peds Flashcards
growth and developemnt
growth = increase in physical development = increase in capability or function
***development does not always follow growth and chronological age
cephalaocaudal development
moes from head downward through body and towards feet
proximodistal development
moves from center of body outward to extremities
play and toys
play is the “work” of children
when born they have involuntary grasp reflex
general peds info
anterior fontanel close 12-18months
posterior fontanel close 2-3months
foods are introduced r/t allergies & immature GI tract
peanuts are dangerous to aspirate because when wet they swell and crumble
when giving IM injections the ventrogluteal muscle is contraindicated in children who have not been walking
pull earlobe down and back
they are not ready if they fail at toileting
should drink 2-3 cups of milk if 15mon
best friend stage occurs at 9-10 yo
suffocation and drowning are common deaths
teach stranger safety
growth rate decreases between 6-12yo
school age child requires 2400 cal/day
VS/assessment
begin with observation
use distraction
talk with parents first
VS: least invasive first observe before touching or talking to them progression of obtaining: RR HR BP Temp infants and toddlers can RR and HR for one full minute
Temps: rectal: most reliable DO NOT give newborns, diarrhea, rectal lesions, chemo, immunosuppressed axillary: all ages when oral is not possible oral: 5-6yo tympanic: all ages
O2:
obtain a picture of the blood oxygen level through the skin
check perfusion, skin temp, edema to determine the best location for the sensor probe
finger and toe
communication w/ newborn
nonverbal express through crying respond to human voice and presence touch has a positive effect enough parent to touch infant
communication w/ infant (1-12months)
primarily nonverbal begin verbal with repeating cosinents communicate through crying and facial expressions attentive to human voice and presence minimal comprehension of words responds to touch through patting, rocking, and stroking speak in gentle toned voice cuddle pat rub to calm encourage the presence of parents
communication w/ toddlers and preschoolers (1-5yo)
verbal skills
3-4 form 3-4 word sentences called telegraphic speech
concrete thinking
vocabulary depends on development and family’s use
may ask a lot of questions
short attention span
limited memory
cognitive development: egocentric magical thinking animism object performance
nonverbal communication:
dramatic play
drawing
play is the work of the child
communication with school age children (6-12yo)
cognitive development: able to use logic understand other point of view understand cause and effect understand body functions
verbal communication:
big vocabulary
receptive and expressive language is balanced
misinterpretation of phrases is still common
nonverbal:
interpret nonverbal messages
expression of thoughts and feelings
communication w/ adolescents (13-18yo)
abstract thinking without full adult comprehension
interpretation of medical terminology is limited
independence
trust and understanding build rapport
privacy
strategies:
straightforward
talk in private
part of interview without parents present
communication w/ children w/ physical and or developmental disabilities
may feel hopeless, fear, and anxiety if cannot communicate
family may experience fear and anxiety
strategies: use gestures picture boards writing tablets head nods eye blinks
observable signs of respiratory distress in children
use of accessory muscles
nasal flaring
sternal retractions
grunting with respirations
any illness than affect O2 and CO2
ex: pneumonia, atelectasis, pneumothorax, pleural effusion
laryngotracheobronchititis
aka croup
viral infection that causes slight/severe dyspnea, barking cough, brassy cough, high temp
viral organisms that cause this:
parinfluenza
adenovirus
RSV
treatment:
steam from hot showers
cool temp therapy (constricts the swollen blood vessels in the trachea that are swelling)
nebulizer epinephrine (fast, improvement 10-15minutes, watch for relapse and return of symptoms) or corticosteroids
epiglottis
obstructive inflammatory process absence of cough presence of dysphagia drooling rapid progression to severe respiratory distress
primary organism cause: H flu
prevention: Hib vaccine
caused by infection of the epiglottis
can lead to occluded airway
medical emergency
** the less noise they may the worse the airway is obstructed
don’t visualize throat with tongue depressor
RSV
respiratory syncytial virus
leading cause of lower respiratory tract illness in children less than 2yo
caused by acute viral infection that affects the bronchioles
RF:
prematurity
congenital disorders
smoke
s/s begins with simple URI nasal discharge fever wheezing nonproductive paroxysmal cough tachypnea with flaring nares dyspnea and retractions know the onset of s/s because RSV will worse at 2-3 days
treatment:
mild: antipyretics
severe:
IV fluids
albuterol sulfate
antipyretics
suction
O2
