exam 1 Flashcards
Know what informed consent is and how it affects nursing care
Informed consent is the formal authorization of the parent or guardian to allow care or procedure for their child. Healthcare workers are responsible for identifying who can sign consent for a child.
When can a minor seek their own care?
Emancipated minors: these patients typically are self-supporting adolescents (under age 18) or those who
may be married, pregnant, or incarcerated and are not subject to parental control
Mature minors: these are adolescents who may give independent consent to receive or refuse treatment
fro a limited number of conditions. These conditions often include: testing and treating sexually transmitted infections (STIs), contraception cervices, substance abuse, and mental health care
What does assent mean?
Assent is the voluntary agreement to accept treatment or participate in research. To
give assent, a child must have a basic understanding of what will be done and what is required for
participation
Who is the pediatric patient? What does “family centered care” mean?
Children < 18, take the family’s wants and needs into consideration as well as the patient
Understand leading causes of mortality and morbidity for each age group
Under 1 year: Suffocation
1 to 4 years: Drowning
5 to 9 years: Motor vehicle
10 to 14 years: Motor vehicle
15 to 19 years: Motor vehicle
What things can nurses do to positively affect morbidity and mortality?
- Pediatric medications are based on the patient’s weight – dosage errors are a major concern.
- Pediatric patients also have immature physiology which affects their ability to metabolize and excrete
medications - Environmental hazards pose additional risks to pediatric patients: crib rails, cords, sleep habitats
- Parents play a very important role in the care of children. It is important to work WITH them to help
provide the safest environment for patients.
Know what a safe sleep environment is and why we care about it
ABC- alone, back, crib
- same room next to parents, no pillows, blankets, toys
Know the effects of hospitalization on each age
Infant: Unaware of illness and its effects only see a deviation from their normal life, Sense stress and anxiety in loved ones, Awareness of self as separate from parents by 6-8 months leading to separation anxiety and stranger anxiety which is exacerbating if the parent is not staying with the child.
Toddlers: Separation from parents and disruption of routine are major stressors and fears, May see illness as punishment
School-age: Beginning understanding of body functions and foster a sense of industry, Stressful procedures can lead to regression or behavior changes
Adolescents: Understands complex nature of illness and often fear results of it, Fear of missing out with friends and peers, Concerned with effects of illness on appearance/body image
How does hospitalization affect parents? Siblings?
Parents:
Disbelief, anger, guilt
Fear, anxiety
Frustration
Depression
Family processes disrupted
Parental roles may be altered
Burdens of missed work, additional expenses, caring for siblings
Siblings:
Confusion
Guilt
Anger
Jealousy
Rejection
Know how to give pediatric medications (oral, IV, IM, ear gtts, eye gtts)
IV: hand, feet, ac,scalp- hourly checks due to increased risk of infiltration
IM: vastus lateralis is preferred no more than 1-2 ml, no gluteus Maximus
Eye: stabilize head by resting wrist of forehead, keep at room temp
Ear: Stabilize hand by resting wrist on head, Pull pinna up from children >3yr or down for kids under <3yr
How can we prepare children for procedures? Does this change based on age?
Infant: explain procedure and reason to parents, allow parents to be present and parents may sooth baby
Toddler: Give explanation just before procedure, since toddler’s concept of time is limited. Explain that child did nothing wrong; the procedure is simply necessary
Preschool: Give simple explanations of procedure. Basic drawings may be useful. While providing supervision, allow the child to touch and play with equipment to be used, if possible
School age:Clear, thorough explanations are helpful. Use drawings, pictures, books, and contact with equipment. Teach stress-reduction techniques such as deep breathing and visualization. Offer a choice of reward after procedure is completed.
Adolescent: Give clear explanations orally and in writing. Teach stress-reduction techniques. Explore fear of certain procedures, such as staple removal or venipuncture.
up to what age do you use length instead of height for measuring a child?
up to two years
up to what age do you measure head circumference?
up to age 3
up to what age do you measure chest circumference?
up to age 1
what happens to an infant’s weight in the first year?
weight doubles by 6 months and triples by a year
Normal hr range for children
Neonate: 100-180
infant: 100-160
toddler: 80-110
preschool: 70-110
school age: 65-110
adolescent: 60-90
how do you count respirations for a child under 6?
watch rise and fall of belly because thoracic muscles are immature
normal RR for children
infant: 30-60
toddler: 24-40
preschool: 22-34
school age: 18-30
adolescent: 12-16
temperature for hypo and hyperthermia in children
less than 36.5 C (97.7 F) or greater than 38 C (100.4 F)
normal bp calculation for children
90 + (2x age in years)
how should fontanelles feel during an examination
normal: flat and soft
increased icp: tense and above the margin of skull
dehydration: sunken fontanelles
when do fontanelles close?
anterior: 2-4 months
posterior: by 18 months
