PEDI--EXAM 1 Flashcards
(212 cards)
1
Q
The entire DNA sequence of an individual and the study
A
genome
2
Q
the set of 46 chromosomes contains 22 pairs of _____.
A
autosomes
3
Q
how many copies of autosomes?
A
2!
one from mom & one from dad
4
Q
members of a chromosome pair are called
A
homologous chromosomes
5
Q
which chromosome pare are the sex chromosomes?
A
23rd pair
6
Q
picture of an individual’s chromosomes
A
karyotype
7
Q
takes place in somatic or tissue cells of the body and represents how the body makes new cells.
A
mitosis
8
Q
fertilized ovum
A
zygote
9
Q
is also known as reduction division of the cell
A
meiosis
10
Q
occurs only in the reproductive cells of the testes and ovaries and occurs only in the reproductive cells of the testes and ovaries and results in the formation of sperm and oocytes
A
meiosis
11
Q
the formation of sperm and oocytes
A
gametes
12
Q
a segment of a chromosome that can be identified with a particular function, most commonly production of one or more proteins
A
gene
13
Q
different forms or versions of the nucleotide sequence because each gene copy is inherited form each parent
A
alleles
14
Q
an individual who has two functionally identical alleles of a gene
A
homozygous
15
Q
an individual who has 2 different alleles of the gene is said to be
A
heterozygous
16
Q
may be apparent as a trait, such as curly hair or straight hair, or as signs or symptoms of a disease
A
phenotype
17
Q
each individuals particular set of genes represents their _____.
A
genotype.
18
Q
which statement indicates correct information has been given to the parents of a child having genetic screening? autosomal recessive characteristics:
A
affect males and females equally
19
Q
in discussing concerns with a pregnant woman, which information is crucial for the nurse to collect to ensure the most accurate genetic information is available? select all that apply
A
- a family medical history 3 previous generations
- relationships btw any affected family members
- the birth history for any siblings of the baby
- a medical history for both mother and father
20
Q
hyponatremia genetic referral concern?
A
speech problems
21
Q
which will best facilitate genetic information from a child?
A
implement developmentally appropriate assessment skills
22
Q
freud’s stages of development
A
oral anal phallic latency genital
23
Q
age for oral
A
birth to 1 year
24
Q
age for anal
A
1-3
25
phallic age
3-6
26
latency age
6-12
27
genital age
12 to adulthood
28
sucking on their finger or pacifier – baby gets pleasure and comfort through the mouth
oral
29
nursing considerations for oral stage
♣ Encourage breast feeding
| ♣ Offer bottle
30
potty training
anal
31
nursing considerations for anal
```
♣ Ask if they are toilet trained
♣ Any rituals about going to the potty
♣ Words they use for elimination
♣ Keep a normal pattern for elimination
♣ Do not start potty training during an illness
```
32
• – genitalia – noticing a difference between boys and girls – they may start touching themselves – relationship between sexes (parents)
phallic stage
33
phallic nursing considerations
♣ Determine if the child is more comfortable with male or female nurses
♣ Explain procedures that will involve the genitalia
♣ Keep the parents involved
PRIVACY
34
• – into the social thing, starting to understand their bodies better and they want privacy
latency
35
latency nursing considerations
♣ Provide them gowns
♣ Keep them covered
♣ They can keep their underwear on if at all possible
♣ Knock before you enter the room
36
• developing relationships, starting to mature sexually, have a surge of hormones, focus is on their genitalia function and relationships, time when parents should be encouraged to talk to their child about sex.
genital
37
nursing considerations for genital
```
♣ Enquire about significant friends
♣ Provide privacy for exams
♣ Educate about sexuality
♣ Gynecologic care for females
♣ Any changes
♣ Testicular exam for males.
```
38
freud viewed the personality as a structure with 3 parts
id
ego
superego
39
the basic sexual energy that is present at birth and drives the individual to seek pleasure
id
40
the realistic part of the person, which develops during infancy and searches for acceptable methods of meeting impulses
ego
41
the moral and ethical system, which develops in childhood and contains a set of values and a conscience
superego
42
freud's defense mechanisms of children
regression
repression
rationalization
fantasy
43
o return to earlier behavior: toilet training
| ♣ Start having accidents in the hospital
regression
44
o involuntary forgetting: abused child
| ♣ With uncomfortable situations the abused child is not able to recall what happened
repression
45
unacceptable becomes acceptable: “He hit me first!”
rationalization
46
o mind creation to protect self: special powers, superman
fantasy
47
erikson's stages of development
```
trust vs. mistrust
autonomy vs. shame & doubt
initiative vs. guilt
industry vs. inferiority
identity vs. role confusion
```
48
age for trust vs. mistrust
birth to 1 year
49
autonomy vs. shame & doubt age
1-3
50
initiative vs. guilt age
3-6
51
industry vs. inferiority age
6-12
52
identity vs. role confusion age
12-18
53
piaget's theory of cognitive development
sensoriomotor
preoperational
concrete operational
formal operational
54
age for sensoriomotor
birth to 2
55
age for preoperational
2-7
56
age for concrete operational
7-11
57
age for formal operational
11 - adult
58
what to kids use during sensorimotor stage (birth - 2)
object permanence
59
they touch everything, they learn through their senses and their motor activities, learning about object permanence- just bc it’s out of sight doesn’t mean it’s gone
object permanence
60
what do they use in preoporational stage
```
egocentrism
transductive reasoning
magical thinking
centration
animism
```
61
if they were bad and weren’t listening then that’s why this happened),
transductive reasoning
62
(believe inanimate objects come to life – ex. Blood pressure cuff makes noises so it is going to eat their arm)
animism
63
• They think the reason something bad happens was because they said it or thought it.
preoperational
64
what to they use in concrete operational (7-11)
conservation
65
starting to understand things a little bit more. Their arm will still be there when they take the cast off, etc. better understanding of cause and effect. Like to manipulate objects, see things and touch them
conservation
66
• abstract thinking keep them up to date with what’s going on with their care. Consider different outcomes or alternatives
Formal operational (11-adult)
67
kohlberg's stages of moral development
preconventional
conventional
postconventional
68
preconventional age
4-7
69
conventional age
7-11
70
postconventional age
12 and up
71
what do they want in pre conventional stage (4-7)
avoid punishment
| please others
72
what do they want in conventional stage (7-11)
they want to please others by following rules, they want to be good.
73
what do they do in post conventional stage (12 and older)
develop their own ethical standards and principles;
look at 2 different approaches and make a decision
74
pavlov's theory
positive and negative reinforcement
75
positive reinforcement
will encourage good behavior
76
negative reinforcement
get rid of behavior such as scolding
77
environmental systems
```
microsystem
mesosystem
exosystem
macrosystem
chronosystem
```
78
♣ Daily consistent relationships at home or school that affects the child; as well as the child affecting them
microsystem
79
♣ These are microsystem relationships with each other; home affects school performance, etc.
mesosystem
80
♣ Settings that the child are not in daily contact with but they do still influence the child. Ex. Parents work – If parents can’t take off to go to a child’s field trip. Parents can’t take off of work when their child is sick because they don’t have any sick time is another example.
exosystem
81
♣ Cultural, political and faith influences
macrosystem
82
♣ Time when the child is growing up effects the views of health and illness
macrosystem
83
♣ Time when the child is growing up effects the views of health and illness
chronosystems
84
generally moderate in activity; shows regularity in patterns of eating, sleeping, and elimination; and is usually positive in mood and when subjected to new stimuli
adapts to new situations and is able to accept rules and work well with others.
schedule for eating, sleep, and pooping
"easy" temperament
85
displays irregular schedules for eating, sleeping, and elimination; adapts slowly to new situations and persons; and displays a predominantly negative mood
intense reactions to the environment are common
the "difficult" child
86
has reactions of mild intensity and slow adaptability to new situations.
the child displays initial withdrawal followed by gradual, quiet, and slow interaction with the environment
the "slow-to-warm-up" child
87
• Their ability to function with health responses with significant stressful situations
resiliency model
88
resiliency model
```
developmental and situational stresses
healthy functioning
protective factors
risk factors
adjustment
adaptation
assessment
application to nursing care
```
89
• Physical growth milestones
| 2-4 months:
o Posterior fontanel closes
o Holds rattle and plays and looks at own fingers
o Rolls from side to back then returns to side
o Holds head up and supports weight on forearms when on stomach
o Follows objects 180 degrees and turns head toward voices or sounds
90
• Physical growth milestones
| 4-6 months:
o Birth weight doubled by 6 months
o Teething
o Puts objects in mouth, holds bottle, pulls feet to mouth
o Can roll from stomach to back by 4 months and back over to stomach by 6 months
o Able to hold head up when sitting
o Watches falling objects
91
• Physical growth milestones
| 6-8 months:
```
o Likes to bang objects while holding them
o Can move objects between hands
o Sits without support by 8 months
o Bounces when held in standing position
o Looks and smiles when name spoken
```
92
• Physical growth milestones
| 8-10 months:
```
o Can pick up small objects by using pincer grasp
o Crawls or creeps
o Pulls up to standing by 10 months
o Recognizes sound
o Says mama and dada
```
93
• Physical growth milestones
| 10-12 months:
o Birth weight triples by 1 year
o Can hold crayon, places blocks into containers with holes
o Stands alone, walks holding furniture, sits from standing
o Plays peek a boo and patty cake
94
• Physical growth milestones
| 1-2 years:
```
o Birth weight quadrupled by 2 years
o Pot-bellied appearance
o Anterior fontanel closes
o Can scribble, build 4 block tower, undress self, throw ball, push/pull toys
o Runs, walks up and down stairs
```
95
• Physical growth milestones
| 2-3 years:
o Has approximately 20 teeth by 3 years
o Can draw simple shapes
o Learning to dress self
o Jumps, kicks a ball and throws it overhand
96
weight by 6 months
should be double the birth weight
97
when should baby be able to roll from stomach to back
4 months
98
roll from back to stomach by?
6 months
99
sit without support by which age?
8 months
100
pulls up to standing by
10 months
101
birth weight ____ by 1 year
triples
102
birth weight ___ by 2 years
quadrupled
103
how many teeth by 3 years
20
104
uses parallel play
toddler 1-3 years
105
looses first deciduous tooth around __ years
6
106
cooperative play
school age 6-12
107
♣ Don’t use then when trying to speak to someone and educate them.
medical jargon
108
forms of nonverbal communication
```
paralanguage
gestures
touch
personal space
facial expression
body language
eye contact
physical appearance
```
109
o Ability to perceive another person's experience from their view “putting self in their shoes”
empathy
110
• Communication with infants is still primarily ______.
nonverbal
111
how to talk to infant
high-pitched soft tone
112
where to let the infant sit during the assessment
with the parents on their lap
113
toddler & preschooler cognitive development
magical thinking
114
how do toddlers & preschoolers express themselves?
dramatic play & drawing
115
who to talk to first with toddlers & preschoolers?
acknowledge child but speak with parents first
116
how to sit when talking to toddlers & preschoolers
@ eye level
117
can you talk about procedures in front of the preschooler or toddler?
not if its scary
118
• now able to use logic
o Begin to understand others' viewpoints
o Begin to understand cause-effect
o Understanding of body functions
school age children
119
can school age children interpret nonverbal messages?
YES
120
* Abstract thinking without full adult comprehension
| * Interpretation of medical terminology is limited
adolescents
121
strategies to facilitate rapport and data collection
```
introduction
purpose of interview
use open and close-ended questions
timing of questions
privacy
nonverbal communication
observations
honesty
language
```
122
• Past health and illness history/ages of occurrence examples:
o Birth history
o Communicable diseases and illnesses
o Hospitalizations and surgery
o Injuries
123
how many generations for genetic FH
3
124
Sequence of Examination for young children
foot to head
125
Sequence of Examination
| for older children
head to toe
126
• Infants Under 6 Months of Age
o Encourage the parents to participate in the exam
o Distract the infant with toys
o Use gentle warm hands and warm stethoscope
127
• Do procedures that provoke crying when
at end of exam
128
when to auscultate on under 6 month olds
when quiet or sleeping
129
where to keep the baby over 6 months old during the assessment
as close to parent as possible to alleviate separation anxiety
130
when to examine ears, eyes, & mouth for toddlers?
end of the exam
131
what to do before examining toddler?
o Demonstrate instruments on parent or other before examining child
132
• Head circumference Done until the child is
2-3 years
133
o Length Children under 2
= supine position even if they are able to stand
134
o Standing scale for what age groups
♣ Preschooler and older
135
• Head circumference done until
child is 2-3
136
anterior fontanel
12-18 months
137
posterior fontanel
2-3 months
138
• Child ___ years old and older for six cardinals fields
3
139
• See if an infant reaches for objects when you place it in front of their _____.
face
140
Pinna back & up for
over 3years
141
pinna down & back for `
under 3years
142
♣ A child 6 months or younger will not automatically open up their mouth if?
their nose is stuffy
143
♣ Common to feel mobile form lymph nodes up to
1 cm
144
♣ Warm tender nodes could be
infection
145
2 y/o chest
oval shaped
146
check chest circumference until about ____ years
2
147
how to heck HR on infants and children
full minute & apical pulse
148
• Up until about 6 years they breath with their
diaphragm
149
♣ auscultate for At least ___ minutes before saying they don’t have bowel signs
5
150
♣ female Pubic hair Usually will not develop before ___ years old
8
151
male pubic hair usually will not develop before __ years old
9
152
scale used to measure male puberty and sexual maturation
tanner scale
153
check posture and spinal alignment for ____ in school aged children
scoliosis
154
how to check lower extremity musculoskeletal system on a child
have child stand on one leg then the other
155
how to check lower extremity musculoskeletal system on an infant
ortilani-barlow maneuver
156
legs should be straight by___ years old
4
157
• By ____ years old you should be able to understand the child clearly
3
158
• Test memory by about ___ years old
4
159
o how to check Sensory functioning
♣ Close their eyes and touch them with something – tell them to point where they felt it
160
♣ Pain sensation check at ____ years and older
4
161
♣ Moro (startle)reflex disappears by about ___ years old
6
162
♣ Palmer grasp disappears by ___ months
3
163
♣ Plantar (grasp with toes) disappears by ___ months
8
164
♣ Babinskis response – normal under
2 years old
165
skin turgor for a baby
chest or abdomen
166
♣ If fontanels are bulging-
increased intracranial pressure
167
♣ Sunken fontanels -
dehydration
168
♣ When we listen for breath sounds, we listen
anterior and posterior
169
• Psychological impact of disaster on Infants, toddlers, and preschoolers
♣ Fear, separation anxiety, regression
♣ They may have a change in their sleeping or eating patterns
• Nightmares, fear the dark, separation anxiety, regression
♣ Whole family may be together in a shelter but it is not their normal atmosphere.
170
• Psychological impact of disaster on school-aged
♣ Sadness, anger, fear
♣ Fearful for themselves or their family
♣ Loss of usual interests
♣ May act out
171
• Psychological impact of disaster on adolescents
```
♣ Decreased interest in usual activities
♣ They may act out or step up to the plate and be part of the clean-up etc.
♣ Risky behavior
♣ Acting out
♣ Sadness and anger
♣ Somatic complaints
• Headache
• Stomach ache
```
172
♣ _____ may be more readily absorbed in children's thin skin
Toxins
173
♣ Children breath faster so they might breath in more
toxins
174
o Pediatric drugs/supplies for disaster
♣ 3 day supply of food, water, etc.
| ♣ Bring medications, toys, diapers, baby formula, etc. to the shelter.
175
o will fear pain, invasive procedures, and mutilation of their bodies
toddlers
176
o fear being alone, the dark, being abandoned as well as mutilation
school age child
177
o fear a change in their body image, bodily injury, disability, pain, death, and separation from their friends and home, and loss of privacy and their independence.
adolescents
178
(when a child returns to an earlier behavior such as sucking thumb)
regression
179
(involuntary forgetting)
repression
180
(putting things off)
postponement
181
• Therapeutic play Addresses fears, concerns how?
♣ Give them a piece of paper to draw their concerns
182
respiratory changes due to pain in children
♣ Alkalosis
♣ Retained secretions
♣ Decreases oxygen saturation
183
o Neurological changes due to pain in children
♣ Increase in heart rate, blood sugar, cortisol levels
| ♣ Altered sleep patterns
184
metabolic changes due to pain in children
♣ Increase in fluid and electrolyte losses
• Fever, increased respiration, perspiration
♣ Delayed wound healing because of pain
185
o Infant behavior due to pain
♣ Cry, not eating right, irritable, restless, etc.
186
toddlers behavior due to pain
♣ Aggressive behavior
♣ Physical resistance
♣ Cry
♣ Can’t describe pain but may say ouch or boo-boo
187
preschooler behavior due to pain
♣ They may deny pain so they may not say a lot
♣ May believe the nurse or parent already knows they are hurting
♣ Aggressive behavior
188
school age behavior due to pain
♣ Tell you where their pain is and describe it
♣ A lot of times they try to be brave
♣ May withdraw emotionally
189
school age behavior due to pain 10-12 years old
* Describe their pain a little bit more
* Trying to be brave
* May pretend they are comfortable, but the pain and anxiety could cause some regression
190
adolescents behavior due to pain
♣ A lot of times they think that the nurse should know when they’re hurting so they may not complain about anything
♣ Try to control their responses to pain
♣ May use distraction with them as well
191
Neonatal characteristic facial responses to pain include
bulged brow; eyes squeezed shut; furrowed nasolabial creases; open, angular, squarish lips and mouth; taut tongue; and a quivering chin.
192
Memories of past pain can trigger _____
anxiety
193
o FLACC
♣ Face, legs, activity, crying, consolability
194
♣ Observe the child during routine care for about 1-5 minutes and pick the behavior that goes along with each category.
FLACC scale
195
which age groups use the FLACC scale
infants
toddlers
preschoolers
196
which age group uses the OUCHER pain scale
all but infants
197
toddlers use the FLACC scale, oucher scale, and.....
faces pain rating scale
198
preschoolers use FLACC scale,oucher scale, faces pain rating scale and?
poker chips
199
• School age painting scale
```
o Oucher
o Faces Pain Rating scale
o Poker Chip
o Word Graphic
o Visual analogue
```
200
♣ Numeric pain scale
| ♣ Horizontal line numbered 1-10
visual analogue
201
• Adolescent pain scales
```
o Oucher
o Faces Pain Rating Scale
o Poker Chip
o Word Graphic
o Visual analogue
o Adolescent pediatric pain tool
```
202
o for less severe pain or chronic pain
NSAIDs
203
o For severe pain
o Have the correct dosing for weight
side effects: Sedations, N/V, urinary retention, constipation
opioids
204
heat/cold therapies can treat
muscle spasms & bleeding
205
how to evaluate after pain meds are given
o Assess the pain 15-30 minutes and then 1 hour after a PO medication
206
what is the preferred route for meds
oral
207
can you mix the meds in a bottle?
NO
208
what is preferred over the IM route
IV
209
purpose of sedation
to control pain during a procedure
210
light sedation
child able to support airway
| talk normally
211
moderate sedation
conscious sedation
can maintain airway
purposeful response to vocal or tactile stimuli
212
deep sedation
cannot support airway
ventilate or oral airway
bag mask
