A nurse is caring for an infant after a surgical procedure. After ...

[madam-professor]

A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant's age and weight, the nurse administers a narcotic analgesic intravenously.
 
  When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths per minute and a heart rate of 110 beats per minute. The infant is asleep in the parent's arms and does not awaken when vital signs are assessed. The nurse understands that these findings are the result of:
  a. an allergic reaction to the medication.
  b. immaturity of the blood-brain barrier in the infant.
  c. toxic effects of the narcotic, requiring naloxone (Narcan) as an antidote.
  d. unexpected side effects of medications in infants.

Question 2

An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the medication information and learns that the drug is excreted by the kidneys. When giving the medication, the nurse will assess the infant for:
 
  a. decreased effectiveness of the drug.
  b. shorter period of the drug's effects.
  c. signs of drug toxicity.
  d. unusual CNS effects.

[dlook33]

Answer to Question 1

ANS: B
The blood-brain barrier is not as well developed in infants, making them more susceptible to CNS effects of medications. This assessment of the patient reveals no signs of an allergic reaction. Although this infant is somnolent, the vital signs are stable, so toxicity is not a concern. CNS effects are not unexpected with narcotic analgesics, but they may be more pronounced in infants.

Answer to Question 2

ANS: C
Renal drug excretion is lower in infants, so drugs that are eliminated primarily by renal excretion should be given in reduced doses or at longer intervals. Drugs with a narrow therapeutic range should be monitored closely for toxicity. This drug likely will have intensified effects and be present for a longer time. Nothing indicates that unusual CNS effects will occur because of this alteration in excretion.

[madam-professor]

Excellent

[dyrone]

TYSM