1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 38 Nursing Care of the Family When a Child Needs Medication Administration or Intravenous Therapy

2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Medication and Intravenous Therapy Assessment Nursing diagnosis Outcome identification, planning Implementation Outcome evaluation

3. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration Pharmacokinetics in children –Absorption –Distribution –Metabolism –Excretion

4. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration (cont’d) Adverse drug effects Safe storage

5. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration (cont’d) Safe administration –Right medicine –Right child –Right dosage –Right route, time –Right information

6. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration (cont’d)

7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration (cont’d) Oral Intranasal Ophthalmic

8. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration (cont’d)

9. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration (cont’d) Otic Rectal Transdermal/topical Intramuscular, subcutaneous Continuous subcutaneous pump infusion

10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration (cont’d)

11. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration (cont’d)

12. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration (cont’d)

13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Intravenous Therapy Determining fluid, caloric needs Obtaining venous access Determining rate, amount of fluid –Intravenous medication

14. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Intravenous Therapy (cont’d) Intermittent infusion devices Central venous access catheters, devices Vascular access ports Intraosseous infusion Subcutaneous infusion

15. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Intravenous Therapy (cont’d)

16. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question You will be assisting with an intraosseous infusion on a 4-year-old. You would explain this to the child’s parent as a(n) A.fluid infusion into the subcutaneous tissue. B.convenient long-term site for intravenous therapy. C.infusion into the skull bones of the head. D.infusion into the bone marrow cavity of a long bone.

17. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer D. An infusion into the bone marrow cavity of a long bone Rationale: An intraosseous infusion is an infusion into the bone marrow cavity of a long bone. It cannot be used long-term because of the danger of osteomyelitis.

18. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question To give an intramuscular injection to an 8- month-old infant, which of the following sites would you use? A.A deep portion of the deltoid muscle B.The muscle of the anterior thigh C.The largest bulk of the gluteus maximus D.The inner lower quadrant of the buttocks

19. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer B. The muscle of the anterior thigh Rationale: The gluteus maximus is not well developed in infants until they walk. That makes the muscle of the anterior thigh the best site for an intramuscular injection.