Deck 14: Pediatric Medications

Question 1

Ordered: Hydrocortisone,IV push,50 mg bolus dose,for an adolescent with adrenal insufficiency.Patient weight is 45 kg.
SDR: 1-2 mg per kg
IV bolus: Dilute each 250 mg or fraction thereof with 2 mL bacteriostatic SW and give over 3 minutes.

A)SDR for this patient:
B)Evaluation: Safe to administer or hold and contact prescriber promptly?
C)Amount to withdraw from the vial: Estimate: DA: Evaluation: Total mL for IV bolus (prepared dose plus diluent added):
D)mL per minute to administer: DA:
E)Draw an arrow indicating the volume administered at end of first minute and second minute.

Answer 1

a.SDR: 45-90 mg
b.Evaluation: Safe to administer
c.Estimate:
of 2 mL; less than 0.5 mL
Estimate support Answer.Equation is balanced.
d.Total mL for IV bolus: 2.4 mL - 0.4 mL medication = 2 mL diluent
e.0.8 mL per minute
DA:

Question 2

Ordered: leucovorin 10 mg stat,for a child who has been receiving IV antineoplastic agents
SDR: 10 mg per m²
Child's BSA: 1.0 m²
Available:

A)What does the acronym BSA mean?
B)How would you say m² aloud?
C)Does m² = mg?
D)Decision: safe or unsafe order? If unsafe, state the reason.If safe to give, how many tablets should the nurse give?
E)Estimated dose:

Answer 2

a.Body surface area
b.Square meters
c.No,they are two different units of metric measurement.
d.Safe
e.Estimate: Give two 5-mg tablets.
f.tab = g.Equation is balanced.Estimate supports answer.

Question 3

Ordered: amikacin sulfate 600 mg IV infusion q8h,for a child with an infection
Pediatric SDR: 5-7.5 mg per kg q8h,not to exceed 1.5 g per 24 hr
Child's weight: 40 kg
Available: IV amikacin 1 g in 250 mL D₅W

A)SDR for this child:
B)Decision: safe or unsafe order? State the reason.If safe to give, what flow rate should the nurse set on the pump?
C)DA equation:
D)Evaluation:

Answer 3

a.200 mg low safe dose
300 mg high safe dose
b.Unsafe.Order exceeds SDR.Hold medication and contact prescriber immediately for orders.Document.
c.N/A
d.N/A

Question 4

Ordered: A bronchodilator,Aminophylline,8 mg per hr continuous infusion,for a child who received an appropriate loading dose,on a pump based upon frequent and current serum theophylline levels for a child with asthma.Obtain a serum theophylline concentration level 4 hours after infusion is started and call prescriber.
SDR: 0.8 mg per kg per hr for continuous infusion after appropriate loading dose.Child's weight is 40 kg.
Remove 20 mL from a 500 mL D₅W IV and add the Aminophylline.Total mL will remain approximately 500 mL.

A)SDR for this child:
B)Evaluation: Safe to give or hold and clarify promptly with prescriber?
C)Flow rate if applicable: DA:
D)Evaluation:

Question 5

Ordered: An anticholinergic,Scopolamine 300 mcg IV stat for a child with nausea and vomiting
SDR: 6 mcg per kg per dose up to a maximum of 0.3 mg per dose.May repeat every 6-8 hr.The child's weight is 40 kg.
Dilute with an equal volume of sterile water for injection (SWI)and administer by direct IV injection over 2 minutes using the syringe calibrations shown.

A)SDR for this child:
B)Safe to give or hold and contact prescriber promptly?
C)Total amount of diluted medication in mL to be administered:
D)Total minutes to administer if applicable:
E)mL per min to be administered:
F)Total seconds to administer medication:
G)Total seconds per calibration to administer:

Question 6

Ordered: Drug X 125 mg 4 times daily
SDR for children: 20-30 mg per kg per day in 4 divided doses
Child's weight: 50 lb.Use a calculator.

A)Estimated weight in kg:
B)Child's weight in kilograms to the nearest tenth:
C)Calculate the SDR for this child.Low safe dose: High safe dose:
D)Decision: safe or unsafe order? State the reason.

Question 7

Ordered: doxycycline suspension 100 mg bid PO on admission day,for a 10-year-old child with Haemophilus influenzae
Child's weight: 40 kg
Available:

A)SDR (refer to label):
B)Child's estimated weight in pounds:
C)Child's actual weight in pounds:
D)SDR for this child:
E)Decision: safe or unsafe order? If unsafe, state the reason.If safe to give, how many milliliters should the nurse prepare?
F)Estimated dose:
G)DA equation:
H)Evaluation: Shade in the medicine cup to the nearest measurable dose.Indicate with an arrow on the syringe the additional amount to be added.

Question 8

Vancomycin HCl 0.3g IV intermittent infusion,for a child with methicillin resistant Staphylococcus aureus infection (MRSA).
Child's weight: 30 kg
SDR: Infants and children.40 mg per kg per day in divided doses q 6-8 hr not to exceed 5 mg per mL concentration.

Available from pharmacy: An IV piggyback solution of 60 mL containing 300 mg of Vancomycin with directions to infuse over 30 minutes.

A)SDR for this patient: DA:
B)Evaluation:
C)Is the pharmacy-supplied dilution safe for 0.3 g drug according to the label directions? DA:
D)Flow rate on pump in mL per hr based on pharmacy directions.Estimate: DA:
E)Evaluation:

Question 9

Ordered: A diuretic,furosemide 15 mg IV initial dose,for a child with edema
The child's weight is 14 kg.
SDR: 1-2 mg per kg per dose every 6 to 12 hr
The nurse plans to deliver the medication in a volume control device,filling the container up to 20 mL with Ringer's lactate Sol from an existing infusion,gently mixing it.It will be infused at the rate of 1 minute per mL.

A)SDR for this child's weight (mental math):
B)Evaluation: Safe to give or hold and clarify promptly?
C)Dose to be prepared if safe: Estimate; more or less than drug concentration? DA:
D)Flow rate if applicable (mental math):
E)Evaluation:

Question 10

Ordered: atropine 0.15 mg IM on call to OR
Pediatric SDR: 0.01 mg per kg
Child's weight: 33 lb
Available:

A)Child's weight in kilograms: If safe to give, how many milliliters should the nurse prepare?
B)Estimated dose:
C)DA equation:
D)Evaluation: Indicate with an arrow on the syringe the nearest measurable dose.

Question 11

Ordered: Lanoxin pediatric elixir 100 mcg PO tid loading dose,for a child with heart failure.
SDR for child over 2 years of age: loading dose 0.02-0.04 mg per kg per 24 hr in 3 divided doses; maintenance dose 0.006-0.012 mg per kg per 24 hr in 2 divided doses
Child's weight: 12 kg
Available:

A)SDR for this child in milligrams: In micrograms:
B)Decision: safe or unsafe order? State the reason.If safe to give, how many milliliters should the nurse prepare?
C)Estimated dose:
D)DA equation:
E)Evaluation:
F)What is the difference between a loading dose and a maintenance dose?

Question 12

Ordered: cefaclor 0.4 g PO q8h,for a child with otitis media
Child's weight: 30 kg.Use a calculator.
Available:

A)SDR (refer to label):
B)SDR for this child:
C)Decision: safe or unsafe order? If unsafe, state the reason.If safe to give, how many milliliters should the nurse prepare?
D)Estimate:
E)DA equation:
F)Evaluation: Shade in the medicine cup to the nearest measurable dose.Indicate with an arrow on the syringe the additional amount to be added.

Question 13

Ordered: potassium chloride (KCl)IV 0.5 mEq per hr,for a baby with hypokalemia
Pediatric SDR: up to 3 mEq per kg per 24 hr
Child's weight: 16 lb
Available: 10 mEq KCl in 100 mL D₅W

A)Child's weight in kilograms to the nearest tenth:
B)SDR for this child:
C)Decision: safe or unsafe order? State the reason.If safe to give, what flow rate should the nurse set on an infusion pump?
D)DA equation:
E)Evaluation:
F)The IV is to be infused with a volume-control device.Agency policy states that only a 2-hour supply may be placed in the device.How many milliliters should the nurse place in the chamber?

Question 14

Ordered: kanamycin 45 mg IV stat,for a child with an infection
SDR: 15 mg per kg per day divided in 2 or 3 doses
Child's weight: 13.2 lb.Use a calculator.
Available:

A)Estimated weight in kilograms:
B)Child's weight in kilograms:
C)SDR for this child:
D)Decision: safe or unsafe order? If unsafe, state the reason.If safe to give, how many milliliters should the nurse prepare?
E)Estimate:
F)DA equation:
G)Evaluation:

Question 15

A child's weight is 34 lb 8 oz.
Weight in kilograms to the nearest tenth:

A)Estimated weight:
B)DA verification:
C)Evaluation: