT MINIMIZES PHYSICAL AND PSYCHOLOGICAL TRAUMA
RESTRAIN CHILD IF NECESSARY
PROVIDE DISTRACTION
PROCESS MUST BE PERFORMED QUICKLY, WITH COMFORT MEASURES AFTERWARD

6. INTRAMUSCULAR
USUAL NEEDLE LENGTH FOR PEDIATRIC PATIENTS IS ½ TO 1 INCH LONG
22 TO 25 GUAGE
GRASP MUSCLE BETWEEN THUMB AND FOREFINGER; NEEDLE LENGTH SHOULD BE HALF THE DISTANCE

7. INTRAMUSCULAR SITES NEONATE: VASTUS LATERALIS
INFANT 1-12MONTHS: VASTUS LATERALIS
TODDLER 1-2 YEARS: VASTUS LATERALIS, RECTUS FEMORIS OR DELTOID
PRESCHOOL 3-12 YEARS: VASTUS LATERALIS, RECTUS FEMORIS, VENTROGLUTEAL, DORSO GLUTEAL OR DELTOID
ADOLESCENT YEARS: VASTUS LATERALIS, RECTUS FEMORIS, VENTROGLUTEAL, DORSO GLUTEAL OR DELTOID

8. INTRAVENOUS
MAXIMUM AMOUNT OF IV FLUIDS NEEDS TO BE CALCULATED INTO THE PLANNING OF THEIR 24-HOUR INTAKE
24-HOUR INTAKE MUST BE MONITORED CAREFULLY TO AVOID OVERHYDRATION
100 ML/KG FOR FIRST 10 KG BODY WEIGHT
50 ML/KG FOR THE NEXT 10 KG BODY WEIGHT
20 ML/KG AFTER 20 KG BODY WEIGHT

9. PEDIATRIC DRUG CALCULATIONS
DETERMINED BY BODY WEIGHT AND/OR BODY SURFACE AREA
USUALLY, RECOMMENDED DOSAGES COME FROM THE DRUG MANUFACTURER (MG/KG, MCG/KG, UNITS/KG)
BODY SURFACE AREA IS USUALLY CONSIDERED MORE ACCURATE AND SAFER
NOMOGRAM IS USED TO DETERMINE BSA
NEED TO KNOW CHILD’S HEIGHT AND WEIGHT
REMEMBER: 2.2 LBS. = I KG
PLOT ON THE NOMOGRAM AND DRAW LINE TO DETERMINE BSA

10. NOMOGRAM

13. EARDROPS
TECHNIQUE:
PLACE CHILD ON RIGHT OR LEFT SIDE WITH EAR FACING UP
PULL THE CHILD’S EAR DOWN AND BACK
PULL THE PINNA, NOT THE EARLOBE!
INSTILL THE ORDERED NUMBER OF DROPS
A COTTON PLEDGET MAY BE PUT OVER THE EAR
NEVER INSERT A FOREIGN OBJECT INTO THE EAR CANAL!