Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nurs 3032 > Test #1 > Flashcards

Test #1 Flashcards

1
Q

atraumatic pediatric care

A

interventions to minimize physical and psychological distress for children and families

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ACEs

A
  • Findings showed the more negative events a child experienced that higher the likelihood of adult experiencing health and behaviour problems
  • Reducing pathologizing of symptomatic behaviour by viewing symptoms as normal reactions to abnormal experiences
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

resilience

A
  • Resilience involves being able to recover from difficulties or change – to function as well as before and then move forward.
  • Factors include the protective or risk factors involving the individual, family and environment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

communicating with parents

A
  • Encouraging parents to talk
  • Directing the focus (ask directing questions/stay relevant/redirection)
  • Listening and cultural awareness
  • Providing anticipatory guidance (preparing them for what may happen, explain procedures, etc.)
  • Avoiding blocks to communication (ie, information overload)
  • Communicating with families through an interpreter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

risk factors for infant death

A

low maternal education
inadequate housing
lack of access to health care
food insecurity
Poverty
Unemployment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Childhood morbidity

A

Prevalence of specific illnesses in the population at a particular time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most common morbidity in children

A

respiratory: asthma, RSV, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Children with increased morbidity

A

Homeless and immigrant children; children living in poverty; Indigenous peoples; children in care of child services; low-birth-weight (LBW) children; children with chronic illnesses; and immigrant adopted children, genetics, family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

General Approaches Toward Examining the Child

A
  • Minimize stress and anxiety associated with assessment of various body parts
  • Foster trusting nurse–child–parent relationships
  • Allow for maximum preparation of child
  • Preserve security of parent–child relationship
  • Maximize accuracy and reliability of assessment findings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

head circumference

A

under 3 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

growth charts

A

5-95% is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

BMI

A
  • Measurement of body fat using height and weight
  • BMI = Weight(kg)/Height(m)2
  • Recommended for screening children two years and older to identify potential wasting, overweight or obesity.
  • On growth charts for ages 2 to 20 years
  • BMI <3rd% = underweight
  • BMI >85th% = overweight
  • BMI >97th% = obese
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

temperature routes for children

A
  • Birth-2 years - rectum (armpit)
  • 2-5 - rectum (ear/armpit)
  • 5+ - mouth (ear/armpit)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

pulse for children

A
  • 1 full minute under 10 years
  • Apical under 2 years of age
  • Radial greater than 2 years
  • Take brachial and femoral pulse together to make sure they are the same
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

respirations for children

A

Infants - diaphragmatic breathers (abdomen moves)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

blood pressure for children

A
  • Pay attention to pulse pressure
  • Wide - 50+
  • Narrow - less than 10
  • Left arm first (closer to heart)
  • If you have to recheck bp, wait 5 minutes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

airway <6 months

A
  • Obligate nasal breathers (mucus in nose makes it hard to breathe)
  • Passages easily obstructed with mucus secretions
  • Prone to upper airway respiratory infections (throat up → ear, nose, throat)
  • At risk of airway compromised (tongues are large in comparison to mouth, heavy head, face and mandible small)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

airway 3-8 years

A
  • Problems because of adenotonsillar hypertrophy
  • Horseshoe shaped epiglottis (flexible & flat in adults)
  • Trachea short and soft
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

cardiovascular

A
  • Heart is higher in chest
  • Heart rate higher on inspiration
  • Resting heart rate higher than adult
  • Sinus arrhythmia normal
  • Children’s circulating blood volume is higher than adults
  • 70 - 80 ml/kg but actual volume is small
  • Therefore small blood loss may be significant in children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ABCDEF

A

Airway
Breathing
Circulation
Disability - LOC, pain response, pupil size, light reaction, glucose
Exposure - remove clothing to look
Family - family interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

GCS 8 or less

A

intubate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

when do fetuses start feeling pain

A

24 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

response to pain: young infant

A
  • Generalized body response of rigidity or thrashing, possibly with local reflex withdrawal of stimulated area
  • Crying
  • Facial expression of pain (brows lowered and drawn together, eyes tightly closed, mouth stretched open and squarish)
  • No association demonstrated between approaching stimulus and subsequent pain
  • Preterm infants feel more pain than term infant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

response to pain: older infant

A
  • Localized body response with deliberate withdrawal of stimulated area
  • Loud crying
    Facial expression of pain or anger
  • Physical resistance, especially pushing the stimulus away after it is applied
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

response to pain: young child

A
  • Loud crying, screaming
  • Verbal expressions such as -“Ow,” “Ouch,” “It hurts”
  • Thrashing of arms and legs
  • Attempts to push stimulus away before it is applied
  • Requests for termination of procedure
  • Clinging to parent, nurse, or other significant person
  • Requests for emotional support, such as hugs or other forms of physical comfort
  • Becoming restless and irritable with continuing pain
  • Behaviours occurring in anticipation of actual painful procedure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

response to pain: school age

A
  • May see all behaviours of young child, especially during actual painful procedure, but less in anticipatory period
  • Stalling behaviour, such as “Wait a minute” or “I’m not ready”
  • Muscular rigidity, such as clenched fists, white knuckles, gritted teeth, contracted limbs, body stiffness, closed eyes, wrinkled forehead
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

response to pain: Adolescent

A
  • Less vocal protest
  • Less motor activity
  • More verbal expressions, such as “It hurts” or “You’re hurting me”
  • Increased muscle tension and body control
28
Q

QUESTT

A

Q - question the child and parent
U - use pain rating scale
E - evaluate behaviour and physiologic changes
S - secure parental involvement
T - take cause of pain into account
T - take action and evaluate results

29
Q

FLACC Pain Assessment

A

Face
Legs
Activity
Cry
Consoliability
*Used for kids less than 3 years, or kids that can’t tell us about their pain

30
Q

FACES Pain Scale

A
  • The child chooses a face that describes his or her pain
  • Ages 3-10
31
Q

Numeric rating scale

A

Useful in children 8 years and older

32
Q

adolescent pediatric assessment scale

A
  • Assesses pain location, intensity, and quality
  • shade in body parts that have pain
  • circle words on side that relate to pain
  • Facilitates assessments of pain quality + location
  • Useful for 8 and up
33
Q

gold standard opioids for kids

A

morphine

34
Q

what does the nurse do during a procedure?

A
  • Before the procedure: adequate preparation reduces anxiety and promotes coping
  • During the procedure: use a firm, positive, confident approach that provides the child with a sense of security
  • After the procedure: hold and comfort the child
35
Q

transporting infants and children

A
  • Determined by age, condition, destination, and hospital policy
  • Infants and small children can be carried short distances.
  • Critically ill patients should always be transported on a bed/stretcher
  • Can’t walk around with kid in arms, need to be in bed, stretcher, chair, etc
36
Q

therapeutic holding

A

the parent or caregiver holds the child in a secure, comfortable position that provides close physical contact for 30 minutes or less

37
Q

bone marrow aspiration or biopsy

A

Infants - tibia
Children - posterior or anterior iliac crest

38
Q

Emla patch

A

(numbs) - put on 60 minutes before taking blood

39
Q

pharmacodynamics

A

what the drug does to the body. Drugs physiological effects on molecular level

40
Q

Pharmacokinetics

A

what the body does to the drug. how the drugs moves through the body, (distribution, absorption, metabolism, excretion)

41
Q

Medication Administration: Age Based Considerations

A
  • Infants: Need TLC before and after (parents too), trust
  • Toddlers: Need immediate preparation. Do not offer unreal choices. Allow caregivers to help with oral meds.
  • Preschool children: Need to know what they are expected to do. Let them handle equipment. A bandage is very important for body integrity.
  • School-aged children: Need explanation of their role and choices when possible. Longer preparation time needed for invasive procedures.
  • Adolescents: Generally want more information. Privacy is important. Recognize need for independence. Allow client choices.
42
Q

oral medication

A

Under age 6 risk for aspiration so needs to be crushed

43
Q

otic administration

A
  • can be upsetting to child
  • Reinforce need for head to be still
  • Room temperature med
  • Keep them laying on side for 2 minutes after
44
Q

nasal administration

A

Head hyperextended for 1 minute post instillment

45
Q

Intramuscular Injection sites

A

Vastus lateralis: for most medications
Ventro gluteal: not until 3 years
Deltoid: not until 4 years

46
Q

Max fluid per day given

A

2400 mL

47
Q

output

A

0.5-1 ml/kg/day

48
Q

fluid replacement per day

A

below 10 kg - 100 ml/kg
10-20 kg - 1000 + 50 ml/kg
greater than 20 - 1500 + 20 ml/kg

49
Q

fluid requirements per hour

A

below 10kg - 4ml/kg
10-20 kg - 2ml/kg for each kg more than 10
greater than 20 - 1 ml per kg for each kg greater than 20

50
Q

how to take temp for child under 3

A

pull pinna down and back

51
Q

how to take temp for child over 3

A

pull pinna up and back

52
Q

indications for O2 therapy

A

1) Documented hypoxemia
2) An acute care situation in which hypoxemia is suspected
3) Severe trauma
4) Acute myocardial infarction
5) Short-term therapy (e.g., post-anesthesia recovery)
6) Increased metabolic demands, i.e. burns, multiple injuries, and severe infections.

53
Q

Variations in Pediatric Anatomy & Physiology: Nose

A

-Infants up to 4-6 weeks are obligate nose breathers
- Upper respiratory mucus serves as a cleansing agent, yet newborns produce very little mucus making them more susceptible to infection
- Young infants nasal passages are smaller so any excess mucus can cause airway obstruction
- The frontal sinuses and the sphenoid develop by age 6-8 years making younger children less likely to acquire sinus infections compared to adults

54
Q

Variations in Pediatric Anatomy & Physiology: Throat

A
  • Infants oropharynx is larger than in adults
  • Children tend to have enlarged tonsillar and adenoidal tissues even in the absence of illness
  • The epiglottis in infants is hard, narrow and folded horseshoe shaped (flexible & flat in adults)
55
Q

Variations in Pediatric Anatomy & Physiology: Trachea

A
  • Infants trachea is approximately 4 mm wide compared to the width of adults of 20 mm
  • A small reduction in the airway diameter of the pediatric child can increase resistance to airflow, leading to increased work of breathing
  • In infants and children under 10 years the cricoid cartilage is underdeveloped, resulting in laryngeal narrowing and a funnel shape
56
Q

Variations in Pediatric Anatomy & Physiology: Lower Respiratory Structures

A
  • Bifurcation of the trachea occurs at T3 in children, compared with the level of the sixth thoracic vertebra in adults
  • Bronchi and bronchioles of infants and children are narrower in diameter placing them at increased risk for lower airway obstruction
  • Alveoli reach adult number around 7 or 8 years of age, placing the younger child, infant or premature infant at higher risk for hypoxemia and carbon dioxide retention as there are fewer overall gas exchange units
57
Q

Variations in Pediatric Anatomy & Physiology: metabolic rate and oxygen needs

A
  • Children have a significantly higher metabolic rate than adults
  • Infants consume 6-8 L02/ min compared to adults of 3-4 L02/ min
  • In any sort of respiratory distress children will develop hypoxemia more rapidly than adults
58
Q

general ethology of respiratory infections

A

Infectious agents
-Most are viral (RSV)
Age
-<3 months have maternal antibodies and are better protected
-Infection rate increases from 3-6 months
Size
-Airway is smaller, more susceptible to obstruction from swelling and mucous
-Shorter distance between structures → easy spread of bacteria
Resistance
-Children who are breastfed have better immunity
Seasonal variations

59
Q

general clinical manifestations of respiratory infections

A

Fever (first sign of infection)
Poor feeding and anorexia
Vomiting
Diarrhea
Abdominal pain
Nasal blockage
Nasal discharge
Cough
Respiratory sounds (cough, hoarseness, grunting, stridor, wheezing, crackles)
Sore throat
Meningismus

60
Q

non specific signs of infection

A

Diarrhea, poor feeding, abdominal pain

61
Q

easing respiratory efforts

A

Sit them up
Chest physio
Suctioning
Cool mist humidifier
High flow O2
Nebulizers or puffers
No cold meds under 6 (only supportive care)

62
Q

nursing care for respiratory infections

A

Easing respiratory effort
Promoting rest
Promoting comfort
Reducing the spread of infection
Reducing temperature
Promoting hydration
Providing nutrition
Encouraging family support and home care

63
Q

respiratory failure

A

-Defined as inability of respiratory system to maintain adequate oxygenation, with or without carbon dioxide retention
-Most common cause of cardiopulmonary arrest in children

64
Q

respiratory arrest

A

Cessation of respirations

65
Q

apnea

A

-Cessation of breathing for more than 20 seconds
-Cessation of breathing for a shorter period when associated with cyanosis, pallor, hypoxemia or bradycardia

Types
-Central - respiratory efforts absent for 20 seconds or more
-Obstructive - have respiratory efforts
-Mixed

66
Q

respiratory insufficiency

A

-when there is increased work of breathing but gas exchange function is near normal
-when normal blood gas tensions cannot be maintained and hypoxemia and acidosis develop secondary to carbon dioxide retention

Nurs 3032 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions