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NRSG 206: OB > [Exam 3] Chapter 31 – Heath Supervision > Flashcards

[Exam 3] Chapter 31 – Heath Supervision Flashcards

1
Q

Principles of Health Supervision: What does this involve?

A

Providing services proactively with the goal of optimizing the child’s level of functioning

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2
Q

Principles of Health Supervision: What does Healh Supervision ensure?

A

That the child is growing and developing appropriately and it promotes the best possible health of the child by teaching parents about preventing injury

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3
Q

Principles of Health Supervision: Three components of health supervision?

A

Developmental surveillance and Screening

Injury and Disease Prevention

Health Promotion

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4
Q

Principles of Health Supervision - Wellness: Health supervision visit provides what?

A

Opportunity to maximize health promotion for child, fam, and community.

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5
Q

Principles of Health Supervision - Medical Home: What is a medical home?

A

An approach to care that builds a long-term and comprehensive relationship with the family.

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6
Q

Principles of Health Supervision - Medical Home: This continuing relationship promotes what?

A

Trust between the pediatric care team and family and leads to continuous, comprehensive, coordinated care

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7
Q

Principles of Health Supervision - Medical Home: How can this be effective?

A

Medical home must be accessible, family centered, culturally effective and community based. Integrated into childs world

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8
Q

Principles of Health Supervision - Medical Home: Characteristics of a medical home?

A

Care accessible in childs community

All insurance accepted

Family able to speak to physician when needed

Partnership based on mutual trust and respect.

Coordinated care with other care providers.

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9
Q

Principles of Health Supervision - Medical Home: Provides continuity of care for what age group

A

From infancy through adolescence

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10
Q

Principles of Health Supervision - Partnerships: How can nurse become effective here?

A

Must offer commitment and develop an ongoing partnership with the child, family, and community. Allows for mutual goal setting, marshalling of resources, and development of health practices

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11
Q

Principles of Health Supervision - Partnerships: Parents role for infant?

A

Family is the surrogate for the child in the partnership

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12
Q

Principles of Health Supervision - Partnerships: What does a partnership between nurse and child allow for?

A

For the child to take increasing responsibility for his or her personal health and optimizes health promotion

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13
Q

Principles of Health Supervision - Partnerships: Why must helath care community involve the family

A

To have significant impact on childs health

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14
Q

Principles of Health Supervision - Partnerships: How can nurse strengthen the partnership between family and health care community?

A

By recognizing the families health practices, addressing their health issues, and strengthening their skills.

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15
Q

Principles of Health Supervision - Partnerships: Nurse can learn about the family dynamic by observing the family for behavioral clues that include?

A

Does the parent make eye contact with infant?

Does parent anticipate infants needs?

Are parents effective when dealing with toddlers temper tantrum?

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16
Q

Principles of Health Supervision - Partnerships: How can nurse benefit from input from community partners?

A

Nurse can perform an assessment of the communities needs. Then provides foundation for development of community-based promotion programs

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17
Q

Special Issues in Health Supervision: Special issues include?

A

Cultural influences, community influences, health supervision of chronically ill and internationally adoted child

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18
Q

Special Issues in Health Supervision - Cultural Influences: Successful interactiosn results when?

A

Nurse is aware of beliefs and interactive styles that are often present in members of a specific culture

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19
Q

Special Issues in Health Supervision - Cultural Influences: Optimal wellness for child can be met how?

A

Nurse and family negotiate a mutually acceptable plan of care. Must balance cultural beliefs and practices of family with those of health care establishment.

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20
Q

Special Issues in Health Supervision - Cultural Influences: Most health promotion and disease prevention strategies in US have what kind of orientation?

A

Future-based orientation, and view the child as an active and controlling agent in their own health

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21
Q

Special Issues in Health Supervision - Cultural Influences: The problems with cultures is they focus on what type of orientation?

A

Present-based orientation. They are more concenred about what is going on now.

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22
Q

Special Issues in Health Supervision - Cultural Influences: How are health care activites performed on a present-based orientation?

A

Health promotion activites need shorter-term goals and outcomes to be useful

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23
Q

Special Issues in Health Supervision - Cultural Influences: How will children with a fatalistic world view their actions?

A

As ineffective. May feel that a god figure or supernatural forces control their fate and that health is a gift to be appreciated.

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24
Q

Special Issues in Health Supervision - Community Influences: If home and access to medical care are close, what barriers are reduced?

A

Lack of transport, expense of travel, and time away from the parents workplace reduced

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25
Q

Special Issues in Health Supervision - Community Influences: Having medical home within community facilitates bonds between?

A

Health team and schools, churches, and support services and agencies.

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26
Q

Special Issues in Health Supervision - Community Influences: What may a community assessment reveal?

A

Problems that are causing or contributing to the child’s helath problems.

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27
Q

Special Issues in Health Supervision - Community Influences: What can a deteriorating infrastructure contribute to?

A

Decreased access to care and increased risk of injury or illness

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28
Q

Special Issues in Health Supervision - Community Influences: Poverty linked to what?

A

Low birthweight and premature birth

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29
Q

Health Supervision and Child With Chronic Illness: What do assessments determine here?

A

The frequency of visits and types of interventions needed

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30
Q

Health Supervision and Child With Chronic Illness: What enhances qualitiy of life and health of these children?

A

Coordination of speciality care, community agencies, and family support network

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31
Q

Health Supervision and Child With Chronic Illness: Comprehensive health supervision includes what?

A

Health insurance coverage

Transport

Financial Stressors

Family Coping

Schools Response to Chronic Illness

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32
Q

Health Supervision and Child Adopted Internationally: Health supervision of these children must include what?

A

Comprehensive screening for infectious diseases, disorders of growth, along with vision, and any additional testing needed

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33
Q

Health Supervision and Child Adopted Internationally: When is screening recommended?

A

Within the first few weeks of child’s arrival to US

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34
Q

Health Supervision and Child Adopted Internationally: What is a common problem with these children?

A

Intestinal parasites, with children being symptom free

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35
Q

Health Supervision and Child Adopted Internationally: What universal screening performed?

A

Hep B/C/A, Varicella Virus, HIV, Syphillis, and TB

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36
Q

Components of Health Supervision: When are health supervision visits for children recommended?

A

Birth and 1st Wk Life

2/4/6/12 Months

15/18/24 Months

30 Months

Yearly until 21

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37
Q

Components of Health Supervision: Each health supervision visit includes?

A

History and Physical Assessment

Developmental/Beahvioral Assessment

Sensory Screening

Approrpriate At-Risk sCreening

Immunizations

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38
Q

Components of Health Supervision - Developmental Surveillance and Screening: What is this?

A

An ongoing collection of skilled observations made over time during health care visitns

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39
Q

Components of Health Supervision - Developmental Surveillance and Screening: Components of this includes?

A

Nothing and adressing parental concerns

Obtaining a developmental hx

Making accurate observations

Consulting with relevant professionals

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40
Q

Components of Health Supervision - Developmental Surveillance and Screening: What are developmental screenings?

A

Brief assessment procedures that identify children who warrant more intensive assessment and testing

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41
Q

Components of Health Supervision - Developmental Surveillance and Screening: Data collection for developmental survillence of infants and young children performed how?

A

Through developmental questionnaires, physician observations, and a thorough physical exam

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42
Q

Components of Health Supervision - Developmental Surveillance and Screening: How to gain input into child’s emotional and social development?

A

Input from teachers, coaches, and other adults

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43
Q

Components of Health Supervision - Developmental Surveillance and Screening: What to do when developmental delay suspected?

A

Frequent developmental surveillance warranted. Re-emphasize parental roles.

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44
Q

Components of Health Supervision - Developmental Surveillance and Screening: Some factors that place infant/toddler at risk for developmental delay?

A

Birthweight < 1.5 kg

Gestational age < 33 years

CNS Abnormality

Hyperbilirubinemia

Kernicterus

Ssupected sensory impairment

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45
Q

Components of Health Supervision - Developmental Surveillance and Screening: Additional data that can be used to determine school-age child’s developmental level includes

A

handwriting samples, ability to draw, school performance, and social skills

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46
Q

Components of Health Supervision - Developmental Surveillance and Screening: When should screening tests be performed for autism?

A

At 18 and 24 months

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47
Q

Components of Health Supervision - Developmental Surveillance and Screening: When should risk assessment for alcohol and drug use be performed?

A

At every visit from 11-21 years

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48
Q

Components of Health Supervision - Injury/Disease Prevention: What is disease prevention?

A

Interventions performed to protect child from disease or to identify it at an early stage and lessen its consequences.

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49
Q

Components of Health Supervision - Injury/Disease Prevention: How are these interventions determined?

A

By the results of nurses assessment, nationally accepted practice guidelines, and the families goals

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50
Q

Components of Health Supervision - Injury/Disease Prevention: Components of disease prevention includes?

A

Screening tests and immunizations

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51
Q

Components of Health Supervision - Injury/Disease Prevention: Injury prevention primarily accomplished how?

A

Through education, anticipatory guideance, and physical changes in the environment.

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52
Q

Injury/Disease Prevention - Screening Tests: What are screening tests?

A

Procedures or lab analyses used to identify children with a certain condition. Done to ensure no disorder msised.

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53
Q

Injury/Disease Prevention - Screening Tests: What is a risk assessment?

A

Performed by the physician or nuse practitioner in conjunction with the child and includes objects as well as subjective data to determine likelihodo that child will develop condition

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54
Q

Injury/Disease Prevention - Screening Tests: What is universal screening?

A

Entire population is screened regardless of childs individual risk

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55
Q

Injury/Disease Prevention - Screening Tests: What is selective screening?

A

Done when a risk assesment indicates the child has one or more risk factors of the disorder

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56
Q

Injury/Disease Prevention - Screening Tests: How to increase cooperation from young children during screenings?

A

Set up reward ssytem. Such as stamping back of childs hand with smiley face or making an eye cover by placing two sticks back to back over tongue blade

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57
Q

Injury/Disease Prevention - Screening Tests and Metabolic Screening: What do all states currently require ?

A

Newborn screening for 26 health conditions. Some screen for over 50 disorders.

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58
Q

Injury/Disease Prevention - Screening Tests and Metabolic Screening: Amino acid metabolism disorders?

A

PKU, Maple Syrup Urine Disease, Homocystinuria, Citrullinemia, Trysosinemia Type I

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59
Q

Injury/Disease Prevention - Screening Tests and Metabolic Screening: Hemoglobinopathies metabolism disorders?

A

Sickle cell anemia, HBS Disease

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60
Q

Injury/Disease Prevention - Screening Tests and Metabolic Screening: What should nurse confirm during initial health supervision visit?

A

That newborn metabolic screening was performed prior to discharge from birting unit. If not, perform at that visit.

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61
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: When should screening be done?

A

Before discharge from birthing unit, or by 1 month of age.

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62
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: Screening for hearing loss in older children begins with what?

A

History from the primary caregivers. If problems noted, audiometry performed

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63
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What is the whisper test?

A

Easy to perform but requires a quiet room that is away from distractions

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64
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What are the Weber and Rinne tests?

A

Typically performed togetehr and can be used to screen for sensoineural and conductive hearing loss

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65
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: Universal hearing screening with objective testing recommended when?

A

At ages 4.5.6.8, and 10.

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66
Q

Injury/Disease Prevention - Screening Tests and Vision Screening: When is this performed?

A

At every scheduled health supervision visit

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67
Q

Injury/Disease Prevention - Screening Tests and Vision Screening: Screening procedure for children younger than 3?

A

Involves evaluating ability to fixate on and follow objects

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68
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What does Auditory Brainstem Response (ABR)do??

A

Measures electroencephalographic waves, electrodes placed on forehead and click sitmulus delivered by earphonesq

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69
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What is the Otacoustin Emissions?

A

Machine produces clicks that sitmulate cilia in cochlea, and measures the response

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70
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What is visual reinforcement audiometry?

A

Visual reward linked to a tone signal. Child looks for visual reward in response to the tone. Reward activtated, reinforcing the response

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71
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What is Tympanometry?

A

Measures tympanic membrane mobility and determines middle ear pressure

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72
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What is conditioned playa udiometry?

A

Similar to VRA, except uses listening games. Does listening game at tone and receives social reward

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73
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What is Pure-Tone (Conventional) Audiometry?

A

Measures hearing acuity through range of frequencies and intensities. Wears headphones, soundproof room

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74
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What is whisper test?

A

One ear occluded. Exainer stands behind child and whispers a word. Child must accurately repeat the word

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75
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What is the weber test?

A

Place a vibrating tube form in moddle of top of head. Ask if sound is in one ear or both ears. Sound should be heard in both

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76
Q

Injury/Disease Prevention - Screening Tests and Hearing Screening: What is Rinne test?

A

Place a vibrating tuning fork on mastoid process to assess bone conduction. Child signals when sound gone. Next place outside ear in air. Air should be twice as long

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77
Q

Injury/Disease Prevention - Screening Tests and Vision Screening: What kind of objects should be used for those younger than 6 months?

A

Use objects with black-and-white patterns. More attuned to high-conrast patterns than colors

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78
Q

Injury/Disease Prevention - Screening Tests and Vision Screening: After 3, what screening charts available?

A

Tumbling “e” and Allen figures

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79
Q

Injury/Disease Prevention - Screening Tests and Vision Screening: What screening chart used by 5-6 ?

A

A traditional snellen chart for vision screening

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80
Q

Injury/Disease Prevention - Screening Tests and Vision Screening: When should screenings be performed?

A

When children are alert, as faitgue and lack of interect can mimic poor vision

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81
Q

Injury/Disease Prevention - Screening Tests and Vision Screening: When using vision screening hart, what simple steps need to be followed?

A

Place chart at childs eye level

Make sure sufficient lighting

Make on floor (10-20 ft away) form chart

Have child read each line with one eye covered.

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82
Q

Injury/Disease Prevention - Screening Tests and Vision Screening: What is the Tumbling E chart?

A

Appropriate for children who don’t know alphabet, but can follow instructions to indiciate directions of arms of the letter “e”

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83
Q

Injury/Disease Prevention - Screening Tests and Iron-Deficiency Anemia Screening: What can iron-deficiency cause?

A

Cognitive and motor deficits resulting in developmental and behavioral disturbances.

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84
Q

Injury/Disease Prevention - Screening Tests and Vision Screening: What is the Ishihara tesst?

A

Screens for colro disscriminiation (numbers composed of dots)

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85
Q

Injury/Disease Prevention - Screening Tests and Iron-Deficiency Anemia Screening: when should these screenings occur?

A

At 4,15,18 and 30 months and then anually.

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86
Q

Injury/Disease Prevention - Screening Tests and Lead Screenings: Blood lead levels should go as high as what?

A

5 ug

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87
Q

Injury/Disease Prevention - Screening Tests and Lead Screenings: What problems can this lead to?

A

Headaches, stomach pain, inattentiveness, irritability, hyperactivity, decreased bone/muscle growth and poor muscle coordination

88
Q

Injury/Disease Prevention - Screening Tests and Lead Screenings: What age of kids does this mostly affect?

A

Those who are younger than 6 years because they are constantly placing things in their mouth

89
Q

Injury/Disease Prevention - Screening Tests and Lead Screenings:What harm can low blood lead levels cause?

A

iq deficits, attention-related behavior problems, and poor academic achievement

90
Q

Injury/Disease Prevention - Screening Tests and Lead Screenings:What these problems be reversed?

A

No

91
Q

Injury/Disease Prevention - Screening Tests and Lead Screenings:What does a healthy diet include that can absorb lead?

A

Calcium, iron, and vitamin c

92
Q

Injury/Disease Prevention - Screening Tests and Lead Screenings:When should screenings occur?

A

6,9,12 months

18,24 months

3,4,5,6 years!

93
Q

Injury/Disease Prevention - Screening Tests and Lead Screenings: Many cases of elevated blood levels has been reported in what type of children

A

Those who are immigrants, refugees or international adoptees

94
Q

Injury/Disease Prevention - Screening Tests and Hypertension Screenings:What does universal hypertension screening begin?

A

At 3 years old.

95
Q

Injury/Disease Prevention - Screening Tests and Hypertension Screenings: Risk factors for systemic hypertension?

A

Preterm birth, very low birthweight, renal disease, organ transplant, or heart disease

96
Q

Injury/Disease Prevention - Screening Tests and Hypertension Screenings: What is used to deemine specific systolic and diastolic blood pressure?

A

Gender and age

97
Q

Injury/Disease Prevention - Screening Tests and Hypertension Screenings: Requirements for normal BP?

A

<90th percentile for sex, age, and height

98
Q

Injury/Disease Prevention - Screening Tests and Hypertension Screenings: Requirements for prehypertension?

A

Bp at or above 120/80 but < 95th percentile for sex, age, and height

99
Q

Injury/Disease Prevention - Screening Tests and Hypertension Screenings: Requirements for Stage 1 Hypertension?

A

> 95 perentile and < 99th percentile + 5 mmHg for sex age, height

100
Q

Injury/Disease Prevention - Screening Tests and Hypertension Screenings: Requirements for Stage 2 Hypertension?

A

> 99th percentile + 5 mm Hg for sex, age, height

101
Q

Injury/Disease Prevention - Screening Tests and Hyperlipidemia Screenings: When do screenings occur?

A

Between 9-11 years

Again between 18-21 years

102
Q

Injury/Disease Prevention - Screening Tests and Hyperlipidemia Screenings: When are risk assessment screenings performed?

A

24 months

4,6,8 , and 12-17 years of age

103
Q

Injury/Disease Prevention - Screening Tests and Hyperlipidemia Screenings: What problem can this cause?

A

Atherosclerosis, and is a link between high lipid levels and development of these lesions

104
Q

Injury/Disease Prevention - Immunizations and Principles of Immunization: Foreign materials are called what

A

Antigen

105
Q

Injury/Disease Prevention - Immunizations and Principles of Immunization: How does body respond to antigens?

A

By producing antibodies or directing special cells to destroy/remove antigen

106
Q

Injury/Disease Prevention - Immunizations and Principles of Immunization: What is immunity?

A

Ability to destroy and remove a specific antigen from the body

107
Q

Injury/Disease Prevention - Immunizations and Principles of Immunization: What is passive immunity?

A

Produced when the immunoglobulins of one person are transferred to another. Lasts weeks or months.

108
Q

Injury/Disease Prevention - Immunizations and Principles of Immunization: What is active immunity?

A

Acquired when a persons own immune system generates immune response.

109
Q

Injury/Disease Prevention - Immunizations and Principles of Immunization: What are live attenuated vaccines?

A

Modified living organisms that are weakened. Can produce an immune response but does not produce the complications of an illness

110
Q

Injury/Disease Prevention - Immunizations and Principles of Immunization: What are killed vaccines?

A

Contain dead organisms. Incapable of reproducing but can produce immune response

111
Q

Injury/Disease Prevention - Immunizations and Principles of Immunization: What are toxoid vaccines?

A

Contain protein products produced by bacteria called toxins. Toxin is heat-treated to weaken its effect, but produces immune response

112
Q

Injury/Disease Prevention - Immunizations and Principles of Immunization: What are conjugate vacines?

A

Result of chemically linking the bacterial cell wall polysaccharide portions with proteins. Increases immune response

113
Q

Injury/Disease Prevention - Immunizations and Principles of Immunization: What are recombinant vaccines?

A

Enginnered organisms. Slide gene portion out of virus into gene of yeast cell, shows up on their surface

114
Q

Injury/Disease Prevention - Immunizations and Immunication Management: Which are given subcutaneously?

A

IPV, MMR, Varicella, and MPSV4

115
Q

Injury/Disease Prevention - Immunizations and Immunication Management: WHat is given intramuscular?

A

Tdap, Hep A/B

HiB

Influenza

PCV

HPV

MCV4

IPV

116
Q

Injury/Disease Prevention - Immunizations and Immunication Management: What should you ask parents when obtaining immunization history?

A

When and dwere did your child receive their last immunizations?

117
Q

Injury/Disease Prevention - Immunizations and Immunication Management: Some side effects of vacines?

A

Tenderness, redness, and swelling at side, and low-grade fever

118
Q

Injury/Disease Prevention - Immunizations and Immunication Management: What must be provided to parents before immunization is given?

A

Vaccine Information Statements . Inform parent about benefits and risks and discuss specific side effects that may occur

119
Q

Injury/Disease Prevention - Immunizations and Immunication Management: Any significant adverse event that ocurs after immunization should be reported to who

A

Vaccine Adverse Effect Reporting System

120
Q

Injury/Disease Prevention - Immunizations and Immunication Management: Documentation in child’s permanent record includes what?

A

Date of vaccine, name of vaccine.

Lot number/expiration

Manufectuer name, and date of expiration with route.

121
Q

Injury/Disease Prevention - Vaccine Descriptions: What are contraindications for withholding vaccines?

A

Conditions that justify withholding an immunization either permanently or temporarily.

122
Q

Injury/Disease Prevention - Vaccine Descriptions: Who should not receive live vaccines?

A

Children who are severely immunocompromised or women who are pregnant

123
Q

Injury/Disease Prevention - Vaccine Descriptions: What side effect from pertussis immunization would contraindicate further administration of this?

A

Encephalopathy without an identified cause withinn 7 days of immunization

124
Q

Injury/Disease Prevention - Vaccine Descriptions: Temporarily postponing vaccinations recommended for what?

A

Moderate-to-severe illness, immunosuppression, pregnancy, or recently received blood products

125
Q

Injury/Disease Prevention - Vaccine Descriptions and Diphteria, Tetanus, and Pertussis Vaccine: Vaccine used for those younger than 7 is?

A

DTaP.

126
Q

Injury/Disease Prevention - Vaccine Descriptions and Diphteria, Tetanus, and Pertussis Vaccine: What does DTaP contian?

A

diphtheria and tetanus toxoids and pertussis cell wall proteins

127
Q

Injury/Disease Prevention - Vaccine Descriptions and Diphteria, Tetanus, and Pertussis Vaccine: What is the Diphtheria and tetanus (DT) vaccine used?

A

For children younger than 7 who have contraindications to pertussis immunization

128
Q

Injury/Disease Prevention - Vaccine Descriptions and Diphteria, Tetanus, and Pertussis Vaccine: For those older than 7, what is given?

A

TdaP . Contains toxoids. Lowercase d designates lower dose of diphtheria toxoid

129
Q

Injury/Disease Prevention - Vaccine Descriptions and Diphteria, Tetanus, and Pertussis Vaccine: ACIP recommendeds that Tdap be used for who?

A

All tetanus boosters in older children (11-12 years) and adolescents

130
Q

Injury/Disease Prevention - Haemophilus Influenzae Type B Vaccine: What is this?

A

Bacterium that causes several life-threatening illnesses in children younger than 5 . Includes meningitis, epiglottis, adn septic arthritis

131
Q

Injury/Disease Prevention - Haemophilus Influenzae Type B Vaccine: What vaccine is used ehre?

A

H. Influenzae Type B Conjugate Vaccine (Hib)

132
Q

Injury/Disease Prevention - Haemophilus Influenzae Type B Vaccine: How many doses of Hib needed for infant?

A

2-3 doses needed for primary infant

133
Q

Injury/Disease Prevention - Haemophilus Influenzae Type B Vaccine: What is needed at 12-15 months?

A

A booster vaccine

134
Q

Injury/Disease Prevention - Haemophilus Influenzae Type B Vaccine: What happens if different brands are administred?

A

Than a total of three doses is necessary to complete primary series in infants

135
Q

Injury/Disease Prevention - Haemophilus Influenzae Type B Vaccine: Not routinely given to what age group?

A

Children 5 years or older, and contraindicated in those younger than 6 weks

136
Q

Injury/Disease Prevention - Polio Vaccine: What vaccine used here?

A

Inactived Polio Vaccine (IPV). Contains killed virus that poses no risk for acquiring disease.

137
Q

Injury/Disease Prevention - Measles, Mumps, and Rubella Vaccines: What vaccine is this?

A

Live attenuated virus combination vaccine. Given during childhood

138
Q

Injury/Disease Prevention - Measles, Mumps, and Rubella Vaccines: Can be given on same day as what

A

Other live attenuated virus vaccine like varicella vaccine (Var)

139
Q

Injury/Disease Prevention - Measles, Mumps, and Rubella Vaccines: What to do if vaccine is not given on the same day as another one?

A

Wait at least 28 days

140
Q

Injury/Disease Prevention - Measles, Mumps, and Rubella Vaccines: Why are anaphylactic reactions believed to be associated with?

A

Neomycin or gelatin components of the vaccine rather than the egg component.

141
Q

Injury/Disease Prevention - Measles, Mumps, and Rubella Vaccines: Is pregnancy a contraindication?

A

No

142
Q

Injury/Disease Prevention - Hep A Vaccine: What type of vaccine is this?

A

HepA is a inactivaed whole virus vaccine.

143
Q

Injury/Disease Prevention - Hep A Vaccine: How is Hep A spread?

A

Thorugh close physical contact and by eating/drinking contaminated food or water

144
Q

Injury/Disease Prevention - Hep A Vaccine: Why are young children more prone to get Hep A?

A

Because of their close contact with other children, inadequate hygiene practices, and tendency to place everything in their mouth

145
Q

Injury/Disease Prevention - Hep A Vaccine: What is this given?

A

At 12 months, followed by repeat ose in 6-12 months

146
Q

Injury/Disease Prevention - Hep B Vaccine: What type of vaccine is this?

A

Recombinant Vaccine

147
Q

Injury/Disease Prevention - Hep B Vaccine: Hep B can cause infection in what body part

A

The liver

148
Q

Injury/Disease Prevention - Hep B Vaccine: How is Hep B spread?

A

Through contact with blood and body fluids and can be spread from infected mother to newborn at birth

149
Q

Injury/Disease Prevention - Hep B Vaccine: When is this vaccine recommended?

A

Within first 12 hours, then at 1-2 months, than 6-18 months.

150
Q

Injury/Disease Prevention - Hep B Vaccine: How many doses needed when combination vaccine with Hep B used after birth?

A

4 doses

151
Q

Injury/Disease Prevention - Varicella Vaccine: What type of vaccine is this?

A

Live attenuated virus vaccine

152
Q

Injury/Disease Prevention - Varicella Vaccine: When should children get this?

A

all children aged 12-15 months who have not had varicella (chickenpox)

153
Q

Injury/Disease Prevention - Varicella Vaccine: Second dose recommened when

A

Betwen 4-6 years

154
Q

Injury/Disease Prevention - Varicella Vaccine: Provides effective postexposure prophylaxis when administered within how many days after exposure

A

Within 3-5 days

155
Q

Injury/Disease Prevention - Varicella Vaccine: Can this be combined with other live attenuated vaccines?

A

Yes, if given on the same day

156
Q

Injury/Disease Prevention - Varicella Vaccine: CAn mother be pregnant and receieve this?

A

Yes

157
Q

Injury/Disease Prevention - Pneumococcal Vaccine: Pneumococcus is most common cause of?

A

pneumonia, sepsis, meningitis, and ottis media in young children

158
Q

Injury/Disease Prevention - Pneumococcal Vaccine: What two versions are available?

A

PCV and PPSV

159
Q

Injury/Disease Prevention - Pneumococcal Vaccine: PCV contains how many strands of S. Pneumoniae?

A

13 strands

160
Q

Injury/Disease Prevention - Pneumococcal Vaccine: When is PCV given?

A

At two months, but can be given as early as six weeks.

161
Q

Injury/Disease Prevention - Pneumococcal Vaccine: How many strains does PPSV contain?

A

23 strains of S. Pneumoniae. Does not provoke immune response in those younger tan 2

162
Q

Injury/Disease Prevention - Pneumococcal Vaccine: When is PPSV given?

A

For children older than 2 years of age and are high risk for pneumococcal sepsis.

163
Q

Injury/Disease Prevention - Influenza Vaccine: Recommended yearly starting at what age

A

6 months or older

164
Q

Injury/Disease Prevention - Influenza Vaccine: For thise 6 months-8 years receiving for first time need how many doses?

A

2, separated by 4 weeks

165
Q

Injury/Disease Prevention - Influenza Vaccine: When is only one dose needed?

A

If the child has received two doses of seasonal influenza in previous years , along with 2009 H1N1 containing vaccine

166
Q

Injury/Disease Prevention - Influenza Vaccine: What did the CDC recommend starting in 2009/2010?

A

Vaccination against H1N1 influenza.

167
Q

Injury/Disease Prevention - Influenza Vaccine: What vaccines are available?

A

Live attenuated influenza vaccine (LAIV) and inactivated influenza vaccine (IIV)

168
Q

Injury/Disease Prevention - Influenza Vaccine: How is LAIV given?

A

Intranasally and indicated for healthy people between 2-49 years.

169
Q

Injury/Disease Prevention - Influenza Vaccine: Who should LAIV not be given to?

A

Should not be given to anyone who will be in contact with an immunsuppresed person requiring a protected environment. Also those with large nasal secretions

170
Q

Injury/Disease Prevention - Influenza Vaccine: Who is IIV suitable for?

A

Any eligible person aged 6 months or older. Not capable of causing disease and given by intramuscular injection

171
Q

Injury/Disease Prevention - Rotavirus Vaccine: What does this cause?

A

Severe gstroenteritis among young children.

172
Q

Injury/Disease Prevention - Rotavirus Vaccine: How does this spread?

A

Virus is shed in the stool and easily spreads via the fecal and oral route.

173
Q

Injury/Disease Prevention - Rotavirus Vaccine: Signs of this in child?

A

Severe, watery, crampy diarrhea quickly leads to dehydration in infected child.

174
Q

Injury/Disease Prevention - Rotavirus Vaccine: What is the vaccine?

A

Live vaccine targeting five strains of rotavirus.

175
Q

Injury/Disease Prevention - Rotavirus Vaccine: How is this given to infants?

A

Via oral route

176
Q

Injury/Disease Prevention - Rotavirus Vaccine: How many vaccines available?

A

Two

177
Q

Injury/Disease Prevention - Rotavirus Vaccine: What does Rotarix require ?

A

Two doses (at 2 and 4 months)

178
Q

Injury/Disease Prevention - Rotavirus Vaccine: What does RotaTeq require?

A

Three doses (at 2,4,6 months)

179
Q

Injury/Disease Prevention - Rotavirus Vaccine: Administration contraindicated in which children?

A

With SCID or a history of intussusception

180
Q

Injury/Disease Prevention - HPV Vaccine: What is HPV?

A

DNA tumor virus transmitted through direct skin-to-skin contact. Most commonly during vaginal or anal sex acts

181
Q

Injury/Disease Prevention - HPV Vaccine: What does HPV cause?

A

Genital warts and responsible for development of cancer..

182
Q

Injury/Disease Prevention - HPV Vaccine: HPV Vaccine is recommended for what age group?

A

Preadolescent girls and boys

183
Q

Injury/Disease Prevention - HPV Vaccine: Vaccines available?

A

Cervarix (HPV2) and Gardasil (HPV4)

184
Q

Injury/Disease Prevention - HPV Vaccine: How many doses?

A

Three

185
Q

Injury/Disease Prevention - HPV Vaccine: When is this given?

A

At 11 to 12 years of age over 6 month period

186
Q

Injury/Disease Prevention - HPV Vaccine: What specific vaccine used for females?

A

HPV2 or HPV4

187
Q

Injury/Disease Prevention - HPV Vaccine: What specific vaccine used for m ales?

A

HPV4

188
Q

Injury/Disease Prevention - Meningococcal Vaccine: Meningococcal disease may manifest as what?

A

Meningitis or bacteremic pneumonia. Caused by N. Meningitidis.

189
Q

Injury/Disease Prevention - Meningococcal Vaccine: How is disease spread?

A

Through direct contact or by air droplets.

190
Q

Injury/Disease Prevention - Meningococcal Vaccine: At what age is this given?

A

11-12 years for all previously unvaccinated children. With booster dose at age 16.

191
Q

Injury/Disease Prevention - Meningococcal Vaccine: Who is routine vaccination recommended for?

A

Children 2 months or older who are at an increased risk for the disease due to certain medical conditions.

192
Q

Injury/Disease Prevention - Meningococcal Vaccine: What group MAKES it so people have to get this?

A

First-year college students living in residence halls.

193
Q

Injury/Disease Prevention - Overcoming Barriers to Immunization: What does ProQuad vaccine contain?

A

Measles, mumps, rubella, and varicella

194
Q

Injury/Disease Prevention - Overcoming Barriers to Immunization: What does Comvax vaccine contain?

A

HepB - Hib

195
Q

Injury/Disease Prevention - Overcoming Barriers to Immunization: What does Pediarix vaccine contain?

A

DTaP - Hep B - IPV

196
Q

Injury/Disease Prevention - Overcoming Barriers to Immunization: What does Pentacel vaccine contain?

A

DTaP - IPV / Hib

197
Q

Injury/Disease Prevention - Overcoming Barriers to Immunization: What is the Vaccines for Children (VFC)??

A

Federally funded program in response to measles epidemic. Provides free vaccines to low-income and uninsured families through private physicians

198
Q

Injury/Disease Prevention - Overcoming Barriers to Immunization: Missed opportunities for immunization can be reduced by?

A

Maintaining centralized immunization record

Verifying immunization status every visit

Veerifying status of siblings

199
Q

Health Promotion: What doees this focus on?

A

Maintaining or enhancing the physical or mental health of children.

200
Q

Health Promotion: Principal compoentns of health promotion inclde?

A

Identifying risk factors for disease

Facilitating lfiestyle changes to eliminate or reduce those risk factors

Empowering children aat the individual and communicty level

201
Q

Health Promotion - Providing Anticipatory Guidance: What is this?

A

Primary prevention . Nurse partners with parents to create a “road map” to optimal health for the child

202
Q

Health Promotion - Providing Anticipatory Guidance: What does the “skeleton” of the guidance provided do?

A

Involves common childhood health problems. Nurse fleshed out that information using results of risk assessments and screening tests.

203
Q

Health Promotion - Promoting Oral Health Care: Optimal oral health can be achieved how?

A

Using anticipatory guideance abou tnonnutritive sucking habits, injury prevention, oral cancer prevention, adn tongue/lip piercing

204
Q

Health Promotion - Promoting Healthy Weight: Principle causes of obesity?

A

Unhealthy eating habits and decreased physical activity.

205
Q

Health Promotion - Promoting Healthy Weight: Focus on healthly weight promotion should be focused on what

A

health centered, not weight centered.

206
Q

Health Promotion - Promoting Healthy Weight: How can nurse begin here?

A

By directly advising the young child on healthy foods. Can teach about differences between healthy and unhealthy foods.

207
Q

Health Promotion - Promoting Personal Hygiene: First personal hygieen topic?

A

Hand washing

208
Q

Health Promotion - Promoting Personal Hygiene: How can nurse introduce handwashing to preschooler?

A

Using cartoon and games. Have the child sing “twinkle twinkle little star” while washing their hands.

209
Q

Health Promotion - Promoting Personal Hygiene: What is the “Glo-Germ” program?

A

Nontoxic substance that shines under a black light is placed on the children’s hands. They can follow how erms travel from object to object

210
Q

Health Promotion - Promoting Sun Exposure: What is a safe way to teach children about sun exposure?

A

Play outside only when your shadow is taller than you (before 10am and after 2pm)

211
Q

During the health interview, the mother of a 4-month-old says, “I’m not sure my baby is doing what he should be.” What is the nurse’s best response?

“I’ll be able to tell you more after I do his physical.”
“Fill out this developmental screening questionnaire and then I can let you know.”
“Tell me more about your concerns.”
“All mothers worry about their babies. I’m sure he’s doing well.”
A

“Tell me more about your concerns.”

212
Q

An infant boy is at your facility for his initial health supervision visit. He is 2 weeks old and responds to a bell during his examination. You review all his birth records and find no documentation that a newborn hearing screening was performed. What is the best action by the nurse?

Do nothing; responding to the bell proves the infant does not have a hearing deficit.
Schedule the infant immediately for newborn hearing screening.
Ask the mother to observe for signs that the infant is not hearing well.
Screen again with the bell at the infant’s 2-month health supervision visit.
A

Schedule the infant immediately for newborn hearing screening.

213
Q

A 15-month-old girl is having her first health supervision visit at your facility. Her mother has not brought a copy of the child’s immunization record but believes she is fully immunized: “She had immunizations 3 months ago at the local health department.” Which would be the best action by the nurse?

Ask the mother to bring the records to the 18-month health supervision visit.
Start the “catch-up” schedule because there are no immunization records.
Keep the child at the facility while the mother returns home for the records.
Call the local health department and verify the child’s immunization status.
A

Call the local health department and verify the child’s immunization status.

214
Q

A 4-year-old child is having a vision screening performed. Which screening chart would be best for determining the child’s visual acuity?

Snellen
Ishihara
Allen figures
CVTME
A

Allen Figures

215
Q

Which facility fulfills the characteristics of a medical home?

An urgent care center
A primary care pediatric practice
A mobile outreach immunization program
A dermatology practice
A

Primary care pediatric practice

NRSG 206: OB (42 decks)

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