Question

A 13-month-old child is to receive an oral medication. The child starts crying as soon as the nurse enters the room with the medication despite the fact that his mother is telling him a story. After checking the child's identification bracelet, how should the nurse proceed with administering the medication? A. Blow gently across his face with a soft whistling sound to stop the crying. B. Allow the mother to administer the medication. C. Delay giving the medication until the child is calmer. D. Hold the child on his or her lap in a semi-Fowler's position.

Short answer

Answer D is most appropriate because it ensures the child's safety by preventing aspiration and helps to calm him by holding him in a comfortable and secure position.

Step-by-step solution

Evaluate Safety and Comfort

Assess the situation for any immediate safety concerns and the child's comfort level. The nurse's primary responsibility is the child's safety, and ensuring the medication is administered in a way that reduces distress is a secondary but important factor.

Consider Distraction and Involvement of Parent

Evaluate the options that involve distraction techniques or the parent's involvement. Distraction can be an effective way to administer medication to children, and a parent can often help soothe and reassure a child better than medical staff.

Decide the Best Approach

Choose the action that best balances safety, efficacy, and the child's emotional state. The nurse should select an approach that is likely to be most successful for administering medication without causing additional distress.

Implement the Chosen Method

Put into action the chosen method after evaluating all options, whilst ensuring that the medication is given correctly and the child remains as calm as possible during administration.

Key concepts

Pediatric Nursing

Pediatric nursing is a specialized area focusing on the care of newborns, infants, children, and adolescents. Providing compassionate and developmentally appropriate care is a cornerstone of pediatric nursing. When administering medication to children, nurses must be adept at assessing the child's emotional and physical state to deliver care effectively. It's essential for the pediatric nurse to understand both the psychological and physical aspects unique to children, such as their ability to understand and cooperate during medical procedures.

Communicating with the child at their level of understanding, including the involvement of parents for distraction and reassurance, reflects an understanding of a child's possible fear or anxiety. For instance, children like the 13-month-old in the exercise may respond better to medication administration when a familiar presence, like the mother, is involved. An educated and empathetic approach can significantly affect the success of the treatment and the mental well-being of the patient.

Oral Medication Administration

Administering oral medication to children can be challenging, as it requires a balance between ensuring proper dosage and maintaining the child's cooperation. Techniques for administering oral medication include using distraction methods, flavoring medications, and choosing the optimal timing. In situations similar to the provided scenario, where a child is crying, distraction can be a useful technique. However, understanding the developmental stage of the child is crucial.

For a 13-month-old, soothing sounds or visual distractions might be helpful. Parents' presence, as mentioned in the exercise, can be a source of comfort and allow for a smoother administration process. Nurses should also be skilled in positioning - such as using a semi-Fowler's position to aid in swallowing and prevent aspiration - which is important for safety during oral medication administration.

NCLEX-RN Examination

The National Council Licensure Examination (NCLEX-RN) is a standardized test that nurses must pass to practice nursing in the United States. It covers a wide range of topics, one being the safe and effective care environment, which includes administering medications safely. The strategies employed in administering medication to children, as shown in the exercise, may appear as questions on the exam. Candidates are expected to demonstrate knowledge of best practices, like confirming the patient's identity and providing care with the least amount of physical and emotional stress possible.

The NCLEX-RN tests not just for technical competence in medication administration, but also for the nurse's ability to incorporate family-centered care and comfort measures, illustrating holistic care approaches that are integral to the nursing profession. Successful candidates are those who can apply critical thinking to select the approach that prioritizes patient safety and emotional well-being in scenarios like the one presented.