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6TH SEMESTER > PEDI--EXAM 1 > Flashcards

PEDI--EXAM 1 Flashcards

1
Q

The entire DNA sequence of an individual and the study

A

genome

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2
Q

the set of 46 chromosomes contains 22 pairs of _____.

A

autosomes

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3
Q

how many copies of autosomes?

A

2!

one from mom & one from dad

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4
Q

members of a chromosome pair are called

A

homologous chromosomes

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5
Q

which chromosome pare are the sex chromosomes?

A

23rd pair

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6
Q

picture of an individual’s chromosomes

A

karyotype

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7
Q

takes place in somatic or tissue cells of the body and represents how the body makes new cells.

A

mitosis

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8
Q

fertilized ovum

A

zygote

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9
Q

is also known as reduction division of the cell

A

meiosis

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10
Q

occurs only in the reproductive cells of the testes and ovaries and occurs only in the reproductive cells of the testes and ovaries and results in the formation of sperm and oocytes

A

meiosis

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11
Q

the formation of sperm and oocytes

A

gametes

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12
Q

a segment of a chromosome that can be identified with a particular function, most commonly production of one or more proteins

A

gene

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13
Q

different forms or versions of the nucleotide sequence because each gene copy is inherited form each parent

A

alleles

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14
Q

an individual who has two functionally identical alleles of a gene

A

homozygous

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15
Q

an individual who has 2 different alleles of the gene is said to be

A

heterozygous

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16
Q

may be apparent as a trait, such as curly hair or straight hair, or as signs or symptoms of a disease

A

phenotype

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17
Q

each individuals particular set of genes represents their _____.

A

genotype.

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18
Q

which statement indicates correct information has been given to the parents of a child having genetic screening? autosomal recessive characteristics:

A

affect males and females equally

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19
Q

in discussing concerns with a pregnant woman, which information is crucial for the nurse to collect to ensure the most accurate genetic information is available? select all that apply

A
  • a family medical history 3 previous generations
  • relationships btw any affected family members
  • the birth history for any siblings of the baby
  • a medical history for both mother and father
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20
Q

hyponatremia genetic referral concern?

A

speech problems

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21
Q

which will best facilitate genetic information from a child?

A

implement developmentally appropriate assessment skills

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22
Q

freud’s stages of development

A 
oral
anal
phallic
latency
genital
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23
Q

age for oral

A

birth to 1 year

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24
Q

age for anal

A

1-3

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25
Q

phallic age

A

3-6

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26
Q

latency age

A

6-12

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27
Q

genital age

A

12 to adulthood

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28
Q

sucking on their finger or pacifier – baby gets pleasure and comfort through the mouth

A

oral

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29
Q

nursing considerations for oral stage

A

♣ Encourage breast feeding

♣ Offer bottle

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30
Q

potty training

A

anal

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31
Q

nursing considerations for anal

A 
♣	Ask if they are toilet trained
♣	Any rituals about going to the potty
♣	Words they use for elimination 
♣	Keep a normal pattern for elimination
♣	Do not start potty training during an illness
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32
Q

• – genitalia – noticing a difference between boys and girls – they may start touching themselves – relationship between sexes (parents)

A

phallic stage

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33
Q

phallic nursing considerations

A

♣ Determine if the child is more comfortable with male or female nurses
♣ Explain procedures that will involve the genitalia
♣ Keep the parents involved

PRIVACY

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34
Q

• – into the social thing, starting to understand their bodies better and they want privacy

A

latency

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35
Q

latency nursing considerations

A

♣ Provide them gowns
♣ Keep them covered
♣ They can keep their underwear on if at all possible
♣ Knock before you enter the room

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36
Q

• developing relationships, starting to mature sexually, have a surge of hormones, focus is on their genitalia function and relationships, time when parents should be encouraged to talk to their child about sex.

A

genital

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37
Q

nursing considerations for genital

A 
♣	Enquire about significant friends
♣	Provide privacy for exams
♣	Educate about sexuality
♣	Gynecologic care for females
♣	Any changes
♣	Testicular exam for males.
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38
Q

freud viewed the personality as a structure with 3 parts

A

id
ego
superego

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39
Q

the basic sexual energy that is present at birth and drives the individual to seek pleasure

A

id

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40
Q

the realistic part of the person, which develops during infancy and searches for acceptable methods of meeting impulses

A

ego

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41
Q

the moral and ethical system, which develops in childhood and contains a set of values and a conscience

A

superego

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42
Q

freud’s defense mechanisms of children

A

regression
repression
rationalization
fantasy

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43
Q

o return to earlier behavior: toilet training

♣ Start having accidents in the hospital

A

regression

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44
Q

o involuntary forgetting: abused child

♣ With uncomfortable situations the abused child is not able to recall what happened

A

repression

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45
Q

unacceptable becomes acceptable: “He hit me first!”

A

rationalization

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46
Q

o mind creation to protect self: special powers, superman

A

fantasy

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47
Q

erikson’s stages of development

A 
trust vs. mistrust
autonomy vs. shame & doubt
initiative vs. guilt
industry vs. inferiority
identity vs. role confusion
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48
Q

age for trust vs. mistrust

A

birth to 1 year

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49
Q

autonomy vs. shame & doubt age

A

1-3

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50
Q

initiative vs. guilt age

A

3-6

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51
Q

industry vs. inferiority age

A

6-12

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52
Q

identity vs. role confusion age

A

12-18

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53
Q

piaget’s theory of cognitive development

A

sensoriomotor
preoperational
concrete operational
formal operational

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54
Q

age for sensoriomotor

A

birth to 2

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55
Q

age for preoperational

A

2-7

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56
Q

age for concrete operational

A

7-11

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57
Q

age for formal operational

A

11 - adult

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58
Q

what to kids use during sensorimotor stage (birth - 2)

A

object permanence

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59
Q

they touch everything, they learn through their senses and their motor activities, learning about object permanence- just bc it’s out of sight doesn’t mean it’s gone

A

object permanence

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60
Q

what do they use in preoporational stage

A 
egocentrism
transductive reasoning
magical thinking
centration
animism
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61
Q

if they were bad and weren’t listening then that’s why this happened),

A

transductive reasoning

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62
Q

(believe inanimate objects come to life – ex. Blood pressure cuff makes noises so it is going to eat their arm)

A

animism

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63
Q

• They think the reason something bad happens was because they said it or thought it.

A

preoperational

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64
Q

what to they use in concrete operational (7-11)

A

conservation

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65
Q

starting to understand things a little bit more. Their arm will still be there when they take the cast off, etc. better understanding of cause and effect. Like to manipulate objects, see things and touch them

A

conservation

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66
Q

• abstract thinking keep them up to date with what’s going on with their care. Consider different outcomes or alternatives

A

Formal operational (11-adult)

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67
Q

kohlberg’s stages of moral development

A

preconventional
conventional
postconventional

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68
Q

preconventional age

A

4-7

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69
Q

conventional age

A

7-11

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70
Q

postconventional age

A

12 and up

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71
Q

what do they want in pre conventional stage (4-7)

A

avoid punishment

please others

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72
Q

what do they want in conventional stage (7-11)

A

they want to please others by following rules, they want to be good.

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73
Q

what do they do in post conventional stage (12 and older)

A

develop their own ethical standards and principles;

look at 2 different approaches and make a decision

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74
Q

pavlov’s theory

A

positive and negative reinforcement

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75
Q

positive reinforcement

A

will encourage good behavior

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76
Q

negative reinforcement

A

get rid of behavior such as scolding

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77
Q

environmental systems

A 
microsystem
mesosystem
exosystem
macrosystem
chronosystem
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78
Q

♣ Daily consistent relationships at home or school that affects the child; as well as the child affecting them

A

microsystem

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79
Q

♣ These are microsystem relationships with each other; home affects school performance, etc.

A

mesosystem

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80
Q

♣ Settings that the child are not in daily contact with but they do still influence the child. Ex. Parents work – If parents can’t take off to go to a child’s field trip. Parents can’t take off of work when their child is sick because they don’t have any sick time is another example.

A

exosystem

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81
Q

♣ Cultural, political and faith influences

A

macrosystem

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82
Q

♣ Time when the child is growing up effects the views of health and illness

A

macrosystem

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83
Q

♣ Time when the child is growing up effects the views of health and illness

A

chronosystems

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84
Q

generally moderate in activity; shows regularity in patterns of eating, sleeping, and elimination; and is usually positive in mood and when subjected to new stimuli

adapts to new situations and is able to accept rules and work well with others.

schedule for eating, sleep, and pooping

A

“easy” temperament

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85
Q

displays irregular schedules for eating, sleeping, and elimination; adapts slowly to new situations and persons; and displays a predominantly negative mood

intense reactions to the environment are common

A

the “difficult” child

86
Q

has reactions of mild intensity and slow adaptability to new situations.

the child displays initial withdrawal followed by gradual, quiet, and slow interaction with the environment

A

the “slow-to-warm-up” child

87
Q

• Their ability to function with health responses with significant stressful situations

A

resiliency model

88
Q

resiliency model

A 
developmental and situational stresses
healthy functioning
protective factors
risk factors
adjustment
adaptation
assessment
application to nursing care
89
Q

• Physical growth milestones

2-4 months:

A

o Posterior fontanel closes
o Holds rattle and plays and looks at own fingers
o Rolls from side to back then returns to side
o Holds head up and supports weight on forearms when on stomach
o Follows objects 180 degrees and turns head toward voices or sounds

90
Q

• Physical growth milestones

4-6 months:

A

o Birth weight doubled by 6 months
o Teething
o Puts objects in mouth, holds bottle, pulls feet to mouth
o Can roll from stomach to back by 4 months and back over to stomach by 6 months
o Able to hold head up when sitting
o Watches falling objects

91
Q

• Physical growth milestones

6-8 months:

A 
o	Likes to bang objects while holding them
o	Can move objects between hands
o	Sits without support by 8 months	
o	Bounces when held in standing position
o	Looks and smiles when name spoken
92
Q

• Physical growth milestones

8-10 months:

A 
o	Can pick up small objects by using pincer grasp
o	Crawls or creeps 
o	Pulls up to standing by 10 months
o	Recognizes sound
o	Says mama and dada
93
Q

• Physical growth milestones

10-12 months:

A

o Birth weight triples by 1 year
o Can hold crayon, places blocks into containers with holes
o Stands alone, walks holding furniture, sits from standing
o Plays peek a boo and patty cake

94
Q

• Physical growth milestones

1-2 years:

A 
o	Birth weight quadrupled by 2 years
o	Pot-bellied appearance
o	Anterior fontanel closes
o	Can scribble, build 4 block tower, undress self, throw ball, push/pull toys
o	Runs, walks up and down stairs
95
Q

• Physical growth milestones

2-3 years:

A

o Has approximately 20 teeth by 3 years
o Can draw simple shapes
o Learning to dress self
o Jumps, kicks a ball and throws it overhand

96
Q

weight by 6 months

A

should be double the birth weight

97
Q

when should baby be able to roll from stomach to back

A

4 months

98
Q

roll from back to stomach by?

A

6 months

99
Q

sit without support by which age?

A

8 months

100
Q

pulls up to standing by

A

10 months

101
Q

birth weight ____ by 1 year

A

triples

102
Q

birth weight ___ by 2 years

A

quadrupled

103
Q

how many teeth by 3 years

A

20

104
Q

uses parallel play

A

toddler 1-3 years

105
Q

looses first deciduous tooth around __ years

A

6

106
Q

cooperative play

A

school age 6-12

107
Q

♣ Don’t use then when trying to speak to someone and educate them.

A

medical jargon

108
Q

forms of nonverbal communication

A 
paralanguage
gestures
touch
personal space
facial expression
body language
eye contact
physical appearance
109
Q

o Ability to perceive another person’s experience from their view “putting self in their shoes”

A

empathy

110
Q

• Communication with infants is still primarily ______.

A

nonverbal

111
Q

how to talk to infant

A

high-pitched soft tone

112
Q

where to let the infant sit during the assessment

A

with the parents on their lap

113
Q

toddler & preschooler cognitive development

A

magical thinking

114
Q

how do toddlers & preschoolers express themselves?

A

dramatic play & drawing

115
Q

who to talk to first with toddlers & preschoolers?

A

acknowledge child but speak with parents first

116
Q

how to sit when talking to toddlers & preschoolers

A

@ eye level

117
Q

can you talk about procedures in front of the preschooler or toddler?

A

not if its scary

118
Q

• now able to use logic
o Begin to understand others’ viewpoints
o Begin to understand cause-effect
o Understanding of body functions

A

school age children

119
Q

can school age children interpret nonverbal messages?

A

YES

120
Q
  • Abstract thinking without full adult comprehension

* Interpretation of medical terminology is limited

A

adolescents

121
Q

strategies to facilitate rapport and data collection

A 
introduction
purpose of interview
use open and close-ended questions
timing of questions
privacy
nonverbal communication
observations
honesty
language
122
Q

• Past health and illness history/ages of occurrence examples:

A

o Birth history
o Communicable diseases and illnesses
o Hospitalizations and surgery
o Injuries

123
Q

how many generations for genetic FH

A

3

124
Q

Sequence of Examination for young children

A

foot to head

125
Q

Sequence of Examination

for older children

A

head to toe

126
Q

• Infants Under 6 Months of Age

A

o Encourage the parents to participate in the exam
o Distract the infant with toys
o Use gentle warm hands and warm stethoscope

127
Q

• Do procedures that provoke crying when

A

at end of exam

128
Q

when to auscultate on under 6 month olds

A

when quiet or sleeping

129
Q

where to keep the baby over 6 months old during the assessment

A

as close to parent as possible to alleviate separation anxiety

130
Q

when to examine ears, eyes, & mouth for toddlers?

A

end of the exam

131
Q

what to do before examining toddler?

A

o Demonstrate instruments on parent or other before examining child

132
Q

• Head circumference Done until the child is

A

2-3 years

133
Q

o Length Children under 2

A

= supine position even if they are able to stand

134
Q

o Standing scale for what age groups

A

♣ Preschooler and older

135
Q

• Head circumference done until

A

child is 2-3

136
Q

anterior fontanel

A

12-18 months

137
Q

posterior fontanel

A

2-3 months

138
Q

• Child ___ years old and older for six cardinals fields

A

3

139
Q

• See if an infant reaches for objects when you place it in front of their _____.

A

face

140
Q

Pinna back & up for

A

over 3years

141
Q

pinna down & back for `

A

under 3years

142
Q

♣ A child 6 months or younger will not automatically open up their mouth if?

A

their nose is stuffy

143
Q

♣ Common to feel mobile form lymph nodes up to

A

1 cm

144
Q

♣ Warm tender nodes could be

A

infection

145
Q

2 y/o chest

A

oval shaped

146
Q

check chest circumference until about ____ years

A

2

147
Q

how to heck HR on infants and children

A

full minute & apical pulse

148
Q

• Up until about 6 years they breath with their

A

diaphragm

149
Q

♣ auscultate for At least ___ minutes before saying they don’t have bowel signs

A

5

150
Q

♣ female Pubic hair Usually will not develop before ___ years old

A

8

151
Q

male pubic hair usually will not develop before __ years old

A

9

152
Q

scale used to measure male puberty and sexual maturation

A

tanner scale

153
Q

check posture and spinal alignment for ____ in school aged children

A

scoliosis

154
Q

how to check lower extremity musculoskeletal system on a child

A

have child stand on one leg then the other

155
Q

how to check lower extremity musculoskeletal system on an infant

A

ortilani-barlow maneuver

156
Q

legs should be straight by___ years old

A

4

157
Q

• By ____ years old you should be able to understand the child clearly

A

3

158
Q

• Test memory by about ___ years old

A

4

159
Q

o how to check Sensory functioning

A

♣ Close their eyes and touch them with something – tell them to point where they felt it

160
Q

♣ Pain sensation check at ____ years and older

A

4

161
Q

♣ Moro (startle)reflex disappears by about ___ years old

A

6

162
Q

♣ Palmer grasp disappears by ___ months

A

3

163
Q

♣ Plantar (grasp with toes) disappears by ___ months

A

8

164
Q

♣ Babinskis response – normal under

A

2 years old

165
Q

skin turgor for a baby

A

chest or abdomen

166
Q

♣ If fontanels are bulging-

A

increased intracranial pressure

167
Q

♣ Sunken fontanels -

A

dehydration

168
Q

♣ When we listen for breath sounds, we listen

A

anterior and posterior

169
Q

• Psychological impact of disaster on Infants, toddlers, and preschoolers

A

♣ Fear, separation anxiety, regression
♣ They may have a change in their sleeping or eating patterns
• Nightmares, fear the dark, separation anxiety, regression
♣ Whole family may be together in a shelter but it is not their normal atmosphere.

170
Q

• Psychological impact of disaster on school-aged

A

♣ Sadness, anger, fear
♣ Fearful for themselves or their family
♣ Loss of usual interests
♣ May act out

171
Q

• Psychological impact of disaster on adolescents

A 
♣	Decreased interest in usual activities
♣	They may act out or step up to the plate and be part of the clean-up etc. 
♣	Risky behavior
♣	Acting out 
♣	Sadness and anger
♣	Somatic complaints
•	Headache
•	Stomach ache
172
Q

♣ _____ may be more readily absorbed in children’s thin skin

A

Toxins

173
Q

♣ Children breath faster so they might breath in more

A

toxins

174
Q

o Pediatric drugs/supplies for disaster

A

♣ 3 day supply of food, water, etc.

♣ Bring medications, toys, diapers, baby formula, etc. to the shelter.

175
Q

o will fear pain, invasive procedures, and mutilation of their bodies

A

toddlers

176
Q

o fear being alone, the dark, being abandoned as well as mutilation

A

school age child

177
Q

o fear a change in their body image, bodily injury, disability, pain, death, and separation from their friends and home, and loss of privacy and their independence.

A

adolescents

178
Q

(when a child returns to an earlier behavior such as sucking thumb)

A

regression

179
Q

(involuntary forgetting)

A

repression

180
Q

(putting things off)

A

postponement

181
Q

• Therapeutic play Addresses fears, concerns how?

A

♣ Give them a piece of paper to draw their concerns

182
Q

respiratory changes due to pain in children

A

♣ Alkalosis
♣ Retained secretions
♣ Decreases oxygen saturation

183
Q

o Neurological changes due to pain in children

A

♣ Increase in heart rate, blood sugar, cortisol levels

♣ Altered sleep patterns

184
Q

metabolic changes due to pain in children

A

♣ Increase in fluid and electrolyte losses
• Fever, increased respiration, perspiration
♣ Delayed wound healing because of pain

185
Q

o Infant behavior due to pain

A

♣ Cry, not eating right, irritable, restless, etc.

186
Q

toddlers behavior due to pain

A

♣ Aggressive behavior
♣ Physical resistance
♣ Cry
♣ Can’t describe pain but may say ouch or boo-boo

187
Q

preschooler behavior due to pain

A

♣ They may deny pain so they may not say a lot
♣ May believe the nurse or parent already knows they are hurting
♣ Aggressive behavior

188
Q

school age behavior due to pain

A

♣ Tell you where their pain is and describe it
♣ A lot of times they try to be brave
♣ May withdraw emotionally

189
Q

school age behavior due to pain 10-12 years old

A
  • Describe their pain a little bit more
  • Trying to be brave
  • May pretend they are comfortable, but the pain and anxiety could cause some regression
190
Q

adolescents behavior due to pain

A

♣ A lot of times they think that the nurse should know when they’re hurting so they may not complain about anything
♣ Try to control their responses to pain
♣ May use distraction with them as well

191
Q

Neonatal characteristic facial responses to pain include

A

bulged brow; eyes squeezed shut; furrowed nasolabial creases; open, angular, squarish lips and mouth; taut tongue; and a quivering chin.

192
Q

Memories of past pain can trigger _____

A

anxiety

193
Q

o FLACC

A

♣ Face, legs, activity, crying, consolability

194
Q

♣ Observe the child during routine care for about 1-5 minutes and pick the behavior that goes along with each category.

A

FLACC scale

195
Q

which age groups use the FLACC scale

A

infants
toddlers
preschoolers

196
Q

which age group uses the OUCHER pain scale

A

all but infants

197
Q

toddlers use the FLACC scale, oucher scale, and…..

A

faces pain rating scale

198
Q

preschoolers use FLACC scale,oucher scale, faces pain rating scale and?

A

poker chips

199
Q

• School age painting scale

A 
o	Oucher 
o	Faces Pain Rating scale
o	Poker Chip
o	Word Graphic
o	Visual analogue
200
Q

♣ Numeric pain scale

♣ Horizontal line numbered 1-10

A

visual analogue

201
Q

• Adolescent pain scales

A 
o	Oucher 
o	Faces Pain Rating Scale
o	Poker Chip
o	Word Graphic
o	Visual analogue
o	Adolescent pediatric pain tool
202
Q

o for less severe pain or chronic pain

A

NSAIDs

203
Q

o For severe pain
o Have the correct dosing for weight

side effects: Sedations, N/V, urinary retention, constipation

A

opioids

204
Q

heat/cold therapies can treat

A

muscle spasms & bleeding

205
Q

how to evaluate after pain meds are given

A

o Assess the pain 15-30 minutes and then 1 hour after a PO medication

206
Q

what is the preferred route for meds

A

oral

207
Q

can you mix the meds in a bottle?

A

NO

208
Q

what is preferred over the IM route

A

IV

209
Q

purpose of sedation

A

to control pain during a procedure

210
Q

light sedation

A

child able to support airway

talk normally

211
Q

moderate sedation

A

conscious sedation

can maintain airway

purposeful response to vocal or tactile stimuli

212
Q

deep sedation

A

cannot support airway

ventilate or oral airway

bag mask

6TH SEMESTER (22 decks)

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