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Study 46. Pediatric Laboratory Medicine and Reference Ranges
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Study 46. Pediatric Laboratory Medicine and Reference Ranges
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Chapter 46. Pediatric Laboratory Medicine and ReferenceRanges show less
1. The nurse is preparing to administer a medication to a 6-month-old infant. The nurse
will monitor closely for signs of drug toxicity based on the knowledge that, compared to
adults, infants have
a. an increased percentage of total body
fat. b. immature hepatic and renal
function.
c. more protein receptor sites.
d. more rapid gastrointestinal transit time.
ANS: B
The liver and kidneys are the primary organs for metabolism and excretion and are immature in
infants. This allows drugs to accumulate and increases the risk for drug toxicity. Infants have
a lower proportion of body fat than adults and fewer protein receptors. They do have more
rapid gastrointestinal transit time, but this decreases the amount of drug absorbed.
2. The nurse reviews information about a drug and learns that it is best absorbed in an acidic
environment. When giving this drug to a 1-year-old patient, the nurse will expect to administer
a dose that will be
a. equal to an adult dose.
b. less than an adult dose.
c. more than an adult dose.
d. twice the usual adult dose.
ANS: C
Because the childs gastric pH is more alkaline than the adults, less drug will be
absorbed. Therefore, the dose should be increased.
3. The nurse assumes care for an infant who is showing signs of drug toxicity to a drug given
several hours prior. The nurse checks the dose and confirms that the dose is consistent with
standard dosing guidelines. Which characteristic of the drug will likely explain this response
in this patient?
a. It is acidic.
b. It is highly protein-
bound. c. It is not fat-
soluble.
d. It is water-soluble.
ANS: B
With fewer protein-binding sites, there is more active drug available. This requires a reduction
in the dose for infants. Drugs that are acidic are not as readily absorbed in infants, since their
, gastric pH tends to be more alkaline. Infants have a lower proportion of body fat; fat-soluble
drugs would need to be decreased to prevent toxicity. Until about age 2 years of age,
pediatric patients require larger than usual doses of water-soluble drugs to achieve
therapeutic effects.
4. The parent is concerned about giving a child medication because of the lack of knowledge
about the effects of drugs on children. The nurse discusses legislation passed in 2002 and
2003 about pediatric pharmacology. Which is true about these laws?
a. They forbid providers from prescribing medications unless they have been FDA- approved for
use in children.
b. They mandate consistent, evidence-based dosing guidelines for use in children.
c. They provide federal grants to fund pediatric pharmaceutical
research. d. They require drug manufacturers to study pediatric
medication use. ANS: D
In 2003, a law known as the Pediatric Research Equity Act joined the Best Pharmaceuticals Act
of 2002 to require drug manufacturers to study pediatric medication use and offer incentives for
pediatric pharmacology research. Providers are not forbidden to prescribe drugs in children that
are not FDA-approved. The laws do not mandate the use of evidence-based guidelines and do
not provide grants to fund research.
5. The nurse will administer an intravenous medication to an adolescent patient. When
preparing the adolescent for the IV insertion, which is an appropriate action by the nurse?
a. Allowing the patient to verbalize concerns about the procedure
b. Covering the insertion site with a bandage after the procedure is
completed c. Explaining any possible adverse drug reactions
d. Reassuring the patient that only one body part will be used
ANS: A
Allowing the adolescent to verbalize concerns about the medication and its regimen may offer
opportunities to clarify misconceptions and teach new information. Preschool-age children
may have concerns about harm to their body and need to have sites covered. Adolescents still
have a present focus, so discussing future adverse reactions is not especially helpful.
Preschool and school-age children fear bodily harm and require reassurance that only one
body part will be affected.
6. An infant will receive a topical medication. What instruction will the nurse include
when teaching the parents how to administer the medication?
a. Apply a thin layer to the affected area.
b. Apply liberally to the skin on and around the area.
c. Use the medication less frequently than what is recommended for adults.
d. Use the medication more frequently than what is recommended for
adults. ANS: A
Topical medications may be altered by skin tissue condition. Children have thinner, more
porous skin and have a proportionately higher skin surface area than adults and thus absorb
topical
medications more readily. Caregivers should be advised to use only a thin layer on the
affected body part. This difference in skin does not affect the frequency of administering
topical
medications.
7. The provider has ordered that vitamin D drops be given to a newborn. Based on the
knowledge of drug distribution in infants, the nurse understands that the infant may
need
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