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Child Health 3122 -winter 2023 > Child Health Final > Flashcards

Child Health Final Flashcards

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1
Q

What type of communication should be used with a toddler?

A

Autonomy- allow for choices to reduce stress

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2
Q

What type of communication should be used with a preschooler?

A

Initiative- provide concrete and literal descriptions

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3
Q

What is Erikson’s theory of psychosocial development for infants?

A

Trust vs. mistrust

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4
Q

What is Erikson’s theory of psychosocial development for toddlers?

A

autonomy vs. shame and doubt

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5
Q

What is Erikson’s theory of psychosocial development for preschoolers?

A

initiative vs. guilt

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6
Q

What is Erikson’s theory of psychosocial development for school age (6-12)?

A

industry vs. inferiority

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7
Q

What is Erikson’s theory of psychosocial development for adolescence?

A

identity vs. role confusion

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8
Q

hypotonic dehydration

A

prolonged vomiting diarrhea, burns , IV fluids with no electrolytes.
here more sodium is lost than water. Compensatory mechanism moves fluid from EC INTO cells causing EVEN more ECF deficit

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9
Q

what is Piaget’s theory of cognitive development for adolescence?

A

Formal operational stage

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10
Q

What is Piaget’s theory of cognitive development for :
infants
toddlers
preschoolers
school age

A

infants - sensorimotor
toddlers - preoperational
preschoolers - preoperational
school age- concrete operational

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11
Q

Isotonic dehydration

A

cause: vomit/diarrhea
sodium and water loss is the same

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12
Q

In the pediatric assessment triangle, what do we look for under “appearance” ( TICLS)

A

Tone
Inter-activeness
Consolability
Look/Gaze
Speech/Cry

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13
Q

Pediatric assessment triangle, under “work of breaking” what do we look for? (RAAN)

A

Retractions (sign of working hard to breath)
Abnormal breath sounds
Abnormal positioning
Nasal Flaring

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14
Q

In the pediatric assessment triangle what is the “circulation to the skin”

A

Pallor
Mottling
Cyanosis

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15
Q

In pediatrics, when there is a decrease in intravasular volume ( due to shock) the CO and SV decrease. What is a compensatory mechanism that only exists in this age group?

A

Increase of HR - this does not happen to adults but we do get RAAS to activate and increase BP

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16
Q

What are some of the symptoms for hypovolemic shock?

A

-normal BP (until later)
-peripheral constriction = poor cap refill
-tachycardia = low central venous pressure
-normal CNS

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17
Q

What are some symptoms of septic (distributive) shock?

A

warm to cold phase
normal BP - or it wide pulse pressure
fever - hypothermia
tachycardia
tachypnea
bounding pulses
irritable

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18
Q

What are some symptoms of anaphylactic shock (distributive)

A

-allergic reactions: swelling, rash, flushed skin and nasusea
feeling dizzy, confusion, anxiety

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19
Q

What are some symptoms of cardiogenic shock?

A

-agitation
-cold and pale
diaphoretic
tachypnea
tachycardia
edema
oliguria
mottled/cyanotic
decreased peripheral circulation

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20
Q

What are the 3 stages of hypovolemic shock?

A
  1. early- compensatory mechanisms work. BP is normal with narrow pulse pressure, peripheral constriction, and increased HR
  2. Late (hypotensive) - NO compensatory mechanisms working now. BP is low, NO peripheral pulses, decreased LOC
  3. Cardiopulmonary failure (irreversible)- vasoconstriction and hypoxia with irreversible organ damage
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21
Q

Dehydration reg flags (TS D3)

A

tachycardia or dry mucous membranes
sunken eyes
decreased urine out put and specific gravity
doughy or tenting tissue turgor
decreased tears

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22
Q

The ABC’s for shock treatment

A

A-airways managed/
B-breathing 100% oxygen
C- circulation - need for IV, fluids (EXCEPT for cardiogenic), assess circulation

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23
Q

signs of infection in an infant?

A

loss of appetite, sleep disruption not regular, elevated temp/resp

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24
Q

Warm vs cold shock - describe warm

A

-tachycardia
-tachypnea
-fever
-bounding pulse
-fussy
-flushed looking
-WIDE pulse pressured (30-40)
BP normal or slightly increased

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25
Warm vs. cold shock - describe cold phase
tachycardia WOB increased and can lead to resp depression hypotension - narrow of pulse pressure by 10-20 hypothermia cool and pale extermities decreased cap refill -decreased pulse - weak @ peripherals -low urine output ( <1 ml/kg/hr) -altered LOC
26
Resp rate for newborn
30-55
27
RR for 1 year old
25-40
28
RR 3 yr old
20-30
29
RR 6 yr old
16-22
30
RR 10 yr
16-20
31
RR 17yrs
12-18
32
HR newborn
100-170 (avg. 120)
33
HR infant-2yrs
80-130 (avg. 110)
34
HR 2-6 yrs
70-120 (avg.110)
35
HR 10-16yrs
60-100 (avg. 85)
36
HR 6-10 yrs
70-110 (avg. 90)
37
Symptoms of anaphylaxis (think FAST)
face airway - loss of tone due to vasodilation, capillaries leak fluids with mast cells stomach total
38
Strategies advocacy and capacity building
1. assess and clarify needs and priorities 2. build effective communication and partnership (IFCP) 3. focus on health promotion 4. support equal opportunities and resources to enable health
39
4 key elements of FCC
1. Collaboration 2. info sharing 3. participation 4. dignity, respect
40
What is the acceptable urine output range?
1-2ml/kg/hr
41
for infants weighting from 3.5 -10kg what is the daily fluid requirment?
100ml/kg
42
When does stranger anxiety develop?
6 months
43
Communication: infants (<12 months)
Trust.vs mistrust; sensorimotor; oral stage -sensory focued, solitary play swaddle, comfort
44
Communication : toddler
Autonomy vs. shame/doubt; pre-operational; anal stahe - promote independece by giving choices -encourgae experession -parallel play -receptive speech
45
when does associative play happen?
preshoolers (3-6yrs) children interacting in groups and partipcaitng in activities
46
6-month-old developmental milestones
-birth weight doubles -say sounds like "daddaa" -first tooth may appear -able to support head when sits with support -grabs objects to put in mouth -may start semi-solids
47
4 month old developmental milestones
-vocalizes with coos and babbles -starts to reach and grab for objects -rolls front to back -able tot support hands when placed on tummy POSTERIOR fontanel closed @ 2-4 months
48
What are all the components of the peds assessment triange?
Appearance: tone, interactiveness, consible, look/gaze, speech/cry Work of breathing: retractions, abnormal rate/position, anxiety, nasal flaring Circulation: cyanosis, mottled, pale
49
What are the airway goals for fluid imbalance?
Airway: increase LOC, normal resp, skin and colour
50
What are the circulation goals for fluid imbalance?
Circulation: increase perfusion, normal VS, normal responsivness
51
What are the breathing fluid balance goals?
normal BP, skin turgor, moist mucous membranes
52
Infant to birth (freud, eriksons, piaget)
Oral; trust/mistrust/ sensorimotor
53
Toddler (freud, eriksons, piaget)
anal; autonomy/shame and doubt; preoperational
54
preschool (freud, erikson,piaget)
phallic; initiative/guilt; preoperational
55
School (freud, eriksons, piaget)
latency; industry/inferiority; concrete operational
56
adolescence (freud, eriksons, piaget)
gentilia; identity/role confusion; formal operational
57
When does pincer grasping start?
8 months
58
when does separation anxiety develop?
10-12 months
59
When is "length" measured until?
Birth to 24months
60
Where do you measure head circumference from?
around supraorbital and occipital prominences
61
When does the anterior fontanel close?
18 months
62
Types of play for : 1. infants 2. toddlers 3. preschool 4.school age
1. solitary 2. parallel 3. medical 4.cooperative play
63
Hypertonic dehydration
less sodium loss compared to water. fluid shifts from cells to ECF ** this is why signs and symptoms are delayed -watch for neuro symptoms: altered LOC, confusion, lethargy, dizziness Causes: diabetes insipidus, IV fluid with lost of electrolytes
64
External strengths - Resiliency model (5)
1. community 2. school culture 3. family 4. learning at school 5. peers
65
Internal strengths- resiliency model (5)
1. self-concept 2. cultural sensitivity 3. social sensitivity and empathy 4. self-control 5. empowerment
66
Total Fluid intake
(100ml x 10kg) + (50ml x10kg) + (20ml x 5kg)
67
Total maintenance fluid rate
ml/kg/hr
68
-vmost common causes of hypovolemic shock
-blood loss : trauma, GI, hemorrhage -plasma loss: -increased capillary permeability due to sepsis, acidosis, burns -extracellular fluid loss : v/d, diuresis, heat stroke
69
What are growth and development signs of a 15 month old?
-crawls and walks upstairs -points to different body parts -able to stack 2 blocks
70
18 month old
-able to stack 3 or more blocks -feeds self with spoon - speaks 15-20 words and follows directions -anterior fontanel closes
71
When can a child understand putting correct shapes into correct holes?
10-12 months
72
when to start toilet training?
2 yrs
73
Contemporary issues
1. literacy 2.mental illness 3. poverty 4. abuse and neglect 5. injuries and disease 6. overweight and physical inactivity 7. environmental contaminants
74
Resp Red Flags
Infants: <20 or >60 BPM Child: <16 or >40 BPM and incresed wob, crackles, wheezes, retraction, nasal flareing, grunting, stridor, desaturations = bradycardia
75
What SEVERE signs of asthma attack?
-lips/nail beds cyanotic - SOB, increased resp - 3-5 word sentences -not improving after taking reliver -retractions ( head bobbing)
76
not used for emergency/acute asthma, has onset of 30-90 minutes, decreased mucus and inhibits bronchoconstriction
Anti-cholingerics (ipatropium
77
used to prevent bronchospasms from exercise, used for nocturnal symptoms, takes 30-60 minutes to become effective
long-acting beta 2 agnosts - salmeterol
78
primary enuresis
child has never had a dry night; due to maturational delay and small functional bladder NOT related to stress
79
superficial partial thickness burn - 1st degree
- damage of outer later, painful, red, heals in a few days. erythema, blanches on pressure, no bullae, peeling withing a few days
80
partial thickness -2nd degree
-includes epidermis and upper dermis heals in 10-14 days, blisters or bullae, erythmea, blanches on pressure, pain/senstive to cold air,
81
Full thickness- 3rd degree
involves all epidermis and dermins, nerve endings destroyed -skin is brown/black/ deep cherry red -white to gray -waxy/transulcent -usually no pain -the injured area looks sunken
82
oxygen therapy for 6 month old or less?
1-2 L
83
Feeding NPO with resp condition when?
RR over 60, with nasal secertions, chocking,coughing with feed
84
SP02 spot check process
1. check o2 every 5-15 minites and 30 minutes after discontinuing oxygen 2. spot check every 4 hours
85
what are the 8 physiological response to burns?
1. increased permeability of capillaries moves fluid out of the vasculars and increases fluid retention 2. decreased cardic output/ increased vascular resisitence 3. airway inflammation 4. suppression of bone marrow (causing anemia) 5. hyper-metabolic state - with protiens being destroyed, increased glucocorticoids, catecholeatimes and dopamine 6. digestive change in absoprtion (n/v), paralytic ileus 7. inflammaotry response = fever, tachycardia, open wounds 8. immune suppresion- infection
86
What is the function of Digoxin?
decreased heart rate to increase contractility time to improve systemic circulation.
87
what is the function of ace-inhbiitors
promotes vascular relaxation and reduces peripheral vascular resistance, decreasing afterload.
88
what is the function of a beta blocker?
improves function of left ventricle, and vasodilation of systemic
89
when is a baby sitting alone?
8 months
90
when can infant raise chest up from floor?
6 months
91
what type of toys do toddlers like to play with?
push -pull toys
92
Jackson's burn model explain: 1. zone of hyperemia 2. zone of stasis 3. zone of coagulation
1. LOTs of vasodilation 2. strong inflammatory response 3. denatured proteins and coagulation- potential for necrosis

Child Health 3122 -winter 2023 (1 decks)

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