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Pediatric Nursing > Exam 1 (Chapters 1-9) > Flashcards

Exam 1 (Chapters 1-9) Flashcards

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1
Q

Family-Centered Care

A

Philosophy of health care in which a mutually beneficial partnership develops between families and the nurse, and also other health care professionals

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2
Q

Extended Kin Network Family

A

Specific form of an extended family in which two nuclear families of primary or unmarried kin live in proximity to each other

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3
Q

Authoritarian Parent

A

High control, low warmth

Child may become fearful, withdrawn, and unassertive

Girls passive and dependent, boys rebellious and aggressive

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4
Q

Authoritative Parent

A

Moderately high control, high warmth

Children are best adjusted, self-reliant, self-controlled, and socially competent

Higher self-esteem, better school performance

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5
Q

Permissive Parent

A

Low control, high warmth

Children are rebellious, aggressive, socially inept, self-indulgent, or impulsive

May be creative, active, and outgoing

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6
Q

Indifferent Parent

A

Low control, low warmth

Children have high expression of destructive impulses and delinquent behaviors

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7
Q

Neonatal Mortality Causes

A

Short gestation

LBW

Congenital malformations

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8
Q

Postneonatal Mortality Causes

A

SIDS

Congenital malformations

UNINTENTIONAL INJURIES

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9
Q

Infant Morbidity Causes

A

Injuries related to live birth

Acute bronchitis

Hemolytic jaundice

Pneumonia

LBW

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10
Q

Child Morbidity Causes

A

Asthma and pneumonia are most common causes

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11
Q

Effects of Divorce on Preschool Aged Children

A

Fear, anxiety, worry, self-blame, sorrow, grief, anger, regression, questioning, temper tantrums, loneliness

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12
Q

Effects of Divorce on School Aged Children

A

Sadness, insecurity, self-blame, guilt, resentment, behavioral problems, withdrawal from friends and activities

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13
Q

Effects of Divorce on Adolescents

A

Panic, fear, depression, guilt, risk-taking, fear of loneliness and abandonment, denial, anger, sadness, aggressiveness, skipping class, use of drugs and alcohol, sex

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14
Q

Eight Stages of Family Life Cycle

A

1: newly married
2: childbearing
3: families with preschool children
4: families with school aged children
5: families with teenagers
6: families launching young adults
7: middle aged parents
8: family in retirement and old age

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15
Q

Aneuploidy

A

Increase or decrease in number of chromosomes

Result of an error during cell division, most often with nondisjunction during meiosis

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16
Q

Nondisjunction

A

Paired homologous chromosomes that do not separate before migrating into egg or sperm cells

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17
Q

Examples of Aneuploidy

A

Turner Syndrome (monosomy)

Trisomy 13 (Patau Syndrome) and Trisomy 21 (Downs Syndrome)

Most monosomic/trisomic errors result in the loss of life

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18
Q

Mosaicism

A

Monosomy/trisomy during mitosis resulting in 2 separate cell line with different chromosomal makeup

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19
Q

Inversion

A

Chromosome breaks in two places and the piece between the breaks turns and reattaches within the same chromosome

Inversion of Factor VIII –> Hemophilia A

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20
Q

Deletion and Duplication

A

Unbalance rearrangement of chromosomes, may be incompatible with life

Cri du Chat is a large deletion of Chromosome 5 that results in microcephaly, intellectual disability, and cat-mewing cry

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21
Q

Translocation

A

Two nonhomologous chromosomes that exchange segments of DNA

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22
Q

Autosomal Dominant

A

Involve altered genes on autosomes rather than sex chromosomes

Individuals with AD disorders are heterozygous for the disease-producing gene; 50% chance affected parent passes on to child

Neurofibromatosis, Marfan Syndrome, Achondroplasia (dwarfism), Huntington Disease, familial hypercholesterolemia

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23
Q

Autosomal Recessive

A

Both copies of the same gene in an individual are altered

Both parents are carriers, child has 25% chance of inheriting, 50% chance of carrying, and 25% chance of being fine

Cystic Fibrosis, Sickle Cell Disease, Tay-Sachs, and most inborn errors of metabolism

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24
Q

X-Linked Disorders

A

Hemophilia A, Duchenne Muscular Dystrophy

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25
Y-Linked Disorders
Contains genes related to spermatogenesis problems
26
Penetrance
Probability a gene will be expressed phenotypically All-or-none concept
27
Variable Expressivity
Degree to which a phenotype is expressed
28
New Mutation
Occurs when there is no family history
29
Anticipation
Occurs when successive generations exhibit earlier onsets with more severe signs/symptoms
30
Minor Anomaly
Usual morphologic feature that is of no serious concern Wide-set eyes, single palmar creases, cafe au lait, low anterior hairline, preauricular pits, broad face, mild proportionate short stature
31
Major Anomaly
Serious structural defect present at birth Congenital heart defects, cleft lip/palate, myelomeningocoele, duodenal atresia, craniosynostosis
32
Syndrome
Collection of multiple anomalies
33
Principles of Growth and Development
Cephalocaudal (growth goes from head to toe) Proximodistal (growth goes from core to periphery)
34
Freud's Psychosexual Theory
Oral (birth-1 year): infant derives pleasure from mouth Anal (1-3 years): control over secretions Phallic (3-6 years): child works out relationships with parents Latency (6-12 years): sexual energy is at rest Genital (12-adulthood): mature sexuality achieved
35
Erikson's Psychosocial Theory
Trust v. Mistrust (birth-1 year): task is to establish trust in those providing care Autonomy v. Shame and Doubt (1-3 years): autonomy shown by controlling excretions, saying no, directing motor activity Initiative v. Guilt (3-6 years): initiation of new activities Industry v. Inferiority (6-12 years): child takes pride in accomplishments and develops new interests Identity v. Role Confusion (12-18 years): thoughts are more complex, finds a definition of self
36
Piaget's Cognitive Development Theory
Sensorimotor (birth-2 years): use of senses to drive motor activity Preoperational (2-7 years): words/symbols used, no logic Concrete Operational (7-11 years): accurate understanding of cause and effect, conversation is learned Formal Operational (11-adulthood): mature intellectual thought
37
Kohlberg's Theory of Moral Development
Preconventional (4-7 years): decisions based on desire to please others to avoid punishment Conventional (7-12 years): conscience becomes important, rules must be followed Postconventional (12 and older): internalized ethical standards, social responsibility recognized
38
Infant Physical Growth and Development
Weight doubles by 5 months and triples by 1 year Height increases by 1 foot Teeth erupt at 6 months, 6-8 teeth by 1 year Kidney and liver maturation Nervous system allows to sit, stand, and walk and sensory function increases
39
Infant Psychosocial Development
Engage in solitary play Reflexes --> manipulation Engage in two-way communication, understand more words than they can speak Temperament usually fits the environment Abnormalities are caused by decreased hearing, developmental delay, or decreased verbal stimulation
40
Toddler Physical Growth and Development
Decreased rate of growth, decreased food consumption Pot-bellied, walk with a wide gait 20 teeth at 33 months Gross motor develops rapidly (running, kicking, riding) and increased control of elimination patterns
41
Toddler Cognitive Development
Object permanence is well-developed Pre-operational thought
42
Toddler Psychosocial Development
Parallel play, increased motor activities Retains temperamental characteristics from infancy, independence increases Imitate speech intonations and words, use expressive jargon
43
Preschool Child Physical Growth and Development
Grow steadily, most growth in long bones of arms/legs Physical skills develop (throw a ball, hold a bat)
44
Preschool Child Cognitive Development
Pre-operational thought Symbols used and understood
45
Preschool Child Psychosocial Development
Associative play, large motor activities, dramatic play Temperament from infancy persists, egocentricity Vocabulary grows to 2000 words
46
School-Aged Child Physical Growth and Development
Decreased fat, increased muscle, mature immune system, increased leg length Nutritional needs increase
47
School-Aged Child Cognitive Development
Concrete operational thought, learns conversation Considers alternative solutions to problems Relies on concrete experiences
48
School-Aged Child Psychosocial Development
Cooperative play, high social component Enduring aspects of temperament continue to manifest Able to correct pronunciation/grammatical erros Aware of sexual differences, interested in sexual issues
49
Adolescent Physical Growth and Development
Growth spurts around 10 (female) and 13 (male) Accompanies by increased breast size and pubic hair in girls and increased penis/testes size and pubic hair in males
50
Adolescent Cognitive Development
Formal operational thought, independent thought
51
Adolescent Psychosocial Development
Temperament from childhood remains stable Uses and understands all parts of speech Quest for self-identity Give privacy during assessments
52
Newborn Assessment
Keep the parent present, use distractions, observe activity, keep sequence flexible Assess with newborn on the table and parent next to them Invasive assessments should be done last
53
Infant Assessment
Examine on the parent's lap, smile and talk soothingly, use toys/pacifier, begin with feet and hands before moving to the trunk
54
Toddler Assessment
Keep toddlers with parents, avoid asking toddler for permission, give choices, observe neuro/muscular by watching them play Begin at the feet and move up, use instruments last
55
Preschool Child Assessment
Assess willingness to separate from the parent, leave underpants on until the genital examination, give simple explanations, offer choices, use distractions, give positive feedback with cooperation Order of the exam may vary
56
School-Aged Child Assessment
Have them sit on the exam table, offer gown to cover underwear, allow privacy Do head-to-toe assessment, demonstrate equipment, offer choices, teach as you go
57
Adolescent Assessment
Give gown, allow privacy, provide modesty Head-to-toe assessment, provide reassurance
58
Top Mortalities of Infants < 1 Year
1. Congenital anomalies 2. Preterm birth 3. SIDS
59
Top Mortalities of Infants 1 Year Old
1. Unintentional Injury (Suffocation) 2. Congenital anomalies 3. Homicide
60
Top Mortalities of Children 1-4 Years Old
1. Unintentional injury 2. Congenital anomalies 3. Homicide
61
Top Mortalities of Children 5-14 Years Old
1. Unintentional injury (motor vehicle accident) 2. Cancer 3. Congenital anomalies
62
Top Mortalities of 15-24 Year Olds
1. Unintentional injury (motor vehicle accident) 2. Suicide 3. Homicide
63
New Morbidity
The effects of society and societal health on children
64
Pediatric Assessment Triad
Appearance Breathing Circulation
65
Pain Assessment
Use pain scales with faces and colors If non-responsive or nonverbal, use objective scales such as FLACC or CRIES, account for muscle tone, grimacing, vital signs, guarding
66
Rough Bladder Capacity
Child's age plus 2 is normally the amount of ounces of bladder capacity they have
67
Diet/Energy Needs of Infants
100 kcal/kg/day
68
S1
Beginning of systole, closing of the AV valves Heard best at the apex with the diaphragm
69
S2
Ending of systole and beginning of diastole, closing of the semilunar valves Heard best at the base with the diaphragm
70
Physiologic Split S2
Normal in pediatrics, particularly the younger the child Split resolves as the child ages Know it's physiologic if the split becomes longer with inspiration Heard best in the pulmonic region with the diaphragm
71
Pathologic Split S2
Not a normal variance Fixed split (no change with inspiration), Paradoxical split (less pronounced with inspiration) Heard best in pulmonic region with the diaphragm Fixed is usually a septal defect, paradoxical is usually a pathological problem causing delayed aortic closure
72
Pathologic S3
Separate heart sound, diastolic gallup Comes at the end of S2 Marker of ventricular overload or systolic dysfunction Low-pitched, more likely to be heard with the bell
73
Pathologic S4
Comes at the end of diastole, right before systole Indicator of poor diastolic function Seen in conditions such as uncontrolled HTN, persistent/recurrent myocardial ischemia Soft and low pitched, heard best with the bell
74
MR. PASS, MVP
Mitral regurgitation, physiologic aortic stenosis (Systolic) Mitral valve prolapse
75
MS. ARD
Mitral stenosis, aortic regurgitation (Diastolic)
76
Grading Murmurs
Grade 1: very faint Grade 2: quiet but immediately heard Grade 3: moderately loud, same volume as S1 and S2, without a thrill Grade 4: moderately loud with a thrill Grade 5: very loud with a thrill Grade 6: audible without a stethoscope
77
Growth/Development Surveillance for Newborns/Infants
Be alert for infants that demonstrate changes in percentile Signs of developmental delay merit immediate investigation Introduce foods that foster growth, encourage developmental toys, demonstrate gross/fine motor skills
78
Nutrition of Newborns/Infants
Hemoglobin/hematocrit can be performed at 9-12 months Newborn (support breastfeeding), 1 month (reinforce breastfeeding), 2 months (begin cleaning infant gums, teach how to prepare formula), 4 months (introduce first foods between 4-6 months), 9 months (encourage self-feeding)
79
Mental/Spiritual Health of Newborns/Infants
Stranger anxiety/separation anxiety occurs at 6 months Learn how to self-regulate
80
Immunizations of Newborns/Infants
Hep B (birth, 1-2 months, 6-18 months) Hep A (12 months, 18 months) DTP (2 months, 4 months, 6 months) Rotavirus (2 months, 4 months) Influenzae haemophilus (2 months, 4 months, 6 months) Polio (2 months, 4 months, 6-18 months) Pneumococcal (2 months, 4 months, 6 months)
81
When Families Should Call HCP for Newborns/Infants
Axillary temperature > 99.3 degrees Fahrenheit Seizure Skin rash Change in behavior Irritability Lethargy Failure to eat Vomiting Diarrhea Dehydration Cough
82
Nutrition for the Toddler and Preschooler
1 year (wean child from bottle, use whole milk, limit juice, limit high fat and sugar) 2 year (encourage total removal from bottle, offer child-sized utensils, 2-3 servings of milk per day) 3 year (teach normal intake, decrease snacks, encourage child in food preparation) 4 year (involve child in snack selection, decrease fat)
83
Physical Activity for the Toddler and Preschooler
Minimum of 60 minutes of unstructured play, minimum 60 minutes of structured play, maximum 60 minutes of sedentary life Motor activities encouraged Kinesthesia develops (sense of one's own body position/movement)
84
Oral Health for the Toddler and Preschooler
Dentist visit by 1 year of age 20 deciduous teeth by 2 years, begin to lose by the end of preschool
85
Mental/Spiritual Health of the Toddler and Preschooler
Good at self-regulation Need 10-12 hours of sleep per night
86
Potential Hazards for the Toddler and Preschooler
Falls, poisoning, burns, drowning, MVA
87
Mental/Spiritual Health of the School-Aged Child
Self-esteem, self-concept, body image, sexuality
88
Immunizations for the School-Aged Child
TDAP (11 year old visit) HPV (three dose series at 9 years or older) Meningococcal (11 years)
89
Hazards for the School-Aged Child
MVA, firearms, burns, assault
90
Nutrition for the Adolescent
5 fruits and vegetables daily, whole grain, three meals a day, decreased fat and sugar, 2-3 servings of dairy
91
Physical Activity of the Adolescent
60 minutes daily is recommended

Pediatric Nursing (7 decks)

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