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Child Health 3122 -winter 2023 > Child Health Final > Flashcards

Child Health Final Flashcards

1
Q

What type of communication should be used with a toddler?

A

Autonomy- allow for choices to reduce stress

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2
Q

What type of communication should be used with a preschooler?

A

Initiative- provide concrete and literal descriptions

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3
Q

What is Erikson’s theory of psychosocial development for infants?

A

Trust vs. mistrust

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4
Q

What is Erikson’s theory of psychosocial development for toddlers?

A

autonomy vs. shame and doubt

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5
Q

What is Erikson’s theory of psychosocial development for preschoolers?

A

initiative vs. guilt

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6
Q

What is Erikson’s theory of psychosocial development for school age (6-12)?

A

industry vs. inferiority

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7
Q

What is Erikson’s theory of psychosocial development for adolescence?

A

identity vs. role confusion

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8
Q

hypotonic dehydration

A

prolonged vomiting diarrhea, burns , IV fluids with no electrolytes.
here more sodium is lost than water. Compensatory mechanism moves fluid from EC INTO cells causing EVEN more ECF deficit

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9
Q

what is Piaget’s theory of cognitive development for adolescence?

A

Formal operational stage

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10
Q

What is Piaget’s theory of cognitive development for :
infants
toddlers
preschoolers
school age

A

infants - sensorimotor
toddlers - preoperational
preschoolers - preoperational
school age- concrete operational

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11
Q

Isotonic dehydration

A

cause: vomit/diarrhea
sodium and water loss is the same

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12
Q

In the pediatric assessment triangle, what do we look for under “appearance” ( TICLS)

A

Tone
Inter-activeness
Consolability
Look/Gaze
Speech/Cry

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13
Q

Pediatric assessment triangle, under “work of breaking” what do we look for? (RAAN)

A

Retractions (sign of working hard to breath)
Abnormal breath sounds
Abnormal positioning
Nasal Flaring

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14
Q

In the pediatric assessment triangle what is the “circulation to the skin”

A

Pallor
Mottling
Cyanosis

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15
Q

In pediatrics, when there is a decrease in intravasular volume ( due to shock) the CO and SV decrease. What is a compensatory mechanism that only exists in this age group?

A

Increase of HR - this does not happen to adults but we do get RAAS to activate and increase BP

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16
Q

What are some of the symptoms for hypovolemic shock?

A

-normal BP (until later)
-peripheral constriction = poor cap refill
-tachycardia = low central venous pressure
-normal CNS

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17
Q

What are some symptoms of septic (distributive) shock?

A

warm to cold phase
normal BP - or it wide pulse pressure
fever - hypothermia
tachycardia
tachypnea
bounding pulses
irritable

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18
Q

What are some symptoms of anaphylactic shock (distributive)

A

-allergic reactions: swelling, rash, flushed skin and nasusea
feeling dizzy, confusion, anxiety

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19
Q

What are some symptoms of cardiogenic shock?

A

-agitation
-cold and pale
diaphoretic
tachypnea
tachycardia
edema
oliguria
mottled/cyanotic
decreased peripheral circulation

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20
Q

What are the 3 stages of hypovolemic shock?

A
  1. early- compensatory mechanisms work. BP is normal with narrow pulse pressure, peripheral constriction, and increased HR
  2. Late (hypotensive) - NO compensatory mechanisms working now. BP is low, NO peripheral pulses, decreased LOC
  3. Cardiopulmonary failure (irreversible)- vasoconstriction and hypoxia with irreversible organ damage
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21
Q

Dehydration reg flags (TS D3)

A

tachycardia or dry mucous membranes
sunken eyes
decreased urine out put and specific gravity
doughy or tenting tissue turgor
decreased tears

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22
Q

The ABC’s for shock treatment

A

A-airways managed/
B-breathing 100% oxygen
C- circulation - need for IV, fluids (EXCEPT for cardiogenic), assess circulation

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23
Q

signs of infection in an infant?

A

loss of appetite, sleep disruption not regular, elevated temp/resp

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24
Q

Warm vs cold shock - describe warm

A

-tachycardia
-tachypnea
-fever
-bounding pulse
-fussy
-flushed looking
-WIDE pulse pressured (30-40)
BP normal or slightly increased

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25
Q

Warm vs. cold shock - describe cold phase

A

tachycardia
WOB increased and can lead to resp depression
hypotension - narrow of pulse pressure by 10-20
hypothermia
cool and pale extermities
decreased cap refill
-decreased pulse - weak @ peripherals
-low urine output ( <1 ml/kg/hr)
-altered LOC

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26
Q

Resp rate for newborn

A

30-55

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27
Q

RR for 1 year old

A

25-40

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28
Q

RR 3 yr old

A

20-30

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29
Q

RR 6 yr old

A

16-22

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30
Q

RR 10 yr

A

16-20

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31
Q

RR 17yrs

A

12-18

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32
Q

HR newborn

A

100-170 (avg. 120)

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33
Q

HR infant-2yrs

A

80-130 (avg. 110)

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34
Q

HR 2-6 yrs

A

70-120 (avg.110)

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35
Q

HR 10-16yrs

A

60-100 (avg. 85)

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36
Q

HR 6-10 yrs

A

70-110 (avg. 90)

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37
Q

Symptoms of anaphylaxis (think FAST)

A

face
airway - loss of tone due to vasodilation, capillaries leak fluids with mast cells
stomach
total

38
Q

Strategies advocacy and capacity building

A
  1. assess and clarify needs and priorities
  2. build effective communication and partnership (IFCP)
  3. focus on health promotion
  4. support equal opportunities and resources to enable health
39
Q

4 key elements of FCC

A
  1. Collaboration
  2. info sharing
  3. participation
  4. dignity, respect
40
Q

What is the acceptable urine output range?

A

1-2ml/kg/hr

41
Q

for infants weighting from 3.5 -10kg what is the daily fluid requirment?

A

100ml/kg

42
Q

When does stranger anxiety develop?

A

6 months

43
Q

Communication: infants (<12 months)

A

Trust.vs mistrust; sensorimotor; oral stage
-sensory focued, solitary play
swaddle, comfort

44
Q

Communication : toddler

A

Autonomy vs. shame/doubt; pre-operational; anal stahe
- promote independece by giving choices
-encourgae experession
-parallel play
-receptive speech

45
Q

when does associative play happen?

A

preshoolers (3-6yrs) children interacting in groups and partipcaitng in activities

46
Q

6-month-old developmental milestones

A

-birth weight doubles
-say sounds like “daddaa”
-first tooth may appear
-able to support head when sits with support
-grabs objects to put in mouth
-may start semi-solids

47
Q

4 month old developmental milestones

A

-vocalizes with coos and babbles
-starts to reach and grab for objects
-rolls front to back
-able tot support hands when placed on tummy
POSTERIOR fontanel closed @ 2-4 months

48
Q

What are all the components of the peds assessment triange?

A

Appearance: tone, interactiveness, consible, look/gaze, speech/cry

Work of breathing:
retractions, abnormal rate/position, anxiety, nasal flaring

Circulation: cyanosis, mottled, pale

49
Q

What are the airway goals for fluid imbalance?

A

Airway: increase LOC, normal resp, skin and colour

50
Q

What are the circulation goals for fluid imbalance?

A

Circulation: increase perfusion, normal VS, normal responsivness

51
Q

What are the breathing fluid balance goals?

A

normal BP, skin turgor, moist mucous membranes

52
Q

Infant to birth (freud, eriksons, piaget)

A

Oral; trust/mistrust/ sensorimotor

53
Q

Toddler (freud, eriksons, piaget)

A

anal; autonomy/shame and doubt; preoperational

54
Q

preschool (freud, erikson,piaget)

A

phallic; initiative/guilt; preoperational

55
Q

School (freud, eriksons, piaget)

A

latency; industry/inferiority; concrete operational

56
Q

adolescence (freud, eriksons, piaget)

A

gentilia; identity/role confusion; formal operational

57
Q

When does pincer grasping start?

A

8 months

58
Q

when does separation anxiety develop?

A

10-12 months

59
Q

When is “length” measured until?

A

Birth to 24months

60
Q

Where do you measure head circumference from?

A

around supraorbital and occipital prominences

61
Q

When does the anterior fontanel close?

A

18 months

62
Q

Types of play for : 1. infants 2. toddlers 3. preschool 4.school age

A
  1. solitary 2. parallel 3. medical 4.cooperative play
63
Q

Hypertonic dehydration

A

less sodium loss compared to water. fluid shifts from cells to ECF ** this is why signs and symptoms are delayed
-watch for neuro symptoms: altered LOC, confusion, lethargy, dizziness
Causes: diabetes insipidus, IV fluid with lost of electrolytes

64
Q

External strengths - Resiliency model (5)

A
  1. community 2. school culture 3. family 4. learning at school 5. peers
65
Q

Internal strengths- resiliency model (5)

A
  1. self-concept 2. cultural sensitivity 3. social sensitivity and empathy 4. self-control 5. empowerment
66
Q

Total Fluid intake

A

(100ml x 10kg) + (50ml x10kg) + (20ml x 5kg)

67
Q

Total maintenance fluid rate

A

ml/kg/hr

68
Q

-vmost common causes of hypovolemic shock

A

-blood loss : trauma, GI, hemorrhage
-plasma loss: -increased capillary permeability due to sepsis, acidosis, burns
-extracellular fluid loss : v/d, diuresis, heat stroke

69
Q

What are growth and development signs of a 15 month old?

A

-crawls and walks upstairs
-points to different body parts
-able to stack 2 blocks

70
Q

18 month old

A

-able to stack 3 or more blocks
-feeds self with spoon
- speaks 15-20 words and follows directions
-anterior fontanel closes

71
Q

When can a child understand putting correct shapes into correct holes?

A

10-12 months

72
Q

when to start toilet training?

A

2 yrs

73
Q

Contemporary issues

A
  1. literacy
    2.mental illness
  2. poverty
  3. abuse and neglect
  4. injuries and disease
  5. overweight and physical inactivity
  6. environmental contaminants
74
Q

Resp Red Flags

A

Infants: <20 or >60 BPM
Child: <16 or >40 BPM
and incresed wob, crackles, wheezes, retraction, nasal flareing, grunting, stridor, desaturations = bradycardia

75
Q

What SEVERE signs of asthma attack?

A

-lips/nail beds cyanotic
- SOB, increased resp
- 3-5 word sentences
-not improving after taking reliver
-retractions ( head bobbing)

76
Q

not used for emergency/acute asthma, has onset of 30-90 minutes, decreased mucus and inhibits bronchoconstriction

A

Anti-cholingerics (ipatropium

77
Q

used to prevent bronchospasms from exercise, used for nocturnal symptoms, takes 30-60 minutes to become effective

A

long-acting beta 2 agnosts - salmeterol

78
Q

primary enuresis

A

child has never had a dry night; due to maturational delay and small functional bladder NOT related to stress

79
Q

superficial partial thickness burn - 1st degree

A
  • damage of outer later, painful, red, heals in a few days.
    erythema, blanches on pressure, no bullae, peeling withing a few days
80
Q

partial thickness -2nd degree

A

-includes epidermis and upper dermis heals in 10-14 days, blisters or bullae, erythmea, blanches on pressure, pain/senstive to cold air,

81
Q

Full thickness- 3rd degree

A

involves all epidermis and dermins, nerve endings destroyed
-skin is brown/black/ deep cherry red
-white to gray
-waxy/transulcent
-usually no pain
-the injured area looks sunken

82
Q

oxygen therapy for 6 month old or less?

A

1-2 L

83
Q

Feeding NPO with resp condition when?

A

RR over 60, with nasal secertions, chocking,coughing with feed

84
Q

SP02 spot check process

A
  1. check o2 every 5-15 minites and 30 minutes after discontinuing oxygen
  2. spot check every 4 hours
85
Q

what are the 8 physiological response to burns?

A
  1. increased permeability of capillaries moves fluid out of the vasculars and increases fluid retention
  2. decreased cardic output/ increased vascular resisitence
  3. airway inflammation
  4. suppression of bone marrow (causing anemia)
  5. hyper-metabolic state - with protiens being destroyed, increased glucocorticoids, catecholeatimes and dopamine
  6. digestive change in absoprtion (n/v), paralytic ileus
  7. inflammaotry response = fever, tachycardia, open wounds
  8. immune suppresion- infection
86
Q

What is the function of Digoxin?

A

decreased heart rate to increase contractility time to improve systemic circulation.

87
Q

what is the function of ace-inhbiitors

A

promotes vascular relaxation and reduces peripheral vascular resistance, decreasing afterload.

88
Q

what is the function of a beta blocker?

A

improves function of left ventricle, and vasodilation of systemic

89
Q

when is a baby sitting alone?

A

8 months

90
Q

when can infant raise chest up from floor?

A

6 months

91
Q

what type of toys do toddlers like to play with?

A

push -pull toys

92
Q

Jackson’s burn model explain:
1. zone of hyperemia
2. zone of stasis
3. zone of coagulation

A
  1. LOTs of vasodilation
  2. strong inflammatory response
  3. denatured proteins and coagulation- potential for necrosis

Child Health 3122 -winter 2023 (1 decks)

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