Pediatric Intravenous Medications Chapter 23 Pediatric Intravenous Medications

Pediatric IV Medications Incompletely developed physiologically Especially under age four Makes drug tolerance, absorption, and excretion ongoing concerns

Pediatric IV Medications Infants and acutely ill children have narrow range of tolerance for hydration

Pediatric IV Medications Require frequent and careful IV site inspection for inflammation and infiltration due to: Fragility and size of veins Irritating nature of many medications Including antibiotics

Inflammation Redness Heat Swelling Tenderness/Pain

Infiltration Swelling Coolness Tenderness/Pain Lack of blood return

Inflammation/Infiltration Presence of inflammation and/or infiltration necessitates: Immediate discontinuance of IV Restart at new site

IV Medication Guidelines Always use to determine drug dosages, dilutions, and administration rates

IV Medication Guidelines May be administered either: Over several hours As intermittent infusions Should be administered using volumetric infusion pump

Steps for Adding IV Medication to Solution Locate type and volume of IV solution prescribed Measure dosage of medication to be added Use strict aseptic technique to add drug to solution bag through medication port, and mix drug thoroughly in solution

Steps for Adding IV Medication to Solution Label IV solution bag with name and dosage of the medication added Add initials with time and date medication added Hang IV and set flow rate for infusion Document administration when completed

Flushing Medications Regardless of method of intermittent administration, medication infusion routinely should be flushed following infusion to be sure that: Medication cleared tubing Total dosage administered

Calculating IV Medication Dosage of 250 mg in 15 mL of D5/0.45% NS to be infused in 30 min Follow medication infusion with 5 mL fluid of D5/0.45% NS Total volume = 15 mL Infusion time = 30 min

Using Ratio and Proportion 15 mL : 30 min = X mL : 60 min X = 30 mL/hr

Using Dimensional Analysis

Flush After medication infusion complete, infuse 5 mL flush at 30 mL/hr

Comparing IV Dosages Prescribed with Safe Ranges Dosages of IV medications calculated on basis of kg of body weight or BSA

Calculating Safe Range Child weighing 22.6 kg prescribed to receive 500 mg of medication in 100 mL of D5W every 12 hours Normal/safe dosage range 40 to 50 mg/kg/day Determine if dosage prescribed within normal/safe range

Calculating Safe Range Calculate safe daily dosage range

Calculating Safe Range Calculate dosage infusing in 24 hours 500 mg in 12 hr = 1000 mg in 24 hours 500 mg in 12 hours is within 904 to 1130mg/day range