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NRSE 250 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Immunizations during toddlerhood:

A

vaccines begin to slow down

Last round is at 18 months

does not start back up until 4

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2
Q

What age is toddlerhood?

A

18 months - 3 years

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3
Q

Erikson: toddlerhood

A

Autonomy vs doubt/shame

Autonomy: being own person

less dependent on parents

lack confidence because of not being able to do things

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4
Q

Growth: toddlerhood

A

Height: 2- 4 inches per year

Weight: 4 -6 pounds

toddler height at 2 is 50% of adult height

” big Belly”

Lumbar Lordosis: curving inward of lower back that put pressure on entire back

anterior fontanelle closes at 18 months

overall growth slows down

start to shed baby fat

posture straightens

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5
Q

Milestones for toddlers:

A

large range of milestones

mobility = trouble

climbing stairs
tricycles
running
kicking
throwing
hold spoon + fork
scribble
copy a circle

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6
Q

Examination of Toddlers:

A

need to have some level of control

hold equipment
blow out otoscope light
let them listen to heart w stethocope
distraction
jokes
Exam done on parents lap
No head- to-toe assessment: get creative
painful things should be last
establish trust

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7
Q

Poisoning: toddlerhood

A

greatest risk from 1-2 years

explore the world with mouth

Medication, household products, plants, cigarettes, alchol, cosmetics

If suspected call posion control

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8
Q

Child Abuse Signs:

A

Parental delay in seeking help and reluctance to provide information

Bare spots and broken hair

Inconsistences in story + old fracture

Pattern injuries

Burn marks

Bruises (especially on back of body)

Lack of guilt

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9
Q

Vision: toddlerhood

A

About 20/40 (worse than adults)

EOMS can be an issue (strabismus)(cross eyed)

Kids may need glasses or surgery to correct

If untreated: result in amblyopia (lazy eye)(permanent issues) (visual acuity)

Diminished or loss of vison in one eye

Brain favors normal eye

Management focused on making child use one eye to reduce vision (lazy eye)

Use a patch

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10
Q

Tantrums: Toddlerhood

A

more common

Say No because they can

Big temper tantrum

Ignore the behavior

Set limits and stick to them

Routine simple and predictable

Trick them into thinking they have control

Waking hours are at play

Do not have verbal skills to communicate needs

Not good at sharing (parallel plays) play side by side; not together

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11
Q

Potty Training: Toddlerhood

A

Usually starts with bowel then urine training

18-24 months; start when psychological able to: before leads to frustration

Skill needed: walking, stooping down to sit on the potty, have to stay dry for at least 2 hours;

Need to Sit for 2-3 minutes intermittently

Incentive charts (get treat when they go on the potty)

Daytime dryness starts before nighttime dryness

Major parental concern

Nurse Role:

Provide anticipatory guidance

Assist with toileting program

Discuss with parents their understanding of children attitude and readiness

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12
Q

Allergies: toddlerhood

A

Toddlerhood is when they begin

Show as hives (red wheals)

High risk foods (TEST QUESTIONS)

Nuts

Shellfish

Dairy (eggs + milk)

Gluten

Soy

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13
Q

Sleeping: toddlerhood

A

Need for sleep decreases: 12 hours a day; 1-2 naps a day

Schedules are helpful to avoid overfatigue

Bedtime rituals are very important; brush teeth, story, bath, need predictable

Night terrors:

Can develop

Recall a frightening dream

Often not awake completely

Usually falls back to sleep in 5- 10 minutes

Avoid awakening: speak softly

Will eventually grow out of night terror

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14
Q

Dental: toddler

A

All 20 baby teeth erupt by the end of toddlerhood

Brushing teeth is very important

Start visiting the dentist

Fluoride supplement if not in the water (controversial)

Prevent dental caries: bedtime bottle should be water only; no juice

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15
Q

Car Seats:

A

Proper installation of safety seat- best to have a certified care seat technician.

Laws vary from state to state

Rear facing until AT LEAST 2 yrs old, then forward facing with 5 point harness. Stay in seat with 5 point harness until as long as possible according to manufacturers guidelines for height and weight.

Transition to booster seat when outgrow manufacturers rec in terms of height and weight
Then Booster seat until 8-12 yrs AND 4’9”
Kids in back seat of car until at least age 13!! (airbag dangers!!)

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16
Q

Autism:

A

1 in 37 boys: 1 in 151 girls

Boys are 4x more likely to have autism

Most children are being diagnosed after 4; can be diagnosed starting at 2

Autism affects all ethnic and socioeconomic groups

Minority groups tend to be diagnosed later and less often

Early intervention affords best opportunity to support healthy development and deliver benefits throughout the lifetime

No medical detection for autism

Diagnosis:

Behavioral: inappropriate social interaction, poor eye contact, compulsive behavior, impulsivity, repetitive movement, self-harm, persistent repetitive of words/ actions

Developmental: learning disability or speech delay

Cognitive: intense interest of limited number of things or problem paying attention

Psychological: unaware of other emotions or depression

Lack of social smile

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17
Q

What is the most common way for a toddler to get injuried?

A

Climbing is most common

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18
Q

What temp should the water heater be set to for toddlers?

A

120- 125 degrees

19
Q

Reyes Syndrome:

A

Rare: can be extremely deadly

ASA can transfer vis breast milk

Aspirin no longer recommended for routine use in children: watch Pepto Bismol, Alka Seltzer: education parent to avoid this

Aspirin usage/ product that contain aspirin (acetyl salicylic acid) + a viral infection

Brain swelling + liver damage

Most often seen in children 4-12

Symptoms: vomiting irritablity, confusion, brain swelling, fatty liver and if untreated coma and death

20
Q

Immunizations: Pre school children

A

getting boosters

Dtap: 4th year
MMR: 4-6
Varicella: if they did not get

Concerns:
relgious
safety
importance of accurate information

21
Q

Erikson: Pre school Age:

A

Initiative vs guilt

encourage child to create and try new things
teach them to make mistakes do not make them bad,
allow childs ambition, abilites, idea, opinion

let them do things on own

22
Q

Lead posioning:

A

can cause irreversible brain damage

old paint, old toys, pottery

Prevention- teach parents about risks, encourage diet low in fat because

lead is retained in fat, encourage Vit C, calcium, and iron intake

Can cause neurological delays

Affects blood brain barrier

Cosmetic imports

Absorption is a lot easier

Developmental delays

Prevention: Handwashing, wash toys, see where toys are imported from, Run Cold Water: Older plumbing,

Poisoning:

No number is safe: 0 is what we want

Special Diet:

encourage diet low in fat because lead is retained in fat, encourage Vit C, calcium, and iron intake

23
Q

Vison: pre school aged:

A

Should approach 20/20 by 6 years of age
Possibility of developing amblyopia decreases
Depth and color vision becomes fully established
Visual capacity can deteriorate rather than improve, however
Early detection with Snellen Screening tests in school and well-child check-ups
Can use the Snellen now
Color blind:
Can be problematic in school because many cues depend on color recognition
Ishihara Test: used to test for color blindness

24
Q

Food allergies: Pre school

A

With increase in food choices, food allergies also emerge

Up to 8% of children have food allergies

I million preschoolers are affected and approx. 1/3 of these are life threatening allergies

High-risk allergens: milk, eggs, peanuts, tree nuts, soybeans, fish, shellfish, glutens, seeds

25
Q

Growth: Pre school

A

remains steady

4 pounds and 2 inches a year

26
Q

Milestones for 3 year olds:

A

Opens doors
Kicks ball, runs, jumps
Knows own name, gender and age
Describes action in picture books
Able to put on some clothing and shoes
Eats without assistance

27
Q

Milestones for 4 year olds:

A

Climbs ladder
Throws a ball overhand
Holds pencil
Asks why, when, how, and the meaning of words
Washes and dries hands – can brush teeth
Draws a person with two or three parts
Rides with training wheels

28
Q

Milestones for 5 year olds:

A

Names four or five colors
Can cut and paste
Knows address and telephone number
Prints some letters
Draws a person with head, body, arms and legs
Engages in make believe, dress-up, role playing

29
Q

6 year old Milestones:

A

Bounces a ball 4-6 times
Can skate and ride bike
Ties shoelaces
Understands right from left
Draws a person with 6 body parts with figure with clothing on

30
Q

Sleep for Pre school:

A

Sleep 8 – 12 hours/night
Often naps are not needed anymore
Pro-long bedtime routines
May become resistant to bedtime routine
Nightmares, sleep walking can continue
Night terrors become more intense

31
Q

Dental: Pre school

A

Primary teeth should all be in. Initial permanent teeth may begin to erupt by the end of pre-school years

Still need assisting brushing, flossing

May need fluoride supplements/sealants

Low-income families may not have resources for prevention

32
Q

Immunizations: school aged children

A

(late childhood/early adolescence): Parent and school nurse partners to ensure up to date-

Meningococcal vaccination (age 11 to 12)

Hepatitis B series, if not completed in early childhood

Human papilloma virus (HPV)

Varicella (if no history of chickenpox)

DTap (booster)

Annual Flu Shot

33
Q

Erikson: School Age children

A

Industry vs. inferior

Industry: success in personal, social + sense of self worth

Inferiority: continuous failure + no support of family

Task: full mastery of whatever child is doing

Self-perception- Self concept

34
Q

Asthma

A

Incidence- More rapid rate increase in preschool group than other ages

Inner city kids have higher rates of asthma: air quality

Biggest cause of missed school days

Inhaler twice a day: control inhaler + rescue inhaler for emergency: carry them all the time

Increase the diameter of the lungs

  Causes

Genetic predisposition, allergens, respiratory infections such as RSV as infant, pets, stress, exercise, MOLD/Moisture

Precipitants: infections, exercise, weather, stress

Exacerbation factors

Tobacco smoke, pollutants, allergens, water/moisture/mold!

35
Q

Vision: school aged children

A

Optimal capacity by age 7

Continue Snellen screening

Good peripheral vision + should know colors

  -myopia

Nearsightness: can’t see far away

  -astigmatism

2 eyes can’t focus: general blurriness

Glasses can correct this

35
Q

Growth: School Aged Children

A

BP values lower than adults, much slower growth rate than

 other stages (about 2 inches/yr, 4-6 lbs/yr), mature nervous system, good coordination  

 and balance, lose about 4 teeth/yr
36
Q

Illness: school aged Children

A

Common illnesses- URI, OM, Strep, gastroenteritis (stomach bug)

Strep (group A): can affect heart from not being treated (rheumatoid fever)

Sore throat, fever

Go on antibiotics: need to be on them for 24 hours.

Transmission occurs where there is close personal contact

36
Q

Sleep: school aged children

A
  • 8-12 hours needed
  • not napping anymore
  • Sleep walking:
  • immature CNS
              - more often in boys than girls: can happen with Enuresis 

          - rates drop with maturity  

           - ensure the child is safe, use gate if needed, sharp objects out of reach, fall risks
37
Q

Dental: school aged children

A

Tooth loss patterns: 4 teeth a year

Cavities: greatest common disease

Low-income family higher risk for cavities

Loss first tooth at 6

All teeth should be out by 13 (should have 28 teeth)

Can see eruption of wisdom teeth (17-22)

38
Q

Enuresis

A

loss of bladder control at night

Kids can outgrow this.

Boys (7%) higher risk

Primary: never had control at all

Secondary: accidents happen on sometimes

Bedwetting at least 1 time per month

Fluid intake, genetic, spinal cord development issue, bladder size, psychological issue (stress, family issues. Sexual abuse, new baby in family)

First thing to do: test for a UTI.

Limit fluid intake,

39
Q

Encopresis

A

involuntary passing of stool after age 4

Not link to psychological issue

Constipation linked: most common cause.

Not as large of an issue

40
Q

Obesity: school aged children

A

Overweight/obesity definition

Obesity: BMI >95th percentile for age/gender or BMI >30

Overweight: BMI >85th but <95th percentile

1/3 of children are overweight/obese

Factors:

Genetic

Environmental: use of food as reward; lack of physical activity, living conditions, financial constraints

Impact of sleep- inadequate sleep associated w/decreased activity

       Impact: health risks, low self-esteem, increased risk depression, bullying, ridicule  

                    by peers.

Surpasses alcohol and drugs as an issue

41
Q

What’s the relationship between being overweight and bone density?

A

Being overweight decreases bone density

Quality of bone is impacted: lower bone mass

NRSE 250 (4 decks)

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