💉 Key Interventions Cram

Pediatrics adds right approach (developmental technique), right form, and the child's right to be educated and right to refuse to the adult five.

Kids: more body water, less fat, less protein binding (more free drug), immature blood-brain barrier, immature kidneys → longer half-life, more toxicity risk. Absorption is less predictable in infants.

Doses by mg/kg or body surface area (mg/m²). Pounds used as kilograms more than doubles the dose. Independent double-checks; monitor response.

Eye drops go in the lower conjunctival sac; never touch the eye with the dropper. Oral liquids: oral syringe, slowly inside the cheek, never force a crying child.

Choose by age, muscle development, volume. Subcutaneous = insulin. Intradermal = diagnostic tests. Always atraumatic technique.

Crushing extended-release dumps the whole dose at once; crushing enteric-coated destroys its protection. Prefer liquids, give meds separately, flush per orders.

Sites: hands/forearms, feet in selected infants, scalp in neonates. Use a pump, verify rate + volume — but never rely on pump alarms alone. Prep equipment before approaching the child.

Example: 25 kg = 1,000 + 500 + 100 = 1,600 mL/day. Monitor: prescribed vs actual volume, intake/output, diaper weights, urine in mL/kg/hr, daily weight.

Phlebitis (vein inflammation): red, warm, tender. Infection: redness, drainage, fever. Overload: edema, breathing changes, weight gain. Remove lines when no longer needed.

Never trust air auscultation alone — it can sound right with the tube in the lung. Never feed when placement is uncertain. NG/OG short-term; G-tube/J-tube long-term. Coughing + distress mid-feed? Stop, assess airway first.

Never stop TPN abruptly — insulin outlasts the glucose and blood sugar crashes. Monitor glucose, electrolytes, weight, line site. Strict aseptic technique.