NCLEX Review Guide: Pediatric Parenteral Medication Administration

Weight-Based Dosing

• Always use actual body weight in kilograms for pediatric calculations, converting pounds to kg by dividing by 2.2.
• Calculate safe dose range using mg/kg/day or mg/kg/dose before administering any medication.
• Verify calculated dose falls within manufacturer's recommended range before proceeding with administration.

Injection Sites and Methods

• Vastus lateralis is preferred IM site for infants under 12 months due to adequate muscle mass and safety.
• Use 22-25 gauge needles for pediatric injections, with length based on age and injection site.
• Maximum IM volume: 0.5mL for infants, 1mL for toddlers, 2mL for school-age children.

Pediatric IV Safety

• Use volume control chambers (Buretrol) to prevent fluid overload in pediatric patients.
• Calculate hourly fluid requirements using 100mL/kg for first 10kg, 50mL/kg for next 10kg, 20mL/kg for remaining weight.
• Monitor for infiltration every 15-30 minutes during IV infusion due to fragile pediatric veins.

1. Verify medication order and calculate dose based on child's weight
2. Select appropriate IV site (avoid dominant hand, areas of flexion)
3. Use smallest gauge catheter appropriate for medication viscosity
4. Secure IV with transparent dressing and arm board if needed
5. Program infusion pump with calculated rate and volume limits

Quick Check Questions

• □ Can you identify the preferred IM site for a 6-month-old infant?
• □ Do you know the maximum IM volume for a 2-year-old?
• □ Can you calculate pediatric fluid requirements using the formula?
• □ Do you understand why volume control chambers are essential?