Wilson & Hockenberry: Wong’s Clinical Manual of Pediatric Nursing, 8th Edition

Patient Teaching Guide

This section may be photocopied and distributed to families.

Spanish translation of this handout available at http://evolve.elsevier.com/Wong/clinical.

Source: Wilson D, Hockenberry MJ: Evolve resources for Wong’s clinical manual of pediatric nursing, ed 8. Copyright © 2012, Mosby, St Louis.

Giving Oral Medications

Your health professional has prescribed special medicine for the child that must be taken by mouth. This is a good time to teach the child about medicines as special things we take to get better. Do not tell her that the drug is candy. If the child thinks that the medicine is candy, and if the bottle is ever left in a place where she can reach it, she may take an overdose. Tell the child to take drugs only from you or other special people, such as grandparents or babysitters. Store all drugs in a safe place such as a locked cabinet. The storage area should be cool and dry. Bathrooms are usually too warm and moist for storing tablets or capsules. Always keep drugs in the original container, with the childproof cap tightly closed. Place drugs that need to be refrigerated on a high shelf toward the back of the refrigerator, not in the door.

To Encourage the Child

Unpleasant tasting drugs can be mixed with a small amount of a pleasant tasting food, such as applesauce, juice, pudding, jelly, flavored ice, ice cream, or other more flavorful foods. Allow the child to choose the food; this will encourage her to eat or drink all of the medicine. Tell the child what you have done so that she does not think the food always tastes like the drug–food combination. Do not add drugs to essential foods and liquids (milk, formula, orange juice, cereal) because the child may refuse them later. When mixing a drug with food or liquids, add it to a small amount (1 or 2 teaspoons) so that the child will have to eat or drink only that small amount to get all of the medicine. Offer the child a drink of water or other liquid to rinse away the taste of the drug.

If the drug tastes unpleasant, the child can suck on a small ice cube or Popsicle to decrease the taste. Also, you can cut a straw in half and have the child sip the medicine through a straw or have the child pinch her nose while taking the medicine. Not smelling the drug will lessen the unpleasant taste.

Some drugs taste better if served cold rather than at room temperature.

Give the child a gold star or sticker for taking the drug. These can be placed on the drug schedule sheet that you were given. The child can keep track of the number of times she has taken the medicine and how many doses are left. The stars or stickers also provide a record of her help.

Tablets and Capsules

Many tablets are pleasantly flavored, and the child can either swallow the tablet whole or chew the tablet. If a half-tablet is prescribed, only scored tablets (those with a visible groove on the tablet) can be broken in half. An unscored tablet may break into unequal portions. Pill cutters can be used to cut the tablet in half. They are sold in most drug stores. This does not matter if the child is taking the whole tablet. Tablets may also be cut in half if they are too large for the child to swallow whole.

If the child cannot swallow the tablet, you can crush the tablet between two spoons or a spoon and a piece of waxpaper. However, before crushing any tablet, check with your health professional or pharmacist to make sure the tablet can be crushed. After the tablet is crushed, you can mix it with a nonessential food such as applesauce, jam, or fruit juice. Make sure all of the crushed tablet is added. If you have added medicine to the food, tell the child.

If the medicine is a capsule, do not open the capsule unless you have been told to do so by the pharmacist or your health professional. If it can be opened, add it to food as described earlier. Praise the child after she has taken the medicine.

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