NURS 330 (PEDS) Flashcards
(174 cards)
1
Q
Jordan’s Principle
A
Puts the childs needs before the logistics and the money
2
Q
30-36 months SPEECH AND LANGUAGE
A
Almost all speech understood by strangers
3
Q
Infants PLAY
A
solitary
4
Q
Potential “RED FLAGS” in infants
A
- frequently in “fisted position” after 6 months.
- too tight or too floppy.
- not bringing both hands to midline by 10 months.
- no pincer grasp by 10 months
- not smiling by 4 months
5
Q
Toddlers (1-3 years) GROSS MOTOR
A
Begins walking with ease
Can run
Can kick and throw balls well
Can jump.
6
Q
12 months FINE MOTOR
A
Transfers objects from hand to hand
7
Q
24 months FINE MOTOR
A
can hold crayon/marker and begin to color, turns pages, builds towers of 6 blocks.
8
Q
36 months FINE MOTOR
A
Copies circle/cross shapes, can color within the lines.
9
Q
5 Years FINE MOTOR
A
starts to write letters, can draw a person.
10
Q
Toddler PLAY
A
Parallel - beside each other, but not together
11
Q
Potential “RED FLAGS” in toddlers
A
- not walking by 18 months
- unaware of environmental changes/routine
- poor/no eye contact
- difficulty calming self
- not responding to noise, sounds or familiar voices
- not engaging in pretend play
12
Q
Preschool FINE MOTOR
A
- button clothing
- hold crayon
- build small blocks
- use scissors
- board games
- draws self-portrait
13
Q
Preschool PLAY
A
Associative (interact with each other, become helpful)
14
Q
Potential “RED FLAGS” in preschool
A
- lack of socialization/not playing
- can’t follow simple directions or carry out self-care tasks
- can’t undo big buttons
- can’t put on shoes by 3 years
15
Q
School Age FINE MOTOR
A
- refined and more focused
- musical instruments
- focus in school
- smaller lego
16
Q
School Age GROSS MOTOR
A
6-8 years: join sports teams
more coordinated (less falls/tumbles)
17
Q
School Age COGNITIVE
A
- focus/concentrate for longer periods
- Gain independence
- can take part in cognitive activities
- reading/writing
18
Q
School age PLAY
A
cooperative
19
Q
Potential “RED FLAGS” school age
A
- lack of friends
- academic failure
- aggressive behaviour
- bullying/fighting
- abusive to animals
- overt sexual behaviour
20
Q
Adolescence SOCIAL/COGNITIVE
A
- increased independence
- challenge authority
- increased reliance on peers
- mood swings
- become experimental
21
Q
Potential “RED FLAGS” adolescence
A
- uninterested in family life
- anger
- suicidal thoughts
- addiction
- eating disorders
- accidents (increased risk taking)
22
Q
How much should babies gain per week from 2-6months?
A
about 70-120g/wk
23
Q
At what age should weight be doubled?
A
By about 5 months
24
Q
At what age should weight be tripled?
A
By about 12 months
25
How much weight do typical adolescence gain?
about 7-25kg over 2-3 years (girls) and about 7-29.5kg over 2-3 years (boys)
26
Factors affecting growth and development
genetics, temperament, health-nutrition, intelligence, gender (boys slower than girls)
27
Autosomal dominant inheritance
Each child has 50% chance of developing disease (ex. huntingtons, braca breast cancer gene)
28
Autosomal recessive inheritance
Each child has 50% chance of being a carrier, and 25% chance of having the disorder (ex. cystic fibrosis)
29
X-linked recessive disorders
Males are at risk: each make has 50% chance of inheriting (ex. color blindness, hemophilia a, duchenne muscular dystrophy)
30
Numerical chromosome abnormality
entire chromosome is added and/or missing
31
Structural chromosome abnormality
part of chromosome added/missing OR abnormal rearrangement
32
Trisomy
extra copy of one chromosome (47)
33
Trisomy 21
Down Syndrome
34
Trisomy 13
Less common, more severe
35
Monosomy
Missing one chromosome (45)
36
Only monosomy compatible with life
Turners syndrome (single X chromosome)
37
Klinefelter Syndrome
Boys have an extra X chromosome.
38
Bowlby Attachment Theory
attachment = motivational-behavioural control system - infants need one special relationship for internal development.
39
Nursing role in immunization
educate, respect, and have a non-judegmental relationship
40
Immunization in PEDS
vaccines decrease chances AND severity of disease.
41
Active immunization
Vaccines
42
Passive immunization
admin of antibodies from humans or animals
43
Respiratory Differences in PEDS
- lack of bony structures
- abdominal breathers (rely on diaphragm)
- appear barrel-chested
- Obligatory nose breathers until 3 months
- smaller airways, shorter distance to lower tract
- trachea short and angle at bronchus is acute, smallest at cricoid until 8 years
- smaller lung capacity and few alveoli
- underdeveloped intercostal muscles
- large tongue and tonsils
44
Asthma
Chronic airway inflammatory disease - infiltration of airway T-cells, mast cells, basophils, macrophages, and eosinophils.
45
Airflow Obstruction caused by...
1. bronchial (airway) hyperresonsiveness
2. airway edema
3. mucous production
46
S&S of Asthma
- narrow airways
- longer expiration (wheezing)
- increase resp rates
- hypoxia (decreased oxygen)
- alveolar hyperinflation
- decreased perfusion
47
Silent Asthma
frequent coughing (at night) when secretions pool.
48
Severe Persistent Asthma
symptoms during the day, nighttime awakening, SABA several times/day, normal activity limited.
49
Chances for child if 1 parent has asthma
50% chance for child
50
Chances for child if 2 parents have asthma
75% chance for child
51
Asthma symptom triggers
exercise, cold air, hot humid air, strong fumes, emotional upsets, smoking, hormones
52
Inflammatory asthma triggers
Resp viral infections, dust mites, animals, cockroaches, moulds, pollens, air pollutants
53
Protective factors from asthma
large family, later brith order, childcare attendance, dog in the house, live on farm.
54
Diagnostic procedures for asthma
pulse ox, chest x-ray, blood gases, pulmonary function, peak expiratory flow rate, allergy testing.
55
SABA (Short-acting beta-agonist)
Ventolin = rescue medication (salbuterol)
56
LABA (Long-acting beta-agonist)
Pre-exercise (salmeterol)
57
Anticholinergic (ipratropium or atrovent)
inhibit broncho-constriction and decrease mucous production
58
Oral corticosteroid
used in bursts to manage uncontrolled asthma
59
Mild PRAM 0-3
Salbutamol q30-60min x1-2 doses, oral steroids
60
Moderate PRAM 4-7
Salbutamol q30min x2-3 doses, oral steroids, ipratropium.
61
Severe PRAM 8-12
Salbutamol and ipratropium q20min x 3 doses, PO steroids, IV methylprednisone, continuous SABA, IV magnesium sulfate.
62
ERIKSON
PSYCHOSOCIAL
- infant-18months: trust vs mistrust
- 18months -3years: autonomy vs shame/doubt
- 3-5years: initiative vs guilt
- 5-13years: industry vs inferiority
63
PIAGET
COGNITIVE
- infant-2years: SENSORIMOTOR (understand world through sense/actions)
- 2-7years: PREOPERATIONAL (understand worlds through language and mental images)
- 7-12 years: CONCRETE OPERATIONAL (understand world through logical thinking
- 12+ years: FORMAL OPERATION (understand world through hypothetical thinking and science)
64
KOHLBERG
MORAL
- infancy: obedience/punishment
- pre-school: self-interest
- School-age: conformity and interpersonal accord, authority and soical order
- Teens: social contract
- Adults: universal principles
65
FREUD
PSYCHOSEXUAL
- infant-12months: oral stage (mouth suckling)
- 1-3years: anal stage (elimination)
- 3-6years: Phallic (genitals)
- 7-11years: Latency (sexual interest, social skill)
- Puberty: Genital (sexual awakening)
66
BOWLBY
ATTACHMENT
- Birth-6weeks: pre-attachment
- 6week-6/8months: attachment-in-the-making
- 6/8 months - 18/24 months: clear-cut attachment
- 24 months +: goal-corrected partnership
67
Birth SOCIAL
Quiets when fed/comforted, makes eye contact
68
Birth SELF-HELP
Alert: interested in sights and sounds
69
Birth GROSS MOTOR
Wiggles and kicks, thrusts arms and legs in play
70
Birth FINE MOTOR
Looks at objects or faces
71
Birth LANGUAGE
Cries, makes small throaty sounds
72
1 month SOCIAL
Social smile
73
1 month GROSS MOTOR
Lefts head and chest when lying on stomach
74
1 month FINE MOTOR
Follows moving objects with eyes
75
1 month LANGUAGE
Cries in a special way when hungry
76
2 month SOCIAL
Recognizes mother
77
2 month SELF-HELP
Reacts to sight of bottle or breast
78
2 month GROSS MOTOR
Holds head steady when held sitting
79
2 months FINE MOTOR
Holds objects put in hand
80
2 months LANGUAGE
makes sounds - ah, eh, ugh
81
3 months SOCIAL
Recognizes familiar adults
82
3 months SELF-HELP
increased activity when shown a toy
83
3 months GROSS MOTOR
Makes crawling movements
84
3 months FINE MOTOR
Holds up hand and looks at it
85
3 months LANGUAGE
laughs out loud, squeals
86
4 months SOCIAL
Interested in his/her image in mirror, smiles, playful
87
4 months SELF-HELP
Reaches for objects
88
4 months GROSS MOTOR
Pivots around when lying on stomach
89
4 months FINE MOTOR
Puts toys or other objects in mouth
90
4 months LANGUAGE
ah-goo
91
5 months SOCIAL
Reacts differently to strangers
92
5 months GROSS MOTOR
Rolls from stomach to back
93
5 months FINE MOTOR
Picks up objects with one hand
94
5 months LANGUAGE
Responds to voices, turns head toward a voice
95
6 months SOCIAL
Reaches for familiar persons
96
6 months SELF-HELP
Looks for object after it disappears from sight or falls
97
6 months GROSS MOTOR
Rolls over from back to stomach
98
6 months FINE MOTOR
Transfers objects from one hand to the other
99
6 months LANGUAGE
Babbles, responds to name, turns and looks
100
7 months SOCIAL
Gets upset and cries if left alone
101
7 months SELF-HELP
Feeds self cracker/cookie
102
7 months GROSS MOTOR
Sits alone, steady
103
7 months FINE MOTOR
Holds two objects (one in each hand) at the same time, brings two objects together
104
7 months LANGUAGE
Makes sounds like da, ba, ga, ka, ma
105
8 months SOCIAL
Plays “peek-a-boo”
106
8 months GROSS MOTOR
Moves forward while on stomach
107
8 months FINE MOTOR
Uses forefinger to poke, push or roll small objects
108
8 months LANGUAGE
Makes sounds like mama, dada, baba
109
9 months SOCIAL
Waves bye-bye
110
9 months SELF-HELP
Resists having toy taken away
111
9 months GROSS MOTOR
Crawls on hands and knees, pulls self to standing position
112
9 months FINE MOTOR
Picks up small objects using thumb and finger grasp
113
9 months LANGUAGE
Imitates sounds that you make
114
10 months SOCIAL
Plays “patty-cake”
115
10 months SELF-HELP
Picks up spoon by handle
116
10 months GROSS MOTOR
Walks around playpen or furniture while holding on
117
11 months GROSS MOTOR
Stands alone briefly
118
11 months FINE MOTOR
Puts small objects in cup or other container
119
11 months LANGUAGE
Understands phrases such as “No” and “all gone”
120
12 months SOCIAL
Imitates simple acts such as hugging or loving a doll
121
12 months SELF-HELP
Helps a little when being dressed
122
12 months GROSS MOTOR
Stands alone, steady
123
12 months FINE MOTOR
Turns pages of a book a few at a time
124
12 months LANGUAGE
Says mama or dada for parent
125
13 months SOCIAL
Plays with other children
126
13 months SELF-HELP
Lifts cup to mouth and drinks
127
13 months GROSS MOTOR
Walks without help
128
13 months FINE MOTOR
Builds tower of 2 or more blocks
129
13 months LANGUAGE
Shakes head to express “no”, hands objects to you when asked
130
14 months SOCIAL
gives kisses
131
14 months SELF-HELP
Insists on feeding self
132
14 months GROSS MOTOR
Climbs up chairs or other furniture
133
14 months FINE MOTOR
Marks with pencil or crayon
134
14 months LANGUAGE
Asks for food or drink with sounds or words
135
15 months SOCIAL
Greets people with hi or similar
136
15 months SELF-HELP
Feeds self with a spoon
137
15 months GROSS MOTOR
runs
138
15 months FINE MOTOR
scribbles with pencil or crayon
139
15 months LANGUAGE
says 2 words besides mama or dada, makes sounds in sequences that sounds like sentences
140
18 months SOCIAL
Sometimes says “no” when interfered with
141
18 months SELF-HELP
Eats with a fork
142
18 months GROSS MOTOR
Kicks a ball forward, good balance and coordination
143
18 months FINE MOTOR
Builds tower of 4 or more blocks
144
18 months LANGUAGE
Uses 5 or more words as names of things, follows simple instruction.
145
GI System Growth and Development
- Structurally complete at birth but immature
- Sucking = reflex until 6 wk
- stomach capacity increases
- intestinal motility is high in newborns (increased stools)
- Enzyme secretions increase (pancreatic enzymes start developing at 4 months)
- Liver matures in first 12 months
- by age 2 - 3 meals/day
- Excretory control by age 2-3 years
146
Necrotizing enterocolitis (NEC)
Most common and severe GI disorder in preterm neonates.
Caused by intestinal ischemia, viral or bacterial infection
147
Symptoms of NEC
Vomit, blood diarrhea, ABD distention, feeding intolerance, irritability OR lethargy
148
Treatment of NEC
SVS or IV fluids, IV antibiotics immediately, surgical resection
149
Complications of NEC
Malabsorption, short-bowel syndrome, scarring/narrowing bowel, bowel obstruction, ABD scarring, problems with long-term TPN
150
Complications in Premature babies
intraventricular hemorrhage (IVH)
retinopathy
feeding & nutrition problems
anemia
resp distress syndrome
151
Types of Central Venous Catheters
1. Short-Term (percutaneous)
2. Tunneled
3. PICC
4. Implanted
5. Hemodialysis
152
CVC Complications
Air embolism, occlusion, infection, malposition or external cath damage, extravasation
153
Causes of Acute diarrhea
VIRAL: rotovirus, norwalk, adenovirus, cytomegalovirus
BACTERIAL: salmonella, ecoli, shigella, c. diff
154
Treatment for Dehydration
NS bolus, then run D5NS to include sodium and glucose
155
Cleft Lip & Palate
1/700 babies
lip - 5-6wk gest
palate - 7-9wk gest
156
Complications of cleft palate
susceptible to colds, hearing loss, speech defect, dental cavities, tooth defects, otitis media, feeding difficulties
157
Hirchsprung (congenital aganglionic megacolon)
Absense of autonomic parasympathetic ganglion cells of colon - no peristalsis
158
Symptoms of Hirchsprung
CONSTIPATION
presents in first 6wks of life
Newborn: no meconium in 24 hours, bilous vomiting, ABD distention, failure to thrive
Older child: hx of constipation, ABD distention, failure to thrive
159
Treatment of Hirchsprung
surgical repair to remove dysfunctional part of bowel and re -connect
160
Tracheosophageal Fistula
Abnormal opening between trachea and esophagus
161
Symptoms of Tracheoesophageal fistula
Excess amniotic fluid, excess saliva, feed comes right back up
162
Diagnosing Tracheoesophageal fistula
catheter into esophagus, barium swallow test
163
Treatment of Tracheoesophageal fistula
Close fistula and anastomize esophagus
164
Imperforated Anus
Passage of feces obstructed by structural anomaly of anus/rectum
165
Diagnosis of imperforated anus
Inspect perineum, rectal atresia
166
Symptoms of imperforated anus
nausea/vomiting, ABD distention, failure to pass meconium at birth)
167
Treatment of Imperforated anus
Stop mouth feeds, surgery to close fistula and create an anal opening
168
Intussuseption
One portion of the bowel slides/invaginates into the next
169
Symptoms of Intussuseption
Nausea and vomiting, “currant jelly” and gelatinous stool, pain
170
Treatment of Intussuseption
Barium Enema
171
Pyloric Stenosis
Hypertrophy of circular pylorus muscle - stenosis of passage between stomach and duodenum (obstructs the lumen of the stomach)
172
Symptoms of Pyloric Stenosis
Projectile vomiting!! irritability, FTT, dehydration
173
Nissen Fundoplication
Surgery for babies with severe acid reflux - wrap the stomach around itself to tighten
174
