Exam 1 v2 Flashcards
What are leading causes of death in children (under one year)
neonates - LWB
neonates - 1 year - congenital anomalies
What are leading causes of death in children over one year
accidents
How does development impact the type of injuries children are susceptible to?
Infant are helpless in any environment - when they begin to roll or propel themselves → can fall from unprotected surfaces
Crawling infant can place things in mouth → risk for aspiration or poisoning
Mobile toddler → falls, burns, collisions
As they age, absorption with play makes them less likely to pay attention to environmental hazards
family centered care (4)
Recognizes the family as the constant in the child’s life
Nurse acknowledges 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
Why should infants and children have a family member with them when they are in the
Hospital?
Part of atraumatic care → part of doing no harm
How would you respond to parents with different cultural practices, concerns?
Need to practice with an openness to learning new cultures
Have a few open ended questions that you can use to ask families about what shapes their lives, what they find meaningful and how they carry that out in their lives
open ended questions for culturally sensitive care
“What is important to you in caring for your child?”
“Please tell me a little bit about your family”
“What is important to you as a family”
how to incorporate spiritual practices into care?
-Nurses should focus on activities that support a persons’ system of beliefs and worship, - praying, reading religious materials, performing rituals
-Children may have different spiritual needs across the illness experience
-eating, care for newborns, care for dying persons
what type of theory is Duvalls?
developmental
value of duvalls theory
Address family change over time based on predictable changes in the family’s structure, function and roles with the age of the oldest child as the marker for stage transition
limitations of Duvalls theory
linear, restrictive
purpose of atraumatic care (4)
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
growth charts
by gender and prematurity if appropriate
Values less than 5th or greater than 95th percentile = outside expected parameters
Important to note TREND of growth
Will have ethnic and gender differences
how to assess infants and children
Quiet to active - performing what needs to be done while child is quiet first
infant and toddler vital sign measurement
Proceed from quiet, listening and feeling to those that may agitate the child
Across the room assessment
Count respirations first - minimum of 30 seconds
Count apical HR second
Measure BP last
Apical temp can be taken first or with other vital signs
Rectal temp is last
child exhibiting industry
6-12 years old
Engage in tasks and activities they can complete
Compete and cooperate with others and learn rules
achievement in school
Sense of accomplishment
child exhibiting autonomy
Increasing ability to control their bodies, themselves and environments
Walking, climbing, manipulating
adolescent exhibiting identity
12-18 years old
Become preoccupied with the way they appear in the eyes of others compared with their own self concept
temperament
Manner of thinking, behaving or reacting characteristic of an individual - refers to way in which a person deals with life
Behavioral tendencies
temperament: easy child
Even tempered, regular and predictable in habits
Positive approach to new stimuli
Adaptable to change
Mild to moderately intense mood that is positive
temperament: difficult child
Highly active, irritable, and irregular in habits
Negative withdrawal responses
Require a more structured environment
Adapt slowly to new things
Mood are usually intense and negative
Frequent periods of crying and frustration
temperament: slow to warm up
React negatively with mild intensity to new stimuli
Inactive and moody but only show moderate irregularity in functions
why is temperament important
Difficult or slow to warm up patterns of behavior = more indicative of behavior problems in early and middle childhood, more likely to display stress and pain
object permanence
realization that objects that leave the visual field still exist
Can search for an item under a pillow or behind a chair
Develops 9-10 months old
introducing new foods in infancy: guidelines
-Solid foods should be introduced 4-6 months old
-Introduction of solids before 6 months can lead to increased risk for food allergy development
-should be added one at a time in intervals of 4-7 days to allow for food allergy identification
-As food increases, amount of milk decreases to less than 1L per day
why are infants more able to consume solids around 4-6 months
GI tract has matured to handle more complex nutrients and is less sensitive to potentially allergenic foods
Tooth eruption is beginning
Extrusion reflex has disappeared → swallowing is more coordinated
Head control
Grasping and improved eye hand coordination
plagiocephaly
oblique or asymmetric head, acquired condition that occurs as a result of cranial molding during infancy, usually as a result of lying in the supine position
Infants sutures are not closed → skull is pliable
plagiocephaly prevention
Place infant to sleep supine and alternate the infant’s head position nightly
avoiding prolonged placement in car safety seats and swings
Use tummy time for 30-60 minutes per day when infant is awake
when should head lag be gone
3-4 months
what conditions would you see head lag past 3-4 months
Marked head lag is seen in neonates with Down syndrome, prematurity, hypoxia and neuromuscular compromise
s/s asthma
-Coughing w/o infection and diffuse wheezing during expiratory phase of respiration
-Cough = chronic but not productive
-Chest tightness
