Body Image and Unintentional Injuries (1)

Question 1

Common causes of unintention injuries in infants

Answer 1

1. Falls
2. Burns
3. Motor vehicle crashes
4. Drowning
5. Poisoning
6. Choking and suffocation

Question 2

Emergency management measure for minor burns

Answer 2

1. Stop the burning process: apply cool water to the burn or hold the burned area under cool running water; do not use ice
2. Do not disturb any blister that forms, unless the injury is from a chemical substance (infection)
3. Do not apply anything to the burn (however, most practitioners favor covering the wound with antimicrobial ointment to reduce the risk of infection and provide some form of pain relief)
4. Removed burned clothing or jewelery

Question 3

Common poisonings that occur in children

Answer 3

1. Cosmetics and personal care products
2. Cleaning products
3. Plants
4. Foreign bodies
5. Heavy metals
6. Lead poisoning
7. Acetaminophen, ibuprofen, aspirin

Question 4

Poisoning: Risk For

Question 5

Suffocation: Risk For

Question 6

Purpose of the posion control center

Answer 6

1. Call BEFORE any intervention
2. Counsels to begin treatment at home or bring child to emergency facility
3. Expert advice; information more accurate than that from hospital emergency departments

Question 7

Poison Control Center’s recommended sequence of actions when poisoning/exposure has occurred

Answer 7

1. Assess the victim:
   
   1. CPR prn
   2. VS, reevaluate routinely
   3. Treat other symptoms, such as seizures
2. Terminate exposure:
   
   1. Empty mouth of pills, plant parts, or other materials
   2. Flush eyes continously with normal saline or tap water at home for 15-20 minutes
   3. Flush skin and wash with soap and a soft cloth; remove contaminated clothes
   4. Bring victim inhalation poisoning into fresh air
3. Indentify the poison:
   
   1. Question the victim and witnesses
   2. Look for environmental cues and save all the evidence of poison
   3. Be alert to signs and symptoms of potential poisoning
   4. Call poison control center for immediate service regarding treatment
4. Prevent poison absorption:
   
   1. Position child to prevent aspiration
   2. Provide antidote, gastric lavage, or activated charcoal to prevent absorption of toxin

Question 8

Nursing Implications for the administration of activated charcoal

Answer 8

• Odorless, tasteless, fine black powder given orally or VIA a gastric tube. Toxins adhere to charcoal and are excreted VIA the GI tract
• Contraindications to charcoal administration:
  
  • Diminished BS
  • Ileus
  • Ingestion of substance poorly absorbed by charcoal

Question 9

Teaching plan for a client at risk for unintentional injuries

Question 10

Common causes of unintentional injuries in preschoolers

Answer 10

1. Motor vehicle crashes
2. Motor vehicle and pedestrian injuries
3. Drowning
4. Burns
5. Hospitalization: need sticks and electrical injury

Question 11

Common causes of unintentional injuries in toddlers

Answer 11

1. Falls
2. Poisoning
3. Burns
4. Drowning
5. Motor vehicle crashes

Question 12

Common causes of unintentional injuries in school age children

Answer 12

1. motor vehicle, pedestrian, bicycle crashes
2. Firearms
3. Burns

Question 13

Common causes of unintentional injuries in adolescents

Answer 13

1. Motor vehicle crashes
2. Sports Injuries
3. Drowning

Question 14

Body Image

Answer 14

Subjective concepts and attitudes that an individual has toward their own body including:

1. Physiologic: perception of one’s physical characteristics
2. Psychologic: values and attitudes toward the body, attitudes and ideals
3. Sociologic: social nature of one’s image of self in relation to others

Question 15

Infants Body Image and Nursing Interventions

Answer 15

Body Image:

• Physical and visual self-exploration
• Receives input about their bodies through self-exploration
• Sensory stimulation from others allows the infant to receive input about their bodies from the sensory stimulation of others

Nursing Implications:

• Limit restraints so they can move extremities, put hands in mouth, hold and transfer toys from one hand to another
• Use verbal and nonverbal sensory stimulation during nursing care, talk, sing, touch, rock, facial expressions when interacting with infant
• Unpredictable routine of the hospital has the potential to promote feelings of distrust

Question 16

Toddlers Body Image and Nursing Interventions

Answer 16

Body Image:

• Learn to identify various parts of their bodies
• Able to use symbols to represent objects

Nursing Interventions:

• Encourage involvement in ADLs
• Avoid emotional climate of blame and punishment
• Use correct names for body parts
• Minimize intrusive procedures such as IM injection, venipunctures, and catheterizations
• Order VS from least to most intrusive: RR, P, BP, T

Question 17

Preschooler Body Image and Nursing Interventions

Answer 17

Body Image:

• Awareness of wholeness of bodies
• Vague concept internal organs and development

Nursing Interventions:

• Draw pictures and explain what organ is, where it is, and what it is needed for
• Allow child to express feelings
• Tell what won’t happen
• Avoid medical terminology
• Minimize intrusive procedures

Question 18

School Age Body Image and Nursing Interventions

Answer 18

Body Image:

• Aware of difference in body size and configuration

Nursing Implications:

• Be sensitive and be sure not to send negative messages to child about body parts
• Be positive and focus on what the child can do
• Assess knowledge and understanding and add to it
• Explain surgery and procedures, use drawings or books

Question 19

Adolescent Body Image and Nursing Interventions

Answer 19

Body Image:

• Concerned about physical self
• Unfamiliar body changes and new physical self must be integrated into self concept
• Face conflicts over what they see and what they visualize as ideal body structure
• Crucial element in shaping identity

Nursing Implications:

• Be sensitive when reacting to issues r/t appearance
• Provide privacy
• Listen respectfully to the adolescent’s feelings and perceptions

Question 20

Anticipatory guidance

Answer 20

1. Prediction of the upcoming developmental tasks of a child and gears teaching to those needs
2. Providing families with information on what to expect during the child’s current and next stage of development
3. Providing age-appropriate information on prevention of poisoning and injury

Question 21

Emergency treatment for major burns

Answer 21

1. Stop the burning process:
   
   1. Flame Burn - smother the fire
   2. Place the victim in the horizontal position
   3. Roll victim in a blanket or similar object; avoid covering the head
2. Assess for adequate airway and breathing
3. If not breathing, begin steps of CPR
4. Remove burned clothing and jewelry
5. Cover wound with clean cloth
6. Keep victim warm
7. Transport to medical aid
8. Begin IV and oxygen therapy as prescribed

Question 22

N-acetylcysteine (mucomyst)

Answer 22

• Treatment given for acetaminophen overdose
• Given orally diluted with juice

Question 23

Naloxone (narcan)

Answer 23

Treatment of opioid overdose

Question 24

Flumazenil (romaxicon)

Answer 24

Treatment of benzodiazepine overdose (valium, versed)

Question 25

Gastric Lavage

Answer 25

1. Lavage involved placement of gastric tube; NS solution is instilled and apirated until the return is clear
2. Indicated in children who are comatose, convulsing, or require a protected airway or if the substance is absorbed rapidly
3. Contraindicated in children who have ingested corrosive agents

Question 26

Corrosives

Answer 26

1. Do not induce vomiting
2. Dilute with 4 oz of water or milk
3. Give activated charcoal

Question 27

Hydrocarbons

Answer 27

1. Do not induce vomiting
2. Gastric Lavage/Activated charcoal are controversial

Question 28

Acetaminophen poisoning

Answer 28

n-acetylcysteine (mucomyst)

Question 29

Aspirin Poisoning

Answer 29

1. Induce Vomiting
2. Gastric Lavage
3. Activated charcoal

Question 30

Iron poisoning

Answer 30

1. Induce vomiting
2. Gastric lavage

Question 31

Plant poisoning

Answer 31

1. Induce vomiting
2. Wash from skin or eyes

Question 32

After immediate care, the RN shifts care to providing…?

Answer 32

1. Emotional Support
2. Preventing Recurrence

Question 33

Anticipatory prevention strategies of childhood poisoning

Answer 33

1. Place household cleaners, medications, vitamins, and other potentially poisonous substance out of reach of children in locked cabinets
2. Use warning stickers such as Mr. Yuk on all of these containers
3. Buy products with child-resistant caps
4. Store products in original containers
5. Never place household cleaners or other products in food or beverage containers
6. Remove all houseplants from the child’s play area
7. Use caution when visiting other settings that are not childproof. Remember visitors may have pills in their purses that are easily accessible

Question 34

Preventing unintentional injuries in infants

Answer 34

1. Do not leave infant unsecured in infant seat
2. DO not place on high surfaces, such as tables or beds, unless holding the infant
3. Check temp of bath water, foods, and liquids
4. Cover electrial outlets
5. Use only approved car restraint system
6. Never leave an infant alone in a bath
7. Keep medications, cleaning products and other harmful substances out of reach and locked up
8. Avoid foods and small toys that commonly cause coking
9. Position infant on back for sleeping; do not place pillows, stuffed toys, etc near head

Question 35

Preventing unintentional injuries in toddlers

Answer 35

1. Supervise toddler closely. Provide safe climbing toys
2. Teach acceptable places for climbing
3. Keep medications and other posionous material locked away. have poison control number by telephone
4. Keep pot handles turned inward on stove
5. Supervise any child near water
6. Use child life jackets near water and on boats
7. Empty buckets when not in use
8. Used only approved car seat

Question 36

Preventing unintentional injuries in preschoolers

Answer 36

1. Older preschoolers may independently get into car and put on seat belt
2. Verify the child is belted and in properly before starting the car
3. Teach child never to go into road
4. Teach child never to go into water without an adult
5. Provide supervision whenever child is near water
6. Teach child to stop, drop and roll if clothes are on fire
7. Keep needles out of reach and beds away from electrical outlets. Monitor child closely

Question 37

Preventing unintentional injuries in school age children

Answer 37

1. Teach safe outdoor play, especially near streets
2. Reinforce use of bike helmets
3. Teach bike safety rules and provide safe places for riding
4. Use booster seat
5. Teach child never to touch guns without parents present
6. Guns should be kept unloaded and locked away
7. Guns and ammunnition should be stored in different locations
8. The child may perform experiments with flames
9. Teach child what to do in case of fire

Question 38

Preventing unintentional injuries in adolescents

Answer 38

1. Insist on driver’s education classes
2. Enforce rules about safe driving: teach hazards of drinking/drugs, talking on cell phones, and driving when tired or distracted
3. Encourage use of protective sporting gear
4. Encourage sweimming only with friends
5. If adolescent supervises younger children near water, near leave them alone

Question 39

Anticipatory prevention for lead poisoning

Answer 39

1. Ensure child does not have access to peeling paint or chewable surfaces painted with lead-based paint (espeically window sills)
2. Wash and dry child’s hands and face frequently, especially before eating
3. Wash toys and pacifiers frequently
4. Use cold water only for consumption. Hot water dissolves lead more quickly, thus contains higher lead levels
5. Do not store food in open cans, patricularly if cans are imported
6. Avoid folk remedies and cosmetics that contain lead
7. Make sure the child eats regular meals
8. Ensure the child’s diet contains sufficient iron and calcium and not excessive fat

Question 40

Common causes of suffocation in young children

Answer 40

1. Vehicle warming in closed garage
2. Use of fuel burning heater not vented to outside
3. Children playing with plastic bags or latex balloons; inserting small onject into their mouths or noses
4. Placement of propped bottle placed in an infants crib
5. Placement of pillow in infant’s crib
6. Consumption of large mouthfuls of food
7. Failure to remove doors on discarded or unused refrigerators or freezors
8. Household gas leaks
9. Hanging pacifer around infant’s neck

Question 41

Lead Poisoning Assessment

Answer 41

Does the child:

1. Live in or regularly visit a house with peeling, chipping paint or chewable surfaces painted with lead-based paint built before 1950?
2. Live in or regularly visit a house built before 1978 with recent, ongoing, or planned renovation or remodeling within the past six months?
3. Have a sibling, housemate, or playmate being monitored or treated for lead poisoning?
4. Frequently come in contact with an adult whose job or hobby involved exposure to lead?
5. Live near an active lead smelter, battery recycling plant or industry that releases lead
6. Live near a heavily traveled major highway where soil and dust may be contaminated with lead
7. Come from a home where traditional ethnic remedies are used

Question 42

When is universal screening done for lead poisoning?

Answer 42

1 and 2 years of age or any children between ages 3 and 6 who have not been previously screen. children with risk factors should be screened more often

Question 43

Low Exposure Lead

Answer 43

1. Distracibility
2. Impulsivity
3. Hyperactivity
4. Hearing Impairment
5. Mild intellectual deficits

Question 44

High Exposure Lead

Answer 44

1. Severe intellectual deficits
2. Paralysis
3. Blindness
4. Convulsions
5. Coma
6. Death

Question 45

TNI Low Exposure Lead

Answer 45

1. Instructions in risk reduction
2. Wet mop to remove lead dust on floors, window sills and other surfaces
3. Nutrition counseling increase diet in iron and calcium and decrease fat to decrease absorption of lead
4. Child needs to eat regular meals, because more lead is absorbed on an empty stomach
5. Follow up testing to monitor child’s blood lead level

Question 46

TNI High Exposure Lead

Answer 46

1. Blood levels greater than 25mcg/dl oral chelation therapy with succimer (dimercaotosuccinic acid) may be initiated
2. Oral succimer and/or calcium disodium edetate (CaNa2 EDTA or EDTA) reserved for blood levels greater than 45 mcg/dl
3. EDTA is given IV over several hours preferably; IM are very painful
4. With EDTA administration, observe for and control seizures during treamtnet
5. Never give EDTA in absence of adequate urine output and adequte hydration is critical
6. All TNI listed for low exposure lead poisoning