Preparation
for a child and family for medication administration
Every
child require psychological preparation for parental administration of
medication and supportive care during procedure even if child have received
several injections, they rarely become accustomed to the discomfort and have as
much right to understanding and patience from those involved in giving the
injection as any other child.
The nurse usually assumes the responsibility
for preparing family to administer medication at home. The family should have
an understanding of why the child is receiving the medication
And
the effect that might be expected, as well as the amount, frequency, and the
length of time the drug is to be administered. The care giver is carefully
instructed regarding the correct dosage. Some person has difficulty in
understanding or interpreting medical terminology, and just because they nod or
otherwise indicate an understanding, it cannot be assumed that the message is
clears. It is important to ascertain their interpretation of teaspoon, for
example, and to be certain their interpretation of a teaspoon, for example and
to be certain they have acceptable device for measuring the drug. If the drug
is package with a dropper, syringe or plastic cup, the nurse should show the
point on the device that indicate the prescribed dose and demonstrate how the
dose is drawn up into a dropper or syringe and measured and the bubbles
eliminated. If the nurse has any doubts about the parent’s ability to
administer the correct dose, the parent should give a return demonstration.
Drug administration to children
via oral route
The oral route is preferred for administering
medication to children whenever possible. Because of the ease of administration
of oral medications, most are dissolved or suspended in liquid preparations.
Although some children are able to swallow or chew solid medications at an
early age, solid preparations are not recommended for young children. There is
danger of aspiration in any oral preparation but solid form (pills, tablets,
capsules) are especially hazardous if their administration causes extreme
resistance or crying. Most pediatric medications in palatable and colorful
preparations for added ease of administration.
Although administering liquid to infant is
relatively easy, care must be observed to prevent aspiration. With the infant
held in a semi reclining positions, the medication is placed in the mouth from
a spoon, plastic cup, plastic dropper or plastic syringe (without needle). The
dropper or syringe is best placed along the side of the infants tongue, and the
liquid is administered slowly in a small amount, waiting for the child to
swallow between deposits. Medicine cups can be used effectively for older
infants who are able to drink from a cup. Because of the natural outward tongue
thrust in infancy, medication may need to be retrieved from the lips or chin
and refed. Allowing the infant to suck the medication that has been placed in
an empty nipple or inserting the syringe or dropper into the side of the mouth,
parallel to the nipple, while the infant nurses are other convenient methods
for giving liquid medication to infants. There is always a risk in using even
mild forceful techniques. A crying child can aspirate the medication,
particularly when lying on the back. If the nurse holds the child in the lap
with the child right arm behind the nurse, the left hand firmly grasped by the
nurse’s left hand and head securely cradled between the nurse’s arm and body,
the medication can be slowly poured into the mouth.
Drug administration to children via otic route
There
are few differences in administering ear medication to children and to adult.
The major difficulty is in gaining children’s cooperation. The infant’s oryoung
child’s head is immobilized in the same manner. Older children need only
explanation and direction. Although the administration of otic medication is
not painful, the drug can cause unpleasant sensation, which can be eliminated
with various techniques.
Ear drops are instilled with the child in
the supine position and the head turned to the appropriate side. For the
children younger than 3yrs of age, the external auditory canal is straightened
by gentle pulling the pinna downward and straight back. The pinna is pulled upward and back in
children older than 3yrs of age. To place the drops deep into the ear canal
without contaminating the tip of the dropper, place a disposable ear speculum
in the canal and administer the drops through the speculum. After instillation,
the child should remain lying on the opposite side for a few minutes. Gentle massage
of the area immediately anterior to the ear facilitates the entry of drops into
the ear canal. The use of cotton pledgets prevents medication from flowing out of
the external canal. However, they should be loose enough to allow any discharge
to exist from the ear. Premoistening the cotton with a few drops of medication
prevent the wicking action from absorbing the medication instilled in the ear.
SUMMARY
Medication administration
is a significant responsibility that
requires adherence to the safety principles discussed in this block of
instruction. Every patient has a unique response to the drugs they are
given so these principles should be followed every time you are required to
administer a medication.
