peds Flashcards
(147 cards)
1
Q
9th gestational week to birth is called
A
Fetus
2
Q
4 weeks to 1 year is called
A
infant
3
Q
1 year to 3 years
A
toddler
4
Q
three to 6 years is
A
preschool
5
Q
6 to 12 years is
A
school-age
6
Q
12 to 18 years is called
A
adolescent
7
Q
factors that influence growth and development
A
hereditary
race, gender, environment
nationality, ordinal position in family
8
Q
theres an increase in head development during infancy and it is 4inch
A
know
9
Q
Toddler
A
Chest circumference continues to increase, body changes proportions, legs. and arms lengthen through ossification and growth in epiphyseal areas of long bones, birth weight quadrupled by 2 1/2, rate of brain growth decelerates.
10
Q
Eruption of deciduous teeth in a toddler until age
A
2 1/2
11
Q
Differences between an adult and child in growth and development
A
The child is in a continuous process of growth and development
growth spurts followed by plateaus
the growth is measurable, can be observed and studied
not all parts mature at the same time
12
Q
Nursing process applied to growth and development
A
Ht and wt, plot standard growth chart.
record developmental milestones achieved related to the age of the child
observe infant, interview parents.
13
Q
analysis and diagnosis applied to growth and development
A
determine appropriate nursing diagnosis’ related to parenting, coping skills, and unmet developmental needs.
14
Q
Nursing process applied to growth and development outcomes and planning
A
offer guidance and teaching to family, school personnel, and child to meet developmental needs.
15
Q
nursing process applied to growth and development: implementation
A
interventions that foster growth and development in the hospital setting can include encouraging age appropriate self care.
anticipatory guidance may be given to parents so they understand changes in behavior, eating habits, and play for the growing child.
16
Q
the nursing process applied to growth and development: evaluation
A
ongoing environment of growth and development of the child and follow-up of teaching and guidance at prior clinic/home visits are essential.
17
Q
a progression increase in the functions of the body
A
development
18
Q
an increase in physical size, measured in feet or meters and pounds or kilograms
A
growth
19
Q
the total way in which a person grows and develops, as dictated by inheritance
A
maturation
20
Q
cephalocaudal means
A
proceeds from head to toe
21
Q
Proximodistal means
A
from midline to periphery
22
Q
growth standards Height increases by __ inch per month for the first 6 mo
A
1 inch
23
Q
height increases by __% by the 1 year of age
A
50%
24
Q
weight BW usually ___ by age 5-6 mo
A
doubles
25
weight: BW usually ___ by 1 year of age
triples
26
growth standards- standardized
compare the measurement of a child to others of the same age and sex
compare the childs present measurements with the former rat eof growth and patterns of progress
27
some developmental differences between children and adults
height, weight, body proportions, metabolic rates, respirations, cardiovascular systems, immunity, kidney function, nervous system, sleep patterns, bone growth, critical periods, integration of skills
28
Compares the measurement of a child to others of the same age and sex
standardized data
29
Standardized data compares the childs present measurements with the former rate of growth and pattern of progress
children who are in good health tend to follow a consistent pattern of growth
at any age there are wide individual differences in measured values
there are separate charts for boys and girls
30
Denver developmental screen test
assesses the developmental status of children the first 6 years of life in four categories
1. personal-social
2. fine motor-adaptive
3. language
4. gross motor
31
what is the purpose of Denver developmental screen test
purpose is to identify children unable to perform at an age
| it is NOT an intelligence test
32
all of the following factors are closely related and dependent on one another in their effect on the growth and development of the child
hereditary, nationality and race, ordinal position within the family, gender, environment
33
environment plays a minimal role in childhood development
strongly disagree
34
traditional husband, wife, children (natural or adopted)
nuclear
35
grandparents, parents, children and relatives is a description of what type of family.
extended
36
women or men establish separate households through individual preference, divorce, death, illegitimacy, or desertion
single-parent
37
parent who care for children requiring parenting bc of a dysfunctional family, no family, or individual problems
foster-parent
38
communal family
alternative
39
both parents work outside of the home bc of desire or need
dual-career
40
remarriage of persons with children
blended
41
more than one spouse
polygamous
42
two persons of the same sex adopt children or have children from a previous marriage
homosexual
43
heterosexual or homosexual couples live together but remain unmarried
cohabitation
44
a family apgar is used to
assess family function
45
family apgar:
adaptation: how the family helps and shares resources
partnership: lines of communication and partner ship in the family.
growth: how responsibilities for growth and development of the child are shared.
affection: overt and covert emotional interactions among family members.
resolve: how time, money, and space are allocated to prevent and solve problems.
46
```
*asthma
Nutritional concerns
Access to health care
Clean water
Utilities
Primary language
Alternate lifestyles
Street life influences
```
Conditions that may affect the normal growth and developement
47
Personality is the result of interaction between biological and environmental heritages
Unique organization of characteristics that determine the individuals typical or reoccurring pattern of behavior
Personality development
48
```
Self acualization
Esteem
Love
Safety and protection
Activity
Physiological needs
```
Maslow hierarchy of needs
49
Erickson: tasks must be mastered at each developmental stage to achieve optimum maturity.
Freud: believed personality was developed between 5-12 years old, and failure to progress may lead to dysfunction
Kohl berg: moral developement is sequential
Maslow: the needs at the bottom of the pyramid must be met before you can fulfill the ones at the top.
Sullivan: got core concepts from Freud, placed focus on social aspects of personality and cognitive representations. Eclectic approach, interpersonal theory: belief that peoples interactions with other people, determines their sense of security, sense of self, and the motivation for their behavior.
Piaget: intellectual maturity through 4 stages:
- sensorimotor (birth to 2 years)
- preoperational (2 to 7 years)
- concrete operations (7 to 11 years)
- formal operations (11 years and older)
Developmental theorists
50
Intellectual ability
Sensorimotor: progression from newborn w/ automatic reflexes to intentional interaction with the environment.
Preoperational: thought process internalized, use of symbols increases, child’s world is viewed egocentrically.
Concrete operations: child can focus on several aspects of a situation simultaneously, cause-effect reasoning becomes more rational and systematic, decrease in egocentrism permits child to take another’s view.
Formal operations: hypothetical and abstract thought expands, understanding of scientific and theoretic processes deepens
***consists of interaction and coping with the environment
Piagets theory of cognitive development
51
- sequential
- theory is based upon piagets
- three levels
- preconventional: 4-7 years (obedient to parents, fear of punishments)
- conventional: 7-11 years ( conformity and loyalty and focus on obeying rules)
- Post conventional: 12- older ( moral values)
* **each level contains 2 stages
* **emphasis on the conscience of the individual in society.
Kohlbergs theory of moral development
52
- tasks must be mastered at each stage to achieve optimum maturity
- parents must interact with child to assist in management of stages
ericksons stages of development
53
Controversial theorist
- believed personality was developed between 5-12 years of age
- failure to progress may lead to dysfunction
* *based on “psychoanalytical or psychosexual stages”
***the id, ego, and superego.
Sigmund freud (5 stages)
54
- focused on social aspects of personality and cognitive representations
- moved him away from freuds psychosexual development and towards a more eclectic approach.
-developed the interpersonal theory (belief that peoples interactions with others, determine their sense of security, sense of self, and they motivate their behavior.
Harry sullivan
55
First prenatal Trimester:
- childs task: growth
- parents task: develop attitude towards newborn (happy,sad)
Ericksons growth and development of parent
56
Second prenatal trimester
- child task: growth
- Parent task: mother focuses on infant because of fetal movements felt
Ericksons growth and development of parent
57
Third prenatal trimester
- child task: growth
- parent task: mother feels large, focus on getting fetus out
Ericksons growth and development of parent
58
Growth and development of a parent
* ***BIRTH
- baby task: adjust to external environment
- parent task: elicit positive responses from child and respond by meeting child’s needs for food and closeness.
Growth and development of a parent
59
Growth and development of a parent
****INFANT
- child’s task: develop trust, meeting ______****
- parents task: learn “cues” presented by infant to determine individual needs.
Growth and development of a parent
60
The theorist that has most influenced knowledge on childhood development is:
Erickson
61
- provides heat and energy
- builds and repairs tissues
- regulates body processes
- is given in a mixture of elements (minerals, compounds, and water)
Food
62
0.5/kg body weight in childhood and eventually 20 to 35 g/day by end of adolescence.
Can fill the small stomach capacity and provide few of the nutrients and calories needed by the active, growing child.
(Dried fruit, raisins, oatmeal, apple, whole grain bread)
Fiber needs of the young child
63
-traditional grains not used: corn, rice, soy, tapioca takes adjustment to the textures must contain less than 29 ppm of _______ or 20 mg/kg of the food.
Gluten free diet
64
Digestive system of the newborns:
- immature and functions minimally for the first 3 months of life
- saliva is minimal
- hydrochloric acid and Renin in the stomach and trypsin found in the intestines aid in the digestion of milk.
- the physiology of the digestive tract is the basis for introduction of various foods in the first years of life.
Know
65
- fat and cholesterol are needed for calories for the development of the central nervous system.
- requires more as an infant: calories, protein, minerals, vitamins, fluids.
Infant nutritional needs
66
Tip:
- introduce solid foods at about 5-6 months, use spoon feeding method, start with rice cereal.
- no whole milk before 1 year of age
- no low fat milk before age 2
Know
67
Sx:
- restlessness
- crying
- failure to gain weight
Sx:
- regurgitation
- mild diarrhea
- too rapid weight gain
SX of underfeeding
SX of overfeeding
68
- High fat diets cause: delayed gastric emptying, abdominal distention.
- High carbs cause: abdominal distention, Flatus, excessive weight gain.
- Constipation: too much fat or protein, deficiency in “bulk”
Feeding the healthy child: infant
69
Feeding;
- likes finger foods
- dawdling and regression common in this age group
- more vulnerable to protein-calorie deficiencies.
Feeding the preschool child
70
Feeding:
- food attitude is unpredictable
- typical low intake of: protein, calcium, vitamin A, and ascorbic acid.
- intake of sweets decreases appetite and provides “empty” calories.
Feeding the school aged child
71
Feeding:
- grow rapidly and expend large amounts of energy
- important to involve adolescent in food selections that are nutritious and appetizing
- fad food drives a lot of food selections
- fatigue is common in this age group
feeding of the adolescent
72
Obesity:
- more than doubled in last 30 years
- related to obesity in adulthood
- can cause: high cholesterol, high blood pressure.
- most often related to diet and inactivity
- BMI: height in inches power to 3 x 703
Child hood obesity
73
- a tablespoon of food for each year of age
- sweet drinks and snacks should not be served before meals
- infants who are placed on NPO status should be given a pacifier
Feeding the ill child
74
- Drug-Drug: nurse needs to know the side effects of each drug prescribed and administered.
- Drug-Environment: involves interactions of the effects of a drug on the response of the patient to the environment.
- Drug-Food: nurse needs to know if any foods are contraindicated when child is receiving certain drugs.
Food- drug interactions
75
Know where the canine, incisor, and molars are in the mouth
Know
76
- if deciduous teeth come out too early, the permanent teeth can come in poorly aligned.
- delayed or early eruption can be indicative of certain endocrine disorders or other pathologic conditions
- sticky foods have more potential to cause dental caries than sugared drinks.
- avoid: sugared gum, dried fruits, soft drinks, cake, and candy.
- eat more: cheese, milk, sugarless gum, raw vegetables.
Dental health know
77
- occurs when infant falls asleep while breastfeeding or is put to bed with a bottle of milk or sweetened juice.
- sugar pools in the oral cavity
- most often seen in children 18 months to 3 years of age
Dental caries
78
- fever is not associated with teething
- Replace toothbrush every 3 months or after a viral illness.
- don’t rinse bristles in hot water
- don’t used closed container for toothbrush storage
Dental care and info
79
- place tooth in cow’s milk until dental care is obtained
| - gently clean tooth of obvious debris and dirt
Know
80
Health problems: asthma, hemophilia, seizure disorders, bulimia.
Effects on teeth:
- sucrose content of medications can cause decay
- can cause oral bleeding, impaired healing
- causes decreased saliva; gigival over growth
- erosion of teeth from acid content during vomiting
Know
81
- play is the “work” for children
| - don’t give asthmatics children stuffed animals
Know
82
- establishment of sleep wake cycle
- social smile
- drinking from a cup
- separation anxiety
Milestones
83
- respiration’s are abdominal; 40 breaths/min
- pulse: 100-118 bpm
- temperature is taken axillary
- blood pressure is 90/60mm Hg by first year
Average infant vital signs
84
- sucking brings comfort and relief from tension
- allow sufficient time for infant to suck
- infants on IV need special attention and a pacifier
Oral stage
85
- Grasp reflex is seen at around 3 months
- Prehension, grasping between the fingers and opposable thumbs occurs around 5 to 6 months of age and follows an orderly sequence of development.
- Parachute reflex, appears around 7 to 9 months as a protective mechanism, the arms extend.
- Pincer frappe well-established by 1 year of age, coordination of the index finger and the thumb is established.
Motor development
86
- consistency must be established to develop trust
- infants who are consistently picked up when they cry tend to have fewer crying episodes and less aggressive behavior as toddlers.
- infants will easily accomplish various activities if they are not forced before they reach readiness.
- when infant shows readiness to learn a task, parents should provide encouragement
Emotional development
87
- physical patterns cannot be separated from social patterns
- abrupt changes do not take place with each new month of life.
Development and care
88
- a lethargic baby may “shut down” and sleep in order to avoid an excessively stimulating (loud or noisy) environment.
- shield infants eyes from bright light
Coping with an irritable infant
89
-periods of unexplained irritability and crying in an otherwise healthy and well fed infant
Colic
90
- avoid bright lights
- move and handle the infant slowly and gently
- talk in calm voice
- sit infant upright at intervals
- slowly dress and undress the infant
Coping with the lethargic infant
91
- newborns sleep in 4 hour intervals (by 4 to 6 months, can be up to 8 hours.)
- synchronizing circadian rhythm of infant to family routine is a learned behavior
- position infants on their backs on a firm mattress
Developing sleep patterns
92
-infant should have at least 5 physical exams in the first year
Know
93
Solid food can slowly be added in at around 6 months
- tongue extrusion reflex has completely disappeared
- GI tract is mature enough to digest food
- between 4 and 6 months, sucking is more mature, and munching or an up and down chewing/chomping motion ensues.
Nutrition counseling
94
- parental knowledge
- infant developmental behavior, readiness
- parent child interaction
- cultural and ethnic practices
What should be assessed prior to nursing patient teaching
95
- the infant has gained 4 to 7 oz per week for the first 6 months.
- the infant has at least 6 wet diapers a day
- the infant sleeps peacefully for several hours after feeding
Weight adequacy
96
Prebiotics:
- non-digestible food ingredient
- indirectly stimulates growth or activity of Bifidobacterium( a microorganism)
- assures balance of bacteria is maintained
Probiotics:
- productive to the GI tract
- used to treat diarrhea
Prebiotics and probiotics
97
- only offer a new food in a 4 day to 1 week period to help determine level of tolerance
- fruit juices can begin around 5 to 6 months of age, when the infant begins to drink from a cup
- sucking is mature at age 4 to 6 months, munching/chewing motions
Know
98
- infants require almost three times more calories per kilogram of weight than adults.
- by age 6 months, the digestive tract has the ability to digest fats present in food.
- a low-fat diet should not be given to infants under age 2.
Recommended infant fat intake
99
Weaning
Signs of readiness:
-infant eagerly looks forward to new tastes and textures found on the spoon
- may not want to be held close during feedings
- may start to “bite” the nipple as teeth erupt
- imitates parents/siblings
- should be gradual, start with daytime then progress to nighttime.
100
Car Safety
-rear facing for infants younger than 1 year or 22 lbs
101
- weight doubles by 6 months of age and triples by 1 year of age
- head and chest circumference are equal by 1 year of age
- maternal iron stores decrease by age 6 months
- depth perception begins to develop at age 9 months
- tooth eruption begins at age 6 months, when “biting” activities begin.
Developmental changes
102
A newborns birth weight was 6 ounces. What would you expect this child’s weight to be at 6 months?
12 pounds
103
Toddler age
1-3 years old
104
Ericksons stage of autonomy versus shame and doubt
Know
105
Negativism can be countered by:
- offering limited choices
| - use of distraction
106
- developing self control and socially acceptable outlets for aggression and anger
- Ritualism increases the toddler’s sense of security by making compulsive routines of simple tasks
Characteristics
107
- birth weight quadruples by 2.5 years of age
- rate of birth slows
- bowel and bladder control usually complete by 2.5 to 3 years of age
Physical development
108
- sensory and motor abilities do not function independently
- memory strengthens
- able to assimilate information through trial and error, and repetition
Piaget’s sensorimotor and preconceptual phase of development emerges rapidly in this age group.
Sensorimotor and cognitive development
109
- parallels cognitive growth
- comprehension exceeds verbalization
- showing empathy toward the toddler who is trying to communicate verbally will help minimize frustrations
Speech development
110
- goal is to teach and not punish
| - discipline involves guidance
Guidance and discipline
111
Time out should be one minute per one year of life
Know
112
Screening for signs of autism
preliminary symptoms include
- no pointing, gesturing by 12 months
- no single words by 16 months
- no spontaneous two word phrases by 24 months
- loss of achieved language or social skills
*****make sure to rule out lead poisoning, hearing deficit, neurological disorders, musculoskeletal diseases, and inborn errors of metabolism.
113
Shoes should be 1/2 longe and 1/4 inch wider than the foot.
Know
114
Toilet independence
- Voluntary control of anal and urethral sphincters begins around 18 to 24 months of age .
- bowel training usually attempted first
- don’t leave toddler on toilet for more than a few minutes at a time
- bladder training can begin when toddler stays dry for about 2 hours
115
Nutritional needs
- caloric needs decline to about 100 calories/kg/day
- limit milk intake to no more than 24 ounces (720 ml) a day
- serving size is 1 tablespoon of solid food per year of age
- food is chopped into fine pieces
- various foods are offered
- a 2 year old likes finger foods
116
Toddlers engage in Parallel play
Know
117
- nonflammable sleepwear
- childproof caps on medicine bottles
- maximum temperatures for water heaters
- smoke and carbon monoxide detectors
- slat space in infant cribs
- car seat
Federal government and private organizations regulate variables to prevent injuries
118
Through play toddlers learn how to:
- manipulate and understand their environment
- socialize
- explore their world
119
- social development takes form
- egocentric thinking
- parallel play gradually leads to cooperative play
- protect the child from sunburn, mosquitoes, and other vectors
- child proofing the home is also important
Toys and Play Know
120
Fetus
9th gestational week to birth
121
Neonate
Birth- 4 week
122
Infant
4 weeks-1 year
123
Toddler
1-3 years
124
Preschool
3-6 years
125
School age
6-12 years
126
Adolescent
12-18 years
127
Determine factors that influence growth and development
- hereditary
- race
- gender
- envirnoment
- nationality
- ordinal position in family
128
Physical development of the infant and toddler
Infant:
- growth in head circumference increases 0.6 inches each month for the first 6 months to reach 18 inches by month 12
- height increases 1 inch per month for the first 6 months to reach 29 inches by year 1 (mainly the trunk grows)
- weight doubles by age 6 months and triples by age 1 year.
- head circumference and chest circumference are equal by 1 year old.
- posterior Fontanelle closes at 2 months
- anterior fontanelle closes by 18 months
Toddler:
- body changes proportions, legs and arms lengthen through ossification and growth in epiphyseal areas of long bones.
- birth weight quadruples by 2 1/2.
- rate of brain growth decelerates.
- chest circumference continues to increase.
- eruption of deciduous teeth until 2 1/2.
- complete bowel and bladder control is usually achieved by age 2 1/2-3 years.
129
Nutritional needs of the growing child
- nutrition is essential to reach growth potential
- need appropriate fat and protein
- lack of nutrition can lead to intellectual disabilities
- 05g of fiber/kg of body weight
130
Define personality; what effects personality development?
Personality: the result of interaction between biological and environmental heritages “unique organization of characteristics that determine the individuals typical recurrent pattern of behavior.”
Read table 15.2 (pg.365-370)
131
Recognize a growth chart for a child
Standardized data: compares the measurement of a child to others of the same age and sex.
- compares the child’s present measurements with the former rate of growth and pattern of progress.
- children who are in good health tend to follow a consistent pattern of growth.
- at any age, there are wide individual differences in measured values.
- there are separate charts for boys and girls.
132
What are the characteristics of play and appropriate toys for various ages?
Play is the “work” of children
- infant: explore, imitate (touch stimuli and toys involving manipulation)
* 1-2 years old: parallel play (toys that reflect ADL’s)
* 3-5 years old: cooperative play, creative play (a simple box)
* 5-7 years old: symbolic group play, secret clubs
* 7-10 years old: competitive play (sports or games)
* 10-13 years old: group sports and internet games (internet games)
* 13-18 years old: fantasy play, cliques (board games)
133
Ways to prevent auto accidents
- teach street safety
- teach red light color meaning
- don’t run behind parked cars
- hold toddlers hand when crossing street
- don’t let them play in the car alone
134
Ways to prevent burns:
-teach them the meaning of hot, don’t leave matches, candles, and incense out, turn hands of the pots and pans to the back of the stove, test fluids and foods after using the microwave to see if they’re hot, keep a fire extinguisher, and have a fire evacuation routine.
135
Ways to prevent falls:
- teach them how to go up and down stairs
- secure crib sides
- supervise climbing
- use window guards
- lock basement doors and shut gates
136
How to prevent chocking:
- don’t play with deflated balloons
- inspect toys for small pieces
- avoid popcorn and nuts
- debone fish and chicken
- keep plastic bags out of their reach
137
Ways to prevent poisoning:
- keep cleaning agents put away
- keep medicine in a locked cabinet
- use non toxic paint
- wash fruits and veggies
138
Ways to prevent drowning
- watch them around pools
- drain wading pools
- wear life jackets when on a boat
- wear life jacket or floaties when swimming
- teach water safety
139
Ways to prevent electrocution:
- cover electrical outlets
| - teach them not to touch electrical outlets with wet hands
140
How to prevent animal bites
- teach them to avoid stray animals
- don’t let them abuse household animals
- supervise them closely
141
Identify the principles/guidelines of toilet training:
- voluntary control of anal and urethral sphincters begins at about 18-24 months
- they must be willing to sit on the toilet for several minutes at a time
- a potty chair may make the toddler feel more secure because it is small
- bowel training is generally attempted first; however, some toddlers become bladder trained during the day.
- they should not be left on the toiler for more than a few minutes at a time
- restricting fluids before bedtime may help
- the word that toddlers use to signal defecation or urination should be one that is recognized by others besides the immediate family
- bladder training is begun when toddler stays dry at least 2 hours at a time
- demands and threats do more damage than good.
142
Review the principles of safety during infancy:
Car safety:
-a rear facing infant seat should be used for infants less than 1 year old and weighing less than 22lbs.
-infants left to sleep in car seats for prolonged periods tend to flex their necks so that the chin rests on the chest, and this can cause oxygen desaturation and hypoxia.
Fall Prevention:
-an infant should never be left unattended on a flat surface (changing table)
- infants younger than 4 months have a rounded back and can roll off things
- keep cords, unstable furniture, and other hazardous things out of their ways and reach.
Toy safety:
- make sure to inspect the child’s toys for small parts and anything they can choke on
-make sure they’re playing with toys that are age appropriate
143
Become familiar with varieties of family’s
Pg. 365-370
144
Toddler
- childs task: autonomy
- parents task: try to accept the pattern of growth and development. Accept some loss of control but maintain some limits for safety.
Ericksons growth and development of the parent
145
Preschool:
-childs task: initiative
?genders
-parents task: learn to separate from child
Ericksons growth and development of the parent
146
School age:
-childs task: industry
Learning/recognition relating to ones own self
-parents task: accept importance of childs peers and learn to accept some rejection from child at times. Patience is needed to allow children to do for themselves, even if it takes longer. Provide age appropriate chores, and let them do things themselves to learn.
Ericksons growth and development of the parent
147
Adolescents
- childs task: establishing identity, accepting puberty changes, developing abstract reasoning, deciding on career, investigating lifestyles, and controlling feelings.
- parents task: learn to let child live his or her life and not expect total control, expect to be discredited sometimes, and expect differences of opinions and respect them. Guide but do not push.
Ericksons growth and development of the parent
