Pediatric Nurse Pharmacology and Medication Administration Flashcards

A pediatric nurse is caring for a 5-year-old prescribed ceftriaxone. Before administration, which assessment is the highest priority?

Answer: Ask about allergy to penicillin or other cephalosporins

Cross-reactivity between penicillins and cephalosporins is possible, so allergy history must be confirmed before the first dose.

An 8-year-old with type 1 diabetes presents with blood glucose of 54 mg/dL and is alert and oriented. Which is the most appropriate initial intervention?

Answer: Give 15 g of fast-acting carbohydrate orally and recheck in 15 minutes

The 15-15 rule: give 15 g of fast-acting carbohydrate for mild hypoglycemia in a conscious child and recheck glucose in 15 minutes.

Which of the following is a key nursing responsibility when a child is receiving a blood transfusion?

Answer: Remain with the child and monitor vital signs during the first 15 minutes of infusion

Transfusion reactions most commonly occur within the first 15 minutes; close monitoring during this period is mandatory.

A child is prescribed codeine for pain management after tonsillectomy. Which concern has led major health organizations to advise against this practice?

Answer: Ultra-rapid metabolizers of CYP2D6 can convert codeine to dangerously high morphine levels causing respiratory depression

Ultra-rapid CYP2D6 metabolizers convert codeine to toxic morphine levels, causing fatal respiratory depression, especially in post-tonsillectomy patients.

A nurse must verify a high-alert medication before administration to a pediatric patient. According to best practice, what process should be followed?

Answer: Independent double-check with a second licensed nurse using the original order and drug calculations

An independent double-check by two licensed nurses — each calculating separately — is the gold standard for high-alert pediatric medications.

A 14-year-old is started on isotretinoin for severe acne. Which monitoring requirement is unique to this medication?

Answer: Monthly pregnancy tests and enrollment in the iPLEDGE program

Isotretinoin is highly teratogenic; all patients must be enrolled in the iPLEDGE REMS program, which requires monthly pregnancy testing for those who can become pregnant.

When using the SALAD (Sound-Alike, Look-Alike Drugs) safety strategy in pediatric settings, which pair represents a commonly confused medication set?

Answer: Amoxicillin and amphotericin B

Amoxicillin and amphotericin B are a classic high-risk SALAD pair; amphotericin B has a much narrower safety margin and potentially fatal if given in place of amoxicillin.