Term
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Definition
| IV fluids are adminitered to provide water, electrolytes, nurients, to replace water, correct electrolyte deficits and to provide a route for IV drug or blood administration |
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Term
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Definition
| The alrgest isible vein is not necessarily the prefferred one, consider the comfort of the patient, consider the position and exten of restrain, consider the vessel's ability to maintain a needle, consider th solution to be infused. |
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Term
| Pediatric Locations for IV |
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Definition
| Hands, forearm, feet, scalp |
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Term
| Characteristics of Pediatric Administration Sets |
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Definition
Drip chamber with microdropper delivering 60 gtts= 1ml or 60cc/hour
Tubing compatible with pum, catheter adapter for needleless systems
Standard of practice: All IV sites should be checked and reporgrammed every 1-2 hours
Armboards are utilized to maintain integrity of IV site |
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Term
| Developmental considerations INFANT |
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Definition
| Handle infant gently, speak softly, avoid arm used for thumb sucking, cuddle immediately after insertion, don't feed immediately prior to insertion |
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Term
| Developmental considerations TODDLER/PRESCHOOLER |
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Definition
| prepare child immediately prior to procedure, give simple explanations in concrete terms, explain that you will help child hold still, emphasize that the IV is not punishment |
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Term
| Development considerations SCHOOL AGE |
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Definition
| Prepare child ahead of time, but on the day of insertion only, give the child choices as appropriate, give positive reinforcement after completion |
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Term
| Developmental considerations ADOLESCENT |
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Definition
| Prepare teenager several hours to a day before procedure, approach discussions on a more adult level, discuss fears related to procedure, include teen in decisions |
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Term
| Variables to consider with IV rates |
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Definition
| Patient weight, patient fluid status patient, diagnosis (fluid restrctions), additional medication to administer, volume of medications. |
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Term
| Maintenance Fluid Requirements 4-2-1 |
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Definition
First 10kg of weight= 4cc/kg/hr
For the second 10kg of weight= 2cc/kg/hr
For each additional kg therafter= 1cc/kg/hr |
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Term
| Complications of IV therapy |
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Definition
Infiltration (extravision) Fluid leaks into subcutaneous tissue
Catheter occlusion- Blockage usually by clotted blood or pecipitate
Air embolism- Air enters circulation and travels to right side of heart
Phlebitis- injury to vein without clot
Inflammation of the blood vessel
Thrombophlebitis- Inflammation of a blood vessel with thrombus formation
Infection- Introduction of pathologic organisms locally or systemic
Metabolic derangement- imbalance in electrolytes, minerals, glucose and proteins. |
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Term
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Definition
Calculate safe does mg/kg
Calculate amount to administer cc
Calculate final concentration or dilution for IV medications
Calculate rate of infusion
Set pump accordingly
Flush Med (same rate as administered) |
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Term
| Intramuscular Administration |
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Definition
Must consider tissue size, mass, and age
Essential to identlify landmarks in order to select correct location
Vastus Lateralis is most common in pediatrics
Needle Length guage selection involves nursing judgement: long enough to inject past sub-Q tissue into muscle but not long that it hits the bone |
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Term
| IM injection sites in children |
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Definition
| Vastus Lateralis, ventrogluteal, deltoid |
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Term
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Definition
| Restraints or more than one nurse may be needed to give injection safely, if child is agitated, use distraction and have parents present to assist with anxiety, after the medication is drawn into the syringe, change the needle prior to administration |
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Term
| Subcutaneous Administration |
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Definition
| Sites similar to adults SubQ tissues of thigh and upper arm most common, needle length shorter than with IM in order to inject only into subQ tissue, restrain support similar to IM injection. No aspiration needed for SQ injections. |
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Term
| Oral Medication Administration |
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Definition
Depends upon childs ability to suck, swallow, drink or chw.
Oral liquids preferred until the age of 5
Most children at least 2 1/2 years may be able to take chwable form
Most medications can be crushed and mixed with solution/applesauce. Check with pharmacist first, do not crush time release or enteric coatds |
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Term
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Definition
Elixer: Alcohol solution that is sweet and aromatic
Suspension: One or more drugs finely ground/ divided into a liquid, such as sterile H2O, NS
Syrup:
Medication dissolved in concetrated solution of sugar and H2O |
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Term
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Definition
| Checked by 2 RNs, Insulin, Digoxin, Narcotics, Heparin |
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Term
| Goals of Pediatric Assessment |
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Definition
Minimize stress and anxiety associated with assessment of various body parts
Foster trusting nurse-child-parent relationship, Allow for maximum preparation of child. Preserv the security of parent-child relationship, maximize accuracy of assessment findings |
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Term
| Preparation of the child for assessment |
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Definition
| Perform exam in appropriate, non-threatening area, provde time for play and becoming acquainted, utilize age-appropriate techniques to assist in cooperation, involve child in exam process, proceed to examine the body in an organized sequence, reassure child throughout the exam, cooperation usually enhanced with parent's presence. |
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Term
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Definition
| Measured when a child is supine, measured until 24 months, full extension required, head to heels. |
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Term
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Definition
| Measure height or stature, wall mounted, most accurate |
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Term
| Skin fold thickness and Arm circumference |
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Definition
Distinguishes between adipose tissue and muscle mass/
Skin fold thickness measure of body fat, use tricep area. Arm circumference- indirect measure of muscle mass. |
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