Medication Administration

i. Dosage Calculations for Pediatric Medications

1. Dosage Calculations Based on Weight

Step 1: Determine the Ordered Dose

Step 2: Check the Medication Label

Step 3: Convert Weight Units

Step 4: Calculate the Desired Dose

• Use the formula:
• Desired Dose (mg) = Ordered Dose (mg/kg) × Weight (kg)

Step 5: Administer the Correct Dose

2. Dosage Calculations Based on Body Surface Area (BSA)

Step 1: Determine the Ordered Dose

Step 2: Check the Medication Label:

Step 3: Calculate BSA

• Use a BSA calculator or the Mosteller formula:
• BSA (m²) = √[(Height (cm) × Weight (kg)) / 3600]

Step 4: Calculate the Desired Dose

• Use the formula:
• Desired Dose (mg) = Ordered Dose (mg/m²) × BSA (m²)

Step 5: Administer the Correct Dose

ii. Safe Medication Administration in Children

Safe administration of medication in children is of paramount importance to ensure their well-being and prevent potential harm. It requires careful attention to dosage, route of administration, and consideration of the child's age, weight, and individual characteristics.

1. Accurate Dosage Calculations

   - Calculate medication dosages based on the child's weight or body surface area, following established pediatric dosing guidelines.

   - Double-check all calculations with a colleague or by using a calculator to minimize errors.

2. Verify Medication Orders

   - Confirm the medication order with the prescribing healthcare provider, especially if there are any discrepancies or uncertainties.

3. Check Medication Labels

   - Ensure that the medication name, dose, concentration, and expiration date match the prescription. Be cautious with look-alike or sound-alike medications.

4. Use Age-Appropriate Formulations

   - Administer medications in forms suitable for the child's age (e.g., liquid vs. tablet). Be cautious with crushing or cutting medications as some should not be altered.

5. Confirm Patient Identity

   - Use at least two patient identifiers (e.g., name and date of birth) before administering any medication to verify the correct patient.

6. Administer at the Right Time

   - Administer medications at the prescribed times to maintain therapeutic levels in the body.

7. Select the Correct Route

   - Choose the appropriate route of administration (e.g., oral, intravenous, intramuscular) based on the medication and the child's condition.

8. Maintain Proper Technique

   - Follow the aseptic technique during medication preparation and administration to prevent contamination and infection.

9. Provide Age-Appropriate Education

   - Offer clear, age-appropriate explanations to the child (when developmentally appropriate) and caregivers about the medication, its purpose, and any potential side effects.

10. Use Developmentally Appropriate Communication

   - Tailor your communication style to the child's age and cognitive level. For younger children, use simple language and incorporate play to ease anxiety.

11. Observe for Allergies and Adverse Reactions

   - Prior to administration, confirm allergies and ask about any previous adverse reactions to the medication.

12. Monitor for Side Effects

   - Continuously observe the child for any immediate side effects or adverse reactions after medication administration.

13. Document Thoroughly

   - Record all pertinent information, including the medication name, dosage, route, date, time, and any observed effects or concerns.

14. Follow Up and Evaluation

   - Monitor the child's response to the medication over time, and report any significant changes or concerns to the healthcare provider.

15. Store Medications Safely

   - Keep medications out of the reach of children and in a secure, designated area to prevent accidental ingestion.

16. Adhere to Legal and Ethical Guidelines

   - Follow institutional policies and legal regulations regarding medication administration and documentation.

iii. Common Pediatric Medications:

Common medications in pediatrics encompass a range of drugs used to treat various conditions in children. It's crucial to remember that dosages, formulations, and administration methods may vary based on a child's age, weight, and specific health needs. Here are some of the frequently prescribed medications in pediatrics, along with their common uses:

1. Analgesics and Antipyretics

   - Acetaminophen (Tylenol): Used to reduce pain and fever in children. Available in various formulations, including liquid and chewable tablets.

   - Ibuprofen (Advil, Motrin): Nonsteroidal anti-inflammatory drug (NSAID) used for pain relief and to reduce fever. Suitable for children over a certain age and weight.

2. Antibiotics

   - Amoxicillin: A broad-spectrum antibiotic used to treat bacterial infections such as ear infections, respiratory tract infections, and urinary tract infections.

   - Azithromycin (Zithromax): Used for a wide range of bacterial infections, including respiratory and skin infections.

3. Respiratory Medications

   - Albuterol (Proventil, Ventolin): A bronchodilator used to relieve asthma symptoms by opening airways.

   - Inhaled Corticosteroids (e.g., Fluticasone - Flovent): Used as a maintenance treatment for asthma to reduce inflammation in the airways.

4. Antihistamines

   - Diphenhydramine (Benadryl): Used to relieve allergy symptoms such as itching, sneezing, and runny nose. Can also be used as a sleep aid.

5. Gastrointestinal Medications

   - Omeprazole (Prilosec): Proton pump inhibitor (PPI) used to treat gastroesophageal reflux disease (GERD) and stomach ulcers.

   - Ondansetron (Zofran): Antiemetic used to prevent nausea and vomiting, often administered before surgery or chemotherapy.

6. Anticonvulsants

   - Levetiracetam (Keppra): Used to control seizures in children with epilepsy.

   - Lamotrigine (Lamictal): Another anticonvulsant used to treat epilepsy, particularly in older children and adolescents.

7. Steroids

   - Prednisolone: A corticosteroid used to treat inflammatory conditions, such as asthma exacerbations and certain autoimmune disorders.

8. Vaccines

   - Various vaccines are administered to prevent a range of infectious diseases, including measles, mumps, rubella, polio, diphtheria, pertussis, tetanus, influenza, and more.

9. Topical Medications

   - Hydrocortisone Cream: Used to alleviate itching and inflammation associated with skin conditions like eczema and insect bites.

   - Mupirocin (Bactroban): Topical antibiotic used to treat skin infections and prevent bacterial colonization in wounds.

10. Antifungals

   - Nystatin (Mycostatin): Used to treat fungal infections like thrush in the mouth and diaper rash caused by yeast.