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Pharmacology-PH1031

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Chapter 05: Pediatric Considerations

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Chapter 05: Pediatric Considerations

A 9-month-old infant weighing 20 pounds comes to the emergency department with a 3-day history of vomiting, fever greater than 102.5°F, and significant pain. Physical assessment reveals acute otitis media, for which the doctor prescribed amoxicillin 500 mg three times a day for 5 days and ibuprofen 2.5 mL every 6 hours.

1. Prior to administration of amoxicillin, what must the nurse assess for?

2. If the safe dose of amoxicillin for a child under the age of 2 is 80 mg/kg/day in divided doses, is the prescribed dose safe? How do you know?

3. How will you instruct the family member to safely administer the drugs?

Answer 1

Weight of the infant = 20 pounds = 9.1 kg ( 1pound = 0.45 kg)

amoxicillin 500 mg TID 5 days For One time = 500/3= 166.6mg every 8 hours should be given

ibuprofen 2.5 mL Q6H

a. Prior to administration of any medication ,a nurse's responsibility is to assess and inquire about any allergic reactions to the drug previously . Also the nurse must educate the mother about allergic reaction for amoxicillin , so that if the child get hives or any other reaction , nurse must be notified immediately or call 911. Nurse can send a baseline C&S test before initiation of therapy if prescribed by physician .

2. According to The American Academy of Pediatrics 80 to 90 mg/kg/day PO in divided doses every 12 hours is recommended as first-line therapy and also do not exceed 500 mg/dose if given every 8 hours or 875 mg/dose if given every 12 hours.

The baby is 9.1 kgs , so if 80mg/kg= 9.1 × 80= 728 mg

So the baby is prescribed with correct dosage of medication, as the baby can be given 728 mg in divided doses according to weight.

3. The mother or family member should be instructed about the medication administration.

• As the amoxicillin prescribed is liquid preparation, advice the mother to shake well the preparation before administration orally.
• Provide the appropriate dosage of the solution using a syringe or measuring cup.
• Advice her not to skip doses
• Store the preparation in a cool place and discard the unused preparation after 14days.
• Report to the physician or health care practitioner if the child develops diarrhea, hives or any other allergies.
• Keep the preparation out of reach from children.