N331 - Pediatric Nursing - Lecture 1 Fluid & Medication

Importantconcepts importantconcepts

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Unformatted text preview: angle to the skin with a quick thrust. It is NOT necessary to aspirate (do not pull back on the syringe plunger after needle insertion) Multiple injections given in the same extremity should be separated by a minimum of 1 inch. Practice Exercise: Practice Exercise: IM Injections (see Kee/Marshall) Look up Rocephin for IM use. Using dosage handbook: What is the safe dose range for a 14­kg 2­year­old child? In what concentration is the drug available? Describe how you will draw up and administer the medicine. Important Concepts Important Concepts – Recommended dosage (what the literature states) – Actual dosage (how much the client is receiving) Most commonly, safe dosage will be expressed in mg/kg/day, or whatever unit the medication is measured in. Example 1: John has gentamicin 60 mg IV ordered for an infection. The drug reference indicates that a safe single dose is 2 ­ 2.5 mg / kg. If John weighs 44 lbs, is this a safe dose? 44 ÷ 2.2 = 20 kg. Min: 20 kg x 2 mg/kg = 40 mg Max: 20 kg x 2.5 mg/kg = 50mg Recommended: 40­50 mg per dose. Actual order: 60 mg Example 2: Example 2 John also has an order for ampicillin sodium 395 mg IV q 6 hr. The safe range for his type of infection in the literature is 100­200 mg/kg/day. Is this a safe dose? Minimal: 100 mg x 20 kg = 2000 mg Maximal: 200 mg x 20 kg = 4000 mg Recommended range is 2000 ­ 4000 mg. Actual dose: 395 x 4 (q 6 hr) =1580 mg/d Dose is “safe”, but not necessarily therapeutic. Max Concentration Max Concentration Refer to Parenteral route To decrease vein irritation from rapid infusion of concentrated med. Can be found under administration Referred to as final max concentration Can be more concentrated if IVP vs. piggyback IV Route: IV Route: options 1. IV push 2. IVPB (piggyback) 3. Volutrol/Buretrol 4. IV antegrade 5. Syringe pump Terminology Terminology Rapid IV Push (IVP)< than 30 seconds. Slow IV Push (SIVP) 3­5 minutes. IV intermittent infusion over 30­60 minutes ( antegrade if volume is <2ml in first port or <8ml in second port and piggyback if volume >8ml). IV Push: CAUTION! IV...
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