Considerations in the administration of medicines in children

The administration of medications to children is one of the most important oblig

ations of nurses. Security and competition are basic conditions for administerin
g the correct dose as painless as possible
EU-Lic. René Castillo F.
Considerations in the administration of medicines in children
The pediatric population varies greatly between age, weight, body surface area a
nd ability to absorb, metabolize and excrete medications
EU-Lic. René Castillo F.
Considerations in the administration of medicines in children
Do keep in mind the following
The younger the child, the greater its
metabolism The calculation of the dose is usually done by weight or body surface
area, according to the type of drug, so it is very important to have the exact
weight of the child In the RN, especially those of pre-term be tempted to take e
xtreme precautions in the use of antibiotics, due to immaturity of the systems
EU-Lic. René Castillo F.
Considerations in the administration of medicines in children
Do keep in mind the following
Another important fact is that the oliguria requires a reduction in extreme dose
s and monitoring of renal function Preparation should take place in accordance w
ith all rules and respecting aseptic dilution volumes accepted by the child and
the drug
EU-Lic. René Castillo F.
Basic rules in the administration of medicines
Administer medicines only
prewritten by the physician, in compliance with dose and route indicated. Check
container. if the medication administered is the one, reading their
EU-Lic. René Castillo F.
5 correct
Patient Drug correct correct correct correct dose Route of administration time c
orrect
EU-Lic. René Castillo F.
Basic rules in the administration of medicines
Check the expiration date. Prepare the medication at the time to be used. Admini
ster the medication in the period indicated.
EU-Lic. René Castillo F.
Basic rules in the administration of medicines
Meet doses of drugs used in pediatrics and discussed with the medical indication
s that warrant doubts. Knowing the desired therapeutic effect. Knowing the possi
ble adverse drug reactions occur. (R.A.M), which could
EU-Lic. René Castillo F.
ORALLY
Objective
Drug administration as drops, suspension, tablets, oral tablets for therapeutic
purposes and / or diagnostic
EU-Lic. René Castillo F.
ORALLY
In young children, only oral medications may be given liquid consistency, since
they are not able to swallow tablets or capsules. In the case of these tablets s
hould be crushed and dissolved (dissolved in water or 5 ml.de S. dextrose 5%)
EU-Lic. René Castillo F.
ORALLY
Form grinding and dissolving capsules
EU-Lic. René Castillo F.
ORALLY
How to administer the drug orally (PO) Placing the child in a position conducive
to eating (semi-sitting) in infants given the drug with a syringe without needl
e, facilitates accurate dosing and allows the child to eat them without spilling
. In preschool graduation. the glass can be used
Once administered the medication record time, medication, route and dose.
EU-Lic. René Castillo F.
ORALLY
Precautions
NO medication should be added to food formulas when the child refuses to coopera
te or refuses, despite the explanations and of minds:
We must exert a light physical coercion, which must be carried out quickly and c
arefully Keep in mind that this involves a risk, the crying baby can suck the me
dication, especially when supine
EU-Lic. René Castillo F.
ORALLY
Nursing Recommendations To encourage acceptance of oral medications from the chi
ld:
Give an ice cube before giving the medicine to numb the tongue is mix the medici
ne with a small amount (1 teaspoon) of a substance sweet as honey, jam or fruit
juice. Offer a small glass of water, juice, etc..
EU-Lic. René Castillo F.
ORALLY
Nursing Recommendations To encourage acceptance of oral medications from the chi
ld:
If nausea is a problem, give a liquid poured over crushed ice before or immediat
ely after medication to stimulate swallowing in infants under and children with
neurological deficit, throwing a small puff of air on the face to cause swallowi
ng reflex.
EU-Lic. René Castillo F.
ORALLY
Special Considerations as your child's age
INFANT CHILD
Hold in position semiinclinada Place the syringe, the measuring spoon or dropper
with medication in the mouth,€well back on the tongue or the side of her Admini
ster slowly to reduce the possibility of choking or aspiration Allow the medicat
ion infant suck on a pacifier attached
EU-Lic. René Castillo F.
ORALLY
Special Considerations as your child's age
Give older infants the medicine in a cup or small spoon Manage reluctant in chil
dren using a mild or partial clamping. (Essential help from parents). Do not mak
e the child actively resists the risk of aspiration, to postpone for 20-30 min.
And again deliver medication
EU-Lic. René Castillo F.
with
syringe
spoon
dropper or measuring Like
ORALLY
Special Considerations as your child's age
PRESCHOOL Using a direct presentation reluctant in children, use the following:
Simple persuasion innovative packaging reinforcements (rewards) They may give a
balloon or let them make collection syringes
EU-Lic. René Castillo F.
Rectal
Objective
Drug administration in the form of ointment or suppository into the rectum for t
herapeutic purposes and / or diagnostic
EU-Lic. René Castillo F.
Rectal
Administration of drugs rectally
The suppository is a drug preparation conical or elongated ovoid solid consisten
cy and is able to melt at the physiological temperature of the rectum or solubil
ized in the fluids. It is given with the intention of pursuing a local or system
ic action (by absorption into the general circulation).
Tapered end
EU-Lic. René Castillo F.
Rectal
Administration of drugs rectally
The rectal administration, is one of the least reliable. It requires that the re
ctal ampulla is empty, otherwise the drug absorption may be delayed, reduced or
prevented by the presence of stool. Used this way, when the oral route is contra
indicated. The drugs most used in this way are antipyretics, sedatives, analgesi
cs and antiemetics.
EU-Lic. René Castillo F.
Rectal
Materials
Gloves medicine procedures. Lubricant. torula indicated cotton. Toilet paper. Wa
ste bag. dry
(Suppository, ointment)
EU-Lic. René Castillo F.
Rectal
Procedure
Report to be made. Wash your hands. Prepare the tray. Place sims position. the c
hild or the child of lateral and / or Put on gloves. In administering the suppos
itory, you remove the wrapper and lubricate the suppository with water or hot Va
seline.
family proceedings
EU-Lic. René Castillo F.
Rectal
Spread with one hand the buttocks with the other hand to view the anus, gently i
nsert the suppository into the rectum with the tapered forward Keep buttocks
tight or pressing with a dry torula about 5 minutes. Clean anal. Remove the comp
uter. Record date, time, medication etc.
EU-Lic. René Castillo F.
the
excess
zone
lubricant
Rectal
EU-Lic. René Castillo F.
PARENTERAL ROUTE
The term refers to the parenteral route of administration of drugs. That is, thr
ough one or more layers of the skin or mucous membranes by injection. The daily
injection is used in many situations
EU-Lic. René Castillo F.
PARENTERAL ROUTE
When administering a medication should act consistently, meeting a series of ste
ps: Prepare the necessary material. Prepare the medication. Choose the injection
site. Drug administration.
EU-Lic. René Castillo F.
PARENTERAL ROUTE
COMMON USES OF THE PARENTERAL ROUTE
EU-Lic. René Castillo F.
Intravenous needle Parties
Bevel Cone
Metal Part
EU-Lic. René Castillo F.
PARENTERAL ROUTE
EU-Lic. René Castillo F.
PARENTERAL ROUTE
27Gx1 / 2''25Gx5 / 8''sizes of needles used by injecting 23Gx1 23Gx11''/ 4''''22
Gx1 21Gx11 / 2''
EU-Lic. René Castillo F.
PARENTERAL ROUTE
Needle Sizes
Hypodermic Needle Hypodermic Needle 18G X 1 18G X 1 1 / 2 Hypodermic Needle 18G
X 11 / 4 Hypodermic Needle Hypodermic Needle 19G X 1 19G X 1 1 / 2 X 1 20G Hypod
ermic Needle Hypodermic Needle Hypodermic Needle 21G X 1 21G X 1 1 / 2 Hypodermi
c Needle Hypodermic Needle 22G X 1 22G X 11 / 2 23G Hypodermic Needle Hypodermic
Needle 23G X 1 X 11 / 4 X 1 24G Hypodermic Needle Hypodermic Needle Hypodermic
Needle 25G X 1 25G X 5 / 8 Hypodermic Needle 26G X 1 / 2 Needle hypodermic 27G X
1 / 2 Hypodermic Needle 30G X 1 / 2
EU-Lic. René Castillo F.
PARENTERAL ROUTE
Comparison of the angles of insertion
EU-Lic. René Castillo F.
Intramuscularly (I.M)
Objective
Drug administration by injection applied in the muscle tissue for therapeutic an
d / or diagnostic
EU-Lic. René Castillo F.
Intramuscular (IM) General
The intramuscular route offers greater guarantees in terms of absorption of drug
s. The disadvantages are related to the trauma caused by the administration, the
increased risk of local reactions.
EU-Lic. René Castillo F.
Intramuscularly (I.M)
In children there is also the disadvantage of poor development of muscle tissue
that limits the areas to be punctured. The IM route should only be used to admin
ister medications limited, not exceeding 0.5 ml. 2 ml.en infants and preschooler
s.
EU-Lic. René Castillo F.
Intramuscularly (I.M)
General considerations
Selection of the syringe and needle:
The volume of prescribed medication to young children and small amount of tissue
required to select an injection syringe that can measure very small amounts of
solution volume to less than 1 mL of solution is appropriate tuberculin syringe
EU-Lic. René Castillo F.
Intramuscularly (I.M)
General considerations
Selection of the syringe and needle:
The length of the needle should be enough to penetrate the subcutaneous tissue a
nd depositing medication in the body muscle of small diameter needles are those
that cause less discomfort, but larger diameters are needed for medications visc
ous needle used should have a greater than 2.5 cm long and must have good bevel
EU-Lic. René Castillo F.
Intramuscularly (I.M.)
Technical cavity
Intramuscular injections used in this technique are less irritating to the subcu
taneous tissue is injected a small volume of air after medication empty air all
of the drug remaining on the needle After preparing the correct dose is aspirate
d 0, 2 ml. air
EU-Lic. René Castillo F.
Intramuscularly (I.M.)
Technical cavity
Then the needle is inserted down a 90 degree angle so that the air is directed t
oward the top of the drug into the plunger As the drug is injected into the musc
le, the air follows the drug, creating the camera air
EU-Lic. René Castillo F.
Intramuscularly (I.M.)
Technical cavity
Air chamber
0.2 ml
Drug
Subcutaneous Tissue
Muscle
Air chamber
Drug
EU-Lic. René Castillo F.
Intramuscularly (I.M)
Puncture sites for injections
Area middle third of the thigh ventrogluteal Zone Zone Zone back gluteal deltoid
EU-Lic. René Castillo F.
Intramuscularly (I.M)
Area middle third of the thigh
It
the
Absence
area
y
more
cups
appropriate by:
blood
major nerves.
EU-Lic. René Castillo F.
Intramuscularly (I.M)
Ventrogluteal Zone
To identify the area the child is placed in the supine position. Place a finger
on the same iliac spine anterior hand on the top and another finger from the ili
ac crest.
Injection site
EU-Lic. René Castillo F.
Intramuscularly (I.M)
Ventrogluteal Zone
The apex of between
Injection site
triangle including both points, is the area to puncture. Should be puncture at 4
5 and cephalad.
EU-Lic. René Castillo F.
Intramuscularly (I.M) back gluteal area
This area should be chosen when the child is walking more than a year. It is del
imited as in the adult with four quadrant
EU-Lic. René Castillo F.
punctured quadrants
anatomical landmarks are more content.
Intramuscularly (I.M)
Deltoid area
Zone bit recommended in children because of their lower muscle development, but
can be used as an alternative, if the characteristics of injecting drug permit (
somewhat irritating substances and low volume) The needle should be inserted in
the most prominent non-muscle radial muscle damage.
EU-Lic. René Castillo F.