Life span: Children

• Children are different from adults both physically and emotionally, and these differences seriously affect the planning of safe and effective drug therapy. • Most drugs have not been tested for effi cacy or safety in children and thus are prescribed off-label to children. Additional monitoring for adverse effects from drug therapy is necessary when drugs are used off-label. • A child's age, growth, and development are crucial considerations in relating core drug knowledge with core patient variables in drug therapy. • A child's age, weight, body surface area, water content, and fat content must be considered when determining the proper dose of a drug. Drug dosage is calculated for each child, using mathematical formulas. Most drug dosages are calculated based on the child's weight. No medication should be administered unless the current weight is documented on the chart. • Pediatric dosages must be accurate because even small errors can cause adverse effects, toxicity, or death. A misplaced decimal point results in a ten-fold dosing error. This is the most common dosage calculation error occurring in children. The nurse independently verifi es all dosage calculations made by other health care providers prior to administering each dose. • To maximize the therapeutic effect of any drug, the nurse must ensure that all of the appropriate dose is administered by the desired route. • Many of the adverse effects of drug therapy can be avoided or minimized by ensuring that the child receives the appropriate drug dosage calculated specifi cally for him or her. Nurses should have access to a pediatric drug reference, guide, or electronic data base that gives the pediatric ranges for drug doses, including those for preterm and full-term neonates. • In addition to determining the correct dose for a child, pediatric medication errors can be prevented by standardizing as much as possible within a hospital setting, using computerized order entry whenever possible, using the appropriate administration equipment, involving the family in medication administration, and carefully communicating the drug therapy plan at points of transition in care. • One of the adverse effects in pediatric drug administration is psychological distress in the child or parent. The nurse who uses knowledge of age-related emotional needs and communication techniques can greatly help relieve this emotional distress and enhance compliance with drug therapy. • Patient and family education regarding drug therapy should include information needed to help the child take the drug safely and effectively. Teaching involves giving honest and straightforward explanations about drug therapy, answering questions, allaying patient and family anxiety, and emphasizing the importance of drug compliance. Parents should be taught how to measure a correct dose at home and how to use the appropriate measuring/ dosing tool.