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Pediatrics > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

4 components of family centered care

A

Recognizes the family as the constant in the child’s life
Nurse acknowledge the parent’s expertise in caring for their children
Nurses consider the needs of all family members
Acknowledges the diversity among family structures and backgrounds

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2
Q

atraumatic care

A

Eliminate or minimize the psychological and physical distress experienced by children and their families in the health system
First, do no harm
Prevent and minimize child’s separation from family
Prevent, minimize bodily injury and pain

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3
Q

what is involved in history taking? (4)

A

Chief complaint
History of present illness
Family history
Interval history

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4
Q

components of interval history

A

Diet
Previous illnesses, injuries or operations
Allergies
Medications
Immunizations
Growth and dev

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5
Q

what can play serve as? (4)

A

Therapeutic intervention
Stress reliever
Pain reliever and distraction
Barometer of illness

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6
Q

how to examine a child?

A

quiet to active

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7
Q

what are the growth measurements done up until 38 months?

A

head circumference
length
weight

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8
Q

what are growth measurements after 37 months?

A

Standing height
weight
body mass index (BMI)

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9
Q

what does it mean if a patient is below the 5th percentile for growth?

A

falling off growth curve
failure to thrive

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10
Q

what does vital sign assessment include

A

temp
HR
RR
BP
pain

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11
Q

how do you measure vital signs in infant and toddlers?

A
  1. quiet first - listen and feel
  2. count RR
  3. count HR apical
  4. measure BP last
    *temp can be taken first or with other vitals
    rectal temp at the end
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12
Q

what does assessing the general appearance entail?

A

cumulative, subjective impression of:
physical appearance
state of nutrition
behavior
personality interactions with others
posture
development
speech

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13
Q

head assessment

A

fontanelles
shape - normocephalic atraumatic (NCAT)
facies - general appearance of face

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14
Q

neuro assessment

A

LOC, alertness, behavior
Reflexes - neonates, infants
History - seizures, irritability, feeding pattern
Glasgow vs. child coma scale
Posture - flaccid vs. rigid
Pupil reactions
Developmental level - prematurity, chronic illness

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15
Q

resp assessment

A

Rate, rhythm
Work of breathing
Breath sounds

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16
Q

symptoms of resp distress

A

Nasal flaring, sternal retractions
Tripoding
Use of accessory muscles
Tachypnea
Cyanotic

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17
Q

CV assessment

A

Pulses
Activity level
Skin color - pallor or mottling
Heart rate
Pulse quality
Cap refill

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18
Q

GI assessment

A

Abdomen shape, size
Distension
Stool
Auscultation
Palpation
Self positioning (Guarding, pain)
Skin color

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19
Q

GU assessment

A

Urine output - amount, color, odor
*Renal issues can manifest as periorbital edema

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20
Q

how much water are newborns

A

70-80%

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21
Q

what is the relationship between % of body water and dehydration

A

Higher % of body water = higher risk of dehydration

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22
Q

musculoskeletal assessment

A

History
Developmental variations (toe walking, bow legs)
Symptoms: loss of mvmt or strength, pain
Deformities
Look for Trauma, Infections, Tumors, Juvenile arthritis

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23
Q

integumentary assessment

A

Inspection and palpation
Focuses on color, texture, temp and turgor
Note rashes, purpura and petechiae - communicable disease and allergies
Note physiological and ethnic factors

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24
Q

psychosocial assessment

A

Family composition
Child’s place in family
Home and who lives in the home
Daycare
Illness in family
Behavioral

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25
Q

age of neonate

A

0-1 month

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26
Q

age of infant

A

1 month to 1 year

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27
Q

Erikson: infant

A

trust vs. mistrust

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28
Q

piaget: infant

A

sensorimotor (0-2)

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29
Q

age of toddler

A

1-3 years

30
Q

erikson: toddler

A

autonomy vs. shame and doubt (over 18 months)

31
Q

piaget: toddlers

A

sensorimotor <2
preoperational >2
time of saying no!

32
Q

age of preschooler

A

4-5

33
Q

erikson: preschooler

A

initiative vs. guilt (3-6)

34
Q

piaget: preschooler

A

preoperational (2-7)

35
Q

school age

A

6-12 years

36
Q

erikson: school age

A

industry vs. inferiority (collections, crafts, building things)

37
Q

piaget: school age

A

concrete operations (7-11)
turn what you are doing into concepts

38
Q

teenage years

A

12/13-18

39
Q

erikson: teenage

A

identify vs. role confusion (12-18)

40
Q

piaget: teenage

A

formal operations (11+)
ability to think about thinking

41
Q

5 components of family centered care

A

Recognizes the family as the constant in the child’s life
We are there to support, respect, encourage and enhance the family’s strength and competence
Acknowledges parent’s expertise
Consider the needs of all family members in relation to the child
Acknowledges the diversity among family structures and background

42
Q

what is included in a family assessment

A

-Family composition
-Child’s place in family
-Home and who lives in the home
-Daily life - work, school, day care,
-Illness in family - health history of family
-interactions

43
Q

DuVall’s family development theory

A

Married couple
Childbearing
Preschool age children
School age children
Teenage children
Launching the children
Middle aged parents
Aging family

44
Q

what are social determinants of health

A

Conditions in the environment in which people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning and quality of life outcomes and risks

45
Q

cultural humility

A

life long process of self reflection and self critique whereby the individual not only learns about another’s culture, but one starts with an examination of her/his own beliefs and cultural identities

46
Q

what influences does religion have on health care (5)

A

Susceptibility to health problems
Beliefs of healing or cure
Food customs
Traditions r/t the care of newborns or critically ill or dying persons
Within group differences

47
Q

normal RR for infants

A

30-60 / minute

48
Q

normal RR for young children

A

20-40 / minute

49
Q

normal RR for older children

A

15-25 / minute

50
Q

normal RR for adults

A

12-20 / minute

51
Q

cheyne stokes

A

deep then shallow respirations followed by apnea

52
Q

biots

A

irregular breathing pattern with periods of apnea

53
Q

what is the normal inspiratory to expiratory ratio

A

1:2 total time for patient to breathe in and out

54
Q

if there is an increase in inspiratory time, what does that indicate

A

upper airway obstruction

55
Q

if there is a increase in expiratory time, what does that indicate?

A

lower airway obstruction

56
Q

what is stridor and what might it indicate

A

high pitch inspiratory - obstruction in upper airway

57
Q

if you have a wheeze on inspiration..

A

upper airway obstruction

58
Q

if you have a wheeze on expiration

A

lower airway obstruction

59
Q

rhonchi - what does it indicate

A

coarse sounds
fluid or section build up in lungs

60
Q

what does crackles indicate

A

Lower portion of lungs
Pneumonia or pleural effusion

61
Q

how often should you measure endotrachial tube

A

minimum of every 4 hours

62
Q

what are emergency equipment items for respiratory distress

A

Working o2 source and supply
Mask for patient
Suction source - yankauer
Soft suction

63
Q

what do you do first if there is a safety alarm of patient’s leads in ICU

A

assess patient first

64
Q

what causes an upper airway obstruction

A

Edema of soft tissues of upper airway in subglottic region or epiglottis or hypopharynx

65
Q

what causes stridor

A

Turbulent airflow through narrow airway

66
Q

croup

A

inspiratory stridor and a barking cough associated with upper airway obstruction and low grade fever

67
Q

epiglottitis: high or low fever

A

high

68
Q

what does tripoding do?

A

Position designed to elongate and help open upper airway

69
Q

characteristic of lower airway obstruction

A

wheezing
delayed emptying of lung units

70
Q

what can cause a lower airway obstruction

A

infection, bronchospasm, allergen

71
Q

what causes a pneumothorax

A

Air in the pleural space between lung and chest wall
Can be result form a pulmonary infection and mechanical ventilation

72
Q

what age does the respiratory system develop until

A

12 years old

Pediatrics (4 decks)

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