Pediatrics Set I Growth & DEvelopment
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Created by:
Carolina5506 on October 14, 2010
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364 terms
Terms | Definitions |
|---|---|
 Growth | increase in physical size |
| Development | increase in abilities (skills) |
| Cephalocaudal development | skills develops head downward through body towards feet. |
| Proximodistal development | skills develops from center to extremities. |
| Anticipatory guidence | Nurses use this to predict upcoming development task and needs of child. |
| Development Theory | Erikson |
| Erikson's Psychosocial Stages of Development | Eight Psychosocial stages - each has a unique developmental task; birth through old age; stages have 2 possible outcomes: either a healthy one or unhealthy. |
| Trust vs. mistrust | Birth to 1 yr. |
| Autonomy vs. shame/doubt | 1 to 3 yrs. |
| Initiative vs. guilt | 3 to 6 yrs. |
| Industry vs. inferiority | 6 to 12 yrs. |
| Identity vs. role confusion | 12 to 18 yrs. |
| Piaget | Four stages of cognitive development. |
| Sensorimotor | Birth to 2 yrs. |
| Preoperational | 2 to 7 yrs Young child thinks by using words as symbols; logic is not well developed.. |
| Preoperational | Transductive reason (Stage Name) Unrealistic cause/effect relationships, "magical thinking" |
| Concrete operational | 7 to 11 yrs. More accurate understanding of cause/effect.Concept of conservation - matter doesn't change when its form is altered.A child can reason well in this stage if concrete objects are used in teaching. |
| Formal Operational | 11 years to adulthood.Mature intellectual thought, can think abstractly, can consider different outsomes |
| Bandura | Social Learning Theorist - a child can learn attitudes, beliefs, and customs through social contact. |
| Social learning behaviors | If positively rewarded, they repeat behaviors. |
| Self-Efficacy | this is the expectation that someone can produce a desired event |
| T | (T/F) Regression is normal in a hospitalized child (1-3yrs.) / might start wetting the bed again. |
| 6 months | Birth weight doubles by ___. |
| 1 year | Birth weight triples by ___. |
| 1 year | Height increases by about a foot each ___. |
| 6 months | Teeth erupt at about ____ months. |
| 6-8 teeth | How many teeth should be showing at 1 year? |
| 1 year | Baby should beable to feed itself by ____. |
| 2 years | Birth weight should quadruple by ____. |
| 33 months | By ____ months, eruptinon of deciduous teeth is complete (20 teeth present) |
| Parallel play | Kids play next to but not with each other (jealousy) |
| 1000 | Toddlers have _______ word vocabulary. |
| 2000 | Preschoolers have ________ word vocabulary. |
| 12-18 months | Anterior fontanel closes at ____ months. |
| 2 - 3 months | Posterior forntanel closes at _______ months. |
| many childhood communicable diseases can be prevented thru | immunizations |
| streptococcal infections can lead to | serious cardiac complications |
| parasitic infections generally involve | the entire family and home enviornment |
| the most common cause of injury to a child is | trauma |
| SIDS | sudden and unexpected death of an apparently healthy infant during sleep |
| common skin disorders include | nevi, rashes, and eczema |
| neurologic disorders include | reyes syndrome and meningitis |
| miningomyelocele | the most serious form of spina bifida, may cause paralysis or other disorders |
| hydrocephalus can be detected by | OFC measurements |
| what food must children with celiac disease avoid | anything with gluten |
| gluten | a protein substance that remains when starch is removed from cereal grains. Ex. gives cohesiveness to dough |
| structural defects of the hear can result in | abnormal shunting of oxygenated and de-oxygenated blood |
| shunting | moving oxygenated blood into vital areas and bypassing less vital areas |
| leukemia | cancer of white blood cells |
| leukemias can be | acute or chronic |
| cystic fibrosis | a fatal disorder in which a thick, sticky mucus clogs passages to the lungs pancreas and liver |
| serious respiratory tract illnesses include | RSV,LTB, epiglottitis, and asthma |
| illness of the GI tract places the young child at high risk for | fluid and electrolyte imbalances or dehydration |
| Urinary tract infections problems | structural, autoimmune, cancerous, or infections |
| the most common reproductive disorder concerns | ambiguous genitalia and cryptorchidism |
| ambiguous genitalia | when the appearance of genitalia can't be used to determine sex |
| cryptorchidism | failure of one or both testes to move into the scrotum as the male fetus develops |
| solid foods are introduced | 4-6months of age |
| nephrotic syndrome | loss of large amounts of plasma protein resulting in systemic edema |
| roseola | Any rose-colored rash marked by maculae or red spots on the skin |
| pediatrics | the area of care that deals with children and adolescents |
| Pediatric Susceptibility to URI | Immature immune system Small airway (small tubular passage ways) Decrease ability to clear airway Everything in mouth School aged siblings |
| reyes syndrome | this disorder is associated with aspirin intake, usually seen in children recovering from viral illness |
| s/sx of URI | fever, dyspnea, with thick tenacious sputum and mucus and edema of the throat |
| tx of URI | antibiotics, humidity, and rest. O2 may be nec. |
| Pneumonia | Inflammation of lungs Alveoli bathed in exudate (interferes w/gas exchange) Viral or bacterial Often extension of URI |
| Pneumonia Symptoms | Dry cough progressing to productive cough Paroxysmal cough Fever Respiratory distress Anorexia Cranky, irritable Cyanosis (late symptom) |
| Pneumonia Treatment | Rest Humidified O2 Nebulizer Tx Chest physiotherapy Antibiotics Increased fluids Close observation |
| croup is a syndrome that results in | a harsh barky cough |
| Laryngotraceobronchitis (Croup) | Inflammation of the larynx, trachea and bronchi Usually viral (often follows a cold) Narrowing of air passages causing varying degrees of airway obstruction Common age 3months- 3yrs More common in winter |
| Laryngotraceobronchitis (Croup) Symptoms | Restlessness Hoarseness Brassy, barking cough (classic symptom) Inspiratory stridor - narrowed airway Respiratory distress Fever (low grade) Condition usually occurs suddenly during the night With a hx of croup, if showing signs during the daytime, admitted to hospital. |
| Laryngotraceobronchitis (Croup) Treatment | Close observation - make sure airway patent Bedrest Cool humidified environment - cool mist humidifier (clean 2x's day) Encourage fluids - thins secretions Antipyretics - Tylenol, Motrin, if fever Corticosteroids - decrease airway inflammation (used for severe cases) Epinephrine - opens airway (used for severe cases) |
| Epiglottitis | Inflammation of the glottis Escalation of croup Edema of tissues above the vocal cords Narrowing of airway that can lead to complete obstruction * Throat examined with extreme care as throat stimulation can lead to laryngoaspasm and obstruction DO NOT TRIGGER THE GAG REFLEX DO NOT EXAMINE THR CHILD'S THROAT WITH TONGUE DEPRESSOR |
| Epiglottitis Symptoms | Anxious, apprehensive, fearful expression Severe respiratory distress High fever Absence of cough Drooling of saliva(w/refusal to swallow due to an extreme sore throat) Dyspnea with rapid progression of distress Red inflamed throat with cherry red epiglottis Muffled, croaking voice Very ill appearance |
| Epiglottitis Treatment | Corticosteroids Epinephrine Antibiotics Cool mist humidifier Oxygen Close monitoring of respiratory status and O2 saturation |
| Bronchitis | Inflammation of bronchi Viral or bacterial Main concern is airway obstruction and pneumonia Often related to URI (moves down) |
| Bronchitis Symptoms | Dry non-productive cough- worse at night Cough eventually breaks and is productive of purulent tenacious (hard to break up) sputum Improves when cough begins to break up Fever Malaise Fatigue Anorexia |
| Bronchitis Treatment | Antibiotics (prevents movement to the lungs) Cool mist humidifier Rest Increased fluids Nebulizer Tx Expectorants (thins secretions) Postural drainage > chest physiotherapy 1st nebulizer 2nd cupping & clapping (not after meal) 3rd postural drainage |
| Bronchiolitis | Common in infants Inflammation of bronchioles with mucous plugs blocking small tubules Air trapped and can not pass out on expiration Increased CO2 levels and respiratory acidosis Viral origin, does not respond to antibiotics Respiratory synctial Virus (RSV) 50% of cases Respiratory distress common symptom |
| Bronchiolitis Treatment | Rest Humidified o2 Nebulizer treatments (best when sleeping) Fluids Chest physiotherapy Close monitoring Babies often vulnerable to resp. arrest |
| Tonsillitis | Inflammation of the tonsillar structures in the oropharynx Bacterial or viral Inflammation of tonsils Erythema and exudate (whit mucous) in throat |
| Tonsillitis Symptoms | Dyspahgia- difficulty swallowing Bad breath Mouth breathing - abdominal pain Nasal muffled voice Persistent cough Fever WBC count is elevated Ear infection may develop (usually in Eustachian) |
| Tonsillitis Treatment | Rest Antibiotics Increased fluids Nebulizer tx Cool mist humidifier Frequent recurrence may require tonsillectomy |
| Tonsillectomy Pre-op | Routing assessment Bleeding and clotting times Explain procedure Informed consent Reassure child and parents NPO midnite b4 surgery No URI |
| Tonsillectomy Post- op | Pulse and respirations frequently Observe for signs of bleeding Restlessness Rapid pulse Frequent swallowing N&V Bright red & flank bleeding Ice collar Ice pops (no red ice pops) Soft diet No straws Not hot beverages No carbonated beverages Analgesics Discourage swallowing of secretions Discourage coughing and clearing of throat |
| Otitis media | Middle ear infection Extension of URI > Eustachian tube Fluid build up behind tympanic membrane Microbial growth supported by warm, dark, moist environment Bacterial or viral |
| Otitis media Symptoms | Earache (pulling at ears) - Major Symptom Fever Irritability, cranky Anorexia Crying Otoscopic exam reveals red, bulging TM Purulent drainage possible |
| Otitis media Treatment | Antibiotics (if viral usually won't give) Analgesics Antipyretics (decrease fever) Decongestants Assessment of hearing if frequent infections - especially if fl remains in ear Myringotomy with insertion of tubes |
| Myringotom | Incision of eardrum Drainage of fluid Insertion of tubes to continue draining fluids Tubes can remain in place for weeks- months Avoid immersing head in water Avoid blowing nose forcefully Not always effective, may need to be repeated |
| Bronchial Asthma | Lower airway disorder characterized by bronchospasm, increased thickened secretions and mucosal edema Common disorder Most common chronic condition of childhood Can be precipitated by allergies, URI, emotional stress |
| Bronchial Asthma Symptoms | Hacking, irritative, non- productive cough SOB, flared nares Prolonged expiratory phase Audible wheeze Restlessness Increasing respiratory difficulty |
| Bronchial Asthma Treatment | Prevention - avoid allergens, treat URI, cool mist humidifier in home, air purifier Children w/food allergies tend to be more prone Rest Bronchodilators - used to open airway and relax smooth muscle during acute attack Corticosteroids - often nebulizer for acute attacks attacks Intal(cromolyn sodium) used to prevent Education regarding meds, prevention and treatment |
| Group A Beta Hemolytic Streptococcus Aureus | Promptly treated to avoid: Rheumatic carditis - invasion of mitral valves Glomerulonephritis - attacks nephrons Gullain Barre syndrome - body's immune system attacks your nerves URI symptoms persisting beyond 5-7 days require a throat culture (probably not viral) Positive throat cultures are treated with Antibiotics Follow up culture to ensure resolution |
| Rheumatic carditis | invasion of mitral valves |
| Glomerulonephritis | attacks nephrons |
| Gullain Barre syndrome | body's immune system attacks your nerves |
| Sudden Infant Death Syndrome (SIDS) | Exact cause unknown Common in premature infants Peaks in 10-12 weeks with over ½ cases occur by 3 months Infant suffers from apnea and dies in sleep Parents devastated Apnea monitor SIDS Foundation *infants sleep on back* |
| Infectious Mononucleosis | Caused by Epstein Barr Viris (EBV) - one of the herpes viruses Transmitted by droplets in saliva, cough, sneezes, contact w/mucous membranes "kissing disease" Child has extreme soar throat |
| s/sx of Infectious Mononucleosis | Flu like HA Low grade fever, anorexia Cervical lymphadenopathy (swollen lymph glands in neck) Enlarged spleen or liver |
| dx of Infectious Mononucleosis | CBC and Mono Test |
| Infectious Mononucleosis Treatment | Symptomatic Rest, Fluids Analgesics If liver/spleen enlarged > greatest risk of rupture is during 2 to 4 weeks of illness Strenuous exercise & contact sports should be avoided while organs are enlarged Systemic steroids to reduce pharyngeal inflammation Edema Fatigue & weakness for several weeks |
| Lyme disease | Bacterial infection - Borrelia Tick bites |
| Lyme disease Sx | appear 3 to 31 days after bite: "bulls-eyed" ring rash Flu like symptoms |
| Lyme disease Tx | Antibiotics w/out rash can go undetected: Goes thru the blood > settles in tissues & multiply > chronic symptoms as pain, loss of muscle function, psychiatric disturbances, etc. Early detection is best Prevention |
| Pediculosis | Infestation w/head lice Highly contagious Nits attach firmly to head shaft |
| Pediculosis Tx | Prediculocidal shampoo (RID or Nix) Manual removal Keep home until knit free Wash clothes, bedding, towels |
| scabies | Infestation w/itch mite Burrows under skin & lays eggs Contagious |
| scabies Tx | Scabicide (rinse off in shower, on for 8-12 hrs) Keep home until resolved Wash clothes, beeding, towels |
| Dermatophytoses (Tinea) | Superficial fungal infection of skin Scaly red patches, itching Areas of baldness (capitis) Blister of toes w/vesicles & burring (pedis) |
| Tinea Capitis | ringworm of scalp |
| Tinea Corporus | ringworm of body |
| Tinea Pedis | athletes foot |
| Dermatophytoses (Tinea) Tx | Topical antifungal creams, powders, sprays Oral Griseofuluin Keep area clean & dry |
| Impetigo | Infection of skin caused by Straphylococcal & Streptococcal bacteria Red raised area, vesicles form, rupture, creating honey yellow crust; face & hands Highly contagious; keep home from school Separate towels & washcloths |
| Impetigo Tx | Antibiotics Frequent hand washing, don't touch Can be dangerous in newborns |
| Infantile Eczema | Non-specific dermatitis Common when new foods are introduced High incidence of food allergies Increase incidence of Asthma |
| Infantile Eczema Tx | Protect from scratching Mitts on hands Aveeno baths |
| Dermatitis | Contact or irritant Exposure to irritating substance Redness, warmth, vesicles, burning |
| Dermatitis Tx | Avoiding irritant Hydrocortisone cream |
| Acne Vulgaris | Overactive sebaceous glands Hormonal & hereditary factors Papules (solid), pustules (contains pus), & comedones (blackheads) on face, chest, & back |
| Acne Vulgaris Tx | Facial cleaning, Benzoyl peroxide Don't pick or squeeze Accutane or Retin-A |
| Congenital Heart Disease | Heart damage resulting from developmental defects Classified as: Cyanotic - causes cyanosis ayonotic- no cyanosis |
| Congenital Heart Disease Cyanotic | causes cyanosis |
| Congenital Heart Disease Acyanotic - | doesn't cause cyanosis |
| Congenital Heart Disease Cyantoic defects (lack of O2) | R to L shunting deoxygenated blood mixing w/oxygenated blood |
| Congenital Heart Disease Acyanotic defects (O2) | L to R shunting Pressure is higher due to L side |
| Cyanotic Defects | Deoxygenated blood(venous) & Oxygen blood (arterial) mixes systemic circulation due to left ventricles sending this mixed blood to the body * will cause cyanosis* |
| Cyanotic Defects Tricuspid Atresia | No opening b/w the R atrium & L ventricle No blood flows from R atrium to L ventricle, which decreases pulmonary blood flow * will cause cyanosis* |
| Transposition of Great Cyanotic Defects Vessels (TGV): | Aorta and the pulmonary artery are reversed, so that each connect to the wrong side of heart High death rate * will cause cyanosis* |
| Cyanotic Defects Tetrology of Fallot | Combination of 4 major defects: Ventricular Septal Defect (VSD): Pulmonary Stenosis: Overriding aorta: Right Ventricular Hypertrophy: |
| Cyanotic Defects Tetrology of Fallot: Ventricular Septal Defect (VSD): | A hole in the septum separating the R & L ventricles |
| Cyanotic Defects Tetrology of Fallot: Pulmonary Stenosis: | Narrowing of pulmonary artery |
| Cyanotic Defects Tetrology of Fallot: Right Ventricular Hypertrophy: | Enlarged R ventricle due to heart pumping harder in an attempt to increase blood flow to lungs |
| Cyanotic Defects Tetrology of Fallot: Right Ventricular Hypertrophy: | Enlarged R ventricle due to heart pumping harder in an attempt to increase blood flow to lungs |
| Acyanotic Defects: | Patent Ductus Arterious: Ductus Arterious connects fetal pulmonary artery to fetal aorta (closes after birth) Patent is when ductus remains open can lead to pulmonary hypertension Coarctation: Aorta narrows, obstructing blood flow Coarctation is further away from heart Atrial Septal Defect: Abnormal opening b/w the R and L atria |
| Acyanotic Defects: Coarctation: | Aorta narrows, obstructing blood flow Coarctation is further away from heart |
| Acyanotic Defects: Atrial Septal Defect: | Abnormal opening b/w the R and L atria |
| Acyanotic Defects: Ventricular Septal Defect: | Abnormal opening b/w R and L ventricle |
| Acyanotic Defects:Pulmonary Stenosis: | Narrowing of the R ventricular outflow tract, including valve, which decreases blood flow to lungs Valve replacement |
| Acyanotic Defects:Aortic Stenosis: | L ventricular outflow tract, Aortic valve malfunction causes the heart to work harder to pump blood to the body |
| Congenital Heart Disease Symptoms | Generalized cyanosis (cyanotic defects) Cyanosis on exertion (crying, feeding, straining) Dyspnea & fatigue (especially w/feeding) FTT (failure to thrive) Tachypnea, murmurs, dysthrymias Growth delays Clubbing of fingernails & squatting (cyanotic defects) Squatting is the PED for of orthopnea Small for age Delicate, frail body Tachycardia Difference in pulse b/w upper & lower extremities (coarctation of aorta) Susceptibility to infection, especially URI's |
| Congenital Heart Disease Treatment | Symptomatic initially Surgical repair performed as soon as child able to tolerate Major defects are repaired in stages Digoxin & Lasix (tx's CHF) Antihypertensives Low Na diet, supplements, vitamins, & iron |
| Congenital Heart Disease Nursing Care | Assess rate & quality of pulse Monitor respirations, observe for cyanosis & dyspnea Avoid temperature extremes Daily wt's Monitor G&D Feed slowly, rest periods I&O Administer drugs as prescribed Protect from infection |
| Kawasaki Disease | Systemic vasculitis Under age 5 Cause unknown Inflammation of small vessels, pericarditis, aneurysm formation Stasis & blood clot formation 25% of children develop heart damage |
| Kawasaki Disease Sx | High fever Red and dry conjunctiva Inflammation of pharynx & oral mucosa Strawberry tongue Perineal rash Redness of palms & soles of feet ECG changes & CHF can develop |
| Kawasaki Disease Tx | IV fl's Gamma Globulin (given IV) - "immunoglobulin" boost body's immune system Antipyretic > ASA very effective Heparin Rest Close monitoring for CHF, Resp. distress & Thrombus Recovery common |
| Iron Deficiency Anemia | Deficiency of dietary iron Common in school aged child, adolescence, & infants fed cow's milk |
| Iron Deficiency Anemia Tx | Iron rich diet & iron supplement Take w/food Change stool's color (tarry green) Discolors teeth (in liquid form, use straw) Iron take w/Vit C to enhance absorption |
| leukemia | Cancer of blood forming organs WBC production increases, cells are immature & poorly formed |
| Leukemia the Dominant Symptoms: | Anemia Thrombocytopenia (low platelet count) Frequent infection |
| Acute lymphocytic Leukemia | most common in young, symptoms much more rapid & severe |
| Chronic lymphocytic Leukemia | common in adults, symptoms less severe |
| Hemophilia | Bleeding disorders: sex linked genetic defect Passed to sons by mother Hemophilia A (defect of factor 8) Hemophilia B (defect of factor 9) Inability to clot blood Bleeding into tissues & joints |
| Hemophilia sx | Prolonged bleeding from anywhere in body Prolonged bleeding from circumcision, teething, umbilical cord, injection & nose bleeds Easy bruising |
| Hemophilia tx | Restrict activity Avoid contact sports Replacement of clotting factor Safety Don't over protect |
| Develop milestones | rolling, crawling, standing, walking, talking, teething, socialization. |
| Failure to thrive (FTT) | not growing, gaining wt, etc. |
| Protest | Loud crying, rejecting Healthcare personnel Most commonly seen |
| Despair | Inactive & sad, withdrawn, & uninterested Regression is seen here |
| Denial | Detachment, rejection of family caregivers |
| IV assessment | monitor frequently for infiltration and infection Dressing changed daily Tubing is changed per facility policy (about 72 hrs) All tubing securely tightened Assess the opening and closing controls Keep tubing behind the child and out of their reach All pediatric infusions are on a pump for precise delivery |
| Gavage feeding | button peg, used bolus |
| Parenteral fluids | given IV |
| Managing a Fever | Keep child quiet, minimize crying Do not overdress Encourage fluids - ice pops Antipyretics (no Aspirin do to Ray's syndrome) Sponge bath, cool compresses on the pulse points Check temperature every 30 min. |
| What develops first: head control vs trunk? Hands vs eye control? Shoulders vs hands? PNS vs CNS? | Head (3mos)- trunk (7mos sit). Eye (2mos) - hands (5mos). Shoulders - hands. CNS - PNS (cephalocaudal & proimodistal) |
| 3 main physiologic measures of kid devlopment? | Length/height, weight, head circumference (1st - 3rd yr) |
| Timeline of 1st year events: Height. Wgt double & triple & quadruple? Teething? Fontanels close? | 6-8 wks: Post fontanel. 4-7 months: wght doubles. 6 mos: Lower incisor teething. 12 months: 50% hght increase, Anterior fontanel closes. Wght triples. 6-8 teeth. 2-2.5 yrs: quadruple wght |
| At what age will a child coo? Transfer objects? Crawl? | 2 mos, 6-8 mos, 9-10 mos |
| At what age will a child have head control? Sit? Learn a few words? | 4 mos, 8-9 mos, 9-12 mos |
| At what age will a child have palmar grasp of objects? Walk with assist? | 4 - 6 mos, 12 mos |
| Time line in months of coo, head control, palmar grasp, transfering objects, sits, crawls, learns few words, walks w/assist? | 2, 4, 4-6, 6-8, 8-9, 9-10, 9-12, 12 |
| When will a child be able to draw a circle, Jump, & Throw overhand? | 2-3 yrs |
| When will a child be able to build a tower of 4 blocks, run/walk up stairs? | 1-2 yrs |
| In growth of kids, what's predictable, the timing of developmental milestones or the sequence? | sequence...timing diff per kid |
| Prenatal time: germinal, embryonic, & fetal? | Conception - 2 wks, 2-8 wks, 8 - 40 wks |
| At 2 months gestation (start of fetal) head = ?% of bdy lngth? In infancy & childhood what grows most rapidly? | 50%. Trunk, then legs |
| How can you estimate a 2 yr olds full grown height? | double their current height |
| The avg newborn weighs how many grams? | 2500 to 4000g (7 - 7.5 lbs) |
| Infants gain __g/wk for 5-6mos. Avg __kg (lbs) at 6 mos? At 1 yr? | 150 to 210 g/wk. 7.5kg (16 lbs at 6 mos). 1 yr= 9.75 kg (21.5 lbs) |
| Who weighs more, brst fed or formula fed? | formula fed |
| Hght inc __cm (inch)/mo until 6 mos. Avg at 6 mos = ? 12 mos? | 2.5 cm (1in)/mo. 6 mos = 65 cm (25.5in). 1 yr = 74 cm (29 in) |
| Avg head circ at birth, 6 mo, 1 yr: | 32-37cm, 43cm, 46cm |
| Most accurate msre of general dvlmpt? Where? | skeletal or bone age (radiologic determination of osseous maturation - hand/wrist best) |
| Who is in deep sleep more? The infant or adolescent? | adolescent. 50% (50 mins) to 80% (90 mins) |
| To promote mastery motivation (do task well & inc cooperativeness) should parent or child have more control in play? Interrupt infant immdtly when something done wrong? Stimulation? | Parent should be unobtrussive, letting infant initiate and troubleshoot 1st. Give early kinesthetic stim (pick up/rock) w/audio/visuals |
| *Timing of Freud's stages: Oral, Anal, Phallic, Latency, Genital | Birth to 1, 1-3yrs, 3-6, 6-12, >12 |
| *During this stage of Freud kids elaborate on prev acquired traits w/vig play vs when kids recognize sex diffs & Oedipus/Electra complexes, penis envy & castration anxiety occur | Latency (6-12 yrs). Phallic (3-6 yrs) |
| *Erikson's Stages: Birth - 1, 1-3, 3-6, 6-12, 12-18 | Trust/mistrust. Aut/shame-doubt. Initiative/guilt. Industry/Inf. ID/Role confusion |
| *Piaget's 4 stages of congition? | Sensorimotor (0-2yrs) Preoperational/transductive/intuitive: 2-7. Concrete (inductive): 7-11. Formal (deductive/abstract): 11-15 |
| *Name the Piaget stage: Egocentrism (inability to put oneself in other's place), transductive rsng (becuz 2 things together they cause each other - wmn w/big bellies = always pregnant) | Preoperational (2-7 yrs) |
| *Name the Piaget stage: conservation (permanence), inductive rsng, socialized thinking. | 7-11 yrs. Concrete operations |
| *3 stages of Kohlberg's moral dvlmpt? | Preconventional (Good/bad based on rewards) (0-6). Conventional: Conformity/loyalty/be nice. Postconventional: rghts/chngelaws/justice (12 - 18) |
| *At which Kohlberg moral stage do kids want to earn approval by being nice/obeying rules? Pre-, conventional, post-? | Conventional (6-12sh) |
| Toys: why avoid those w/strings > 7" for infant? Avoid what for kid<8? For <5? BB guns? | could strangle themselves. <8 no electric toys w/heating. <5 no arrows/darts. BB>16yrs |
| Where take kid's temp? (0-2yrs), (2-5), (>5)? | 0-2: Axillary/rectal. 2-5: Axil, tympanic, oral (when can hold under tongue), rectal, >5: Oral, Axil, Tymp. Rectal only if definite temp needed. |
| What is level of fever for infant <3 mos? 3mos - 36 mos? Kids? | 100.4 (38). 102 (38.9). 104 (40) |
| Normal neonate core temp? | 36.5 - 37.6 (99.7F) |
| Norm HR: Newborn. 1wk - 1yr. 1-3yrs. 3 - 5. 6-10. >10 | 1) 100-160 (2) 100-150 (3) 80 - 130 (4) 80 - 120 (5) 70 - 110. >10 = 60-90/100 |
| Normal HR for 1-3 yr old? | 80-130 |
| Norm RR for newborn, up to 1 yr. 1-3? 3-5? 6-10? 10-16 (adolescent)? | 30 - 60. 25-35. 20-30. 20-25. 18-22. A: 16-19 |
| BP:Newborn, 1 yr old? 6r old? | 75/55, 90/50. 100/60 |
| In dark skin, what do cyanosis & pallor look like? Where find jaundice (4)? | Ashen gary lips/tongue. (yellowsh/brown in brown skin). Jaundice: sclera, hard palate, palms, soles. |
| Hyperextension of head (opisthotonos) w/pain on flexion could indicate what? | meningitis - Immte Referral! |
| An RN notes that a 7 mo old does not have good head control. What does she do? | Refer for further neur/dvlpmt eval. Could be cerebral injury. Usually control @ 4 mos. |
| Why do kids (<2) have inc risk for otitis (fluid & infctn in ear)? | Some (not all) kid's eustachian tubes more horizontal than adults making ears more diff to drain |
| Hydrocephalus vs encephaly? | Fluid build up in brain (can shunt & drain it) vs Brain dvlps outside skull (almost always fatal) |
| An RN notes strabismus (eyes do not line up) in a pre-mie baby, what does she do? Should she do a vision test? | Documents it. It's normal. No but vision should dvlp by 3-4mos...test done in MD office. |
| What do you look for in Resp Assessment? | Chest shape, retractions, Nasal flaring, grunting, access muscles, breath sounds (rales, rhonci, wheeze) |
| Moro, stepping, galant reflexes, babinski? What? Age limit? | Moro: Startle (sprds arms, brings in, cries) 34 wks - 5 mos. Stepping: 0 - 6 wks. Galant: 0 - 6 mos. Stroke side of spine & baby swings toward stroked side (patho if longer). Bab: flare toes - 1 yr |
| What is the Babkin reflex? When observed? | Press babies palms & will flex/rotate head or open mouth. MORE prominent in preemies! |
| With anticipatory guidance what 3 areas must always be addressed? | 1) Safety: (car seats, sleep on back, sun, smoke...). 2) Nutrition. 3)Health care plan (vaccines, dental, next visit?) |
| What does a tense/boardlike abdomen indicate? | Paralytic ileus and intestinal obstruction |
| Absence of femoral pulse sign? | Sign of coarctation of aorta - referred for medical eval. |
| For first few mos for infant what do w/head when in supine pstn? | Put head on either sides to prevent plagiocephaly (flat head) when asleep or awake |
| At birth an infant has bdy wgth that's 75% water (high ECF) & imm Renal w/low spcf gravity. This predisposed them to? | more rapid loss of total body fluid (dehydration) |
| Name 5 grps of Meds that need to be double checked w/RN | Anticoags, Antiarrhythmics, Chemo, E-lytes, Insulin |
| In kids, are chewed solids, swallable tabs, or liquids preferred? Why? | Liquids using syringe. Less risk of aspiration |
| W/kids w/neuro impairments how get them to elicit swallow reflex? | blow small puff of air in their face |
| Max amt of med admin IM is __ml for older infants & smll kids | 1 ml |
| VAD stands for? | Venous Access device (central lines - CVAD - best for chemo, repeated bld draws, hyperalimentation or frequent antbcs) |
| When will the moro, tonic neck (turn head while supine & extends that side), Galant (rub on side of spine) & rooting reflex disappear? | 4-6mos |
| How long does the doll's eye reflex stick around? crawling (touch soles of feet)? | ~1 mo, ~1mos |
| When does the parachute reflex appear? when the plantar grasp disappear? | 8-9mos |
| When can an infant change from prone to sitting & stand holding furniture? | 10 mos |
| When will an infant transfer objects from one hand to other? grasp feet and pull to mouth? coo? make consonants? | 7 mos, 6 mos, 2 mos, 4 mos |
| head circumference msred (1st - 3rd yr) (36 mos) ave newborn & 36 mos? chest new? | New: 32-37 cm. Chest: 30 - 35 36 mos: 46 - 51 |
| Strabismus (lazy eye) common in infant but gone by? If not tx early leads to? | 4 mos. Amblyopia (reduced visual acuity) or perm loss of vision. |
| What is abmlyopia. How rt to strabsimus? | Reduced visual acuity. If strabismus not tx early (if present after 4mos after birth) could lead to this. |
| PHENOBARBITAL | a barbiturate used as a sedative/ anticonvulsant /Hypnotic |
| PHENYTOIN | anticonvulsant drug (trade name Dilantin) used to treat epilepsy and that is not a sedative.Diminish seizure activity |
| CARBAMAZEPINE | (Klonopin), anticonvulsant/ mood stabilizer |
| VALPRATE | (Depakene) Anticonvulsant / Vascular headache supressant |
| CLONAZEPAM | Klonopin - Antiepileptic,Anticonvulsant, |
| ZANTAC | a histamine blocker and antacid-used to treat peptic ulcers and gastritis and esophageal reflux |
| ROBINUL | ANTICHOLINERGIC: GLYCOPYRROLATE / ADJUNCT FOR PEPTIC ULCER |
| ATIVAN | tranquilizer (trade name Ativan) used to treat anxiety and tension and insomnia.Lorazepan |
| TOPAMAX | topiramate (seizures), anticonvulsant |
| SCOPOLAMINE | alkaloid with anticholinergic effects that is used as a sedative and to treat nausea and to dilate the pupils in ophthalmic procedures |
| FORADIL | formoterol (bronchodilator) |
| BACLOFEN | Skeletal Muscle Relaxant. (Kemstro, Lioresal) |
| REGLAN | (metoclopramide) antinausea and vomiting, chemo induced |
| TRILEPTAL | Oxcarbazepine; anticonvulsant |
| LAMICTAL | lamotrigine, Anticonvulsant |
| PULMICORT | budesonide (corticosteroid) |
| DUONEB | (Ipratropium + Albuterol soln) Antiasthmatic/Bronchodilator/ Allergy/ Cold |
| KEPPRA | anticonvulsant (Levetiracetam) Decrease severity of seizures |
| DIGOXIN | digitalis preparation (trade name Lanoxin) used to treat congestive heart failure or cardiac arrhythmia |
| Care of G-Tube | ... |
| Care of J-Tube | ... |
| Care of Tracheostomy | ... |
| Growth | Increase in physicial size,measurable, can be studied & observed. |
| Development | Progressive increase in function of body (ability to digest food) |
| Maturation | Total way in which a person grows... |
| Growth Chart for Children | Assess child's development (compare to others & present w/ former rate of growth)Length & height: shows % position to show underweight or overweight (< or > 50th %) |
| Five factors that influence growth & development | Heredity Nationality & race Ordinal position in family- motor development in youngest may be proolonged Gender-Male weights more Environment- Home,immunizations,positive energy & intelligence. |
| Nursing implications | Identify sources for homeless families Help families modify eating habits ... |
| Raises head | 1 month |
| Disappearance of Moro (stratle)and rooting reflexes | 4 months |
| Sleeps through the night | ... |
| Rolls from abdomen to back | 4 months |
| Sits with support | 6 months |
| Rolls from back to abdomen | 4 months |
| Say's "ma-ma" | ... |
| COGNITIVE Developmental Theory | PIAGET- intelligence consists of interaction and coping w/ environment Sensorimotor (2yrs) sensations Preoperational (2-7) egocentric Concrete Operations (7-11) some reasoning Formal Operations (11-16) abstract concepts |
| MORAL Developmental Theory | KOHLBERG-Conscience w/in society Preconventional(4-7)obedient-fear of punishment Conventional (7-11) conformity & loyalty PostConventional- (12 >) moral values developed |
| Erickson's Stages | -Trust/Mistrust (infant)- recognized mother -Autonomy/shame & doubt (Toddler)-acceptance of reality -Initiative/Guilt (Preschool) questioning/diferentiation of sexes -Industry/Inferiority (School-Age)- recognition by producing things -Identity/Role diffusion (Adolescent)- Abstract reasoning,identity,investigate |
| Feeding practices for infants | ... |
| Introduction of semi-solids and new foods | Rice cereal 1st solid food @ 6 months fed by spoon Tablespoon of food per yr of age |
| Common food allergies seen in children | to food, allergens |
| Influence of family & culture | ... |
| Play | ... |
| Therapeutic play | Improtant for their therapy |
| Play as an assessment tool | ... |
| Family centered care in pediatrics | ... |
| Effects of illness & hospitalization upon child & family | Poor appetites ... |
| Cephalocaudal Development | From head to toe.... Proximodistal (midline to periphery development) |
| Cognition | the psychological result of perception,learning and reasoning. Intellectual ability. |
| Decidious | Baby teeth... |
| Fluorosis | a pathological condition resulting for an excessive intake of fluorine (usually from drinking water) |
| Neonate | Birth - 4 weeks... |
| Infant | 4 Weeks- 1 yr (2x weight) |
| Toddler | 1-3 yrs... |
| Cognitive development of infants first yr of life | ... |
| Nutritional needs of growing infants | Require more calories,minerals,vitamins and fluids. .5 g of fober/ jg in childhood. Breast milk & iron. Fat & cholesterol (development of CNS) Food additivies should be minimized. |
| Select & prepare solid foods for infant | 1 at a time btw 4-7 days |
| Four concerns of parents about feeding of infants | new foods Until whn the milk-m 1 yr whole milk & 2 yrs skim |
| Development of feeding skills in the infant | Toddler: feed themselves @ end of 2yrs,parent present Preschool:Finger foods(dawling & regress.) School-Aged: Unpredictable-Empty calories Adolescent: fatigue |
| Posterior fontanel has closed | 18 months |
| Central Incisors appear | 7 months |
| Birth weight has tripled | 1 yr 4x (2yrs) |
| Child can sit steadily alone | ...8 months |
| Child shows fear of strangers | ...9 months |
| VS of 1 yr old Infant | HR- 70-110 RR: 25-30 BP: 90/56 |
| Safety issues in the care of infants | cAR SAFETY lOCK MEDS HAVE PHONE NUMBERS HANDY |
| Approach & care of an infant w/ colic | Environment, put them in arm |
| Safety during infancy | ... |
| Positive sleep patterns | routine, read a story Avoid liquids before bedtime |
| Parachute Reflex | ... |
| pINCER GRASP | 8 months- index fiunger and thumb use to grab things |
| Prehension | ... |
| Developmental tasks of Toddler period | self control & socially acceptable outlets for aggression Ritualism increasing independece & curiosity |
| Speech development in Toddler period | ... |
| Combating children fears | ... |
| Toilet training (bowel & bladder) | ... |
| Preventing automobile accidents | ... |
| Preventing burns & falls | ... |
| Preventing suffocation & choking | ... |
| Preventing Poisoning | ... |
| Preventing drowning | ... |
| Preventing electric shock | ... |
| Preventing animal bites | ... |
| Play & toys for toddler | ... |
| Guidance & discipline for toddler | ... |
| Nutritional needs & self-feeding abilities of toddler | ... |
| Pre-school age | 3-6 yrs |
| Physical,Psychosocial & spiritual @ 3 | ... |
| Physical,Psychosocial & spiritual @ 4 | ... |
| Physical,Psychosocial & spiritual @ 5 | ... |
| Paiget's Development of preschool | ... |
| Erickson's Theory of preschool | ... |
| Kohlberg's Theory of Preschool | ... |
| Characteristics of a good preschool | ... |
| Value of play | ... |
| Two toys for preschool & rationale | ... |
| Timr-Out periods | ... |
| Consistency | ... |
| Role Modeling | ... |
| Rewards at preschool | ... |
| Predispose activities for accidents & preventions | ... |
| Positive bedtime habits for preschool | ... |
| Enuresis | ... |
| Thumb sucking | until permanent teeth appears |
| Sexual curiosity at preschool age | ... |
| Introducing the concept of death to preschool | ... |
| Animism | the belief that spirits are present in animals, plants, and other natural objects |
| Artificialism | belief that all objects are made by people |
| Echolalia | automatic and immediate repetition of what others say |
| Enuresis | inability to control the flow of urine and involuntary urination-Bedwetting |
| Parallel Play | activity in which children play side by side without interacting |
| 6 yrs | ... |
| 7yrs | ... |
| 8yrs | ... |
| 9yrs | ... |
| 10yrs | ... |
| 11yrs | ... |
| 12yrs | ... |
| Theoretical viewpoints of school yrs | ... |
| Pet ownership | ... |
| Role of school Nurse | Referrals for homeless families ... |
| Androgynous | having both male and female characteristics |
| Latchkey Children | children who go home to empty houses after school and who are left alone until parents return from work |
| SIECUS | ... |
| Stage of Industry | ... |
| School-age | 6-12 yrs |
| Adolescent | 12-18yrs |
| Rapid growth periods | Infancy & puberty |
| Weight | Wt doubles 6 months 3x 1yr 4x 2-2 ½ yrs |
| Denver Developmental Screening | 1. Language communication 2. personal social-interaction 3. fine motor adaptive- ability hand movement 4. gross motor skills- large body movement |
| Family APGAR | A- Adaptation:helps & shares P- Partnership:communication G- Growth:responsibilities shared A- Affection: emotional interactions R- Resolve: prevent & solve problems |
| Maslow's basic needs | Physiological needs Activity Safety Love Esteem Self-Actualization |
| Primary Teeth | 2.5 yrs Avoid tetracycline |
| 1 yr old has __ teeth | Six- 4 above & 2 below |
| Extrusion Reflex | Kids spit out food if you put it in the mouth |
| Ketogenic Diet | To control seizures (High in fats and no Carbs |
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