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NUR 2513 Module 8: Pediatric Data, Assessment, and Prioritization of Interventions

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Module 8: Pediatric Data, Assessment, and Prioritization of Interventions 2 Dosage Gabriel is a 5-year-old male weighing 48 pounds with a penicillin allergy admitted to the emergency room (ER) for ... a right ear infection, acute febrile seizure, and fracture of the right ulna. The client arrived at the ER with an upper-right arm deformity due to falling out of bed after experiencing jerking movement activity as witnessed by his older brother while sleeping. Medication dosage must be exact in children as they can have unforeseen consequences in sensitivity and reaction. The pharmacokinetics of medications are different in children compared to adults due to a child’s rapid growth and development. Therefore, the nurse will need to account for the child's weight and age in the pharmacokinetic process of absorption, distribution, metabolism, and excretion. Hence, the client gets the full therapeutic range of the drug (O'Hara, 2016). The provider ordered cefuroxime 30 mg/kg by mouth (PO) twice a day (BID) for ten days, not to exceed 1,000 mg daily as part of Gabriel’s discharge orders which equals 654.5 mg of cefuroxime. The nurse will need to clarify this dosage order with the provider as taking the prescribed order for cefuroxime exceeds the 1,000 mg daily maximum, and per the drug guide, the dose should be 15 mg/kg for the client’s age and weight (Vallerand et al., 2015). If the cefuroxime is supplied as an oral suspension 125mg/ 5ml, the nurse will calculate that the drug is provided at 26.2 mL. While if the cefuroxime is supplied as an oral suspension 250mg/ 5ml, the nurse would calculate that the drug is supplied at 13.1 mL. It is crucial that the mother understands that the child will need to take all dosages of this antibiotic to treat the client’s ear infection, as missing a dose, skipping, or stopping too early can cause the bacteria to build a resistance to the medication and cause complications for the client. Cefuroxime, like other antibiotics, can alter the colon's normal bacteria, leading to overgrowth of Clostridium difficile (C. diff). Overgrowth of this bacterium leads to toxins that contribute to the client developing C. diff-associated diarrhea. This disease can be dangerous in children leading to dehydration [Show More]

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