Term
| prevention of medical errors |
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Definition
keeping informed of medical knowledge
medical literature review, CE programs, communication with other healthcare professionals
share information, welcome input from colleagues, be involved in staff development and education
carefully perform and double check calculations to ensure correctness
consult literature, references, and colleagues when unsure of a prescription, preparation, or administration of a drug product or pediatric treatment requirements
ensure all pertinent patient information is available and current so appropriateness of therapy can be evaluated
focus! avoid distractions and interruptions |
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Term
| reasons for noncompliance |
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Definition
child is sick
denial
frequency
taking medicine at school
side effects
taste
lack of parent support
lack of education |
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Term
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Definition
every 8 hours vs. TID
try to avoid school hours
BID dosing is most preferred
helpful reminders:
medication schedule
pill boxes
electronic alarms |
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Term
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Definition
be able to calculate amount in mL
Amoxil 250 mg/5mL
dosed at 90mg/kg in 2 divided doses
child weights 25 kg
how many mL/dose should the child take?
22.5mL
use higher concentration to decrease volume |
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Term
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Definition
counsel on:
MAIN side effects
what to do if it occurs
at what point to stop giving the medication
examples:
antibiotics - diarrhea, photosensitivity
antiepileptics - paradoxical reactions, rash
pain medications - constipation |
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Term
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Definition
shake well!
advantages:
dose can be patient specific
good for young patients
disadvantages:
difficult to measure
difficult to administer
poor palatability
stability |
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Term
formulations
chewable tablets |
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Definition
consider for children > or equal to 2 years of age
advantages:
palatability
easier to administer
no stability issues
no measuring necessary
portability
disadvantages:
not as patient specific |
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Term
formulations
tablets or capsules |
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Definition
consider for children 12 years of age and older
choking hazard for those that can't adequately take pills
administer while child is sitting up
may be able to crush tablet or open up the contents of the capsule |
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Term
| administration of liquids |
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Definition
may need assistance
position the child so it is easy to administer
if right handed, hold the child in left arm
hold the child's left arm with your left hand
put the child's right arm under your left arm and behind your back
tilt the child's head back slightly
place the medicine in the back corner of the mouth, between the gum and cheek
administer little amounts at a time
choose the appropriate device |
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Term
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Definition
good for young children that can't drink from a cup
allows for correct administration to the back of the child's mouth
allows parent to pre-measure and cap doses for school, caregivers, babysitter, etc.
comes in different sizes
educate parent on proper use
instructions:
prefer giving an adapter with bottle to draw up doses
if no adapter included, pour medicine into a cup and draw up
rinse syringe with warm water when finished |
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Term
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Definition
also good for children that can't drink from a cup
also allows for correct administration to the back of the child's mouth
some medications include their own dropper
do not use a dropper from a different medication
instructions:
be sure to measure the dropper at eye level
rinse dropper with warm water when finished |
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Term
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Definition
good for older children that can drink from a cup but may still spill it
gives child ability to "take the medicine themselves"
do not use a kitchen spoon for measuring medications
may overdose or underdose child
instructions:
hold spoon upright so markings are legible
fill spoon with medicine to appropriate marking
tilt the spoon in the child's mouth slowly |
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Term
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Definition
good for older children that are coordinated
best for larger volumes of medicine
markings are not defined enough for infants
some medications include their own cup
do not use a cup from a different medication or a regular drinking cup
instructions:
place cup on a flat surface at eye level
pour medication to the appropriate marking
be sure to double check the amount carefully |
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Term
volume measures: < 1 mL
which device should be used? |
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Definition
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Term
volume measures: 1-5 mL
which device should be used? |
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Definition
1-5 mL syringe
medicine spoon |
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Term
volume measured: >5 mL
which device should be used? |
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Definition
10-20 mL syringe
medicine spoon
medicine cup |
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Term
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Definition
adding medication to bottle or feeds
stability issues and don't know if they will eat/drink the entire amount
the medicator pacifier |
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Term
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Definition
what if I forget to give the child his dose?
counseling is the same for when an adult misses a dose
if it is close to the next dose, do not double dose
if it is not close to the next dose, may administer a dose when you remember
what is my child spits out the dose?
if it has been within 15 minutes of giving the medication, may redose the child
if it has been longer than 15 minutes of giving the medication, do not redose the child
child is considered to have absorbed some of the medication |
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Term
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Definition
younger infants don't like the idea of taking a medication that is distasteful
toddlers and older children don't want to take medicines if they don't taste good
choose good tasting medications for these children
if you don't have an option to get antibiotic that tastes better, consider getting the medication flavored
FLAVORx
cherry, root beer, chocolate, apple, watermelon, etc.
children prefer sweet tastes
good tasting:
amoxil
omnicef
cefzil
zithromax
lorabid
orapred
bad tasting:
ceftin
vantin
augmentin
bactrim
biaxin
clindamycin (texture)
prednisolone
iron
flavoring and masking tricks:
refrigerate medications
offer a chaser (milk, chocolate)
pre medication wash (popsicles, chocolate)
mix with food or bottle |
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Term
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Definition
give autonomy to children and adolescents
young children - allow then to choose their own flavor
adolescents - include in medication decisions, counsel to adolescents and parents
use positive reinforcement
make medication a part of the daily routine |
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Term
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Definition
do not tell children medication is candy or tastes like candy
be sure to instruct parents to store medication out of child's reach
use appropriate child resistant bottles and vials
when discarding medications, mix with something that is not appealing to children (coffee grounds) |
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Term
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Definition
Pediatric Dosage Handbook - drug monographs, formulations, dosing, MOA, kinetics
Neofax - same thing but for dosing in neonates; nutritional references
Micromedex
Harriet Lane Handbook - disease states with treatment
Pediatric Drug Formulations
Teddy Bear Book - drug monographs for injectable drugs
Red Book: Report of the Committee on Infectious Diseases - infectious disease book |
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