Physiologic Differences Between Children and
Adults That Affect Pharmacokinetics
Fig. 38-1, p. 993
1
Giving Medications: what’s the same?
Safety & accuracy

6 Rights
Understand expected action and side
effects
Signs of toxicity, adverse reactions
2
Extra Considerations for Children
Safe volume (IM)
Po often liquid
Dosage by body weight
Check dosage with reference

Mg/kg/dose or mg/kg/day?
Check calculations with another nurse
3
Example
1. Order: Augmentin 200 mg po q. 12
hrs
Child: 9.5 kg
Available: suspension 125 mg/5 mL
Range (drug book) 25-45 mg/kg/day
Is dose within range?
How many ml is required to give the
ordered dose?
4
Principles of Medication Administration
in Children
Consider growth and development
principles.
Honesty and praise help to gain trust
and cooperation.
Restraint may be necessary.
Provide rewards for good behavior
and for trying.
Dosages by body wt
5
Safety Considerations
Children unpredictable
Get help with restraining
Extra needle
Parent/caregiver involvement
Be quick, skillful
Never give injection to a sleeping child
6
Must Know:
1 Kg = 2.2 lbs
1 Kg = 1,000 gm
1 Gm = 1,000 mg
Kg = lbs
2.2
Kg x 2.2 = lbs
7
Strategies for Medicating Children
Infants


Restrain
cuddle, comfort.
Toddlers




Use play
minimize restraint
give praise
stickers as rewards.
8F
Strategies for Medicating Children
Pre-school, early school-age



Provide choices, explanations
Distraction
Support
Adolescents




Explain
Allow participation in decisions
praise cooperation
provide outlet for frustrations.
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Methods of Administering Medications to
Children
Oral
NG, GT, JT
Rectal
Topical
Otic (ear)
Ophthalmic (eye)
IV
Intraosseous
IM, SQ
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Giving oral meds
11
Gastric or NG Meds
Stop feeding (as appropriate)
Flush with (sterile) water – 5-25 mL
Administer med
Flush
Always flush when stopping feeding
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Ear drops
13
Intramuscular Sites in Children
table 38-1
Fig. 38-UF01a, p. 999
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Intramuscular Sites in Children
Fig. 38-UF01b, p. 999
M
15
IM
16
Procedure for Pediatric IM
Look at procedure in syllabus
17