Question

21. Provide information for the medication: Diphenhydramine (Benadryl) ; Order is for 1.25 mg/kg/dose; Child’s weight is 18 kg safe o discuss the drug class, side effects, patient and family education and nursing considerations. calculate the safe dose your patient should receive______________________ ; what is the maximum dose? _________________ (remember this is a child)

concentration is ____________ SO how many ml. of the diphenhydramine does the nurse administer draw up into the syringe: _____________

The dilution range for the medication: ______________ SO what is the dilution volume for the med? _______________

What is the infusion time is? _____________________

22. Provide information for the medication: Acetaminophen ; Order is for _________________; Child’s weight is 18 kg safe o discuss the drug class, side effects, patient and family education and nursing considerations.

calculate the safe dose your patient should receive______________________ what is the maximum dose? _________________ (remember this is a child)

concentration is ____________ SO how many ml. of the acetaminophen does the nurse administer draw up into the syringe: _____________

The dilution range for the medication: ______________ SO what is the dilution volume for the med? _______________

What is the infusion time is? _____________________

Answer 1

Diphenhydramine (Benadryl)

Diphenhydramine comes under the class Antihistamine that reduces the effects of histamine in the body.

Indications:

Diphenhydramine is used for the treatment of the following conditions;

1. Cold or allergic symptoms including sneezing, runny nose, watery eyes, hives, skin rash, itching etc.

2. Motion sickness which may occur during a long car or bus ride, airplane or boat travel etc

3. To treat certain symptoms of parkinson's disease

4. To induce sleep

Side Effects:

There may be common side effects as follows;

1. Dizziness, drowsiness and loss of coordination

2. Dryness in the mouth, nose or throat

3. Constipation or diarrhoea

4. Blurred vision or dryness of eyes

5. Sleepy or hang-over feeling

6. Excitement or restlessness

7. Head ache

8. Ringing in the ears

Rarely, there might be allergic reactions including difficulty in breathing, swelling of face, lips, tongue, or throat. Painful urination or no urine, pounding heartbeats or tightness in the chest, tightness in the neck or jaw, uncontrollable movements of tongue and confusion also might occur in case of allergic reactions.

Patient and Family Education

Patient and family should be educated about the dose and administration of the medicine and the importance of taking the prescribed dose at the right time. Dose should be accurate; not use in larger or smaller quantities or for longer than prescribed. Instruct to measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup.Instruct not to use the medication to make a child sleepy. Should not use the medicine if there is a past history of any allergic reaction to Diphenhydramine. Also educate not to give to other children even though showing similar symptoms of the disease, only to give to the prescribed child.

Educate on the possible side effects and symptoms of allergic reactions. To bring the child to emergency room immediately, if any allergic symptoms noticed. Explain about the sleepy or drowsy feeling and instruct not to do any activities or dangerous games, since there is a possibility of getting dizziness. Adult patients should not drive or operate machinery. Instruct to store this medication at room temperature and keep it out of the reach of children. Instruct to take with food if any stomach problems happened.

Nursing Considerations:

Assessment:

Nurses should consider the pharmacological action and side effects of Diphenhydramine as it is a drug which block histamine H1-receptors of the GI tract, blood vessels and respiratory tract. Also consider the side effects of sedation and potential allergic reactions.

History of the Patient

Take detailed history of the patient. Obtain past history of any allergic reactions to Diphenhydramine. Obtain history of taking any other medications which may interfere with the effects of the medicine. take history of any other diseases like asthma, COPD, bladder neck obstruction, narrow angle glaucoma etc.

Physical Examination:

Observe the color and texture of the skin and look for any lesions;

Check for the orientation status of the patient and the reflexes.

Perform vision examination

Check vital signs

Blood test including CBC with differential count

Dose of Diphenhydramine (Benadryl):

Dose of the medicine vary according to the age and weight of the child, as there are various strengths and forms (e.g., children's liquid, elixir) are available.

Dose for children more than 10kg is as follows;

12.5–25 mg tid or qid PO or

5 mg/kg/day PO or

Maximum daily dose 300 mg.

Since the child is 18 kg, a dose of 90 mg/day is a safe dose.

Concentration varies in different brands. Each 5 mL of liquid benadryl contains 6.25 mg of diphenhydramine. Each 5 ml of histalix syrup contains 14 mg of diphenhydramine. Each 5 mL of red elixir contains 12.5 mg of diphenhydramine.