7
Infusion Therapy for the Pediatric Patient
Successful infusion therapy for the pediatric population requires an acute ­
awareness of the many differences not only from the adult population but also
within the group itself. Ranging from the premature neonate to the young
adult, specific requirements vary depending on the stage of development. The
clinician must demonstrate and maintain competency in many areas, including ­
venipuncture site selection, vascular access device placement and maintenance,
intravenous medication administration including dose and rate calculations, and
instruction related to infusion therapy not only for the patient, but also for the
parents and/or primary caregivers involved with the child’s care.
Infusion Therapy Implications for Vascular Access Device
Placement by Childhood Age and Developmental Stage
Age-Group Developmental Stage and Clinical Implications
Characteristics
Infant Basic Trust vs. Mistrust Keep infant warm. Use a
Birth to 1 year Develops trust as basic needs are met. pacifier. Avoid feeding
Separation anxiety and fear of strangers immediately before
with infant older than 6 months. procedure to minimize
Communicates by crying. risk of vomiting and
aspiration. Use assistants
other than family to restrain
infant. Encourage parent/
caregiver interaction imme-
diately after procedure and
throughout therapy. Protect
infusion site from infant’s
reach.
Toddler Autonomy vs. Shame Prepare the child
1-3 years Child has little understanding of cause immediately before the
and effect. Communicates by crying, procedure, if able. Use
pointing, or using basic words. May simple and honest
regress in developmental milestones. explanations; speak to
the child at eye level. Use
positioning or comfort
techniques to restrain.
Transitional objects provide
comfort (blanket, toy).
Likes rewards such as stick-
ers. NOTE: securement
of vascular access device is
crucial for this age-group.
I n f u s i o n T h e r a p y f o r t h e P e d i a t r i c P a t i e n t
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