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Peds > concepts, roles, and issues > Flashcards

concepts, roles, and issues Flashcards

1
Q

name some different roles of the nurse in pediatrics

A
  • direct care provider (tailored to childs developmental stage)
  • patient/fam educator
  • patient advocate
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2
Q

whats needed to effectively educate children and families

A

planning and preparation as well as understanding of the childs developmental and cognitive level

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3
Q

describe being a patient advocate

A
  • enable child/fam to deal with changes in health in their own way
  • awareness of fams needs and resources
  • assist in making informed choices and act in childs best interest
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4
Q

what is case management

A
  • process of coordinating healthcare services for children w complex health conditions, in which a nurse performs long term coordination to help a child receive timely access to needed health servies in a safe, high quality, and cost effective manner
  • provides continuity of care
  • creating an interdisciplinary plan to address significant health probs in a child
  • considers fam wishes
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5
Q

whats included in case management

A
  • medical and nursing needs
  • developmental needs
  • educational needs
  • psychosocial needs
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6
Q

describe research

A
  • studies effectiveness of new treatments
  • evalutae interventions for improved outcomes
  • may reduce cost of care
  • increases integration of EBP
  • all nurses can participate in research
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7
Q

what was the major cause of death back in the day for kiddos

A

infectious disease

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8
Q

describe the evolution of pediatric care

A

then:
- imited visiting hours
- extended stays
- children treated the same as adults

now:
- parents stay at bedside
- shorter stays with many procedures done on outpatient basis
- recognition of childhood and special needs of child

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9
Q

describe clinical reasoning

A

utilizing the nursing process
- analyzing data from the history, physical exam, and lab tests
- discriminating between signs, therapies, or appropriate nursing actions

  • seeking additional appropriate care to provide
  • using logical reasoning when developing a plan of care
  • identifying expected outcomes associated with plan of care
  • evaluating outcomes and need for modification
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10
Q

describe critical thinking

A

individualized reasoning process used to problem solve

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11
Q

describe EBP

A
  • problem solving approach that combines best evidence with clinical expertise, patient circumstances/values/preferences
  • provides bridge between research and practice
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12
Q

describe clinical practice guidelines (clinical pathways)

A
  • collaboration of evidence based and expert opinion
  • used to decide appropriate care
  • sets standards and benchmarks
  • often set by national health organizations like American Academy of Pediatrics
  • describe sequence and timing of interventions that should result in expected patient outcome
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13
Q

describe fam centered care

A
  • building collaborative relationships between health professionals and families
  • respectful of diversity, beliefs about the nature of the childs condition, and ways to manage it
  • always ask families about their normal routines at home and try to incorporate it into care at hospital
  • families are partners in care of child
  • recognize importance of fam presence and involvement in helping child recover from illness and injury
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14
Q

what is infant mortality

A

death within the first year of life

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15
Q

what are some causes of neonate mortality (birth - 28days)

A
  • congenital malformations (#1 cause)
  • low birth weight, prematurity
  • maternal or birth complications (placenta probs, premature rupture of membranes)
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16
Q

what are some causes of infant mortality (28days - 1yr)

A
  • congenital malformations (#1 cause)
  • low birth weight (#2)
  • SIDS (#3 - teach about safe sleep practices)
  • unintentional injury (#4 - suffocation, homicide, MVA, drowning)
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17
Q

whats the leading cause of death in children 1-19yrs

A
  • injury is the leading cause of death
  • education of parents and families very important
18
Q

describe childhood mortality

A
  • death rates for children greater than1yr of age are less than that for infants
  • ages 5-14 have the lowest death rate
  • sharp increase occurs in adolescence - injuries, homicide, suicide
19
Q

describe child morbidity

A

illness or injury that limits activity, requires medical attention or hospitalization or results in chronic condition

20
Q

what are some factors that contribute to increased morbidity

A
  • homelessness
  • poverty
  • low birth weight
  • chronic illness
  • foreign born, adopted children
  • attendance at day care
21
Q

name some different programs for healthcare financing

A
  • CHIP
  • medicaid
  • private insurance
22
Q

describe CHIP

A
  • serves uninsured children up to age 19
  • whe income is too high for medicaid but inadequate for private insurance
23
Q

describe ACA

A
  • for kids with incoe too high for both CHIP and medicaid
  • no exclusion for preexisting chronic conditions
  • no annual limits
  • allow kids to stay on parents insuance until 26
24
Q

describe nurse practice act

A
  • regulated by each state
  • defines legal roles and responsibilities of nurses
25
Q

describe standards of clinical practice

A
  • developed by ANA, SPN, NAPNAP
  • defines standards for nursing care and performance
26
Q

describe informed consent

A
  • must be given voluntarily and prior to procedure or enrolling a child in research
  • children are not considered competent to make informed healthcare decisions
  • legal guardians are requested to give informed consent on behalf of child
  • formal preauthorization for an invasive procedure - signed and witnessed
  • also needed for participation in research
  • focuses on the comprhension by patient and fam of what is going to be done
27
Q

what information must be provided in order to obtain informed consent

A
  • explanation of condition
  • detailed description of treatment
  • risks and benefits of treatment
  • possible alternative treatments
  • right to refuse treatment for child
28
Q

who is legally responsible for obtaining informed consent?

A

physician

29
Q

whats the nurses role in informed consent?

A

responsible for making sure it is present and available before procedure

30
Q

when parents are divorced, who is eligible to consent to medical treatment of the child

A

only the parent with legal authority may give consent

either parent may consent in cases with shared custody and they meet with social services

31
Q

a child under 18yrs can give consent if they are:

A
  • parent or pregnant
  • emancipated minor (legally)
  • seeking birth control, mental health or substance abuse treatment
32
Q

parents have legal authority about health care choice except when…

A
  • choice doesnt permit life saving treatment for child
  • potential conflict of interest between child and parent (abuse)
33
Q

what is confidentiality

A

information discussed during care will ot be shared without patient permission

34
Q

hat are some exceptions to confidentiality

A
  • adolescent with a reportable disease like STI (public health hazard)
  • suspected child abuse
  • suicide risk
35
Q

what are some concerns to take with confidentiality and adolescents

A
  • speak with patient separately, away from parents
  • speak with parents alone
36
Q

describe the atmosphere with confidentiality and adolescents

A
  • close doors when collecting med history
  • create comfortable atmosphere for discussion
37
Q

what are some limitations to confidentiality and adolescents

A
  • explain parameters of confidentiality
  • identify siuations in which confidentiality may be breached
  • encourage conversation with parents if able and safe
  • never promise that nothing will ever be shared
38
Q

describe patient self-determination act

A
  • informs patient of their rights about preferences for treatment options and making advanced directives like living wills and durable power of attorney
  • especially important for adolescents with life threatening conditions
39
Q

describe DNR/AND

A
  • more common for children with terminal illnesses
  • children may be cared for at home or hospice
  • community issue - state parameters put in place to honor
40
Q

describe ethics

A
  • ethical issues may include saving newborns with severe impairments, genetic testing or organ transplants
  • ethics committees are in all hospitals
  • know personal feelings on ethical issues

Peds (15 decks)

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