Kayla Clark - Shriners Pediatric Medication Sheets

Nursing: Family
Medication Information Sheet
Student Name: Kayla Clark
Child’s Initials:
Drug Name
Generic Name: zolpidem
Brand Name: Ambien
Classification: sedative/hypnotics
What is the action of this medication on the body? Produces CNS depression
by binding GABA receptors; resulting in sedation and induction of sleep
*Why is this child receiving this medication?
What is a normal dosage for a child? 5 mg at bedtime, but safety for children
not established
*What is Normal Dosage for this child’s age?
*What is Ordered Dosage for this child? Is it within normal range?
What are the side effects the nurse should to assess for in a child? Amnesia,
behavior changes, daytime drowsiness, dizziness, “drugged” feeling,
hallucinations, diarrhea, nausea, vomiting, hypersensitivity reactions.
What special information would the nurse need to know when giving this
medication (including contraindications)? This medication is contraindicated in
cases of hypersensitivity to the drug and in clients with sleep apnea. Use
cautiously in clients with a history of previous psychiatric illness, suicide
attempts, drugs or alcohol abuse.
What should the nurse teach the parent/child about this medication? Instruct to
take medication as directed. Do not take more than the amount prescribed
because of the habit-forming potential. Advise patient to go to bed
immediately after taking this medicine because of rapid onset. Advise
patient to avoid activity requiring alertness until the response to this
medication is known.
Reference: Deglin, J. Davis’s Drug Guide for Nurses 11th ed. F.A. Davis
Company, 2009.
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: hydroxyzine
Brand Name: Atarax
Classification: antianxiety agents, antihistamines, sedative/hypnotics
What is the action of this medication on the body? Acts as a CNS depressant at
the subcortical level of the CNS. Has anticholinergic, antihistaminic, and
antiemetic properties and block histamine 1 receptors; resulting in
sedation, anxiety relief, decreased nausea and vomiting, decreased allergic
symptoms associated with release of histamine.
What is a normal dosage for a child? 2 mg/kg/day divided q 6-8 hrs.
What are the side effects the nurse should to assess for in a child? Drowsiness,
agitation, ataxia, dizziness, headache, weakness, wheezing, constipation,
nausea, urinary retention, flushing, chest tightness.
medication (including contraindications)? Contraindicated in cases of
hypersensitivity. Use cautiously in clients with severe hepatic dysfunction.
Injections contain benzyl alcohol, which can cause potentially fatal gasping
syndrome in neonates.
What should the nurse teach the parent/child about this medication? Take
medication as directed. Inform parent/child that frequent mouth rinses,
good oral hygiene, and sugarless gum or candy may help decrease dry
mouth and if dry mouth persists for more than 2 weeks, consult dentist
about saliva substitute. Teach other methods to decrease anxiety.
Company, 2009.
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: diphenhydramine
Brand Name: Benadryl
Classification: antihistamine/antitussive
What is the action of this medication on the body? Antagonizes the effects of
histamine at H-receptor sites; significant CNS depressant and
anticholinergic properties; decreases symptoms of histamine excess
(sneezing, rhinorrhea, nasal and ocular pruritis, ocular tearing and redness,
urticaria). Prevention of motion sickness. Suppression of cough.
What is a normal dosage for a child? Children 2-6 yrs: 6.25-12.5 mg every 4-6
hrs (not to exceed 37.5 mg/day); Children 6-12 yrs: 25-50 mg every 4-6 hrs,
not to exceed 300 mg/day
dizziness, headache, hypotension, palpitations, anorexia, dry mouth,
constipation, nausea, dysuria, frequency, urinary retention, chest
tightness, thickened bronchial secretions, wheezing.
medication (including contraindications)? Contraindicated in cases of
hypersensitivity, and acute asthma attacks. Use cautiously in children with
severe liver disease, seizure disorders, and hyperthyroidism.
What should the nurse teach the parent/child about this medication? Take
medication as directed. Do not exceed recommended amount. Caution
patient not to use OTC diphenhydramine products with any other product
containing diphenhydramine. Dry mouth interventions. Teaching sleep
hygiene techniques. Use sunscreen to prevent photosensitivity reactions.
Company, 2009.
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: sucralfate
Brand Name: Carafate
Classification: antiulcer agents
What is the action of this medication on the body? Aluminum salt of sulfated
sucrose reacts with gastric acid to form a thick paste, which selectively
adheres to the ulcer surface.
What is a normal dosage for a child? 40-80 mg/kg/day divided Q6H
What are the side effects the nurse should to assess for in a child?Dizziness,
drowsiness, constipation, diarrhea, dry mouth, gastric discomfort,
indigestion, nausea, rashes
medication (including contraindications)?Contraindicated in patients with
hypersensitivity. Use cautiously in clients with renal failure because
accumulation of aluminum can occur.
What should the nurse teach the parent/child about this medication?
-Advise to continue with course of therapy for 4-8 weeks, even if feeling
better, to ensure ulcer healing.
-Advise that increase fluid intake, dietary bulk, and exercise may prevent
drug-induced constipation.
-Emphasize importance of routine examinations to monitor progress.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: cefazolin
Brand Name: Ancef
Classification: anti-infectives/first-generation cephalosporins
What is the action of this medication on the body? Binds to bacterial cell wall
membrane, causing cell death
What is a normal dosage for a child? 16.7-33.3 mg/kg Q8H (max 6 g/day)
What are the side effects the nurse should to assess for in a child? Seizures,
diarrhea, nausea, vomiting, cramps, rashes, pain, phlebitis, and low CBC
values.
medication (including contraindications)? Contraindicated in patients with
allergies to cephalosporins or penicillins. Use cautiously in clients with
renal impairment and history of GI disease.
-Instuct to take medication around the clock at evenly spaced times and to
finish the medication completely as directed, even if feeling better.
-Instruct parents to use calibrated measuring device with liquid
preparations.
-Advice to report signs of superinfection (furry overgrowth on tongue,
vaginal itching or discharge, loose or foul-smelling stools) and allergy.
-Instruct patient to notify health care professional if fever and diarrhea
develop, especially if diarrhea contains blood, mucus, or pus. Don’t treat
without consulting health care professional.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: Ipratropium bromide/albuterol combination
Brand Name: Combivent
Classification: bronchodilators
What is the action of this medication on the body? Maintenance therapy of

reversible airway obstruction due to bronchitis or asthma.
What is a normal dosage for a child? 2 inhalations Q6H, PRN

What are the side effects the nurse should to assess for in a child? Dizziness,
headache, blurred vision, sore throat, nasal irritation, bronchospasm,
cough, hypotension, palpitations, GI irritation, nausea, and rash.
medication (including contraindications)? Contraindicated in clients with
history of allergies to soy and peanuts; use cautiously in patients with
bladder neck obstruction.
-Instruct in proper use of inhaler, nebulizer, or nasal spray.
-Advise that rinsing mouth after using inhaler, good oral hygiene, and
sugarless gum/candy may minimize dry mouth.
-Don’t exceed 12 doses in 24 hours; notify health care professional if
symptoms don’t improve within 30 minutes of medication administration or
if condition worsens.
-Avoid spraying medication in the eyes; may cause irritation.
-Inform health care professional if cough, nervousness, headache,
dizziness, nausea, or GI distress occurs.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: polyethylene glycol
Brand Name: Miralax
Classification: osmotic laxatives
What is the action of this medication on the body? Acts as an osmotic agent,
drawing water into the lumen of the GI tract
What is a normal dosage for a child? Dose determined by physician
What are the side effects the nurse should to assess for in a child? Abdominal
bloating, cramping, flatulence, nausea
medication (including contraindications)? Contraindicated in GI obstruction,
gastric retention; toxic colitis; Megacolon. Use cautiously in abdominal
pain of uncertain cause particularly if accompanied by fever.
-Inform that it may take 2-4 days to produce a bowel movement.
-Prolonged, frequent, or excessive use may result in electrolyte imbalance
and laxative dependence.
-Notify health care professional if unusual cramps, bloating, or diarrhea
occurs.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: folic acid
Brand Name: Apo-Folic, Folate, Folvite, Novofolacid, Vitamin B
Classification: antianemics, vitamins
What is the action of this medication on the body? Stimulates red blood cell
production, white blood cell production, and platelet production
What is a normal dosage for a child? 1 mg/day initial dose; then 0.1-0.4
mg/day maintenance dose
What are the side effects the nurse should to assess for in a child? Rashes,
irritability, difficulty sleeping, confusion, and fever.
medication (including contraindications)? Contraindicated in uncorrected
pernicious, aplastic, or normocytic anemias. Use cautiously in
undiagnosed anemias.
-Eat foods high in folic acid: like vegetables, fruits, and organ meats.
-Explain that folic acid may make urine more intensely yellow.
-Notify health care professional if rash occurs, may indicate allergy.
-Emphasize importance of follow-up exams to evaluate progress.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: ketamine
Brand Name: Ketalar
Classification: general anesthesia
What is the action of this medication on the body? Produces rapid-acting

anesthetic state with profound analgesia, normal pharyngeal-laryngeal
reflexes, normal or slightly enhanced skeletal muscle tone, cardiovascular
and respiratory stimulation, and occasionally, respiratory depression.
What is a normal dosage for a child? Initial dose: 1-4.5 mg/kg via slow
infusion (over 60 seconds); maintenance: ½ to full induction dose, repeated
as needed.

What are the side effects the nurse should to assess for in a child? Arrythmia,
bradycardia, increased BP and heart rate, hypotension, confusion,
delirium, hallucinations, irrational behavior, enhanced skeletal muscle
tone, rash, increased eye pressure, anorexia, nausea, vomiting, pain at
injection site, respiratory depression.
medication (including contraindications)? Contraindicated in patients whom
significant BP elevation would be a serious hazard; and in those who are
allergic to it.
-Advise that neurologic effects may persist for 24 hours after anesthesia.
-Advise parents to be cautious during this period, especially if child tries to
perform tasks requiring mental alertness.
Reference: http://www.drugs.com/ppa/ketamine-hydrochloride.html
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: artificial tears
Brand Name: Lacrilube
Classification: artificial tears/ocular lubricants
What is the action of this medication on the body? Keep the eyes moist with
isotonic solutions and wetting agents in the management of dry eyes due
to lack of tears.
What is a normal dosage for a child? 1-2 drops 3-4 times daily
What are the side effects the nurse should to assess for in a child?
Photophopia, lid edema, stinging, temporarily blurred vision, eye
discomfort
medication (including contraindications)? It may alter effects of other
concurrently administered ophthalmic medications.
-How to properly instill the medication
-Possible side effects of the medication
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: escitalopram
Brand Name: Lexapro
Classification: antidepressant/selective serotonin reuptake inhibitors(SSRIs)
What is the action of this medication on the body? Selectively inhibits the
reuptake of serotonin in the CNS
What is a normal dosage for a child? 5-10 mg once daily

What are the side effects the nurse should to assess for in a child? Insomnia,
dizziness, drowsiness, fatigue, diarrhea, nausea, abdominal pain,
constipation, dry mouth, indigestion, increased sweating, hyponatrmia, and
increased appetite.
hypersensitivity, using MAO inhibitors, and using citalopram; may increase
risk of suicide attempt/ideation especially during early treatment or dose
adjustment.
-Take as directed; take missed doses on the same day as soon as
remembered and consult health care professional; resume regular dosing
schedule next day; do not double dose; do not stop abruptly.
-May cause dizziness; avoid activities requiring mental alertness.
-Emphasize importance of follow-up exams to monitor progress.
-Encourage participation in psychotherapy to improve coping skills.
-Refer patient/family to local support groups.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: gabapentin
Brand Name: Neurontin
Classification: analgesic adjuncts, anticonvulsants, mood stabilizers
What is the action of this medication on the body? Mechanism of action not
known, may affect transport of amino acids across and stabilize neuronal
membranes.
What is a normal dosage for a child? 10-15 mg/kg/day in 3 divided doses

titrated upward over 3 days to 25-35 mg/kg/day in 3 divided doses
What are the side effects the nurse should to assess for in a child? Confusion,
depression, drowsiness, sedation, anxiety, concentration difficulties,
dizziness, emotional lability, hostility, hyperkinesia, vertigo, weakness,
abnormal vision, hypertension, weight gain, ataxia.
medication (including contraindications)? Contraindicated in hypersensitivity.
Use caution in renal insufficiency.
-Take as directed; don’t exceed 12 hours between doses.
-Don’t take it within 2 hours of an antacid.
-No activities requiring mental alertness.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: nystatin
Brand Name: Mycostatin; Nadostine, Nyaderm, Nystop
Classification: antifungals (topical)
What is the action of this medication on the body? Affect the synthesis of the
fungal cell wall, allowing leakage of cellular contents.
What is a normal dosage for a child? Apply 2-3 times daily until healing is
complete
What are the side effects the nurse should to assess for in a child? Burning,
itching, local hypersensitivity reactions, redness, stinging
medication (including contraindications)? Contraindicated in hypersensitivity
to active ingredients, additives, preservatives, or bases; avoided in patients
with known alcohol or bisulfate intolerance. Use cautiously in patients with
nail and scalp infections.
-Instruct patient to apply medication as directed for full course of therapy,
even if feeling better. Emphasize importance of avoiding the eyes.
-Caution that some products may stain fabric, skin, or hair.
-Report increased skin irritation or lack of response to therapy to health
care professional.
Company, 2009
D. Rouse
Nursing: Family

Child’s Initials:
Drug Name
Generic Name: promethazine
Brand Name: Phenergan
Classification: antiemetics, antihistamines, sedative/hypnotics;
phenothiazines
What is the action of this medication on the body? Blocks the effects of
histamine; has inhibitory effect on the chemoreceptor trigger zone in the
medulla, resulting in antiemetic properties. Alters effects of dopamine in
the CNS.
What is a normal dosage for a child?0.25-1 mg/kg (not to exceed 25 mg) Q4-
6H
disorientation, sedation, dizziness, fatigue, insomnia, nervousness, blurred
vision, tinnitus, bradycardia, hypertension, hypotension, tachycardia,
constipation, photosensitivity, rashes.
medication (including contraindications)? Contraindicated in hypersensitivity,
comatose patient, may cause fatal respiratory depression in children less
than 2 years old. Use cautiously in children less than 2 years, use lowest
effective dose, avoid concurrent respiratory depressants.
-Review dose schedule with patient; take dose as soon as remembered
unless time for next dose.
-Caution caregivers to use only the measuring device accompanying the
liquid medication and not to use household measuring devices.
-Warn that it may cause drowsiness.
-Advise patient that frequent mouth rinses, good oral hygiene, and
sugarless gum or candy may decrease dry mouth.
-Use sunscreen and protective clothing to prevent photosensitivity
reactions.
-Advise patient to change positions slowly.
-Notify health care professional if sore throat, fever, jaundice, or
uncontrolled movements are noted.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: metoclopramide
Brand Name: Reglan
Classification: antiemetics
What is the action of this medication on the body? Blocks dopamine receptors
in chemoreceptor trigger zone of the CNS. Stimulates motility of the upper
GI tract and accelerates gastric emptying.
What is a normal dosage for a child? 0.1-0.2 mg/kg/dose, repeated in 6-8

hours if needed.
extrapyramidal reactions, restlessness, anxiety, depression, irritability,
tardive dyskinesia, arrhythmias, hypertension, hypotension, constipation,
diarrhea, dry mouth, nausea.
possible GI obstruction or hemorrhage, and history of seizure disorders.
Side effects of this med occur more often in children than adults.
-Take as directed; take missed doses as soon as remembered if not almost
time for next dose.
-Unintentional overdose has been reported in infants and children with the
use of metoclopramide oral solution. Teach parents how to accurately read
labels and administer medication.
-Notify health care professional immediately if involuntary movement of
eyes, face, or limbs occurs.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: acetaminophen
Brand Name: Tylenol

Classification: antipyretics, nonopioid analgesics
What is the action of this medication on the body? Inhibits the synthesis of
prostaglandins that may serve as mediators of pain and fever, primarily in
the CNS.
What is a normal dosage for a child? PO = 10-15 mg/kg/dose Q4-6H as needed
(not to exceed 5 doses/24 hours); Rect = 10-20 mg/kg/dose Q4-6H as
needed.
What are the side effects the nurse should to assess for in a child? Hepatic
failure, renal failure, neutropenia, rash, urticaria.
medication (including contraindications)? Contraindicated in previous
hypersentitivity. Use cautiously in patients with hepatic or renal disease or
those with malnutrition.
-Take as directed and don’t take more than the recommended amount.
-Avoid taking concurrently with salicylates or NSAIDs for more than a few
days, unless directed by health care professional.
-Advise parents/caregivers to check concentrations of liquid preparations.
Have parents or caregivers determine the correct formulation and dose for
their child (based on the child’s age/weight), and demonstrate how to
measure it using an appropriate measuring device.
-Inform patients with diabetes that acetaminophen may alter results of
blood glucose monitoring.
-Advise patient to consult health care professional if discomfort or fever is
not relieved by routine doses of this drug or if fever is greater than 103°F or
lasts longer than 3 days.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: acetaminophen and codeine
Brand Name: Tylenol #3
Classification: opioid analgesic
What is the action of this medication on the body? Acts on certain centers in
the brain to reduce pain.
What is a normal dosage for a child? Dose to be determined by physician.
Constipation, dizziness, drowsiness, lightheadedness, nausea, shortness
of breath, vomiting, abdominal pain, allergic reactions, headache, high
fever, itching, nervousness, redness or swelling in an area of pain,
restlessness, rash, stomach upset, insomnia.
medication (including contraindications)? Physical dependence, psychological
dependence, and abuse have occurred with the use of this medication.
Contraindicated in people allergic to acetaminophen and/or codeine.
-Take as directed and don’t take more than recommended amount.
-Monitor for confusion, notify health care professional if it occurs.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: ondansetron
Brand Name: Zofran
Classification: antiemetics; 5-HT3 antagonists
What is the action of this medication on the body? Blocks effects of serotonin
at 5-HT3 receptor sites (selective antagonist) located in vagal nerve
terminals and the chemoreceptor trigger zone in the CNS.
What is a normal dosage for a child? IV = 0.15 mg/kg
What are the side effects the nurse should to assess for in a child? Headache,
dizziness, drowsiness, fatigue, weakness, constipation, diarrhea,
abdominal pain, dry mouth, increased liver enzymes, extrapyramidal
reactions.
and patients with phenylketonuria. Use cautiously in liver impairment,
abdominal surgery (may mask ileus), and children under 3.
-Take as directed.
-Notify health care professional immediately if involuntary movement of
eyes, face, or limbs occurs.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: ranitidine
Brand Name: Zantac
Classification: antiulcer agents; histamine H2 antagonists

What is the action of this medication on the body? Inhibits the action of
histamine at the H2-receptor site located primarily in gastric parietal cells,
resulting in inhibition of gastric acid secretion.
What is a normal dosage for a child? Treatment of ulcers: 2-4 mg/kg/day in 2
divided doses (up to 300 mg/day); Maintenance treatment: 2-4 mg/kg once
daily (up to 150 mg/day); GERD treatment: 5-10 mg/kg/day in 2 divided
doses (up to 300 mg/day).
dizziness, drowsiness, hallucinations, headache, arrhythmias,
constipation, diarrhea, nausea, anemia, neutropenia, thrombocytopenia,
pain at IM site, hypersensitivity reactions, vasculitis.
hypersensitivity. Use cautiously in patients with renal impairment, hepatic
impairment, or acute porphyria.
-Take as directed for the full course of therapy; take missed doses as soon
as remembered but not if almost time for next dose; do not double dose.
-Notify health care professional if difficulty swallowing occurs or
abdominal pain persists.
-Inform patient that increase fluid and fiber intake and exercise may
minimize constipation.
-Advise to report onset of black, tarry stools; fever; sore throat; diarrhea;
dizziness; rash; confusion; or hallucinations to health care professional
promptly.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: albumin
Brand Name: Albuminar, Albutein, Buminate, normal human serum

albumin, Plasbumin
Classification: volume expanders; blood products, colloids
What is the action of this medication on the body? Provides colloidal oncotic
pressure, which serves to mobilize fluid from extravascular tissues back
into the intravascular space; requires concurrent administration of
appropriate crystalloid.
What is a normal dosage for a child? 0.5-1 g/kg/dose (10-20 mL/kg/dose) may
repeat as needed (maximum 6 g/kg/day)
pulmonary edema, fluid overload, hypertension, hypotension, tachycardia,
increased salivation, nausea, vomiting, rash, back pain, chills, fever, and
flushing.
medication (including contraindications)? Contraindicated in allergic reactions
to albumin, severe anemia, CHF, and normal or increased intravascular
volume. Use cautiously in patients with severe hepatic or renal disease,
dehydration, requiring sodium restriction, and preterm neonates.
-Explain the purpose of this solution to the patient.
-Instruct patient to report signs and symptoms of hypersensitivity reaction.
Company, 2009
D. Rouse
Nursing: Family

Child’s Initials:
Drug Name
Generic Name: dobutamine
Brand Name: Dobutrex

Classification: inotropics; adrenergics
What is the action of this medication on the body? Stimulates beta1
(myocardial)-adrenergic receptors with relatively minor effect on heart rate
or peripheral blood vessels.
What is a normal dosage for a child? Start with low infusion rates (0.5-1
mcg/kg/min), titrated at intervals of a few minutes, guided by the patient’s
response (range 2-20 mcg/kg/min) up to 40 mcg/kg/min.
shortness of breath, hypertension, increased heart rate, premature
ventricular contractions, angina pectoris, arrhythmias, hypotension,
palpitations, nausea, vomiting, phlebitis, rash, fever, bronchospasm, non-
anginal chest pain.
to dobutamine or bisulfites and idiopathic hypertrophic subaortic stenosis.
Use cautiously in patients with history of hypertension, myocardial
infarction, atrial fibrillation, hypovolemia, risk of tachycardia is increased.
-Explain to patient the rationale for instituting this medication and the need
for frequent monitoring.
-Advise patient to inform nurse immediately if chest pain; dyspnea; or
numbness, tingling, or burning of extremities occurs.
-Notify nurse immediately of pain or discomfort at the site of administration
-Instruct caregiver on proper care of IV equipment.
-Instruct caregiver to report signs of worsening CHF (shortness of breath,
orthopnea, decreased exercise tolerance), abdominal pain, and
nausea/vomiting to health care professional promptly.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: insulin
Brand Name: Humulin R, Humulin R U-500, Novolin R
Classification: antidiabetics, hormones; pancreatics

What is the action of this medication on the body? Lower blood glucose by:
stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic
glucose production; also inhibition of lipolysis and proteolysis, enhanced
protein synthesis.
What is a normal dosage for a child? Loading dose – 0.1 unit/kg, then
maintenance continues infusion 0.05-0.2 unit/kg/hr.
Hypoglycemia, erythema, lipodystrophy, pruritis, swelling, allergic
reactions
medication (including contraindications)? Contraindicated in hypoglycemia,
allergy or hypersensitivity to a particular type of insulin, preservatives, or
other additives. Use cautiously in stress and infection, renal/hepatic
impairment.
-Advise patient to consult health care professional prior to using alcohol or
other prescription, over-the-counter, or herbal products concurrently with
insulin.
-Advise patient to notify health care professional of medication regimen
prior to treatment or surgery.
-Notify health care professional if nausea or vomiting or fever develops, if
unable to eat regular diet, or if blood glucose levels are not controlled.
-Instruct on signs and symptoms of hypoglycemia and hyperglycemia and
what to do if they occur.
Company, 2009
D. Rouse
Nursing: Family

Child’s Initials:
Drug Name
Generic Name: morphine
Brand Name: Astramorph
Classification: opioid analgesics
What is the action of this medication on the body? Binds to opiate receptors in
the CNS. Alters the perception of and response to painful stimuli while
producing generalized CNS depression.
What is a normal dosage for a child? PO = 0.3-0.6 mg/kg/dose Q12H; IV = 0.02-
2.6 mg/kg/hr
sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations,
headache, unusual dreams, blurred vision, respiratory depression,
hypotension, bradycardia, constipation, nausea, vomiting, urinary
retention, flushing, itching, sweating
Use cautiously in children under 18, neonates and infants < 3 months
(more susceptible to respiratory depression).
-Instruct patient how and when to ask for pain medication.
-Instruct family not to administer PCA doses to the sleeping patient.
Overmedication, sedation, and respiratory depression can result.
-May cause drowsiness or dizziness. Caution patient to call for assistance
when ambulating.
-Advise patient to change positions slowly to minimize orthostatic
hypotension.
-Encourage patient to turn, cough, and breathe deeply every 2 hours to
prevent atelectasis.
-Explain to patient and family how and when to administer morphine and
how to care for infusion equipment properly.
-Teach parents/caregivers how to accurately measure liquid medication
and to use only the measuring device dispensed with the medication.
-Emphasize the importance of aggressive prevention of constipation with
the use of morphine.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: dexmedetomidine
Brand Name: Precedex
Classification: sedative/hypnotics
What is the action of this medication on the body? Causes CNS depression
What is a normal dosage for a child? Child dose determined by physician
What are the side effects the nurse should to assess for in a child? Hypoxia,
bradycardia, sinus arrest, hypotension, transient hypertension, nausea,
vomiting, anemia, fever
Use cautiously in hepatic impairment and in children because safety hasn’t
been established.
-How to take medication correctly.
-Signs of overdose
-Signs and symptoms of an allergic reaction to the medication.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: midazolam
Brand Name: Versed
Classification: benzodiazepines; antianxiety agents, sedative/hypnotics
What is the action of this medication on the body? Acts at many levels of the
CNS to produce generalized CNS depression
What is a normal dosage for a child? 0.05-0.2 mg/kg loading dose; infusion at
0.06-0.12 mg/kg/min
What are the side effects the nurse should to assess for in a child? Agitation,
drowsiness, excess sedation, headache, blurred vision, apnea,
laryngospasm, respiratory depression, bronchospasm, coughing, cardiac
arrest, arrhythmias, hiccups, nausea, vomiting, rashes, phlebitis, pain
shock, comatose patients, uncontrolled severe pain. Use cautiously in
pulmonary disease, CHF, renal and hepatic impairment, obese pediatric
patients.
-Inform that this medication will decrease mental recall.
-May cause drowsiness or dizziness. Advise patient to request assistance
prior to ambulation and transfer.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: sertraline
Brand Name: Zoloft
Classification: antidepressants; selective serotonin reuptake inhibitors

(SSRIs)
What is the action of this medication on the body? Inhibits neuronal uptake of
serotonin in the CNS, thus potentiating the activity of serotonin.
What is a normal dosage for a child? Children 6-12 years: 25 mg daily;

Children 13-17 years: 50 mg daily
drowsiness, fatigue, headache, insomnia, diarrhea, dry mouth, nausea,
increased sweating, tremors
and concurrent MAO inhibitor therapy. Use cautiously in severe hepatic or
renal impairment, patients with a history of mania, patients at risk of
suicide, and children.
-Take as directed.
-Notify health care professional if headache, weakness, nausea, anorexia,
anxiety, or insomnia persists.
-Emphasize importance of follow-up exams to monitor progress
-Refer patient/family to local support group.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: amikacin
Brand Name: Amikin
Classification: Anti-infectives; aminoglycosides
What is the action of this medication on the body? Inhibits protein synthesis in
bacteria at level of 30S ribosome.
What is a normal dosage for a child? 5 mg/kg Q8H or 7.5 mg/kg Q12H (not to
exceed 1.5 g/day).
What are the side effects the nurse should to assess for in a child? Ataxia,
ototoxicity, nephrotoxicity, vertigo, diarrhea, nausea, vomiting,
hypomagnesemia, muscle paralysis, apnea, hypersensitivity reactions
to aminoglycosides, patients with bisulfate intolerance. Use cautiously in
patients with renal impairment, hearing impairment, neuromuscular
diseases, obese patients, neonates have increased risk of neuromuscular
blockade.
-Instruct parent/child to report signs of hypersensitivity, tinnitus, vertigo,
hearing loss, rash, dizziness, or difficulty urinating.
-Advise patient to drink plenty of liquids.
-Caution that it may cause nausea, vomiting, and diarrhea.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: piperacillin/tazobactam
Brand Name: Zosyn
Classification: anti-infectives; extended spectrum penicillins
What is the action of this medication on the body? Binds to bacterial cell wall
membrane, causing cell death.
What is a normal dosage for a child? Child dose determined by physician.
What are the side effects the nurse should to assess for in a child? Diarrhea,
rashes, pain, phlebitis, anaphylaxis, serum sickness, seizures, confusion,
dizziness, headache, insomnia, lethargy, constipation, nausea, vomiting,
bleeding, fever, superinfection.
hypersensitivity to penicillins, beta-lactams, cephalosporins, or
tazobactam. Use cautiously in patients with renal impairment, sodium
restriction, and children (safety and efficacy not established).
-Advise to report signs of superinfection (black furry overgrowth on
tongue, vaginal itching or discharge, loose or foul-smelling stools) and
allergy.
-Caution patient/parents to notify health care professional if fever and
diarrhea occur; especially if stool contains blood, pus, or mucus.
-Advise not to treat diarrhea without consulting health care professional.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: vancomycin
Brand Name: Lyphocin, Vancocin, Vancoled
Classification: anti-infectives
What is the action of this medication on the body? Binds to bacterial cell wall,
resulting in cell death; active against gram-positive pathogens
What is a normal dosage for a child? 20 mg/kg single dose 1 hour

preprocedure
Nephrotoxicity, phlebitis, anaphylaxis, ototoxicity, hypotension, nausea,
vomiting, rashes, back and neck pain, chills, fever, “red man” syndrome,
superinfection.
hypersensitivity. Use cautiously in patients with renal impairment, hearing
impairment, intestinal obstruction or inflammation.
-Take as directed, take missed doses as soon as remembered, do not
double dose.
-Report signs of hypersensitivity, tinnitus, vertigo, or hearing loss.
-Notify health care professional if no improvement is seen in a few days.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: clonodine
Brand Name: Catapres, Catapres-TTS, Duraclon
Classification: antihypertensives; adrenergics (centrally acting)
What is the action of this medication on the body? Stimulates alpha-adrenergic
receptors in CNS; which results in decreased sympathetic outflow
inhibiting cardioacceleration and vasoconstriction centers.
What is a normal dosage for a child? PO = 50-400 mcg (0.05 – 0.4 mg) twice
daily; Epidural = 0.5 mcg/kg/hr initially, titrated as needed.
dry mouth, withdrawal phenomenon, depression, dizziness, nervousness,
bradycardia, hypotension, palpitations, constipation, nausea, vomiting,
rash, sweating, weight gain.
hypersensitivity, injection site infection, anticoagulant therapy, or bleeding
problems. Use cautiously in patients with severe cardiac or
cerebrovascular disease, renal insufficiency.
-Take as directed; if missed more than 1 dose, contact health care
professional.
-Make sure enough medication available for weekends, holidays, and
vacations.
-Avoid sudden changes in position to decrease orthostatic hypotension.
-Consult health care professional before taking any over the counter
cough, cold, or allergy remedies.
-Notify health care professional of medication regimen prior to treatment.
-Notify health care professional if itching or redness of skin, mental
depression, swelling of feet and lower legs, paleness or cold feeling in
fingertips or toes, or vivid dreams or nightmares occur. May require
discontinuation of therapy.
-Instruct patient/family on proper technique for blood pressure monitoring;
check at least weekly and report significant changes.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: diazepam
Brand Name: Valium
Classification: antianxiety agent; benzodiazepines
What is the action of this medication on the body? Depresses CNS by

potentiating GABA receptors, producing skeletal muscle relaxation by
inhibiting spinal polysynaptic afferent pathways.
What is a normal dosage for a child? PO = 0.12-0.8 mg/kg/day 3-4 times daily;
IM, IV = (Children 5-older) 5-10 mg Q3-4H, (Children older than 1 month) 1-2
mg Q3-4H
drowsiness, lethargy, depression, ataxia, slurred speech, headache,
blurred vision, respiratory depression, hypotension, constipation, diarrhea,
nausea, vomiting, weight gain, rashes, pain.
hypersensitivity, comatose patients, pre-existing CNS depression,
uncontrolled severe pain. Use cautiously in patients with hepatic
dysfunction, severe renal impairment, severe pulmonary impairment, and
history of suicide attempt.
-Take as directed; don’t take more than prescribed amount, sharing
medication is dangerous.
-Emphasize importance of follow-up exams to determine effectiveness of
the medication.
-Carry ID describing disease process and medication regimen at all times.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: midazolam
Brand Name: Versed
Classification: antianxiety agents, sedatives/hypnotics; benzodiazepines
What is the action of this medication on the body? Acts at many levels of CNS
to produce generalized CNS depression.
What is a normal dosage for a child? PO = 0.25-0.5 mg/kg, may require up to 1

mg/kg; IM = 0.1-0.15 mg/kg up to 0.5 mg/kg 30-60 minutes prior to
procedure
What are the side effects the nurse should to assess for in a child? Apnea,
laryngospasm, respiratory depression, cardiac arrest, phlebitis at IV site,
agitation, drowsiness, excess sedation, headache, blurred vision,
bronchospasm, coughing, arrhythmias, nausea, vomiting, rashes, pain
hypersensitivity, shock, comatose or those with pre-existing CNS
depression, and uncontrolled severe pain. Use cautiously in patients with
pulmonary disease, CHF, renal/hepatic impairment, and obese pediatric
patients.
-This medication will decrease mental recall of procedure.
-May cause drowsiness or dizziness; request assistance prior to
ambulation and transfer.
Company, 2009
D. Rouse
Nursing: Family
Child’s Initials:
Drug Name
Generic Name: dimenhydrinate
Brand Name: Dramamine
Classification: antiemetics, antihistamines
What is the action of this medication on the body? Inhibits vestibular

stimulation, which may prevent motion sickness
What is a normal dosage for a child? PO = 25-50 mg Q6-8H (not to exceed 300
mg/day); Rect (Children 8-12 years) = 25-50 mg Q8-12H; Rect (Children 6-8
years) = 12.5-25 mg Q8-12H; IM,IV = 1.25 mg/kg Q6H PRN (not to exceed
300 mg/day)
anorexia, dizziness, headache, blurred vision, tinnitus, hypotension,
palpitations, constipation, diarrhea, dry mouth, dysuria, frequency,
photosensitivity, pain at IM site.
hypersensitivity. Use cautiously in patients with seizure disorders.
-May cause drowsiness, avoid activities requiring mental alertness.
-Frequent oral rinses, good oral hygiene, and sugarless gum/candy may
minimize dry mouth effect.
-Use sunscreen and protective clothing to prevent photosensitivity
reactions.
Company, 2009
D. Rouse

Kayla Clark - Shriners Pediatric Medication Sheets

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Kayla Clark - Shriners Pediatric Medication Sheets

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Nursing: Family

Medication Information Sheet

Student Name: Kayla Clark

Generic Name: zolpidem

Brand Name: Ambien

*Why is this child receiving this medication?

*What is Normal Dosage for this child’s age?

*What is Ordered Dosage for this child? Is it within normal range?

Medication Information Sheet

Student Name: Kayla Clark

Generic Name: hydroxyzine

Brand Name: Atarax

Classification: antianxiety agents, antihistamines, sedative/hypnotics

*Why is this child receiving this medication?

What is a normal dosage for a child? 2 mg/kg/day divided q 6-8 hrs.

*What is Normal Dosage for this child’s age?

*What is Ordered Dosage for this child? Is it within normal range?

Medication Information Sheet

Student Name: Kayla Clark

Generic Name: diphenhydramine

Brand Name: Benadryl

*Why is this child receiving this medication?

Medication Information Sheet

Student Name: Kayla Clark

Generic Name: sucralfate

Brand Name: Carafate

Classification: antiulcer agents

What is a normal dosage for a child? 40-80 mg/kg/day divided Q6H

*What is Normal Dosage for this child’s age?

*What is Ordered Dosage for this child? Is it within normal range?

Medication Information Sheet

Student Name: Kayla Clark

Generic Name: cefazolin

Brand Name: Ancef

Classification: anti-infectives/first-generation cephalosporins

Medication Information Sheet

Student Name: Kayla Clark

Generic Name: Ipratropium bromide/albuterol combination

Brand Name: Combivent

What is the action of this medication on the body? Maintenance therapy of

What is a normal dosage for a child? 2 inhalations Q6H, PRN

*What is Normal Dosage for this child’s age?

*What is Ordered Dosage for this child? Is it within normal range?

Medication Information Sheet

Student Name: Kayla Clark

Generic Name: polyethylene glycol

Brand Name: Miralax

Classification: osmotic laxatives

What is a normal dosage for a child? Dose determined by physician

*What is Normal Dosage for this child’s age?

*What is Ordered Dosage for this child? Is it within normal range?

Medication Information Sheet

Student Name: Kayla Clark

Generic Name: folic acid

Brand Name: Apo-Folic, Folate, Folvite, Novofolacid, Vitamin B

Classification: antianemics, vitamins

*What is Ordered Dosage for this child? Is it within normal range?

Medication Information Sheet

Student Name: Kayla Clark

Generic Name: ketamine

Brand Name: Ketalar

Classification: general anesthesia