What is the difference in the way IM injection is aborbed in newborns and infants? (compared to adults)
newborns- slower absorption
infants- faster absorpstion
What leads to high concetrations of free drugs in infants and children?
limited protein binding capacity
Newborns highly sensitive to meds that affect CNS and are metabolized by liver.
Newborns have limited renal excretion abilities and must have reduced dosages of meds that are eliminated by the renal system.
At what age does children's pharmacokinetic response to meds begin to be similar to adults, with the exception of faster metabolism until age 12?
Pediactric dosages are based on what criteria?
body surface area (BSA)
maturation of body organs
What kind of tablets can you not crush?
Step to administering oral medications via a feeding tube or a gastrostomy tube?
check tube placement before given meds
use liquid forms of medication
check compatibility of meds before mixing
do not mix medications with enteral feedings
flush tubing with warm water before and after each medication. amount of flush solution depends on the length and gauge of tubing. Amount is usually 1.5 time the tubing volume, before administering meds.
amount of medication to inject into infant or child's muscle?
child- 2.0 ml
site of subcutaneous administration of medication
upper arm (lateral aspect, center third)
abdomen (avoid umbilicus)
anterior thigh (center third)
intradermal administration of medication
inside surface of the forearm, not the medial surface
tuberculosis skin testing
considerations when selecting a site
medication amount , viscosity, and type
muscle mass, condition, access to site, and potential contamination
treatment course frequency and number of injections
ability to obtain proper positioning of child
General considerations for IM med administration
vastus lateralis site is usually recommended site for infants and children less than 2 years old (0.5 ml for infant and 2.0 ml for children)
after age 2, ventral gluteal can be used
deltoid site has smaller muscle mass (0.5 ml infants and 1 ml in children)
.625 to 1 inch
0.5 ml for infants and 2.0 ml for children
0.625 to 1 inch
2.0 ml for children
less painful for than vastus lateralis
free of any nerves or blood vessels
22 to 25 gauge
0.625 to 1 inch
0.5 ml for infants and 1.0 ml for children
less painful that vastus lateralis
less local side effect than vastus lateralis
should not be used in infants or children with underdeveloped muscles
Peripheral venous access devices
for continuous and intermittent IV medication administration
a child can be sent home with one and have maintained by home health care nurse