drug_addminstreation__in_pediatric .pptx

For nursing

1. Pediatric drug administration by Tagwa Ibrahim Ali Pediatric drug administration 01/01/1443 dr. tagwa ibrahim ali pediatric department 1

2. Learning Objectives: By the end of this session the student will be able to: Define the drug List factors affecting drug use Enumerate the different routs of drug administration 01/01/1443 dr. tagwa ibrahim ali pediatric department 2

3. Definition of drug It’s any substance, solid, liquid or vapor, which may be applied to a child either externally or internally for the prevention, diagnosis or treatment of diseases. 01/01/1443 dr. tagwa ibrahim ali pediatric department 3

4. Factors affecting use of medication Parental factors: Attitude (fear of giving medication) Reliability: parent must be reliable to have responsibility to give medication. Demographic factors (age, sex, socio-economic, education etc..) 01/01/1443 dr. tagwa ibrahim ali pediatric department 4

5. Child’s factors: Acute or chronic illness: diseases cause malabsorption may affect drug absorption, metabolism and execration. Allergy Growth and development 01/01/1443 dr. tagwa ibrahim ali pediatric department 5

6. Health professional factors Communication : to avoid drug errors Health personnel knowledge about drug Health personnel relation with patient 01/01/1443 dr. tagwa ibrahim ali pediatric department 6

7. drug factors Cost Multiple medication may cause adverse effect 01/01/1443 dr. tagwa ibrahim ali pediatric department 7

8. Safe medication administration Accurate interpret the doctor’s order Accurate calculate the amount of drug Five rights documentation 01/01/1443 dr. tagwa ibrahim ali pediatric department 8

9. Metric System Conversions To convert larger unit to smaller unit, move decimal point to right. To convert smaller unit to larger unit, move decimal point to left. 1 kilogram = 1000 grams 1 gram = 1000 milligrams 1 milligram = 1000 micrograms 01/01/1443 dr. tagwa ibrahim ali pediatric department 9

10. The five Rights (5 Rs) of drug administration The responsibility for administering medication safely is one which nurses take seriously, and to assist in this procedure the five Rights: (5 Rs ) of drug administration have been devised: 01/01/1443 dr. tagwa ibrahim ali pediatric department 10

11. Right patient Right drug Right dose Right time Right route 01/01/1443 dr. tagwa ibrahim ali pediatric department 11

12. General principle for administration Dose Identification Safety precautions Never ask report 01/01/1443 dr. tagwa ibrahim ali pediatric department 12

13. Oral Parenteral (IM,IV,SC,ID) rectal Inhalation Topical Instillation (eye ,ear ,nose) Routes of medication: 01/01/1443 dr. tagwa ibrahim ali pediatric department 13

14. Oral route 01/01/1443 dr. tagwa ibrahim ali pediatric department 14

15. Advantages Simple and easy Minimize child discomfort Few side effect Less expensive. Contra-indication Child unable to swallow Child have nausea and vomiting Child with NPO Forms Liquid, capsule and tablets . 01/01/1443 dr. tagwa ibrahim ali pediatric department 15

16. equipment Tray consist of: Medication card Standard measuring devises Water glass Fruit juice or milk medication 01/01/1443 dr. tagwa ibrahim ali pediatric department 16

17. procedure Wash hands Prepare required equipments For infant crush the tablet or open capsule and add adequate amount of water or milk Give honest explanation to the child 01/01/1443 dr. tagwa ibrahim ali pediatric department 17

18. Oral administration either by: By dropper method: Elevate the infant’s head and depress his chin with your thump Use the least amount of force or restrain. Drop the liquid medication slowly on the middle of tongue using dropper or syringe Dispose soiled supplies and wash hand Document the producer 01/01/1443 dr. tagwa ibrahim ali pediatric department 18

19. Cup method: Place a medication in a cup Elevate the child’s head and put the cup to his lips. Allow the child to completely swallow the medication. Wash cups with soap, rinse and dry well. Document the procedure 01/01/1443 dr. tagwa ibrahim ali pediatric department 19

20. Spoon method Place the necessary dose of medication syrup in spoon which belonging to the medication. Elevate the infant’s head and depress his chin with your thump Put the spoon in the middle of the tongue and slowly expel the medication into child mouth. Make sure the child is completely swallowing all the medication before placing him in his bed. Wash spoon with soap, rinse and dry well. Document the procedure 01/01/1443 dr. tagwa ibrahim ali pediatric department 20

21. Nursing considerations Always allow child to know that you are giving medication not a candy Allow the child to drink an adequate amount of water to insure that the drug rich the stomach. Use facilities to ensure correct dose: Calibrated medicine cup, dropper or syringe. 01/01/1443 dr. tagwa ibrahim ali pediatric department 21

22. Intramuscular injection (IM) An intramuscular injection is a technique used to deliver a medication deep into the muscles. The speed ofabsorption is faster for intramuscular injection compared to subcutaneous injection. This is because themuscle tissue has a greater blood supply than the area just under the skin. Muscle tissue may also hold alarger volume of medication than subcutaneous tissue 01/01/1443 dr. tagwa ibrahim ali pediatric department 22

23. Indications of Intramuscular injections Intramuscular injections are used when other types of delivery methods are not recommended. Theseinclude oral (swallowed into the stomach), intravenous(injected into the vein), and subcutaneous ( injectedjust under the layer of skin 01/01/1443 dr. tagwa ibrahim ali pediatric department 23

24. Sites of IM injection in children 1- Infant and young child (less than 2 years of age) For infants, the IM injection site (vastuslateralis muscleof thigh) isthe front outer side of the thigh. Do not use the inner thigh or back of the thigh. Divide the thigh into thirds; the injection site is in the middle third section. 01/01/1443 dr. tagwa ibrahim ali pediatric department 24

25. vastuslateralis muscle 01/01/1443 dr. tagwa ibrahim ali pediatric department 25

26. vastus lateralis & rectus femoris muscles: 01/01/1443 dr. tagwa ibrahim ali pediatric department 26

27. 01/01/1443 dr. tagwa ibrahim ali pediatric department 27

28. 01/01/1443 dr. tagwa ibrahim ali pediatric department 28

29. 2- Children (more than 2 years of age) For children, the IM injection site ( Dorso gluteal muscle) isthe upper outer quadrant of glutealmuscle . Do not use the inner or lower of gluteal muscle. 01/01/1443 dr. tagwa ibrahim ali pediatric department 29

30. A-dorsogluteal site 01/01/1443 dr. tagwa ibrahim ali pediatric department 30

31. 01/01/1443 dr. tagwa ibrahim ali pediatric department 31

32. deltoid muscle 01/01/1443 dr. tagwa ibrahim ali pediatric department 32

33. 3- Deltoid muscle For children and adolescent, the IM injection site is the top and upper part of the arm. 01/01/1443 dr. tagwa ibrahim ali pediatric department 33

34. 01/01/1443 dr. tagwa ibrahim ali pediatric department 34

35. The easiest and safest way to restrain a young child for a lateral thigh 01/01/1443 dr. tagwa ibrahim ali pediatric department 35

36. Checklist for Intramuscular injection (IM) Equipment required  IM medication ampoule  2.5 ml or 5 ml sterile syringe  Alcohol sponges  Cotton wool swab  Gloves  Paper bag  Kidney basin  Tray 01/01/1443 dr. tagwa ibrahim ali pediatric department 36

37. procedure 1. Check medication order accuracy. 2. Wash your hands. 3. Prepareinjection equipment. 4. Prepareinjection away of the child's sight. 01/01/1443 dr. tagwa ibrahim ali pediatric department 37

38. A) Prepare correct medication dose from ampoule.  Clean the neck of an ampoule with alcohol.  Hold the ampoule in one hand and protect the fingers on the other hand with alcohol cotton.  Break off the stem of the ampoule.,  Insert the needle into opened ampoule, being careful not to touch the edges of the glass.  Withdraw the medication from the ampoule by pulling back on the plunger of the syringe. 01/01/1443 dr. tagwa ibrahim ali pediatric department 38

39. B) Prepare correct medication dose from vial.  Remove soft metal cover on a vial.  Clean the exposed rubber cap with an alcohol sponge.  Remove needle cover.  Insert the needle into the distilled water ampoule or from sterile saline bottle, and then take the amount needed for dissolvent.  Inject the solution into the vial and shake vial well.  Hold the inverted vial at the eye level  Withdraw the medication from the vial by pulling back on the plunger of the syringe. 01/01/1443 dr. tagwa ibrahim ali pediatric department 39

40. 7. Place the syringe in tray. 8. Bring the injection tray to the child's bedside. 9. Explain to the parents or to the child and what you plan to do and keep the privacy 01/01/1443 dr. tagwa ibrahim ali pediatric department 40

41. 10. Select the proper site of the injection. A. Dorso gluteal muscle (the upper outer quadrant of glutealmuscle ) for children who have been walking.. B. vastuslateralis muscle of thigh (the area below the great trochanter to above the femoral condyle or knee for infant anyoung child). C. Deltoid muscle, for children and adolescent. 01/01/1443 dr. tagwa ibrahim ali pediatric department 41

42. 11. Remove the infant's diaper or child's underpant " when injection if the lower part of the body". 12. Position the child according to the injection site and maintain firm restrain for him / her through the injection. 13. Cleanse the injection site thoroughly and wait till dry. 14. Remove the needle cover. 15. Compress the muscle mass for injection with other hand. 16. Insert the needle perpendicular to area at 90 degree angle. 17. Fix the needle with left hand and pull the plunger back to insure that injection is away from blood vessels. 18. Inject the medication slowly 01/01/1443 dr. tagwa ibrahim ali pediatric department 42

43. 19. Remove needle quickly. 20. Wipe are with alcohol sponge. 21. Move the limb or massage the site with alcohol sponge. 22. If bleeding occurs apply pressure with dry cotton for few seconds. 23. Cover the child and put him/her a comfort position. 24. Don't recap the needle and discard it in a disposable needle box. 25. Collect the equipment. 26. Wash hands. 27. Chart amount of medication given, time of administration, site of injection, any given complain and observation. 01/01/1443 dr. tagwa ibrahim ali pediatric department 43

44. Sc. injection 01/01/1443 dr. tagwa ibrahim ali pediatric department 44

45. Purpose To insure rapid absorption and action Administer drugs affected by GIT enzymes (insulin, heparin) Sites Out aspect of the upper arm Abdomen Upper back Upper buttocks or thigh. 01/01/1443 dr. tagwa ibrahim ali pediatric department 45

46. 01/01/1443 dr. tagwa ibrahim ali pediatric department 46

47. 01/01/1443 dr. tagwa ibrahim ali pediatric department 47

48. 01/01/1443 dr. tagwa ibrahim ali pediatric department 48

49. 01/01/1443 dr. tagwa ibrahim ali pediatric department 49

50. 01/01/1443 dr. tagwa ibrahim ali pediatric department 50

51. Rectal rout Medication administered by rectal rout either enema or suppository Suppository Definition: Small cylindrically shaped wax base placed into rectum to treat local or systemic complains 01/01/1443 dr. tagwa ibrahim ali pediatric department 51

52. purpose laxative to encourage bowel movement To administer drug are unpleasant orally As equipment Disposable gloves Suppository medication Patient record 01/01/1443 dr. tagwa ibrahim ali pediatric department 52

53. Procedure Place child on his side The anal area is cleaned by warm water and dried. Lubricate the tip of suppository in warm water Insert the suppository into the internal anal sphincter against the rectal wall Hold buttocks together for few minutes Document the procedure 01/01/1443 dr. tagwa ibrahim ali pediatric department 53

54. 01/01/1443 dr. tagwa ibrahim ali pediatric department 54

55. 01/01/1443 dr. tagwa ibrahim ali pediatric department 55

56. 01/01/1443 dr. tagwa ibrahim ali pediatric department 56