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Nursing 304 > Exam 3 > Flashcards

Exam 3 Flashcards

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1
Q

health perception - health managment pattern of toddlers

A

little understanding of health
depend on caregivers for health management
health behaviors part of taught rituals
identify with behavior modeled by caregivers
-nutrition
-exercise
overall health dependent on parents’ preceptions and priorities

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2
Q

nutritional metabolic pattern of toddlers

A

ensure adequate iron intake
moderate amount of milk (low in Fe)
prevent dental caries: bedtime bottle only water
juice overconsumption common
appetite overconsumption is common
appetite decreased from decreased growth rate
-asses intake over 3 to 5 days; obesity is concern
meal time - toddlers often assert control
-opportunity to offer healthy, age-appropriate choices
-avoid overattention or punishment re food behavior

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3
Q

food allergies in toddler

A

becoming more prevalent - reason unclear
common: peanut and tree nuts, itching, swelling, throat tightness, wheezing
symptoms may present as child tries new foods

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4
Q

elimination pattern

A

major parental concern
emotion/physical readiness - usually 18 months of age or older
nurse provides anticipatory guidance to parents on
-developmental readiness of child
-parental attitudes and process of toilet training

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5
Q

activity-exercise pattern of toddlers

A

always busy and exploring
most waking hours at play
-exploring, imitating, creating rituals
-risk for injury, tantrums well known to cocur
-parallel play, side by side but independent play
-sharing and cooperation not until preschool age
-create safety net of rituals around daily routines
anticipatory guidance
-appropriate toys, opportunities for learning and social encounters, limit TV time

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6
Q

sleep-rest pattern in toddlers

A

need 12-13 hours a day ; one to two naps
-down from previous 16 per 24 hr period
schedules are helpful to avoid overfatigue
can be overtired but unable to sleep “cranky”
rituals are characteristic - nap and bedtime ritual
-chane in ritual can be upsetting
-security object helpful
firm and consistency in parenting when toddler tries to delay sleep (common behavior)

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7
Q

night terrors

A

normal, less frequent as child develops
not fully awake - cannot be aroused for minutes
instruct parent to speak soothingly, do not try to wake child
different from nightmares
falls back to sleep after 5-10 minutes
episodes become less frequent as child ages
typically do not recall episode in the morning

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8
Q

perceptual pattern

A

sensorimotor - moving into preoperational
egocentrism : vie4w world as relates to them
object permanence - solid understanding
language skills rapidly develop
-receptive skills greater than expressive
play imperative to learning often by repition
burgeoning curiosity - safety concern
“terrible twos”

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9
Q

hearing in toddlers

A

critical for language/speech
assessed at birth, can be tested during toddler, preschool yers
ottis media : leading cause of hearing loss in toddler
screening: visual-reinforcement audiometry, conditioned-play audiometry

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10
Q

autism spectrum disorder (ADS)

A

impaired social interactions, communications
significantly restricted activities and interest
no known cause or single treatment
prevalence 1 in 59 american children

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11
Q

taste and smell in toddlers

A

begin learning conditioned association between smell/taste; develop food aversions
culturally driven

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12
Q

vision in toddlers

A

amblyopia: diminished or loss of vision in one eye
brain favors normal eye
strabismus: deviation in line of vision
managment focused on making child use eye with reduced vision (lazy eye)
be alert to red flages of vision problems

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13
Q

red flags of vision problems

A

rubs eyes excessively
shuts one eye, tilts head, sideways gaze
difficulty with close vision
blinks, frowns, quints on viewing objects
holds book close to eyes
red, encrusted or swollen eyelids
inflamed or watery eyelids
recurrent styes

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14
Q

self perception and self concept pattern

A

erikson: autonomy vs doubt and shame
relinquish dependence on others
need to explore the world

physcially
relationships: says “NO” and has temper tantrums
experiences conflicting desires

guidance to parents
safe environment - promoting autonomy
preventing and dealing with temper tantrums

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15
Q

roles and relationship pattern

A

limited capability for relationship - egocentric
roles understood as they relate to child
roles understand as they relate to child
sibling rivalry common
ongoing negotion of roles
regression may be seen
parent must “remove reward” dont punish sibling or reward toddler

intate others and prefer others’ possessions
trauma can have long-lasting effects

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16
Q

child abuse

A

toddler years have greatest incidence of abuse
more likely if parents were abused or if turmoil or stress in family
be alert to warning signs of abuse
injuries may be difficult to distinguish from abuse
cultural practices may be mistake for abuse
abusive parents often hesitant to provide info
nurse required by law to report suspected abuse

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17
Q

warning signs of child abuse

A

parents delay in seeking medical help
incosistencies of hx of injury
injury incompatible with child’s capabilities
old unexplained fractures on x-ray
repeated dental fracture or head trauma
bruises limited to back surface - neck to knees
bare spots, borken hair

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18
Q

sexuality - reproductive pattern toddlers

A

genital exploratory ehavior and masturbation
normal developmental process
opportunity to learn about body
parents reaction is highly variable
nurse includes this subject when teaching about toilet training

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19
Q

coping - stress tolerance patern toddlers

A

temperament: individual’s style of emotional and behavioral response across situations
foundation for coping - children have unique temperament - different “models” exist
influenced by environmental characteristics
influences psychosocial adjustment
nurse can assist parents in recognizing temperament and developing management strategies

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20
Q

values - belief pattern toddlers

A

healthy behaviors reflect positive values/beliefs
values/beliefs are learned -needed for integrity
toddler at kohlberg stage 1 - will behave so as to avoid punishment - rules are absolute
developing mroality depends on interaction with parents
religious rituals/beliefs - what is right and wrong
deelopment facilitated by consistent behavioral expectations, reinforcing acceptable beahvior

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21
Q

environment - physical agents toddlers

A

accidents - toddlers at high risk
-appropriate supervision - accidents peak toddlerood
decerased over 20 years but mortality rate remains higher for black and native american children

structural hazards - toddlers like to explore
-baby proof the environment before toddlerhod
-falls; stairs, furniture, windows, playground equip
-inspect for hazards in unfamiliar environments
-gates, locks, gun-safety, large TVs

toys can be hazardous if not age-appropriate

sports
-frearm hazards, weight-lifting equipment
-wear bike helments

drowning: highest risk ages 1-3
-can drown in water if covers nose/mouth
-danger: pools, tubs, toilets, pails of water
-all wt is forward - hard to straighten up from pail H2O

burns - explore, pull - stove is hazardous
-hot liquids, electrical cors, fireplaces
-lower water heater to 120-125 F

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22
Q

Motor Vehicle injury

A

one of the leading causes of death 1-4 years
child safety seats - rear seat position preferred

can switch to forward at 2 years, use belted booster
travel in rear until 12

killed/injured in driveway by backing vehicle
-too small to be seen
-runs after departing vehicle

rear travel to avoid air bag injury until 65’ tall or 1 years

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23
Q

biological and chemical agents

A

potential of bioterrorism: talk about fears, appropriate precautions/response

poisoning - greatest risks age 1-2

-toddlers use mouth as way to explore environment
-medications, household products, plants, cigarettes, alcohol, cosmetics, toys
-suspected poisoning - contact poison control center
lead: primary prevention, screening lead-base paint, imported toys, furniture, older houses

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24
Q

day care

A

interview potential provider and observe setting
ask questions; ages, activites, accreditation, caretaker credentials, illness policy, nutrition, etc
make decision based on specific criteria
check references

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25
Q

USDHSS recommended 4 steps

A

get childcare list
do your homework
call providers
take the tour

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26
Q

culture and ethnicity in toddlers

A

toddlers shaped by family values/beliefs
toddlers do not question cultural values of family

refusal usually stems from need for autonomy
older children may question cultural values

healthcare practices are culturally influenced
provide culturally competent care

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27
Q

levels of policy making and health

A

legislation
-safety and injury prevention
-abuse and neglect protection
-assistance for handicapped children 0-3 years

state laws directed at child safety
-bicycle helments, car seats, define abuse
-nurses by law required to report sustpected abuse

economics
-toddler mortality/morbidity rates increase in poverty
-medicaid, uninsured, SCHIP prorgam

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28
Q

health services/delivery system

A

adequacy of system significantly affects health of toddler
routine assessment needed

growth/development
immunizations - CDC recommendations
discussion of developmental concerns
anticipatory guidance

vaccination remains an issue

no evidence to support vaccination promote autism

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29
Q

nursing application

A

provide education focused on the physical and developmental changes for toddler
teach health-promotion activites to toddlers
engage in screeing activites
promote routine health examinations and childhood immunization schedule
educate parents about resources available in the community - may free or low cost

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30
Q

preschool child

A

age 3-6 years - more developed body structure
ability to control and use body
increasing fluidity with language - closer to adults
major thrust: mastery of self as independent being - extends experience beyond family
in US many gein formal schooling starting with preschool vs kindergarten or 1st grade start
many healthy people 2030 goals aimed at preschooler

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31
Q

biology and genetics of preschoolers

A

protuberant abdomen of toddler disappears
pelvis begins to straighten; mild in-toeing may remain may show transient genu valgum (knock knee) and flat feet
growth 2kg (4lb) and 7 cm (2in) per year
skin matures; negligible sebum, eccrine glands functional, apocrine glands nonsecretory
tooth development: finish primary; start secondary tooth eruption
head <2 circumfrence change

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32
Q

preschoolers kidneys/gi

A

full maturity; voluntary control

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33
Q

preschoolers heart/lungs

A

increased capacity

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34
Q

preschoolers ears

A

change shape, less otitis media

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35
Q

preschoolers tosils and denoids

A

large

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36
Q

immune

A

boosted immune response

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37
Q

musculoskeletal/neuro

A

advances fine/gross motor skills, abdominal muscles develop

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38
Q

gender

A

boys; more illnesses; more accidents

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39
Q

race influences

A

health care
cultural preferences
dietary choices
health-promoting behaviors

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40
Q

genetics: most commonly diagnosed

A

cycstic fibrosis, duchenne muscular dystrophy, fragile x syndrome, william’s syndrome

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41
Q

preschool health perception - health managment pattern

A

body concepts
-curious about body of opposite sex
vauge/inacucurate ideas of internal body
anxiety: fear of mutilation, death

health beliefs and health management
-family influence - context for health beliefs
-upset ove rminor injuries; pain/illness is viewed as punishment
-contribute to health managment (brushing teeth)

health promotion - help failies –> healthy lifestyle

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42
Q

preschool nutritional - metabolic pattern

A

nutritional guidelines
-variety of foods: MyPlate replaces pyramid
-attention to iron, calcium take
-limit fat and sugar

behavioral/motor aspects
-food preferences/refusals - may cause conflicts
-learning utensil use
-helping with meal preperation

begin to eat meals away from home
- preschool/childcare center requirements

oral health
prevention: fluoride toothpaste, water flouridation, dental sealants
self care, population based and professional care needed

food allergies : increasing prevalence
-most develop before age 2
- high-risk allergens: milk, eggs, peanuts
-allergy prevention, exposure prevention, action plan

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43
Q

preschoolers elimation pattern

A

toilet traning: developmental milestone
-must be developmentally ready
-as skills develop they insist on performing this skill independently

supervise washing hands, flushing toilet

soiling
-handle in gentle / encouraging way
- preschooler responsible for changing clothes

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44
Q

preschoolers activity - exercise pattern

A

play - engage in more interactive play
primary activity for the preschooler
important role social/physiological development
play reveals child’s reality and perceptions
promotes problem solving, creativity, collaboration
toys chosen for age appropriateness

imitation play - mimic others - usually older
window into social competency
-fantasy
-imaginary companion, imaginary scenario

time orientation
-idea of past/future
-enjoy planning for family activities

tv and media
-limit time
disengages mind -less learning
-less active lifestyle - obesity

socialization via group activites
requires outlets for high energy

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45
Q

preschoolers sleep rest pattern

A

8-12 hrs/night; nap or quiet time
bedtime ritual
-prolonged bedtime routines
-honor reasonable rituals
-be firm and consistent

sleep disturbanes
-night terrors vs nightmares
-night terros: not fully awake no recall of incident in am
-nightmares : frightening dreams can describe and recall
helping child understand “real” vs “pretend” stories/ideas - lessen nightmares

46
Q

cognitive - perceptual pattern of preschoolers

A

can internalize family rules; sense of time

piaget : preoperational stage
-ability to function symbolically with language
-concrete thought process
-egocentrism
-irreversibility
-transductive reasoning

imaginary friends
-controlled by child not a threat
-way to practice social interactions

47
Q

vision in preschoolers

A

amblyopia (infancy to age 4)

refractive errors
-myopia (near sighted) - elongated eyeball
-glasses always indicated

strabismus (crossed-eyed) - cover test

color blindness

detection vision problems: screening
-denver eye screening test - visual defects
-snellen E screening test - visual acuity
-ishihara’s test - color-blindness
-pupillary light reflex - heterotropia

48
Q

hearing in preschoolers

A

audiometry: screening; speech delays

49
Q

language in preschoolers

A

receptive/expressive skill development
speech maturation: issues of speech rhythm and fluency

50
Q

memory in preschoolers

A

affects language development, learning
enhanced by grouping iterms, verbally naming iterms, rehersal

51
Q

Autism Spectrum Disorder (ASD)

A

CDC identifies 1 in 68 children on spectrum
more common in boys (4-5 times)
prevalence increasing (NOT caused by vaccines)
genetically determined disorders - only rarely nongenetic factors
risk factors: atypical birth weight, low Apgar, hemolytic disease, juandice, respiratory distress, advanced parental age
screening tests available: modified checklist for autism in toddlers (M-chat)

52
Q

preschooler self-perception - self -concept pattern

A

self concept emerges from struggle for autonomy
-refined through taks-oriented and societally oriented experiences

erikson: initiative vs guilt
-sense of initiative: viagouours activity and active imagination
-parental role: promote initiative; nurtue ideas, encourage behaviors for positive self-concept

53
Q

preschooler roles and relationships pattern

A

expanding influences
-peers becoming increasingly significant
-gender expectations
-older siblings

social interaction
-play with peers - learn to negotiate “the rules”
-acquires readiness for group situations
-follow directions - recognize others’ rights
-demonstrate increasing independence

parental divorce
-disruption in family relationships
-regression, confusion, irritability common response
-need for closeness, patience, consistency

child abuse
-complex contributory factors
-family stressors important trigger
-primary and secondary prevention
-recognize sings - mandatory reporting

54
Q

preschoolers sexuality - reproductive pattern

A

gender identification
body image
-perception of sex organs
-curiousity about bodies/sexual functioning
-encourage addressing questions simply/factually
-resources: preschool recommended books
many good children’s books available as resource

55
Q

preschoolers coping -stress tolerance pattern

A

play approaches
-doll or puppet play
-mutual storytelling

coping
-similar coping mechanisms to toddler
-maturing coping skills: fewer tantrums
-more problem-solving abilities
-use of projection.fantasy
-controlling behavior
-gentle consistent adult direction recomended

56
Q

preschoolers values-beliefs pattern

A

lack fully developed conscience
-age 4-5 some internal controls

modeling and inductive explanations
-moving from specific to general

preschool typical behavior
-control behavior to retain parental love/approval
-express likes/dislikes, ask endless questions

death
-fascinated by life beginning/death concepts
-needs support, possible counseling, to cope with loss

57
Q

environmental processes

A

injuries : leading cause of death
-MVA: car seats; ride in back
-household furniture/tools/equipment
-firearm safety: child access protection

burns:
scald/direct flame burns
teach danger of matches, open flames, hot objects

drowning: swimming pool greatest risk
-fencing, flotation device, water survival, supervision

58
Q

mechanical forces

A

bikes
- age appropriate limits needed
- helmet: with brain transition from tricycle to bicycle

automobile-related risk
-teach proper street-crossing techniques
-supervision when crossing the street
-consistent and proper use of restraint devices in car
-forward facing car seat with 5 point harness
-transition to booster seat when Ht and Wt indicated

59
Q

biological agents

A

boosters
-DTaP - fourth year
-MMR: between 4-6

immunization concerns
-religious
-safety of immunizations
-importance of accurate information

additional considerations
-new and combined vaccines
-under-vaccination, “catch-up” schedules

60
Q

chemical agents

A

factors impacting risk exposure
lead: folk remedies, old paint, pottery
poisonings : poison control number
-more than half occur in children <6 years old
-teach children about poisons
-solids: pills, vitmans, aspirin, lipstick
-liquids: cleaning products, fuel, alcohol
-sprays: furniture polish, oven cleaner
-invisibles: carbon monoxide, space heater fumes

61
Q

cancers in preschool children

A

acute lymphocytic leukemia
-most common; incidence rises ages 2-5

wilms’ tumor < age 5
-correlated with congenital malformations

retinoblastoma : <age 5; genetic mutations

neuroblastoma < age 2
-sympathetic nervous system; half of cases in children

nurses role
-identify significant history/physical finding; secondary prevention, support to child/family

62
Q

asthma in preschoolers

A

incidence
-more rapid rate increase than other ages
-higher in black and hispanic populations

causes
-genetic predisposition, allergens
-precipitants: infections, exercise, weather, stress

exacerbation factors:
-tobacco smoke pollutants allergens
-poverty contributes significantly to disability and death
-dust mite, pet/rodent, dander, cockroach particles

63
Q

determinants of health in preschoolers

A

social factors and environment:
-variance in degree, type of outside contact
-preschool: wider social contacts; skill development for group interaction

culture and ethnicity:
notice differences in cultural practice
socialization to ethnic differences
family culture may differ from playmates _> confusion

64
Q

levels of policy making

A

health care delivery system
-recommendations for preventive care
-early and periodic screening, diagnosis and treatment (EPSDT) - medicaid program
Affordable care act ensures health coverage
CHIP programs guarentee coverage for all children
medicaid provides for one screening per year

65
Q

nursing application for preschoolers

A

preschoolers interested in tools/procedures
-explains the test in age-appropriate terminology
-expect child to cooperate for most of the visit
-play with stethoscope, otoscope, equipment

include preschooler in the history-taking
-direct questions about diet and health
-examples: tooth brushing, favorite activities, and friends

need parents close during injections

66
Q

overview of school aged child

A

entrance to kindergarten to beginning of asolescence 6-10 years of age
wide range of growth, development, and cognitive ability
growth is slower vs infancy and adolescence
motor skills perfected- cognitive abilities greatly increase - read,write, math
peer groups develop
increasing ability for self-care

67
Q

biology and genetics of school aged child

A

5-12 years: calm before storm body systems reach adult level function
overall slimmer appearance
thoracic muscles develop
elevated blood pressure - screen yearly
-ID and treatment prevents adult organ damage
-black and mexican american children at greater risk for organ damage
-prevalence : 5 out of 100 children

68
Q

growth in school aged children

A

physical growth: slower steadier pace
standardized growth charts but consider family height
alternating “spurts” and minimal growth
height: 5cm (2in) per year; weight 2-3kg (4.4-6.6 lb) per year
differ by race, gender, genetics
head growth slows until puberty
preadolescent growth spurt: earlier in girls than boys
menarche: occuring earlier releated to genetics, sufficient body fat - normal: age 11-15

69
Q

organ development - teeth in school aged children

A

tooth eruption: transistion form deciduous to permanent teeth; occurs earlier for girls - orthandontic care is common

lost in same order they initially erupted 4 teeth/year

potential for dental caries, peridontal disease, malocclusion

school sealant program reduce caries by 60% - in line with healthy people 2030 initiatives

70
Q

lymphoid tissue growth in school aged children

A

lymphoid tissue
-grows rapidly; stronger immune system
-enlarged tonsils are normal
-lymphoid tissue increases to 10 years then decrease
-children may have more lymphoid tissue than adults

71
Q

lung capacity and cardiovascular system in school aged children

A

increase proportionately with body size

72
Q

motor skills in school aged children

A

maturated nervous system by age 7-8 brain heisphere articulation - more control
lengthening long bones - risk fracture, joint pain
muscle mass increase: potential for more complex fine and gross motor function
ossification - bone replaces cartilage
-occurs throughout childhood completed in adulthood
avoid excessive weight, backpacks
propersized shoes, desk, and chairs

73
Q

health perception and health management pattern of school aged children

A

health perception
-correlated with cognitive development
-stage is concrete operation: can grasp germ theory
-illness often viewed as punishment
-cultural influences: karma, “evil eye”, talismans

facilitating health promotion - healthy people 2030
-monitor/reinforce preventive practices
-parents to model health promoting behaviors
-teach healthy behaviors at home and school

74
Q

nutritional metabolic pattern of school aged children

A

nutritional guidlines include a well balanced diet: 1200-1800 kcal/day

factors influencing food intake
-access to food: lack of nutritious good, make own snacks, fast food issues: promotes obesity
influences - mass media, billboards, TV, peers, family
contemporary busy lifestyles: skip meals, eat out

nutritional education
-school programs: 35% low income are food insecure
-dietary guidelines

obesity : BMI >95th percentile for age/gender or BMI >30
overweight BMI> 85th but <95th percentile
-genetic and cultural issues contribute
-environmental: use of food as reward; lack of physical activity, living conditions, financial constraints
-postparandial hyperinsulinemia may contribute

hazards: HTN, BM, heart disease, sleep apnea

75
Q

how much vegetables and fruits should school aged children be eating

A

two or more portions of vegetables and fruit 3-4 cups daily

76
Q

psychosocial issues of obesity

A

low self esteem
psychosocial ridicule and discrimination

77
Q

management of obestity; multimodal intervention

A

reasonable caloric restriction
physical exercise
peer counseling
habit changes
few overweight children achieve or maintain weight loss

78
Q

elimination pattern

A

phyiscal ability: most have achieved full bowel/bladder control

79
Q

enuresis: involuntary urination

A

primary vs secondary
nocturnal vs diurnal enuresis
behavior management strategies; drug therapy

80
Q

encopresis - persistent involuntary passing of stool

A

common complicaition of chronic constipation
psychosocial component
bowel management program and counseling recommended
90% have history constipation & painful stool -> hold BM -> fecal impacation and rectal distension with leaking stool

81
Q

activity and exercise pattern in school aged children

A

critical time to acquire and foster activity behaviors

types of activites - tend to be naturally active
group: little league
individual: gymnastics, ballet
unorganized bike riding rollerblading

play activities
promotes social, personal, cognitive development
focus on fun connection to peers and family

82
Q

sleep-rest pattern in school aged children

A

8-12 hours of sleep/night
fewer difficulties with going to bed
sleeping arrangments
-culturally influenced : own bed vs bed sharing

sleep disturbances
-most outgrow with CNS maturation
-sleepwalking and sleep talking
-disorder of arousal: immaturity of nervous system
-consider safety, relaxation techniques, sleep preparation consistency

83
Q

cognitive perceptual pattern of school aged children

A

piaget: concrete operations stage
-learn by manipulating concrete objects
-lack of abstract thinking
-less egocentric - consider others’ views
expanded conceptual understanding
-conservation of substance
-time

major operation: classifying and ordering
example: can separate beads by color and/or material
requisite for reading and math

84
Q

vision for school aged children

A

vision: optimal function by age 6 or 7
-visual acuity (at least 20/30)

eye changes
-farsighted to normal vision
-vision screening needed to detect abnormalities

vision problems: 25% of school children
-myopia (nearsightedness)
-astigmatism (uneven focusin)
-correcting vision promotes more effective learning

85
Q

hearing and sensory perception of school aged children

A

hearing
auditory acuity nearly complete by 7 years
chronic serous otitis media - hearing deficit
periodic hearing evaluations - tympanograms
education on hearing protection

sensory perception
most learn via combo of patterns and sense
auditory learners - learn from audio
kinesthetic learners - learn by doing
visual learners - learn by seeing

increasing ability to differentiate detail- needed to read

86
Q

language and memory of school aged children

A

language - rapid development during school years
capacity to imitate sounds
complex sentences; multiple meanings
reading: letter and sound recognition; combos to form words
handwriting skills - hand-eye coordination

memory - improved ability
-organizing, classifying, labeling facilities retention

87
Q

intelligence of school aged children

A

debate: intelligence quotient (IQ)

traditional IQ test short comings
-don’t test all forms of intelligence
-culturally insensitive
-may measure achievement vs ability

environmental factors affect achievement
nutrition, sociocultural, environmental stimuli
programs: WIC, head start

88
Q

learning disabilities

A

14% age 6-17 have learning disability
attention-deficit/hyperactivity disorder (ADHD)
difficult to assess
treatment controversial: behavior mangement, counseling, nutrition, medication

89
Q

nurses role with learning disabilities

A

includes detection, referral, collaboration on plan, counseling, liason with family, socialization needs

90
Q

legislation relative to learning disabilities

A

individual with disabilities educaation act of 1997
section 504 of rehabilitation act of 1973

91
Q

diagnostic criteria for attention deficit -hyperactivity disorder

A

a disturbance of at least 6 months exists during which at least six of the criteria for either inattentive behavior or hyperactivity-impulsivity behavior are met

some inattentive or hyperactive-impulsive symptoms that caused impairment existed before age 7 years

some impairment for the symptoms exists in two or more settings

clear evidence of clinically significant impairment exists in social or academic functioning

92
Q

self perception and self concept pattern in school aged children

A

erikson: industry vs inferiority
major task: mastery of whatever the child is doing
develops sense of industry and avoids inferiority
sense of industry: success in personal/social tasks
sense of inferiority: occurs with repeated failures

self concept develops over time
-self esteem sense of control and body concept

93
Q

roles and relationships pattern in school aged children

A

family environment provides sense of security
increasing independence and maturity
-begin to reduce parental authority/structure
-broaden interests outside home (clubs, sports, gangs)
-more responsibility in home and community
(pets, chores, earn allowances)

learn socially accepted behaviors
limit setting - discipline
nonviolent resolutions to conflict
behavioral contracts

strategies
positive reinforcement effective limit setting
punishment - negative reinforcement
-greater use in lower socioeconomic class parents
-temporarily stops behavior but only until repeated behavior is not caught

94
Q

child abuse in school aged children

A

physical, sexual, or emotional exploitation and/or neglect
increased of child repeating cycle
may occur with or without recognized risk factors
consider cultural factors in detecting abuse
nurses are mandated to report
sexual abuse - becoming more common but hidden
-abuser typically known by child; often authority figure
-males report less often but more negative effects

95
Q

sexuality-reproductive pattern in school aged children

A

strong identification with parent of same gender
-affects concepts of role and self-concept

desire for knowledge of sexual function
-exploration of others’ sexual organs or strong attachment
-desire for privacy - discuss sexuality with peers

sex ed

96
Q

coping and stress tolerance pattern in school aged children

A

childhood stresses: multiple new stressors
-school expectations
-peer relationships
-cultural differences
-bullying

may respond to stress with negative behavior
coping strategies: buffer stressful events
very stressful situations may need referral, counseling

97
Q

coping and stress tolerance pattern in school aged children

A

childhood stresses: multiple new stressors
-school expectations
-peer relationships
-cultural differences
-bullying

may respond to stress with negative behavior
coping strategies: buffer stressful events
very stressful situations may need referral, counselingd

98
Q

divorce in school aged children

A

stressful - after affects may result in juvenile behavior problems or require counseling
school: role of advocate for child

99
Q

depression in school aged children

A

somatization: transfer of feelings to physical problems
depression: symptoms include anorexia, sleeplessness, lethargy, changed affect, aggressive behavior, crying, withdrawal - 2-3%
treatment: individual and family counseling, medication

100
Q

values and beliefs pattern of school aged children

A

kohlbergs theory: decisions on moral development
younger school age: preconventional
- moral behavior based on self-interest
older school age: conventional
- concern about group interests/values

moral behavior problems
-lying stealing, cheating
-comon developmental behaviors
-guidance needed to choose more socially acceptable ways to cope with stressors

101
Q

environmental processes: accidents`

A

accidents leading cause of death for children > 1 year
environmental factors
-seasonal
-SES (physical environment, access dangers)
-social environment - family stress, playmates

drowning
-fewer incidents than younger children - racial differences
-prevention: water safety

heavy backpacks
-common with school aged children
-associates with musculoskelertal and neuroproblems

burns
firearms
sports and recreation

102
Q

mechanical forces

A

motor vehicles
- car dafety (age appropriate)
-no requirement for seat belts in buses
-pedestrian-car accidents

bicycles, motorized skateboards, and all terrain vehicles (ATVs) - safely helmets needed
-rollerblades, skateboards, skate scooters - more severe than pedestrian injuries
-more boys than girls injured
-AAP reccomends 16 yo

103
Q

biological agents

A

fewer infections than preschool child - common
-upper respiratory infections (viral)
-streptococcal infection, otitis media (bacterial)
-gastroenteritis (viral)
-scabies, pediculosis and lice

immunization
-meningoccoccal vaccination (11-12)
-hep B serires
-human papilloma virus (HPV)
-varicella (if not history of chickenpox)
-covid 19 approved for children 12 yrs and older

104
Q

chemical agents in school aged children

A

food additives
drugs
-alcohol
-inhalants
-tobacco exposure/smoking
-experimentation with ilicit drugs

pollution
lead exposure: clothes soil pipes older homes
asthma higher rates in cities
chemicals for insects/weed control

105
Q

radiological agents

A

xray exposure
-natural and human made ionizing radiation
-risk of breast and thyroid cancer, leukemia

cancer
-most common types: leukemia, cancers of brain/nervous system, lymphomas
-may be cured: potential for later health effects
-nurses roles physocial/emotional support; assists in meeting goals

106
Q

determinants of health in school aged children

A

community and work
peers - strongest relationship outside family
other adults - influential role models
working parents - after school care
latchkey children - left alone until parents return (work)

culture and ethnicity
attitude toward racial differences develops
TV video computer challenges
-violent images, sedentary activity, internet, dangers
-need to limit screen time

107
Q

levels of policy making : legislation

A

public law 94-142 education for all handicapped children act: individualized educatoin plan (IEP)
no child left behind (2001) - aims to improve the disadvantaged

108
Q

levels of polciy making : economics

A

poverty - 18% of children below poverty level
homeless depression developmental delay more disease

109
Q

levels of policy making: health care delivery system

A

state children’s health insurance program (SCHIP)
medicaid and ACA

110
Q

nursing interventions: assessment

A

well-child evaluations
learning disabilities

111
Q

nursing interventions: testing-screening

A

vision, hearing, scoliosis

112
Q

nursing interventions: health-promotion education

A

lifestyle choices
safety

Nursing 304 (2 decks)

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