6A - Paediatric medications

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Karteikarten am 6A - Paediatric medications, erstellt von Elizabeth Then am 15/06/2018.
Elizabeth Then
Karteikarten von Elizabeth Then, aktualisiert more than 1 year ago
Elizabeth Then
Erstellt von Elizabeth Then vor mehr als 6 Jahre
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Neurological system tightly packed epithelial cells blood - brain barrier to prevent most proteins and polarised molecules from entering the brain lipidssoluble molecules can pass through the blood- brain easily, most chemicals are kept out
Neurological system continued protective blood brain barrier not developed in children ie morphine can cause resp depression, more dramatic in children
Cardiavascular system standard blood volume is: neonate - 85-90mls/kg child 75-80ml/kg adult 70-75ml/kg
Cardiovascular system continues heart less development, increase strength of contraction increase in heart rate and contractile force peripheral vasoconstriction occurs earlier - less effective in circulating blood volume hypotension last sign in children stroke volume decreases as blood volume decreases
Body composition relative to their size, consist up to 70% water water - soluble drugs more dilute in a child dehydration can quickly affect how drugs are transported by blood stream most is extracellular fluid fluid loss rapid
Respiratory system small airway - excessive secretions and inflammation promote brochodilation supplemental oxygen higher oxygen consumption rate hypoxemia - major sign of bradycardia
Gastrointestinal system small - infant holds 90mls, 1 year 360 mls oral drugs reduce oral food intake absorption of drugs are faster
Endocrine system smaller glycogen stores, increases glucose demand predisposes to hypoglycaemia, and glucagon may be less effective convert and remove drugs more slowly - newborn metabolism elevated
Renal system normal urine output is 2m/kg/hr cannot conserve fluids well increase waste-production rate higher urine production rate
Drug administration smaller but more frequent doses doses are weight based if unknown use a height
Fluid administration prefer IV fluids containing dextrose due to increased metabolic rate and demand
Pain management begins with oxygen paracetemol is most common fentanyl can cause chest rigidity , morphine resp distress in high doses
Medication errors APINCH - classify medications according to risk active failures - unsafe acts committed by staff in direct contact latent conditions - arise made by designers, management, error waiting to happen
Medication errors: actions actions should include: address underlying cause use numerous risk reduction use strategies that have impact on management assess effectiveness be sustainable
IM medication vastus lateralis site for infants and children less than 2 years more than 2 years ventral gluteal
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