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Child Health Nursing > Health promotion of infant and toddler > Flashcards

Health promotion of infant and toddler Flashcards

1
Q

research shows involving ______in care is something they expect and desire and helps with outcomes

A

family

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2
Q

Give Equal ______ to the different parenting styles regardless of your personal opinions and beliefs

A

respect

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3
Q

parenting style:
– do what I say you’re going to do, has rules and they’re going to be followed

A

authoritarian

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4
Q

parenting style:

– have no control, pretty much let the kid decide, let the child regulate whatever they want to do,

A

permissive

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5
Q

Parenting style:

–is a combo of authoritarian/permissive, have boundaries and standards that they want the kid to follow, is not about control with the kid but is on being able to focus on action to get the kid to comply with what is going on

A

authoritative

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6
Q

kids are like a _____ –too much pressure or too little pressure is not good

A

spring

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7
Q

What are the three parenting styles?

A

authoritarian
permissive
authoritative

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8
Q

–explaining why it is right or wrong, works when they can see the world from outside, doesn’t happen until 4th or 5 th grade

A

Reasoning

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9
Q

–can be in extremes and can take connotation of shame and criticism, is more so if youre saying youre a bad boy for breaking that toy, be mindful of how you word things

A

Scolding

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10
Q

– rewards, research shows it works really well.

A

Behavioral Modification

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11
Q

– MUST BE CONSISTENT, can work but you have to be consistent

A

Ignoring

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12
Q

t/f: all discipline has its place

A

true

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13
Q

Time-out
general rule for time-outs are??

A

one minute per year of age

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14
Q

– it teaches that violence is acceptable, if the parent is upset they can end up harming the child, kids also develop a tolerance to the spanking (if theyre not here I don’t have to worry about it)

A

Corporal/physical punishment

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15
Q

–works sometimes by taking away certain things

A

Loss or removal of privileges

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16
Q

Schools
Peer groups
Local community
Race and ethnicity
Social class – wealth vs. poverty

Mass media influences – advertisements, association to obesity
two hours total/day beginning at two years of age
Religious and traditional influences

A

sociocultural influences

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17
Q

___ is the primary source of strength and support for the child

A

Family

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18
Q

Family centered care
Stressors
Fear of bodily injury and pain
Separation from parents and loved ones
Fear of the unknown
Loss of control and autonomy

A

Stressors of Hospitalization

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19
Q

What are the phases of separation anxiety?

A

protest phase
Despair phase
detachment phase

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20
Q

stards at 6 months and lasts until 30 months
Cry and scream, cling to parent

A

protest phase

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21
Q

–get a little depressed, less activity than expected, get them something familiar
Crying stops, evidence of depression, regression

A

despair phase

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22
Q

very extreme long term, happens when parents run out of FMLA, look like theyre going back to normal, can happen with long extended stay, they recover from it and learn new skills, overcome different stressors in life, no long term issues usually
Denial, resignation; not contentment

A

detachment phase

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23
Q

Promote freedom of movement
Maintain child’s routine, if possible
Self-care (age-appropriate)
Wearing street clothes
Making food choices
Schoolwork
Friends and visitors

A

normalizing environment for children

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24
Q

______can help with procedures – sometimes have animal therapy, collab with them, right before the procedure is the best time

A

child life specialist

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25
Q

What level are these toys appropriate for?

A

toddler

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26
Q

What level are these crayons appropriate for?

A

older child

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27
Q

focus on maintaining health with preventions

A

community health concepts

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28
Q

Are PSA type stuff

A

primordial

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29
Q

immunizations are an example of what level of prevention?

A

primary

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30
Q

screening for exposure is?

A

secondary prevention

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31
Q

include optimizing programs such as rehab

A

tertiary

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32
Q

Active immunity can be gained from?

A

natural immunity from contracting the disease

artificial immunity from receiving a vaccination

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33
Q

Passive immunity can come from?

A

Natural immunity conveyed from mom to neonate
Artificial immunity from immunoglobulin administration

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34
Q

______ is the act of introducing antigen

A

vaccination

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35
Q

______ is something that gets developed as far as the immune system (sometimes over time)

A

immunity

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36
Q

Diphtheria
Tetanus
Pertussis
Poliomyelitis
Measles
Mumps
Rubella
Haemophilus influenzae Type b

Hepatitis A
Hepatitis B
Influenza
Pneumonia
Varicella (chickenpox)
Rotavirus
Human papillomaviruses
Meningitis
Zoster (shingles)

A

vaccine preventable diseases

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37
Q

Be familiar with the schedule – updated annually
Be aware of contraindications and precautions
Provide information and anticipatory guidance
Be prepared for adverse reactions
Ensure parental consent prior to administration
Provide safe administration
Ensure documentation is complete

A

role in immunizations

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38
Q

you dont have to memorize about when certain vaccines are given, but you do need to understand that different vaccines are given at _______

A

different ages

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39
Q

its ok to give a vaccine when a child has a low grade fever, but not a severe one

if they have a severe fever, the vaccine will be ____

A

less effective

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40
Q

If the patient is immunocompromised or has had a recent blood transfusion, which type of vaccines should you not give?

A

life attenuated vaccines

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41
Q

if the patient has had a recent blood transfusion, how long should you want before giving their vaccine?

A

3-5 months

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42
Q

If an individual is pregnant, which type of vaccines cannot be given?

A

live vaccines

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43
Q

severe febrile illness and immunoglobulin administration are?

A

contraindications for vaccine administration

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44
Q

military, marriage, pregnancy, STDs, mental health

A

conditions for medical emancipation

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45
Q

Appropriate needle length
______ for infants < 28 days old; 1 inch for infants 1 month and older

A

5/8 inch

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46
Q

Appropriate anatomical site – IM – 22-25 gauge
<12 months old – ______
>12 months old – may use deltoid muscle if enough muscle mass exists

A

vastus lateralus

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47
Q

Appropriate anatomical site – _____ – 5/8-inch, 23-25 gauge
<12 months old – outer thigh
>12 months old – upper-outer triceps

A

Subcut

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48
Q

If multiple vaccines – space an_______ apart

A

inch

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49
Q
A

best position to administer vaccines for child or infant

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50
Q

Inject rapidly without aspiration
Inject vaccines that cause most pain last
Distraction – blowing bubbles
Encourage a comforting hold
Breastfeeding or sweet-tasting solution for <2-year-olds
Tactile stimulation
Use a colorful bandage
Cool compresses to site
Parent may give acetaminophen or ibuprofen afterwards

A

minimizing discomfort measures for vaccine administraiton

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51
Q

_______ vaccines hurt the most, wait until the end to give them

A

pneumonia and MMR

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52
Q

pressing an inch above the injection site is an example of?

A

tactile stimulation

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53
Q

give IM before ______

A

SUBQ

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54
Q

Tenderness, redness, swelling

A

Local reactions – most frequent, least severe

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55
Q

Low-grade fever, malaise, muscle pain, headache, syncope, loss of appetite

A

Systemic reactions – less frequent than local reactions

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56
Q

Epinephrine and airway management equipment should be available for this allergic reaction to vaccines

A

anaphylaxis

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57
Q

sycope happens more with men getting the ______vaccine –response doesn’t always happen immediately

A

HPV

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58
Q

Provide VIS (Vaccine Information Statement) – federal law requires it
Document date, site, route, manufacturer, and lot number
Discuss s&s of a reaction with parents
Provide materials – After the shots…
Review education

A

Vaccine Information, Guidance, and Documentation

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59
Q

_______ children are most susceptible to the complications of communicable disease

A

Immunocompromised

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60
Q

Barrier protection from blood and body fluids
Respiratory hygiene/cough etiquette
Safe injection practices
Hand hygiene

A

standard precautions

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61
Q

Reduce risk by direct
or indirect contact

A

contact precautions

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62
Q

must clean hands
wear gloves
gown
dedicated or disposable equipment

A

contact precautions

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63
Q

Reduce risk by airborne droplet nuclei
(<5 mm) suspended in air
Negative pressure isolation rooms

A

airborne precautions

64
Q

clean hands
put on fit tested n 95
keep door closed to room

A

airborne precautions

65
Q

Reduce risk by droplets (>5 mm)
do not remain suspended in air
These droplets travel 3 feet
or less through the air

A

droplet precautions

66
Q

clean hands
make sure eyes, nose, and mouth are fully covered before room entry
remove face protection before room exit

A

droplet precautions

67
Q

What transmission precautions are used with varicella zoster?

A

airborn, contact, of course standard

68
Q

When is varicella zoster (chicken pox) transmissible?

A

day before rash appears until rash scabs over

Probably 1 day before eruption of lesions (prodromal period) to 6 days after first crop of vesicles when crusts have formed

69
Q

Is there a vaccine for the varicella virus?

A

yes, live attenuated vaccine

70
Q

Prodromal stage—slight fever, malaise
Pruritic rash begins a macule → vesicle then erupts
Rash is typically centripetal → extremities, face

A

clinical manifestations of Varicella

71
Q

Keep child cool as it may lessen number of lesions
Symptomatic relief – diphenhydramine or antihistamines
Varicella immune globulin minimizes severity in exposed child
Acyclovir IV given to immune compromised children
oatmeal baths may help

keep fingernails short

keep in cool clothing –cotton linens, topical antiitch stuff

A

treatment for varicella virus

72
Q

What are the transmission precautions for measles or Rubeola?

A

Airborn precautions until day 5 of the rash

73
Q

how is Measles or Rubeola transmitted?

A

Usually by direct contact with droplets of infected person; primarily in the winter

74
Q

Possible complications
Otitis media, pneumonia, laryngitis, encephalitis

A

possible complications from measles

75
Q

Clinical manifestations
Prodromal state: fever, malaise → 3 Cs: coryza, cough, conjunctivitis
“Koplick Spots” on mucosa
Maculopapular rash on day 3-4 of illness

A

clinical manifestations of measles or rubeola

76
Q

Treatment
Bed rest, antipyretics, and support
Vitamin A supplements

A

treatment for measles or rubeola

77
Q

Coryza is hallmark of _______

A

measles

78
Q
A

what measles may look like

79
Q

what is the transmission for mumps?

A

Direct contact with or droplet spread from an infected person

80
Q

What precautions are needed for mumps?

A

droplet and standard and contact

81
Q

when is mumps communicable?

A

Period of communicability – immediately before and after swelling

82
Q

Clinical manifestations
Prodromal state: fever, headache, malaise, anorexia for 24 hours → earache that increases with chewing
Swollen and tender in one or both parotid glands

A

clinical manifestations of mumps

83
Q

Treatment
IV fluids if vomiting or unable to eat and drink
Soft foods if able to eat
Analgesics
Hot or cold compresses, whichever feels better

A

treatment for mumps

84
Q

______ after puperty will have swelling of the scrotum or ovaries

A

mumps

85
Q

oophoritis =______

A

ovary inflammation

86
Q

orchitis = ______ –elevate scrotum –roll up a towel and place it underneath

A

testes inflammation

87
Q

you can actually pass it to the baby in utero: miscarriage, still birth, or cataracts. Vaccinated or not.

A

rubella

88
Q

Vaccinate after pregnancy,

A

rubella

89
Q

What are the transmission precautions for rubella?

A

contact droplet

90
Q

they need to abstain or wear condom if mom is not vaccinated bc the vaccine is live attenuated

A

rubella

91
Q
A

mumps

92
Q
A

rubella

93
Q
A

rubella

94
Q

Clinical manifestations
Low-grade fever, headache, malaise, sore throat, profuse nasal drainage, diarrhea, rash (from face towards legs)

A

rubella

95
Q

Treatment
Supportive care

A

rubella

96
Q

B-19 virus

more common in kids than adults

saliva, sputum, blood

starts out like a cold, and can have cold for a few days

theyre most contagious before the rash even appears

A

Erythema infectiosum

97
Q

What precautions are necessary for Erythema infectiosum ?

A

droplet standard

98
Q

this can affect pregnancy so keep them away, (small percentage can result in fetal demise which can cause miscarriage)

A

erythema infectiosum

99
Q

is there a vaccine available for erythema infectiosum?

A

no vaccine is available

100
Q

Clinical manifestations
Fever, runny nose, headache
Rash appears in three stages
1. “Slapped Cheek” appearance
2. Maculopapular red spots on extremities from proximal to distal
3. Rash subsides but reappears when skin is irritated
Polyarthropathy Syndrome

A

erythema infectiosum or fifth disease

101
Q

what is the treatment for Erythema infectiosum or fifth disease?

A

supportive care

102
Q
A

fifth disease

103
Q
A

erythema infectiosum or fifth disease

104
Q

hallmark is slap cheek appearance

rash moves from prosimal to distal areas

A

fifth disease

105
Q

pain and swelling in joints: polyarthropathy syndrome –treated. arthritis pain can last up to 9 years, should resolve but there have been lingering pain from the syndrome as a result of the disease though

A

fifth disease erythema infectiosum

106
Q

if you have a kid in your ER with rashes and stuff: use ___ precautions and use your ____

A

all, N95

107
Q

___ ounces of weight gain every week

A

5-7

108
Q

______ birth weight by six months
______ birth weight by one year

A

Double, Triple

109
Q

Height increases one ______ for six months
Growth in “spurts” rather than gradually

A

inch/month

110
Q

Depth perception begins by 7-9 months
Parachute reflex appears at 7 months

A

Sensory changes

111
Q

Grasps object,

A

2-3 months

112
Q

Palmar grasp has a bidextrous approach,

A

5 months

113
Q

Transfers object between hands, ___
Pincer grasp, _____
Finger-feds self, ______
Removes objects from container,______
Builds tower of two blocks (but fail), _____

A

7 months
9 months
10 months
11 months
12 months

114
Q

Grasps object, 2-3 months
Palmar grasp has a bidextrous approach, 5 months
Transfers object between hands, 7 months
Pincer grasp, 9 months
Finger-feds self, 10 months
Removes objects from container, 11 months
Builds tower of two blocks (but fail), 12 months

A

Fine Motor Development

115
Q

Head lags, 1-3 months
Rolls over, 4-5 months
Sits leaning forward on hands, 6-7 months
Crawls and pulls up, 8-9 months
Stands alone and walks with hand held, 10-12 months

A

gross motor development

116
Q
A

development of sitting

117
Q

Cephalocaudal direction of development
Crawling, 6-7 months
Creeping, 9 months
Walk with assist, 11 months
Walk alone, 12 months

A

locomotion

118
Q

Crying is first verbal communication, 1-3 months
Vocalizations, 4-5 months
Begins to imitate sounds, 6-7 months
Meaning of “NO”, 8-9 months
Two to three words with meaning by one year of age, 10-12 months

A

language development

119
Q

Crying is first verbal communication,

A

1-3 months

120
Q

Vocalizations, 4-5 months
Begins to imitate sounds, ______

A

6-7 months

121
Q

Meaning of “NO”, ______
Two to three words with meaning by one year of age, 10-12 months

A

8-9 months

122
Q

Bright, shiny object such as mobile
Talk/sing to them
Play music box
Rattle, chimes
Rock infant or use swing
Move legs in swimming motion
Splash in bath
Bounce on lap

A

Play and the Infant – Birth to 6 Months

123
Q

Play peek-a-boo
Rock or bounce
Let them feel textures
Repeat simple words
Pat-a-cake
Call them by name

Name parts of body and other frequently seen objects
Clap hands
Let them play in running water with supervision
Simple nursery rhymes
Roll ball

A

Play and the Infant – 6 Months to 1 Year

124
Q

Need for setting safe limits to prevent injury
Behavior is exploratory, not oppositional
Remove unsafe objects and unsafe areas
Age-appropriate discipline
“Time-out”

A

Limit Setting and Discipline for infants

125
Q

Aspiration of foreign objects
Suffocation
Motor vehicle injuries
Falls
Poisoning
Burns
Drowning

A

injury prevention for infants

126
Q

Aspiration and suffocation
Drownings
SIDS prevention “back to sleep”
Heating bottles
Risk of falls
Safety while traveling
Do not place car seats in front seat with airbags

A

Injury Prevention – Birth to 3 Months

127
Q

Keep small objects out of reach
Do not feed hard or round cylindrical foods
Avoid candy, nuts, food with pits or seeds
Do not feed lying down
Inspect toys for removable parts

Watch storage of chemicals
Keep latex balloons out of reach
Remove toys hanging above crib when child can push up
Keep plants out of reach
Secure furniture
Child-proof home

A

Injury Prevention – 4 to 7 Months

128
Q

Keep small objects away and off of floor
Only small pieces of food
No beanbags
Fence pools and install a gate alarm
No pools of water
Close bathroom doors

Always keep one hand on child when child is in tub
Avoid walkers
Fence stairways
Secure furniture
Guards around heating appliances
Baby-proofing

A

Injury Prevention – 8 to 12 Months

129
Q

Attachment – distinct preference around 6 months
Separation anxiety – normal around ______
Stranger anxiety – begins between ______
Nurses can talk softly, meet at eye level, and maintain a safe distance
Play as major socializing agent

A

4-8 months , 6-8 months

130
Q

VFrom nipple to solids
4-6 months of age
Weaning from breast/bottle may begin
Extrusion reflex disappears
reflex where the tongue pushes food or stuff out, disappearance of it indicates they are ready for solids
Swallowing is more coordinated
Head control
Able to sit while supported in chair

A

Nutrition – Assessing Readiness for Solids

131
Q

Eggs, milk, peanuts, tree nuts, fish, shellfish, wheat, and soy
Manifestations
GI – abdominal pain, vomiting, cramping, diarrhea
Respiratory – ”barky” cough, wheezing, rhinitis, dyspnea
Cutaneous – urticaria, rash, atopic dermatitis
Systemic – anaphylactic, growth failure

A

food sensitivity

132
Q

many allergies are ______

milk intolerance is developed as we become adults

A

grown out of

133
Q

______ appear approx. 6-10 months

A

Central incisors

134
Q

During the first two years of life
_________________ = # of teeth

A

age of child in months minus 6

135
Q

drooling, ↑finger sucking, or biting on hard objects, irritability, difficulty sleeping, mild temperature elevation, ear rubbing, and decreased appetite for solids

no aspirin and no whiskey

A

teething s/s

136
Q

Weight less than 5th percentile though height WNL

A

failure to thrive

137
Q

Inadequate caloric intake
Inadequate absorption – i.e., CF/Celiac disease
Increased metabolism – hyperthyroidism
Defective utilization – Genetic/metabolic
child abuse and neglet

A

Failure to Thrive (FTT)

138
Q

Focus is on reversing the cause
Long-term effects
Shorter statures
Lower weights
Lower scores on psychomotor development
Lower IQ scores
Eating and behavioral issues

help them catch up on calories and growth

never assume that information is known, don’t be condescending

A

FTT

139
Q

Sudden death of infant <1 year remaining unexplained after an autopsy

A

SIDS

140
Q

Risk factors
Maternal smoking
Co-sleeping
Prone sleeping
Soft bedding
Low birth weight

Low Apgar scores
Recent viral illness
Siblings of two or more SIDS victims
Male sex
Infants of Native American or African American ethnicity

A

Risk factors for SIDS

141
Q

Avoid smoking during pregnancy and near the infant
Breastfeeding
Supine sleeping position “Back to Sleep”
Avoid soft, moldable mattresses, blankets, and pillows
Avoid bed sharing
Avoid overheating during sleep
Vary infant head position to prevent plagiocephaly
Educate parents on “tummy time” during awake hours
fontanels are open so they can pass through the birth canal

tummy time- 10-15 minutes three to five times a day, will help them get stronger

A

Reducing the Risk of SIDS

142
Q

Weight gain about 5 lbs./year

A

toddlers

143
Q

Birth weight should be _____by 2-3 years of age

A

quadrupled

144
Q

Height increases to about _____
for toddlers

A

3 in./year

145
Q

Intense period of exploration
Temper tantrums, obstinacy occur frequently
Clear guidance such as limit setting necessary

A

toddlers

146
Q

Steady growth in height and weight
Walks without help but loses balance easily
Throws ball but falls
Throws objects
Scribbles
Uses cup with lid
Tolerates some separation from parent
Imitates parents
Kisses parents
Expresses emotions
Knows 4-6 words

A

milestones for 15 months

147
Q

Small appetite due to reduced growth
Anterior fontanel closed
Runs clumsily and often falls
Jumps in place
Can turn pages in a book (two or three at a time)
Manages spoon without rotation

Imitates
Unzips clothing
Temper tantrums
“Mine!” – Begins to understand ownership
Security item (ex- blanket)
Says 10 or more words but may be hard to understand
Points to body parts

A

major milestones 18 months

148
Q

Height at 2 years, double that number = roughly their adult height
May be able to control bowel and bladder during the day
Runs with wide stance
Picks up objects without falling

Turns pages one at a time
Imitates vertical and circular strokes when drawing
Turns doorknob
300-word vocabulary, 2–3-word phrases
Can say own name, talks constantly

A

major milestones 24 months

149
Q

Birth weight quadrupled
Has all primary teeth (20)
Jumps with both feet
Takes tiptoe steps
Good hand-finger coordination
Holds crayon with fingers vs fist
Names colors
Notes gender differences
Separates more easily from parent

A

major milestones 30 months

150
Q

May be able to control bowel and bladder at night
Rides tricycle
May try to dance, but fall
Complete four-to-five-word sentences
Talks incessantly
Asks questions… Why?

Starts to sing songs
Feeds self
Can help set table
May have fears (dark, monsters)
Focus is on Parallel Play
Eager to please parents

A

major milestones 3 years

151
Q

Erikson’s - Autonomy vs. Shame and doubt
Negativism
Ritualization
Separation anxiety
Piaget’s sensorimotor and preoperational phase
Awareness of causal relationships between two events
Learn spatial relationships
“there is something behind that cabinet door”

A

psychosicail/cognitive development for toddlers

152
Q

make decisions and do things by themselves (when they cant achieve it its where the shame and doubt comes in)

negativism: moody and strong emotions, don’t want to be stubborn or disrespectful

routines (talk to the parents and ask about routines so that they can have routines)

they are very egocentric

its expected for them to be egocentric

A

toddlers

153
Q

Voluntary sphincter control
Able to stay dry for 2 hours
Fine motor skills to remove clothing
Willingness to please parents
Curiosity about adult’s or sibling’s toilet habits
Impatient with wet or soiled diapers
Bowel training usually comes before bladder training
Practice sessions of 5-8 minutes

can be frustrating for kids and parents

18 to 24 months old is the period where this can be alright, mylenation does not occur in the spinal cord that controls the anal sphincter until around this age

bowel will come before bladder

A

assessing readiness for toilet training

154
Q

Motor vehicle injuries – car seat safety
5-point harness
Booster seats in rear seat of the car
Drowning
Burns
Poisoning
Falls
Aspiration and suffocation
Bodily damage

A

injury prevention for todlers

155
Q

Phenomenon of “physiologic anorexia”
Ritualism is common
Improved ability to chew and swallow
Don’t reduce fat intake in child younger than 2
Avoid sweets and nutrient-poor, high-calorie foods

Tips
Offer 3 full meals, 2 snacks
Portions = ¼ size of adult or 1 Tbsp./year of age
Serve near room temperature
Cut into bite-size pieces
Finger foods vs. utensil use

kids self regulate and they should carry it and practice it, shouldn’t force them to eat but the parent should decide what theyre eating

encourage utensile use

A

promoting nutrition in toddlers

156
Q

Model eating behaviors
Lifelong eating patterns established in childhood
Don’t allow to eat whatever they want, but don’t coerce either
May require 20 exposures to new food before accepting it
Positive attitude
May prefer only one type of food for a few days
May scream or throw food
Praise for trying new food
Include familiar foods with new foods

A

promoting health habits in toddlers

Child Health Nursing (7 decks)

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