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NUR 425 Peds Exam 1 Review Questions and Correct Answers

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ADHD medication indications and side effects Start at small initial doses Monitor for side effects of appetite loss, abdominal pain, headaches, sleep disturbances (insomnia), HTN, and decrease in growth velocity Need close monitoring and follow up care my PCP Avoid stimulants w/hx of tic-like behav...

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NUR 425 Peds Exam 1 Review Questions
and Correct Answers
ADHD medication indications and side effects ✅Start at small initial doses
Monitor for side effects of appetite loss, abdominal pain, headaches, sleep disturbances
(insomnia), HTN, and decrease in growth velocity
Need close monitoring and follow up care my PCP
Avoid stimulants w/hx of tic-like behaviors, family hs of Tourettes
Medications:
Methylphenidate hydrochloride (Ritalin)→ 1st drug of choice, must be older than 5 y/o
Lisdexamfetamine dimesylate (Vyvanse)
Atomoxetine (Strattera)→ wt based dosing
TCAs and Clonidine ER→ dose depends on results and if child is having sleep
disturbances

Upper Respiratory Meds and mechanism of action ✅Mucolytics
Acetylcysteine (Acedote or Mucamyst)
decreases thickness (viscosity) of mucous secretions
Tylenol OD
smells like rotten eggs

Expectorants
Guaifenesin (Mucinex)
reduce surface tension of secretions, thins thick mucous

Antitussives
Opioids: Codeine
Nonopioids: Dextromethorphan (Delsym), benzonatate (Tessalon)
suppress cough reflex in the brain

Sympathomimetics
Phenylephrine (Neo-synephrine)
mimics the SNS by activating alpha1 adrenergic receptors in the nose
vasoconstriction of blood vessles, causes nasal turbinate to shrink, opens nasal
passage and relieves nasal congestion

1st Gen/Sedating antihistamines
Diphenydramine (Benadryl) & Dramamine
sedating
H1 antagonist

2nd Gen/Nonsedating antihistamines
Cetirizine (Zyrtec), loratadine (Claratin), fexofenadine (Allegra), desloratadine (Clarinex)

, antagonize histamine effects at H1 receptor sites without binding to or inactivating
histamine
minimal anticholinergic affects
effects longer lasting so dosed once a day

Compare the physiological differences between the very young and the older child in
regard to pharmacodynamics.

How does an infant's GI system affect medications? ✅Absorption of feeding can be an
issue, infants eat more often than toddlers meaning they process food differently;
frequent feedings/peristalsis can interrupt the absorption of some medications (each
age group absorbs medications differently)
Infants→ decreased gastric acid secretion, irregular gastric emptying, increased
intestinal motility, frequent feedings
limited binding of drugs to plasma protein due to low albumin, BB barrier not fully
developed until 1st year, infants total body water is 80% compared to adult of 50%
(need higher doses of water soluble meds)
enzymes in liver metabolize drugs are immature so drugs cannot be broken down
immature rental function requires smaller doses of drugs primarily excreted by the
kidneys
Children→ gastric pH equal to adult by 2-3 ys
plasma protein levels at adult levels by age 1, skin and BB barrier more effective
decreased BMR after age 2, results in lowered effects of drugs
adults levels of renal function are reached by age 2

Identify the variations in medication administration between infants/children and adults.

Refer to Chapter 8 in ATI before class readings ✅PO crushed up meds via syringe on
side of mouth for infants (best practice); stroke cheek afterwards to promote swallowing
reflex
Most adults can swallow PO tablets/capsules
most IM injections in infants are given in vastus lateralis rather than deltoid like in adults
Medications in kiddos are weight based
Otic medications→ pull ear down and back for adults pull up and back; massage ear
after to ensure medication reaches canal
Rectal suppositories→ ½ to 1 inch and hold buttocks together for 5-10 mins; cut
suppository lengthwise if necessary
Eye drops in inner canthus when eyes are closed and then massage inner canthus to
prevent medicine from entering lacrimal ducts and going into nasal pharynx

Examine interventions to prevent falls in the pediatric population.

What factors place children at risks for falls? Review Humpty Dumpty tool criteria.
✅Attachment to IV lines/tubes
narcotics/analgesics
first time taking medication-unknown side effects

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