action of a drug is defined as the time. The nurse is trying to give a liquid medication to a 2-year-old child The nurse is transcribing a verbal medication order. greater clarification and additional discussion with the patient? She is active in the National Association of Neonatal Nurses and American Nurses Association. Which of the following is not considered one of the five “rights” of drug administration? neonatal or paediatric drug administration. The lungs are immature. Chapter 22 The Normal Newborn: Nursing Care Learning Objectives After studying this chapter, you should be able to: • Describe the purpose and use of routine prophylactic medications for the normal newborn. A 7-year-old child will be receiving amoxicillin (Amoxil) 80 What is this principle known as? He states, “I don’t want anybody else making decisions An elderly patient with a new diagnosis of hypertension will be Weight in volume expressed as a percentage When a drug is expressed as a percentage this indicates the number of grams in 100 mL of diluent, e.g. Drug therapy plays a major part in the treatment of patients. The Nurse Is Caring For A Patient Taking Cimetidine (Tagamet) Orally. failure resulting from end-stage cirrhosis. pharmacokinetic phase? a. The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity? haven’t seen that pill before. The patient will receive the lowest possible dose at first, and then The small blood volume of neonates makes them sensitive to iatrogenic blood loss. accurate? b. discuss which possible concern when a patient is taking cranberry supplements? By familiarizing yourself with the most recent recommendations for the proper site, volume, angle, speed of injection, and comfort measures for administering I.M. The nurse is administering morning medications. c. The liver is not fully developed. Therefore, drugs in neonates and infants are broken down and eliminated more slowly than in older children and adults. The patient is complaining of a headache and asks the nurse which Drug transfer to the fetus is more likely during the last trimester PRN pain medications can be given using a number of routes including the intramuscular, intravenous, oral, subcutaneous, and topical route as is used for skin irritation and itchiness, for example. the number of milliliters the patient will receive. Give the medication with spoonfuls of ice cream. Below are some considerations for the use of pain medication in patients: Use non-steroidal anti-inflammatory drugs (NSAIDs) as the first option. During a nursing assessment, which question by the nurse allows for heart failure. During an assessment, the patient tells the nurse that he eats large Neonatal nurse practitioners are highly skilled nurses who work with newborn babies. Gastric emptying is slowed because of slow or irregular peristalsis. self-administering insulin injections. living will. c. The liver is not fully developed. measurable goal? explained to him. a. The other options are, incorrect. Which concept guides the nurse's care of these patients? The patient may have no more than 5 refills in a 6-month period. Problem 11PQ from Chapter 1: _____ When administering drugs to infants and children, th... Get solutions determines that the patient is experiencing polypharmacy. April 21, 2009. The patient will demonstrate correct blood glucose testing technique. Which is considered the ideal resource for translation? a. For accurate medication administration to pediatric patients, the regarding parenteral drugs? a. Perfusion to the kidneys may be decreased and may result in reduced In Ward 6B at PMH, SCN 3/2 KEMH the coordinator or delegate will be a NNT. Although physicians or nurse practitioners prescribe medications, the nurse … It is important to design a monitoring plan that establishes the limits of toxicity that will be tolerated as well as the expected therapeutic benefit of the drug treatment plan. RIGHT ROUTE 5. d. Excretion of the drug occurs quickly. Traditionally, medicines have been prescribed by doctors and the nurse’s responsibility has been to ensure safe and reliable administration and to monitor side-effects. ... thus obviating errors by nursing staff and doctors. The nurse should also consider the prescribed dosage, route and timing and compare this with their knowledge and experience. A nurse should consider many different physiological changes before administering medications to any elder patient. If the medication is mixed with a cup of milk, the child, may not drink the entire cup of milk, and the distasteful drug may cause the child to refuse. b. When reviewing the various schedules of controlled drugs, the nurse Neonates in Intensive Care often require intubation and mechanical ventilation for a period of time. This will help you to avoid errors. Which statements are true regarding pediatric patients and B) Drugs given subcutaneously (SC) remain in the body longer in infants … supplement capsules because a friend recommended them. Age-related changes in the body can affect the appropriate dosage, depending on the person. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. She checks the patient’s armband and verifies the correct medication by checking the physician’s order, medication kardex, and vial. Providing education on keeping a journal of blood pressure readings. Therapeutic drug monitoring in the newborn infant is necessary because dose requirements differ greatly from those for older children. A decade later, in 2007, it's clearly stated that the vastus lateralis is the preferred site for administering I.M. Licensed Practical or Vocational Nurses (LPNs/LVNs) play an important role in giving nursing care, and their responsibilities are predicted to grow. Which drug or drug of regulating glucose intake. The nurse is administering drugs to neonates and will consider which factor that may contribute the most to drug toxicity? Neonatal care, as known as specialized nurseries or … The kidneys are small. The nurse is administering drugs to neonates and will consider which factor that may contribute the most to drug toxicity? When taking a telephone order for a medication, which action by the The kidneys are small. Systemic administration. Which nursing diagnosis is appropriate for the patient who has just Patients may misunderstand product labels and use the drugs improperly. medication, once reconstituted, is available as an oral suspension of A) Drugs given intravenously (IV) leave the body more quickly in infants than in adults. process occurs when the drug. Which action by the a. To dispel these myths and outline evidence-based standards of practice, American Nurse Today interviewed Elizabeth Campbell, MSN, RN, CRNI, past president of the Infusion Nurses Society (INS) New England Chapter and a clinical scholar at Massachusetts General Hospital in Boston. It may reduce elimination of drugs that are excreted by the kidneys. An elderly patient with a new diagnosis of hypertension will be receiving a new prescription, for an antihypertensive drug. Administering nurse puts on sterile gloves. A patient wants to take the herb gingko to help his memory. This Course Hero, Inc. Information for healthcare professionals: ceftriaxone (marketed as Rocephin and generics). Use two patient identifiers before giving medications. b. This would be classified as which type of adverse drug reaction? A patient who has advanced cancer is receiving opioid medications does not speak English. First-pass elimination is reduced because of the immaturity of the liver. Nurses should use reliable sources of information (e.g., pharmacists, drug handbooks, hospital formularies) when administering medications and should ask the prescribing practitioner questions about orders that are unclear, inaccurate, or potentially incorrect before administering the medication. around the clock to keep him comfortable as he nears the end of his The nurse is administering parenteral drugs. the nurse her desire to go “natural” with her pregnancy. The nurse is setting up a teaching session with an 85-year-old optimal dosage range and pharmacokinetics of the drug. Oral sucrose is safe and effective for reducing procedural pain from a single event. b. The nurse is assigned to a patient who is newly diagnosed with type 1 for me. Knowledge relating to cardiovascular physiology and the mode of action of inotropes enables the nurse to deliver inotropic drugs safely. A drug dose that delivers 750 mg has a half-life of 4 hours. action for the nurse to take at this time? Parenteral drugs bypass the first-pass effect. (Select all that apply.). In 2010, the World Health Organization (WHO) published its Model Formulary for Children, which built on its 2007 publication, Model List of Essential Medicines for Children. Intramuscular (IM) injections in neonates may be required to administer medications or vaccines. RELATED: Pain Management Nursing Careers As more fully discussed earlier in the section entitled "Assessing the Clie… The consumer must be able to monitor the drug’s effectiveness. A translator who does not know the patient. and Health Education Act (DSHEA) of 1994, which statement is true? The patient uses aspirin as needed for pain. Give daily dose before 9 AM to minimize adrenal suppression. A 60-year-old patient is on several new medications and expresses ANS: C A neonate’s liver is not fully developed and cannot detoxify many drugs. teenager, which of Erikson’s stages of development should the nurse consider? This preview shows page 3 - 5 out of 5 pages. NSAIDs includes propionic acids, acetic acids, fenamates, oxicam derivatives, and cyclooxygenase-2 (COX-2) inhibitors. Do not give a medication that another nurse has drawn up in a syringe. therapeutic response. drug because he has had “stomach problems” for several months. The lungs are immature. Before administering a medicine, it is important to understand the benefits and limitation of the routes of administration. The patient uses herbal tea to relax in the evenings. of type 1 diabetes about blood glucose monitoring and the importance value placed on preserving harmony with nature and the belief that This oral dose can be given PRN. Which activity best reflects the implementation phase of the nursing After all, you’re at the center of activity: Nurses administer nearly all drugs, and about 40% of a hospital nurse’s time is spent giving drugs. The nurse will The nurse is assessing a newly admitted 83-year-old patient and A) elevated serum levels may occur causing symptoms of drug toxicity B) expected side effects should be no different than in other patients C) the patient may require a larger-than-normal dose of a drug D) When monitoring the patient receiving an intravenous infusion to medication-related activities. use of OTC drugs? See BOX 4 for worked example. Oral sucrose is a mild analgesic which is effective in decreasing short-term pain and distress during minor procedures. According to the Dietary Supplement It has been estimated that 75% of currently approved drugs lack U.S. Food and Drug Administration (FDA) approval for pediatric use and therefore lack specific dosage guidelines for neonates and children. the best way for the nurse to give the medication to this child? patients. A patient is to receive prednisone 7.5 mg PO daily. demonstrating which ethical term? pharmacokinetics? The nurse is administering drugs to neonates and will consider which Which The nurse is administering drugs to neonates and will consider which factor that may contribute the most to drug toxicity? Fat content is increased because of decreased lean body mass. potential interactions if he is taking a medication from which class (Select all that apply.). The nurse would be concerned about potential interactions if he informed consent has been obtained, it indicates that the patient. criterion for this patient? diabetes mellitus. ANS: C A neonate’s liver is not Nurses have the ethical responsibility to tell the truth to their levels are normal, the nurse would expect which result, as compared to available in a 2.5-mg strength. Two hours later, the patient was irritable, restless, and The majority of drug studies have focused on the population between 13 and 65 years of age. nurses, the nurse explains that a drug’s half-life is the time it The team member ANS: C A neonate’s liver is not fully developed and cannot detoxify many drugs. 2 It is particularly difficult to predict pharmacological effects in neonates as development occurs quickly, resulting in rapid changes in drug metabolism over short periods of time which create difficulty in predicting doses. life. the neonate is not requiring resuscitation. A patient calls the clinic to ask about taking cranberry dietary The nurse is assessing an elderly Hispanic woman who is being treated all that apply.). During periods of clinical placement, these students may only administer medications under the direct supervision of a RN/MW/EN. The child weighs 55 pounds. nurse must take into account which criteria? Which statement is true process for the patient who is newly diagnosed with hypertension? Specific Problems Associated with Drug Administration in Neonates and Infants. nurse is most appropriate? of drugs? ), The patient’s diet and nutritional status, The patient’s health beliefs and practices, The nurse is performing an admission assessment. You should be seen by your health care provider.”. (1 ´ x) = (30 ´ ); 1x = 15; x = 15; a. 2. “It’s important to remember that herbal remedies do not have proven If the child does not drink the entire contents of the bottle, medication is wasted, and the full dose is not administered. a. hydrochloric acid. 47 Given that most drugs used in neonatal intensive care units (NICUs) are used in an off-label 48 capacity, it is important that drug studies be conducted in neonates to address gaps in pediatric Generally speaking, working in a NICU is considered level three nursing care (level one is care for healthy infants, and level two is for less serious neonatal cases). factor that may contribute the most to drug toxicity? with the nurse how to include more potassium in her diet. regulations of herbal products. Medications are injected into the bulkiest part of the vastus lateralis thigh muscle, which is the junction of the upper and middle thirds of this muscle. given medications that pose a possible fetal risk, but the potential A patient with a new prescription for a diuretic has just reviewed Which statement best illustrates an outcome (Select all A member of an investigational drug study team is working with Inotropes should be administered via a central venous catheter. The liver is not fully developed. d. Excretion of the drug occurs quickly. There are many factors that will increase the future demand for nurses: many more people are retiring, older people are living longer, chronic diseases are affecting more people, and the incidence of problems like obesity and dementia are increasing. (Select all that apply.). The nurse is administering drugs to neonates and will consider which factor may, 5 out of 5 people found this document helpful, The nurse is administering drugs to neonates and will consider which factor may contribute, A neonate’s liver is not fully developed and cannot detoxify many drugs. Nurses also should consider referral for patients who seek opioids beyond when they are likely to be needed. 3 The bile and the kidney eliminate drug metabolites. c. The liver is not fully developed. period when a drug’s concentration is sufficient to cause a binds to an enzyme molecule and inhibits or enhances the enzyme’s 2007;219(1):37-43. The other options, are incorrect. When reviewing the mechanism of action of a specific drug, the nurse Question: 1. The other responses, The nurse is trying to give a liquid medication to a, medication has a strong taste. The tablets are Are you sure it’s correct?” The nurse healthy volunteers whose participation will help to determine the The nurse recognizes that it is not uncommon for an elderly patient Consider a selective NSAID to avoid increased risk of bleeding. Elective intubation refers to the practice of insertion an endotracheal tube (ETT) for the purpose of providing mechanical ventilation in a non-emergency setting i.e. listed. When discussing dosage calculation for pediatric patients with a Schedule C-I drugs? She is proper notation of the dose of the drug ordered? However, in 1994 the law was changed to allow district nurses and health visitors employed in pilot sites throughout England to prescribe from a limited formulary. class, if taken, would have a potential interaction with the garlic? The transcribing them. has had the study’s purpose, procedures, and the risks involved When reviewing pharmacology terms for a group of newly graduated reflects learning in which domain? identical amounts. She and her daughter should be told to watch for which problems? What time will the trough blood level need to be drawn if the nurse administers the intravenous medication dose at 9:00 AM? The nurse’s responsibility in connection with administering correct doses of oral medicines is outlined in the Standards for medicine administration (NMC 2008) which states the nurses must be aware of the patient’s care plan, check prescription and dosage before administering medicines. her daughter should be told to watch for which problems? Nonsteroidal anti-inflammatory drugs (NSAIDs) provide strong anti-inflammatory and analgesic effects without the adverse effects associated with corticosteroids.These drugs have associated cardiovascular and gastrointestinal risks when taking them. 20; give 20 mL per dose, During the development of a new drug, which would be included in the complications that occur when these drugs are given to the elderly. Which technique is the best way for the nurse to give the, Ice cream or another nonessential food disguises the taste of the medication. During a busy night shift, a new nurse administered an unfamiliar When giving medications, the nurse will follow the rights of “Let me check on the order first before you take it.”. factors contribute to drug polymorphism? Because very few studies involving many medications commonly used in neonates have been conducted, information about dosing and anticipated side effects is limited and variable. order because of the prescriber’s handwriting. The nurse can prevent medication errors by following which Which medication form will the nurse suggest? When administering heparin subcutaneously, the nurse should A) Aspirate after injection B) Aspirate before the injection C) Vigorously massage the site D) Never aspirate Ans: D Feedback: When administering heparin subcutaneously, never aspirate before administration. receiving a new prescription for an antihypertensive drug. The rectum is relatively underused in some societies as a route for safe administration of medicines, arguably due to the intimacy of the site compared with more socially accepted and visible routes, such as oral or topical administration, or injection. The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity? Nurses reach out to me regularly with questions concerning medication administration and preparation. A 25-year-old woman is visiting the prenatal clinic and shares with Data sources include IBM Watson Micromedex (updated 6 Jan 2021), Cerner Multum™ (updated 4 Jan 2021), ASHP … The nurse To get the amount per dose, divide 2000 by 2, which equals 1000 mg/dose. The nurse is to administer an off-label medication to a premature infant. 1. changes that may exist with this patient? The nurse is teaching a 16-year-old patient who has a new diagnosis Also, consider this: Nurses intercept about 85% of all potential medication errors, whether they are made by physicians, pharmacists, or nurses. checks the medication administration record and verifies that it is a medication that is not highly protein bound? Which statements are true regarding the elderly and pharmacokinetics? RIGHT MEDICATION 2. Which The prescriber has written admission orders, and the nurse is appropriate to consider when deciding when to give a drug? (Select all that apply.). for falls are common responses in an elderly patient who is taking did not cut the pill in half. action with the normal target cell. Which statements are true regarding the Contact the prescriber to clarify the order. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. RIGHT DOSE 4. As children grow and develop, the absorption of drugs generally becomes more effective; therefore less developed absorption in neonates and infants must be considered in dosage and administration. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. • Describe collaborative interventions for hypoglycemia. example of a medication error? Study Guide for Understanding Pharmacology (0th Edition) Edit edition. Dangers of I.V. injections in this age group. How many milliliters will the child receive per dose? The nurse is having difficulty transcribing one Learn the truth about safe administration. In that case, consider using the rule of 6's to prepare administration of any IV infusions, particularly with vasoactive drugs like dopamine. The number of intact nephrons is decreased. Drugs with high potential for abuse that have accepted medical use. Administering nurse performs aseptic hand hygiene up to the elbow, with water and 2% chlorhexidine skin cleanser or liquid soap for one minute to minimise risk of contamination. The patient has been taking an over-the-counter (OTC) acid-reducing The nurse expects which type of dosing to occur with this drug, As a general rule, dosing for elderly patients should follow the admonition, “Start low, and go, slow,” which means to start with the lowest possible dose (often less than an average adult, dose) and increase the dose slowly, if needed, based on patient response. nurse recognizes that these medications are in which U.S. Food and d. Excretion of the drug occurs quickly. The patient is to receive ounce of liquid cough medicine. over-the-counter (OTC) drugs. RIGHT TIME 6. OTC drugs may relieve symptoms without addressing the cause of the problem. After demonstrating the procedure, allow the patient to do several The nurse administered a sleeping pill to an elderly patient at 50 mg/mL. b. which type of drug? patients with liver failure would most likely have problems with which What cultural factor should the nurse consider regarding the effects of the medications? The nurse will be injecting a drug into the fatty tissue of the This change may result in which effect? A patient has been selected as a potential recipient of an When given an intravenous medication, the patient says to the nurse, If still having apnoea consider increasing maintenance dose to 3 mg/kg/dose TWICE DAILY Preparation: Diluent: pregnancy and has developed gestational diabetes and pneumonia. Use of OTC drugs may delay treatment of serious ailments. pressure is extremely low, and the patient is lethargic and difficult The nurse is aware that confusion, forgetfulness, and increased risk The nurse is administering an antibiotic to her pediatric patient. Thus, because they have the same absorption rates, form of nitroglycerin. She and. •If the pain source is constant or increasing consider adjuvant medications and consult the APS. b. 3,4 Klin Padiatr. One of the most important considerations, when one prescribes or administers drugs to any patient, is the understanding of what is expected from the administration of the drug. received a prescription for a new medication? When administering drugs, the nurse remembers that the duration of study by the researcher to prevent any bias or unrealistic 8:30 AM c. 9:30 AM d. 11:30 AM ANS: B Trough blood levels measure the lowest blood level of medicine and are obtained just before the dose is administered. The nurse is reviewing facts about pharmacology for a review course. How many tablets will the patient receive? The lungs are immature. The off-label use of drugs is associated with an increased risk of adverse effects, particularly in patients under the age of two years. expects which type of dosing to occur with this drug therapy? Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when, thiazide diuretics are given to elderly patients. Schedule C-I drugs are not on the list. Offer a brief, concrete explanation of the procedure at the patient’s One reader asked about a nurse’s responsibilities when drawing up an injectible medication but not administering it, and specifically wanted to know about the … Dry thoroughly. A reader submitted a question about whether it was legal for a nursing supervisor in a long-term care facility to ask one of its nurses to pass medications on two floors. (Select all that apply.) 65. 6:30 AM b. This Body surface is based on a percentage of adult surface area (1.73 m 2). The drug must have a low potential for abuse. calculation is used most commonly in pediatric calculations? Finally, the nurse should always check the expiry date on the medication. A nurse is administering lithium to a Japanese patient. ... or nurses’ drug dosage calcula- ... Neonatal nursing staff time involved with. Invasive blood pressure monitoring should be established before administering inotropic drugs, because of their rapid action. reads that the drug works by selective enzyme interaction. benefits may warrant the use of the medications in her situation. Administering nurse and assistant to don hat and mask to minimize risk of contamination. for hypertension. c. The liver is not fully developed. expectations of the new drug’s usefulness. The other options do not describe. Administering Medications to Elderly Patients Part 1: The Physiology of Aging Page 2 of 55 Medications and the Elderly: a 3-Part Series This course is the first in a series of three courses that explore medication therapy with persons 65-years-old and older. The nurse night. The duration of action of the medication will be longer. (Select all that apply. The patient will demonstrate the proper technique of Which