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Pediatric Nursing > Exam 1 (Chapters 1-9) > Flashcards

Exam 1 (Chapters 1-9) Flashcards

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1
Q

Family-Centered Care

A

Philosophy of health care in which a mutually beneficial partnership develops between families and the nurse, and also other health care professionals

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2
Q

Extended Kin Network Family

A

Specific form of an extended family in which two nuclear families of primary or unmarried kin live in proximity to each other

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3
Q

Authoritarian Parent

A

High control, low warmth

Child may become fearful, withdrawn, and unassertive

Girls passive and dependent, boys rebellious and aggressive

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4
Q

Authoritative Parent

A

Moderately high control, high warmth

Children are best adjusted, self-reliant, self-controlled, and socially competent

Higher self-esteem, better school performance

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5
Q

Permissive Parent

A

Low control, high warmth

Children are rebellious, aggressive, socially inept, self-indulgent, or impulsive

May be creative, active, and outgoing

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6
Q

Indifferent Parent

A

Low control, low warmth

Children have high expression of destructive impulses and delinquent behaviors

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7
Q

Neonatal Mortality Causes

A

Short gestation

LBW

Congenital malformations

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8
Q

Postneonatal Mortality Causes

A

SIDS

Congenital malformations

UNINTENTIONAL INJURIES

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9
Q

Infant Morbidity Causes

A

Injuries related to live birth

Acute bronchitis

Hemolytic jaundice

Pneumonia

LBW

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10
Q

Child Morbidity Causes

A

Asthma and pneumonia are most common causes

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11
Q

Effects of Divorce on Preschool Aged Children

A

Fear, anxiety, worry, self-blame, sorrow, grief, anger, regression, questioning, temper tantrums, loneliness

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12
Q

Effects of Divorce on School Aged Children

A

Sadness, insecurity, self-blame, guilt, resentment, behavioral problems, withdrawal from friends and activities

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13
Q

Effects of Divorce on Adolescents

A

Panic, fear, depression, guilt, risk-taking, fear of loneliness and abandonment, denial, anger, sadness, aggressiveness, skipping class, use of drugs and alcohol, sex

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14
Q

Eight Stages of Family Life Cycle

A

1: newly married
2: childbearing
3: families with preschool children
4: families with school aged children
5: families with teenagers
6: families launching young adults
7: middle aged parents
8: family in retirement and old age

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15
Q

Aneuploidy

A

Increase or decrease in number of chromosomes

Result of an error during cell division, most often with nondisjunction during meiosis

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16
Q

Nondisjunction

A

Paired homologous chromosomes that do not separate before migrating into egg or sperm cells

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17
Q

Examples of Aneuploidy

A

Turner Syndrome (monosomy)

Trisomy 13 (Patau Syndrome) and Trisomy 21 (Downs Syndrome)

Most monosomic/trisomic errors result in the loss of life

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18
Q

Mosaicism

A

Monosomy/trisomy during mitosis resulting in 2 separate cell line with different chromosomal makeup

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19
Q

Inversion

A

Chromosome breaks in two places and the piece between the breaks turns and reattaches within the same chromosome

Inversion of Factor VIII –> Hemophilia A

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20
Q

Deletion and Duplication

A

Unbalance rearrangement of chromosomes, may be incompatible with life

Cri du Chat is a large deletion of Chromosome 5 that results in microcephaly, intellectual disability, and cat-mewing cry

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21
Q

Translocation

A

Two nonhomologous chromosomes that exchange segments of DNA

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22
Q

Autosomal Dominant

A

Involve altered genes on autosomes rather than sex chromosomes

Individuals with AD disorders are heterozygous for the disease-producing gene; 50% chance affected parent passes on to child

Neurofibromatosis, Marfan Syndrome, Achondroplasia (dwarfism), Huntington Disease, familial hypercholesterolemia

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23
Q

Autosomal Recessive

A

Both copies of the same gene in an individual are altered

Both parents are carriers, child has 25% chance of inheriting, 50% chance of carrying, and 25% chance of being fine

Cystic Fibrosis, Sickle Cell Disease, Tay-Sachs, and most inborn errors of metabolism

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24
Q

X-Linked Disorders

A

Hemophilia A, Duchenne Muscular Dystrophy

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25
Q

Y-Linked Disorders

A

Contains genes related to spermatogenesis problems

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26
Q

Penetrance

A

Probability a gene will be expressed phenotypically

All-or-none concept

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27
Q

Variable Expressivity

A

Degree to which a phenotype is expressed

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28
Q

New Mutation

A

Occurs when there is no family history

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29
Q

Anticipation

A

Occurs when successive generations exhibit earlier onsets with more severe signs/symptoms

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30
Q

Minor Anomaly

A

Usual morphologic feature that is of no serious concern

Wide-set eyes, single palmar creases, cafe au lait, low anterior hairline, preauricular pits, broad face, mild proportionate short stature

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31
Q

Major Anomaly

A

Serious structural defect present at birth

Congenital heart defects, cleft lip/palate, myelomeningocoele, duodenal atresia, craniosynostosis

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32
Q

Syndrome

A

Collection of multiple anomalies

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33
Q

Principles of Growth and Development

A

Cephalocaudal (growth goes from head to toe)

Proximodistal (growth goes from core to periphery)

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34
Q

Freud’s Psychosexual Theory

A

Oral (birth-1 year): infant derives pleasure from mouth

Anal (1-3 years): control over secretions

Phallic (3-6 years): child works out relationships with parents

Latency (6-12 years): sexual energy is at rest

Genital (12-adulthood): mature sexuality achieved

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35
Q

Erikson’s Psychosocial Theory

A

Trust v. Mistrust (birth-1 year): task is to establish trust in those providing care

Autonomy v. Shame and Doubt (1-3 years): autonomy shown by controlling excretions, saying no, directing motor activity

Initiative v. Guilt (3-6 years): initiation of new activities

Industry v. Inferiority (6-12 years): child takes pride in accomplishments and develops new interests

Identity v. Role Confusion (12-18 years): thoughts are more complex, finds a definition of self

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36
Q

Piaget’s Cognitive Development Theory

A

Sensorimotor (birth-2 years): use of senses to drive motor activity

Preoperational (2-7 years): words/symbols used, no logic

Concrete Operational (7-11 years): accurate understanding of cause and effect, conversation is learned

Formal Operational (11-adulthood): mature intellectual thought

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37
Q

Kohlberg’s Theory of Moral Development

A

Preconventional (4-7 years): decisions based on desire to please others to avoid punishment

Conventional (7-12 years): conscience becomes important, rules must be followed

Postconventional (12 and older): internalized ethical standards, social responsibility recognized

38
Q

Infant Physical Growth and Development

A

Weight doubles by 5 months and triples by 1 year

Height increases by 1 foot

Teeth erupt at 6 months, 6-8 teeth by 1 year

Kidney and liver maturation

Nervous system allows to sit, stand, and walk and sensory function increases

39
Q

Infant Psychosocial Development

A

Engage in solitary play

Reflexes –> manipulation

Engage in two-way communication, understand more words than they can speak

Temperament usually fits the environment

Abnormalities are caused by decreased hearing, developmental delay, or decreased verbal stimulation

40
Q

Toddler Physical Growth and Development

A

Decreased rate of growth, decreased food consumption

Pot-bellied, walk with a wide gait

20 teeth at 33 months

Gross motor develops rapidly (running, kicking, riding) and increased control of elimination patterns

41
Q

Toddler Cognitive Development

A

Object permanence is well-developed

Pre-operational thought

42
Q

Toddler Psychosocial Development

A

Parallel play, increased motor activities

Retains temperamental characteristics from infancy, independence increases

Imitate speech intonations and words, use expressive jargon

43
Q

Preschool Child Physical Growth and Development

A

Grow steadily, most growth in long bones of arms/legs

Physical skills develop (throw a ball, hold a bat)

44
Q

Preschool Child Cognitive Development

A

Pre-operational thought

Symbols used and understood

45
Q

Preschool Child Psychosocial Development

A

Associative play, large motor activities, dramatic play

Temperament from infancy persists, egocentricity

Vocabulary grows to 2000 words

46
Q

School-Aged Child Physical Growth and Development

A

Decreased fat, increased muscle, mature immune system, increased leg length

Nutritional needs increase

47
Q

School-Aged Child Cognitive Development

A

Concrete operational thought, learns conversation

Considers alternative solutions to problems

Relies on concrete experiences

48
Q

School-Aged Child Psychosocial Development

A

Cooperative play, high social component

Enduring aspects of temperament continue to manifest

Able to correct pronunciation/grammatical erros

Aware of sexual differences, interested in sexual issues

49
Q

Adolescent Physical Growth and Development

A

Growth spurts around 10 (female) and 13 (male)

Accompanies by increased breast size and pubic hair in girls and increased penis/testes size and pubic hair in males

50
Q

Adolescent Cognitive Development

A

Formal operational thought, independent thought

51
Q

Adolescent Psychosocial Development

A

Temperament from childhood remains stable

Uses and understands all parts of speech

Quest for self-identity

Give privacy during assessments

52
Q

Newborn Assessment

A

Keep the parent present, use distractions, observe activity, keep sequence flexible

Assess with newborn on the table and parent next to them

Invasive assessments should be done last

53
Q

Infant Assessment

A

Examine on the parent’s lap, smile and talk soothingly, use toys/pacifier, begin with feet and hands before moving to the trunk

54
Q

Toddler Assessment

A

Keep toddlers with parents, avoid asking toddler for permission, give choices, observe neuro/muscular by watching them play

Begin at the feet and move up, use instruments last

55
Q

Preschool Child Assessment

A

Assess willingness to separate from the parent, leave underpants on until the genital examination, give simple explanations, offer choices, use distractions, give positive feedback with cooperation

Order of the exam may vary

56
Q

School-Aged Child Assessment

A

Have them sit on the exam table, offer gown to cover underwear, allow privacy

Do head-to-toe assessment, demonstrate equipment, offer choices, teach as you go

57
Q

Adolescent Assessment

A

Give gown, allow privacy, provide modesty

Head-to-toe assessment, provide reassurance

58
Q

Top Mortalities of Infants < 1 Year

A
  1. Congenital anomalies
  2. Preterm birth
  3. SIDS
59
Q

Top Mortalities of Infants 1 Year Old

A
  1. Unintentional Injury (Suffocation)
  2. Congenital anomalies
  3. Homicide
60
Q

Top Mortalities of Children 1-4 Years Old

A
  1. Unintentional injury
  2. Congenital anomalies
  3. Homicide
61
Q

Top Mortalities of Children 5-14 Years Old

A
  1. Unintentional injury (motor vehicle accident)
  2. Cancer
  3. Congenital anomalies
62
Q

Top Mortalities of 15-24 Year Olds

A
  1. Unintentional injury (motor vehicle accident)
  2. Suicide
  3. Homicide
63
Q

New Morbidity

A

The effects of society and societal health on children

64
Q

Pediatric Assessment Triad

A

Appearance

Breathing

Circulation

65
Q

Pain Assessment

A

Use pain scales with faces and colors

If non-responsive or nonverbal, use objective scales such as FLACC or CRIES, account for muscle tone, grimacing, vital signs, guarding

66
Q

Rough Bladder Capacity

A

Child’s age plus 2 is normally the amount of ounces of bladder capacity they have

67
Q

Diet/Energy Needs of Infants

A

100 kcal/kg/day

68
Q

S1

A

Beginning of systole, closing of the AV valves

Heard best at the apex with the diaphragm

69
Q

S2

A

Ending of systole and beginning of diastole, closing of the semilunar valves

Heard best at the base with the diaphragm

70
Q

Physiologic Split S2

A

Normal in pediatrics, particularly the younger the child

Split resolves as the child ages

Know it’s physiologic if the split becomes longer with inspiration

Heard best in the pulmonic region with the diaphragm

71
Q

Pathologic Split S2

A

Not a normal variance

Fixed split (no change with inspiration), Paradoxical split (less pronounced with inspiration)

Heard best in pulmonic region with the diaphragm

Fixed is usually a septal defect, paradoxical is usually a pathological problem causing delayed aortic closure

72
Q

Pathologic S3

A

Separate heart sound, diastolic gallup

Comes at the end of S2

Marker of ventricular overload or systolic dysfunction

Low-pitched, more likely to be heard with the bell

73
Q

Pathologic S4

A

Comes at the end of diastole, right before systole

Indicator of poor diastolic function

Seen in conditions such as uncontrolled HTN, persistent/recurrent myocardial ischemia

Soft and low pitched, heard best with the bell

74
Q

MR. PASS, MVP

A

Mitral regurgitation, physiologic aortic stenosis (Systolic)

Mitral valve prolapse

75
Q

MS. ARD

A

Mitral stenosis, aortic regurgitation (Diastolic)

76
Q

Grading Murmurs

A

Grade 1: very faint

Grade 2: quiet but immediately heard

Grade 3: moderately loud, same volume as S1 and S2, without a thrill

Grade 4: moderately loud with a thrill

Grade 5: very loud with a thrill

Grade 6: audible without a stethoscope

77
Q

Growth/Development Surveillance for Newborns/Infants

A

Be alert for infants that demonstrate changes in percentile

Signs of developmental delay merit immediate investigation

Introduce foods that foster growth, encourage developmental toys, demonstrate gross/fine motor skills

78
Q

Nutrition of Newborns/Infants

A

Hemoglobin/hematocrit can be performed at 9-12 months

Newborn (support breastfeeding), 1 month (reinforce breastfeeding), 2 months (begin cleaning infant gums, teach how to prepare formula), 4 months (introduce first foods between 4-6 months), 9 months (encourage self-feeding)

79
Q

Mental/Spiritual Health of Newborns/Infants

A

Stranger anxiety/separation anxiety occurs at 6 months

Learn how to self-regulate

80
Q

Immunizations of Newborns/Infants

A

Hep B (birth, 1-2 months, 6-18 months)

Hep A (12 months, 18 months)

DTP (2 months, 4 months, 6 months)

Rotavirus (2 months, 4 months)

Influenzae haemophilus (2 months, 4 months, 6 months)

Polio (2 months, 4 months, 6-18 months)

Pneumococcal (2 months, 4 months, 6 months)

81
Q

When Families Should Call HCP for Newborns/Infants

A

Axillary temperature > 99.3 degrees Fahrenheit

Seizure

Skin rash

Change in behavior

Irritability

Lethargy

Failure to eat

Vomiting

Diarrhea

Dehydration

Cough

82
Q

Nutrition for the Toddler and Preschooler

A

1 year (wean child from bottle, use whole milk, limit juice, limit high fat and sugar)

2 year (encourage total removal from bottle, offer child-sized utensils, 2-3 servings of milk per day)

3 year (teach normal intake, decrease snacks, encourage child in food preparation)

4 year (involve child in snack selection, decrease fat)

83
Q

Physical Activity for the Toddler and Preschooler

A

Minimum of 60 minutes of unstructured play, minimum 60 minutes of structured play, maximum 60 minutes of sedentary life

Motor activities encouraged

Kinesthesia develops (sense of one’s own body position/movement)

84
Q

Oral Health for the Toddler and Preschooler

A

Dentist visit by 1 year of age

20 deciduous teeth by 2 years, begin to lose by the end of preschool

85
Q

Mental/Spiritual Health of the Toddler and Preschooler

A

Good at self-regulation

Need 10-12 hours of sleep per night

86
Q

Potential Hazards for the Toddler and Preschooler

A

Falls, poisoning, burns, drowning, MVA

87
Q

Mental/Spiritual Health of the School-Aged Child

A

Self-esteem, self-concept, body image, sexuality

88
Q

Immunizations for the School-Aged Child

A

TDAP (11 year old visit)

HPV (three dose series at 9 years or older)

Meningococcal (11 years)

89
Q

Hazards for the School-Aged Child

A

MVA, firearms, burns, assault

90
Q

Nutrition for the Adolescent

A

5 fruits and vegetables daily, whole grain, three meals a day, decreased fat and sugar, 2-3 servings of dairy

91
Q

Physical Activity of the Adolescent

A

60 minutes daily is recommended

Pediatric Nursing (7 decks)

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