Body Image and Unintentional Injuries (1) Flashcards
1
Q
Common causes of unintention injuries in infants
A
- Falls
- Burns
- Motor vehicle crashes
- Drowning
- Poisoning
- Choking and suffocation
2
Q
Emergency management measure for minor burns
A
- Stop the burning process: apply cool water to the burn or hold the burned area under cool running water; do not use ice
- Do not disturb any blister that forms, unless the injury is from a chemical substance (infection)
- 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)
- Removed burned clothing or jewelery
3
Q
Common poisonings that occur in children
A
- Cosmetics and personal care products
- Cleaning products
- Plants
- Foreign bodies
- Heavy metals
- Lead poisoning
- Acetaminophen, ibuprofen, aspirin
4
Q
Poisoning: Risk For
A
5
Q
Suffocation: Risk For
A
6
Q
Purpose of the posion control center
A
- Call BEFORE any intervention
- Counsels to begin treatment at home or bring child to emergency facility
- Expert advice; information more accurate than that from hospital emergency departments
7
Q
Poison Control Center’s recommended sequence of actions when poisoning/exposure has occurred
A
- Assess the victim:
- CPR prn
- VS, reevaluate routinely
- Treat other symptoms, such as seizures
- Terminate exposure:
- Empty mouth of pills, plant parts, or other materials
- Flush eyes continously with normal saline or tap water at home for 15-20 minutes
- Flush skin and wash with soap and a soft cloth; remove contaminated clothes
- Bring victim inhalation poisoning into fresh air
- Indentify the poison:
- Question the victim and witnesses
- Look for environmental cues and save all the evidence of poison
- Be alert to signs and symptoms of potential poisoning
- Call poison control center for immediate service regarding treatment
- Prevent poison absorption:
- Position child to prevent aspiration
- Provide antidote, gastric lavage, or activated charcoal to prevent absorption of toxin
8
Q
Nursing Implications for the administration of activated charcoal
A
- 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
9
Q
Teaching plan for a client at risk for unintentional injuries
A
10
Q
Common causes of unintentional injuries in preschoolers
A
- Motor vehicle crashes
- Motor vehicle and pedestrian injuries
- Drowning
- Burns
- Hospitalization: need sticks and electrical injury
11
Q
Common causes of unintentional injuries in toddlers
A
- Falls
- Poisoning
- Burns
- Drowning
- Motor vehicle crashes
12
Q
Common causes of unintentional injuries in school age children
A
- motor vehicle, pedestrian, bicycle crashes
- Firearms
- Burns
13
Q
Common causes of unintentional injuries in adolescents
A
- Motor vehicle crashes
- Sports Injuries
- Drowning
14
Q
Body Image
A
Subjective concepts and attitudes that an individual has toward their own body including:
- Physiologic: perception of one’s physical characteristics
- Psychologic: values and attitudes toward the body, attitudes and ideals
- Sociologic: social nature of one’s image of self in relation to others
15
Q
Infants Body Image and Nursing Interventions
A
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
16
Q
Toddlers Body Image and Nursing Interventions
A
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
17
Q
Preschooler Body Image and Nursing Interventions
A
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
18
Q
School Age Body Image and Nursing Interventions
A
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
19
Q
Adolescent Body Image and Nursing Interventions
A
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
20
Q
Anticipatory guidance
A
- Prediction of the upcoming developmental tasks of a child and gears teaching to those needs
- Providing families with information on what to expect during the child’s current and next stage of development
- Providing age-appropriate information on prevention of poisoning and injury
21
Q
Emergency treatment for major burns
A
- Stop the burning process:
- Flame Burn - smother the fire
- Place the victim in the horizontal position
- Roll victim in a blanket or similar object; avoid covering the head
- Assess for adequate airway and breathing
- If not breathing, begin steps of CPR
- Remove burned clothing and jewelry
- Cover wound with clean cloth
- Keep victim warm
- Transport to medical aid
- Begin IV and oxygen therapy as prescribed
22
Q
N-acetylcysteine (mucomyst)
A
- Treatment given for acetaminophen overdose
- Given orally diluted with juice
23
Q
Naloxone (narcan)
A
Treatment of opioid overdose
24
Q
Flumazenil (romaxicon)
A
Treatment of benzodiazepine overdose (valium, versed)
25
Q
Gastric Lavage
A
- Lavage involved placement of gastric tube; NS solution is instilled and apirated until the return is clear
- Indicated in children who are comatose, convulsing, or require a protected airway or if the substance is absorbed rapidly
- Contraindicated in children who have ingested corrosive agents
26
Q
Corrosives
A
- Do not induce vomiting
- Dilute with 4 oz of water or milk
- Give activated charcoal
27
Q
Hydrocarbons
A
- Do not induce vomiting
- Gastric Lavage/Activated charcoal are controversial
28
Q
Acetaminophen poisoning
A
n-acetylcysteine (mucomyst)
29
Q
Aspirin Poisoning
A
- Induce Vomiting
- Gastric Lavage
- Activated charcoal
30
Q
Iron poisoning
A
- Induce vomiting
- Gastric lavage
31
Q
Plant poisoning
A
- Induce vomiting
- Wash from skin or eyes
32
Q
After immediate care, the RN shifts care to providing…?
A
- Emotional Support
- Preventing Recurrence
33
Q
Anticipatory prevention strategies of childhood poisoning
A
- Place household cleaners, medications, vitamins, and other potentially poisonous substance out of reach of children in locked cabinets
- Use warning stickers such as Mr. Yuk on all of these containers
- Buy products with child-resistant caps
- Store products in original containers
- Never place household cleaners or other products in food or beverage containers
- Remove all houseplants from the child’s play area
- Use caution when visiting other settings that are not childproof. Remember visitors may have pills in their purses that are easily accessible
34
Q
Preventing unintentional injuries in infants
A
- Do not leave infant unsecured in infant seat
- DO not place on high surfaces, such as tables or beds, unless holding the infant
- Check temp of bath water, foods, and liquids
- Cover electrial outlets
- Use only approved car restraint system
- Never leave an infant alone in a bath
- Keep medications, cleaning products and other harmful substances out of reach and locked up
- Avoid foods and small toys that commonly cause coking
- Position infant on back for sleeping; do not place pillows, stuffed toys, etc near head
35
Q
Preventing unintentional injuries in toddlers
A
- Supervise toddler closely. Provide safe climbing toys
- Teach acceptable places for climbing
- Keep medications and other posionous material locked away. have poison control number by telephone
- Keep pot handles turned inward on stove
- Supervise any child near water
- Use child life jackets near water and on boats
- Empty buckets when not in use
- Used only approved car seat
36
Q
Preventing unintentional injuries in preschoolers
A
- Older preschoolers may independently get into car and put on seat belt
- Verify the child is belted and in properly before starting the car
- Teach child never to go into road
- Teach child never to go into water without an adult
- Provide supervision whenever child is near water
- Teach child to stop, drop and roll if clothes are on fire
- Keep needles out of reach and beds away from electrical outlets. Monitor child closely
37
Q
Preventing unintentional injuries in school age children
A
- Teach safe outdoor play, especially near streets
- Reinforce use of bike helmets
- Teach bike safety rules and provide safe places for riding
- Use booster seat
- Teach child never to touch guns without parents present
- Guns should be kept unloaded and locked away
- Guns and ammunnition should be stored in different locations
- The child may perform experiments with flames
- Teach child what to do in case of fire
38
Q
Preventing unintentional injuries in adolescents
A
- Insist on driver’s education classes
- Enforce rules about safe driving: teach hazards of drinking/drugs, talking on cell phones, and driving when tired or distracted
- Encourage use of protective sporting gear
- Encourage sweimming only with friends
- If adolescent supervises younger children near water, near leave them alone
39
Q
Anticipatory prevention for lead poisoning
A
- Ensure child does not have access to peeling paint or chewable surfaces painted with lead-based paint (espeically window sills)
- Wash and dry child’s hands and face frequently, especially before eating
- Wash toys and pacifiers frequently
- Use cold water only for consumption. Hot water dissolves lead more quickly, thus contains higher lead levels
- Do not store food in open cans, patricularly if cans are imported
- Avoid folk remedies and cosmetics that contain lead
- Make sure the child eats regular meals
- Ensure the child’s diet contains sufficient iron and calcium and not excessive fat
40
Q
Common causes of suffocation in young children
A
- Vehicle warming in closed garage
- Use of fuel burning heater not vented to outside
- Children playing with plastic bags or latex balloons; inserting small onject into their mouths or noses
- Placement of propped bottle placed in an infants crib
- Placement of pillow in infant’s crib
- Consumption of large mouthfuls of food
- Failure to remove doors on discarded or unused refrigerators or freezors
- Household gas leaks
- Hanging pacifer around infant’s neck
41
Q
Lead Poisoning Assessment
A
Does the child:
- Live in or regularly visit a house with peeling, chipping paint or chewable surfaces painted with lead-based paint built before 1950?
- Live in or regularly visit a house built before 1978 with recent, ongoing, or planned renovation or remodeling within the past six months?
- Have a sibling, housemate, or playmate being monitored or treated for lead poisoning?
- Frequently come in contact with an adult whose job or hobby involved exposure to lead?
- Live near an active lead smelter, battery recycling plant or industry that releases lead
- Live near a heavily traveled major highway where soil and dust may be contaminated with lead
- Come from a home where traditional ethnic remedies are used
42
Q
When is universal screening done for lead poisoning?
A
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
43
Q
Low Exposure Lead
A
- Distracibility
- Impulsivity
- Hyperactivity
- Hearing Impairment
- Mild intellectual deficits
44
Q
High Exposure Lead
A
- Severe intellectual deficits
- Paralysis
- Blindness
- Convulsions
- Coma
- Death
45
Q
TNI Low Exposure Lead
A
- Instructions in risk reduction
- Wet mop to remove lead dust on floors, window sills and other surfaces
- Nutrition counseling increase diet in iron and calcium and decrease fat to decrease absorption of lead
- Child needs to eat regular meals, because more lead is absorbed on an empty stomach
- Follow up testing to monitor child’s blood lead level
46
Q
TNI High Exposure Lead
A
- Blood levels greater than 25mcg/dl oral chelation therapy with succimer (dimercaotosuccinic acid) may be initiated
- Oral succimer and/or calcium disodium edetate (CaNa2 EDTA or EDTA) reserved for blood levels greater than 45 mcg/dl
- EDTA is given IV over several hours preferably; IM are very painful
- With EDTA administration, observe for and control seizures during treamtnet
- Never give EDTA in absence of adequate urine output and adequte hydration is critical
- All TNI listed for low exposure lead poisoning
