pharm ch 11

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pharm ch 11
2012-01-10 16:38:04
pharm 11

Kee,Pediatric Phamacology
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  1. Pediatric Pharmacokinetics
    Differences in body composition and organ maturity and appear to be more pronounced in neonates and younger infants but less significant in older school-aged and adolescent children.
  2. The degree and rate of absorption are based on many factors such as
    • child's age
    • health status
    • weight
    • route of administration
  3. Oral medication absorption is influenced by
    • Gastric acidity
    • emptying
    • motility
    • surface area
    • enzyme levels
    • intestinal flora
  4. IM/subQ routes absorption is influenced by
    • peripheral perfusion
    • effectiveness of circulation
  5. Topical medication may be alterd by the condition of the skin tissue. What would absorption be like for children, why?
    absorption is more enhanced because childrens skin is thinner and more porous.
  6. Distlribution of a medication throughout the body of a child is impacted by factors such as
    • Body fluid composition
    • Protein-binding capability
    • Effectiveness of various barriers to medication transport
  7. What is the body fluid composition of neonates and infants?
  8. Neonates have less ______ than older clients, which allows medication to be more available for use and dictates a decrease in the dosage nedded.
  9. The skin is more absorptive in young children which provides for rapid distribution. What about Infants' blood-brain barriers?
    Infants' blood brain barrier is relatively immature, allowing medications to pass easily into nervous system tissue and increasing the likelihood for toxicity.
  10. Metabolism of medication depends greatly upon
    • the maturational level of child
    • first-pass effect
    • higher metabolic rate
  11. first-pass effect
    provides that drugs administered by the oral route and absorbed via the GI tract undergo some metabolism in the hepatocytes in the liver before they are made available to the body tissues
  12. Excretion of medications occurs in the
    kidneys, intestines, lungs, sweat glands, salivary glands, and mommary glands. With kidneys providing the most elimination
  13. Infants have decreased _______, ________, and _______ pertaining to the kidney.
    • renal blood flow
    • glomerular filtration rate
    • renal tubular function
  14. Pediatric medication dosing and monitoring
    monitoring for therapeutic effects and adverse reactions
  15. Pediatric medication administration
    • Client identification
    • Considering developmental
    • -Differentiating developmental from chronologic age.
    • Maintaining safety with minimal reatraint
  16. Adolesent conciderations
    • Idividualized care specific to developmental stage.
    • -physical changes
    • -cognitive level and abilities
    • -emotional factors
    • -impact of chronic illness
  17. Nursing process: Assessment
    • age, weight, height
    • developmental age
    • health status
    • history of drug use
    • nurtitional/hydration status
    • cognitive level
    • family/child understanding
  18. Nursing diagnoses
    • Delayed growth and developement
    • Ineffective tissue perfusion
    • Impaired urinary elimination
    • Deficient knowledge
  19. Planning
    Child recieves drug dose based on assessment data
  20. Potential goal
    The child will have decreased cough within 2 days
  21. Interventions
    • Use appropriate references
    • Monitor child closely for side effects
    • Communicate with health care provider
    • Correctly calculate dosage based on appropriate parameters
  22. Client teaching
    • Report use of OTC products
    • Report sid e effects immediately
    • Advise breastfeeding women that a portion of most drugs is excreted in breast milk
    • Keep meds out of reach of children
    • Use child-resistant containers for meds
  23. Evaluation
    • Determine family member's knowledge concerning drug, drug dose, schedule for administration, and side dffects
    • Determine child's physiologic and psychologic response
    • Determine therapeutic and adverse effects of drug(s)
  24. Children have higher metabolic rates that adults. The nurse realizes that this affects administration of medication for pain in children in all of the following ways except
    A. higher requrement for medication
    B. increased dosage
    C. Decreased frequency
    D. Increased frequency
    C: Children inherently have higher metabolic rates than adults, causing metabolism to occur more rapidly. This may necessitate a higher medication requrement including increased dosage and frequency.
  25. Although adolescents have physical appearance and organ structure and function similar to that of adults, the nurse knows that their bodies continue to grow and require increased vigilance in monitoring
    A. therapeutic and toxic drug levels
    B. side effects of medications
    C. route of medication administation
    D. frequency of medication administration
    A: Although the physical appearance and organ structure and function of adolescents' resemble those of adults, adolescent bodies continue to grow and change, requring increased vigilance in monitoring therapeutic and toxic drug levels.