Final Exam Flashcards by Rebecca Fawver

Erikson stage for toddlers

Autonomy vs shame and doubt

Achieves autonomy and self control
Separates from parent/caregiver
Withstands delayed gratification
Negativism abounds

How well did you know this?

Not at all

Perfectly

Erikson stage for infants

Trust vs Mistrust

How well did you know this?

Not at all

Perfectly

Piaget stage for toddlers

Sensorimotor

Differentiates self from objects
Increased object permanence
Uses all senses to explore environment
Places items in and out of containers
Imitates domestic chores
Imitation is more symbolic

How well did you know this?

Not at all

Perfectly

Erikson stage for preschool

Initiative vs guilt
Age: 3-6

Likes to please parents
Begins to plan activities, make up games
Initiates activities with others
Enjoys sports, shopping, cooking, working
Negotiates soln to conflicts

How well did you know this?

Not at all

Perfectly

Piaget stage for pre-school

Preoperational stage
Age: 2-7

How well did you know this?

Not at all

Perfectly

Erikson stage for school-aged

Industry vs inferiority

Interested in how things are made and run
Success in personal and social tasks
Increased activities outside home
Increased interaction with peers
Needs support and encouragement from important people in child’s life
Inferiority occurs with repeated failures with little support or trust from those who are important to the child

How well did you know this?

Not at all

Perfectly

Piaget stage for school-aged

Concrete operational

Learns by manipulated concrete objects
Lacks ability to think abstractly
Learns that certain characteristics of objects remain constant
Understands concepts of time
Starts collections of items

How well did you know this?

Not at all

Perfectly

Kohlberg stage for school-aged

Conventional
Age 7-10: interpersonal conforming, “good child, bad child”
Age 10-12: “law and order”

An act is wrong bc it brings punishment
Beh is completely right or wrong
Does not understand the reason behind rules
If child and adult differ in opinions, the adult is right
Can put self in another person’s position
Begins to exercise the “golden rule”

How well did you know this?

Not at all

Perfectly

Erikson stage for adolescents

Identity vs role confusion

Focuses on bodily changes
Experiences frequent mood changes
Importance places on conformity to peer norms and peer acceptance
Strives to master skills within peer groups
Defining boundaries with parents and authority figures

How well did you know this?

Not at all

Perfectly

Piaget stage for adolescent

Formal operational stage

Egocentrical thinking

How well did you know this?

Not at all

Perfectly

Kohlberg stage for adolescent

Postconventional

How well did you know this?

Not at all

Perfectly

What are live virus vaccines

Attenuated (weakened) form of the virus
Closest thing to a natural infection
Ex. MMR, varicella

How well did you know this?

Not at all

Perfectly

What are killed virus vaccines

Use organisms that have been killed but can still elicit an immune response
Ex. Inactivated polio

How well did you know this?

Not at all

Perfectly

What are toxoid vaccines

Use the actual toxin for the vaccine instead of the organism itself to begin the antibody process
Ex. Tetanus

How well did you know this?

Not at all

Perfectly

What are recombinant vaccines

Use genetic altered form of the microbe instead of the whole organism
Ex. Hepatitis B

How well did you know this?

Not at all

Perfectly

What are conjugate vaccines

These are made by combining a weak antigen (typically polysaccharides) with a strong antigen (typically proteins) to illicit the immune response
Ex. Prevnar, Hib

Nursing management of vaccines

Must obtain parental consent this includes providing parents with information on the vaccines being given
Know patient’s medical hx. Do they have any chronic illnesses that would prevent a certain type of vaccine?
Has child had a previous serious rxn?
Previous vaccination record for the child
Document appropriately
Report any adverse events

Vaccine contraindications

Any hx of severe allergic rxn (anaphylaxis) to prior vaccine dose
Severe immunodeficiency patients should not receive live vaccinations
Egg allergy is no longer a strict contraindication for the MMR
There are protocols for egg allergic pts and the flu vaccine. This has made it possible for the majority of egg allergy pts to tolerate the flu vaccine

Vaccine nursing considerations

Mild fever or mild illness such as a cold are not contraindications to receiving immunizations
Redness, swelling, and pain at the site of injection along with mild fever after immunization is normal
Some vaccinations can cause other “normal” rxns
Prophylactic Tylenol is NO longer recommended
Injectable live virus vaccines MUST be given SQ
Inactive virus vaccines are typically given IM but can be given SQ in some instances

Asthma triggers

Infection (viruses)
Irritants
GERD
Allergies
Cold Exercise

Asthma obstructive mechanisms

Inflammatory response
Mucus production
Bronchial muscle contraction in response to foreign stimuli

Asthma symptoms

Classic signs: dyspnea, wheezing, cough
Cough –> cough with mild wheeze –> worsening wheeze with mild difficulty with breathing- particularly with exertion –> difficulty with breathing with severe wheeze at rest

What is status asthmaticus

Unrelenting, respiratory distress with bronchospasms unresponsive to tx measures

Asthma diagnosis

Based on hx of recurrent problems
Pulmonary function tests (PFTs)
Can do methacholine challenge if unsure of dx
Peak expiratory flow rate (PEFR)

Asthma assessment

Tripod position Use of accessory muscles Speak in short, panting phrases Breath sounds are coarse- often with decreased airflow Inspiratory/expiratory wheezing

Asthma severity classification

Tx & education based on severity classification: intermittent mild persistent mod persistent severe persistent

Chronic asthma management

B-agonist prn (albuterol or xopenex) Trigger avoidance

Asthma controller medications

Inhaled corticosteroids Long-acting bronchodilators Leukotriene modifiers- singulair/montelukast Oral prednisone -long term is rare Allergy shots- desensitization to allergens if allergies play a major role

Patho of bronchiolitis/RSV

Virus invades mucosal cells Cells die: debris Irritation leads to increased mucus & bronchospasm Air trapping

S/S of bronchiolitis

Infant <1 yr Recent upper respiratory infection exposure Gradual onset of respiratory distress Crackles throughout Expiratory wheezing Extreme tachypnea (60-100) Cyanosis Typically worsen for 5 days

Bronchiolitis treatment/management

Viruses won't respond to antibiotics, respiratory treatments, or steroids Suction, position, avoid over stressing Humidified oxygen Monitor cardiac apnea IV fluids (NPO) if poor intake or tachypnea

Physical abuse signs

Bruises on uncommonly injured surfaces Hand shape marks & bruising Bite marks Rope, belt, or cord marks, usually seen on the mouth, buttocks, legs, back & arms Multiple bruises or fractures in various stages of healing

Submersion burns

Physical abuse sign Scald burns with clear lines of demarcation (glove or stocking distribution)

Shaken baby syndrome S/S

Difficulty breathing or apnea Cyanosis Irritability Seizures Vomiting Inability to make sounds Extreme sleepiness or unable to arouse

Moxibustion

involves the burning of mugwort, a small spongy herb, to facilitate healing

Coining

Alternative treatment for minor illnesses-involves rubbing heated oil on the skin and then rubbing a coin over the area in a linear fashion until a red mark is seen

Cupping

Alternative therapy in which heated glass cups are applied to the skin along the meridians of the boy, creating suction as a way of stimulating the flow of energy

Nursing documentation for physical abuse

describe what you see measure and record bruises document parent demeanor photographs document who and when report is made