Gastrostomy feedings Often used for children in whom passage of a tube through the mouth, pharynx, esophagus, and cardiac sphincter of the stomach is contraindicated

Alternative feeding techniques Gavage feedings Preparations A suitable tube selected according to the child’s size, the viscosity of the solution being fed, and anticipated duration

Nasogastric, Orogastric, Or Gastrostomy administration In children Use elixir or suspension (rather than tablet) preparations of medication whenever possible. Dilute viscous medication or syrup with

Aerosol Therapy Deposits medication directly into the airway Useful in avoiding systemic side effects Nebulized with oxygen Handheld nebulizers discharge a medicated mist into a

Optic, Otic, and Nasal administration The major difficulty is in gaining children’s cooperation. Older children need only an explanation and direction.  Although the administration of

Maintaining fluid balance Measurement of intake and output Fluids to be measured Nursing responsibility: To identify when fluids should be measured Receiving IV therapy Who

Intraosseous infusion Temporary route of administration for use in an emergent situation in which venous access cannot be obtained Use an intraosseous or large bore

Description Benefits Care Considerations Tunneled Catheter (e.g., Hickman or Broviac Catheter) Silicone, radiopaque, flexible catheter with open ends or VitaCuffs (biosynthetic material impregnated with silver

Subcutaneous and intradermal administration Give anywhere there is adequate subcutaneous tissue. Common sites are the lateral aspect of the upper arm, abdomen, and anterior thigh

Intramuscular injection sites in children Vastus Lateralis Location Palpate to find greater trochanter and knee joints; divide vertical distance between these two landmarks into thirds;

Administration of medication Determination of drug dosage Few standardized doses ranges Body surface area Checking dosage Identification Two identifiers Preparing the parents Preparing the child

Blood specimens Guidelines for skin and vessel punctures To reduce the pain associated with heel, finger, venous, or arterial punctures: Apply EMLA topically over the