FINAL REVIEW Flashcards
Major stressor of children ages 6 to 30 months
SEPARATION ANXIETY, also called anaclitic depression.
What are the 3 stages of separation anxiety
protest, despair, detachment
Describe the protest stage of separation anxiety
cries, screams, searches for parents, avoids strangers, may verbally/physically attack strangers,
Describe the despair stage of separation anxiety
inactive, withdrawn, depressed, regressive behavior, may refuse to eat/drink
Describe the detachment/denial stage of separation anxiety
increased interest, interacts with strangers, appears happy, difficult to reverse damaging psychological effects at this point
T/F: A toddler throwing a temper tantrum once the parent returns is a sign of abuse and should be investigated further
False. If the child is very “clingy” but seems unhappy, this is normal reaction to a child experiencing separation anxiety
T/F: It is normal for a child to be “hot and cold” towards parents after being discharged from a inpatient experience
True. Both young and older children may switch between aloofness towards parents, followed by clingy/demanding behavior towards parents.
Informed consent should include…
- The person must be capable of giving consent
- he or she must be over the age of 18
- must be considered competent (i.e., possess the mental capacity to make choices and understand their consequences) - The person must receive the information needed to make an intelligent decision.
- The person must act voluntarily, exercising freedom of choice without force, fraud, deceit, duress, or other forms of constraint or coercion.
T/F: One universal informed consent is the only paperwork required for a hospital stay
false. Written informed consent of the patient, parent, or legal guardian is usually required for medical or surgical treatment of a minor, including many diagnostic procedures.
One universal consent is not sufficient.
Who is allowed to sign informed consent forms for children
As long as children are minors, their parents or legal guardians are required to give informed consent before medical treatment is rendered or any procedure is performed.
If the parents are married to each other, consent from only one parent is required for nonurgent pediatric care. If the parents are divorced, consent usually rests with the parent who has legal custody
If there wasn’t a parent available to give consent during an emergency situation, they can withdraw consent later. If the legal caregivers disagree on the treatment course, it is within the health care providers’ scope to request consultation of a hospital ethics board.
T/F: A nurse can explain the procedure, risks, benefit’s, and alternatives to a procedure.
FALSE: A nurse can only REINFORCE what the patient has been told and witness the signature.
When can verbal consent be used for informed consent?
If parents are unavailable to sign consent forms, verbal consent may be obtained via the telephone in the presence of two witnesses. Both witnesses record that informed consent was given and by whom.
What is the age of majority,
the age at which a person is considered to have all the legal rights and responsibilities of an adult. In most states, 18 years is the age of majority
What is an emancipated minor
legally under the age of majority but is recognized as having the legal capacity or social status of an adult under circumstances prescribed by state law, such as pregnancy, marriage, high school graduation, independent living, or military service.
How can you treat a child when the parents do not consent
If the child is accompanied by a grandparent, child care provider, teacher, or others.
Parental refusal to give consent for life-saving treatment or to prevent serious harm can occur and requires notification to child protective services to render emergency treatment.
When can adolescents receive care without their parent’s knowledge
All 50 states have enacted legislation that entitles adolescents to consent to treatment without the parents’ knowledge to one or more “medically emancipated” conditions such as sexually transmitted infections, mental health services, substance abuse and addiction, pregnancy, and contraceptive advice. Consent to abortion is controversial, and statutes vary widely by state.
How do you prepare a child for oral medication
give them ice or a popsicle to numb their tastebuds
mix with sweet things
avoid giving with dairy
if it causes nausea, give bubbly drink before and after
pinch the nose when swallowing
don’t combine with foods the child NEEDs to eat in case they refuse to eat later
What is the most accurate means for measuring small amounts of medication
the plastic disposable calibrated oral syringe
Molded plastic cups with measuring lines are often supplied with over-the-counter medications for cough and fever, but most families in one study could not accurately measure a 5-mL dose within 0.5 mL
T/F: In infants up to 11 months old and children with neurologic impairments, blowing a small puff of air in the face frequently elicits a swallow reflex.
True
What techniques can you use when using an oral syringe for med admin
Infants: give them a bottle with milk the same time as syringe insertion. slowly dribble med into side of mouth
Children: have them help you, release the med against the inner cheek toward the lower teeth little by little as the child swallows
If the child fights the med admin, have the parent hold them sitting up in the lap, and slowly admin
What syringe should you use for IM injection volumes less than 1 mL
the tuberculin syringe, calibrated in 0.01-mL increments, is appropriate.
How much solution remains in a standard needle hub after plunging
0.2 ml
How do you prevent IM drugs from getting into SQ tissue
The Z-track method is performed by using the nondominant hand to move skin slightly laterally at the injection site just prior to inserting the needle. This action will shift the subcutaneous skin over the muscle below. Maintain the skin in this displaced position while giving the injection, then remove the needle before releasing the skin. The skin and subcutaneous tissue slide back to their original position, creating an interruption in the needle’s pathway and minimizing the risk of fluid leaking from the muscle into subcutaneous tissue.
What size needles do you generally use for IM meds
Smaller-diameter (25- to 30-gauge) needles
How much med can be administered at once to pediatric muscles
Usually 1 mL is the maximum volume that should be administered in a single site to small children and older infants. The muscles of small infants may not tolerate more than 0.5 mL.
Where is the best place to admin IM meds in infants
anterolateral thigh or vastus lateralis
How can you mitigate pain when giving an injection to a child
make the site cold before, apply pressure to site before
When do you expect to have to measure I/Os
- Current IV therapy * Recent major surgery * Medications that include diuretic or corticosteroid therapy * Severe thermal burns or injuries * Renal disease or damage * Congestive heart failure * Dehydration * Diabetes mellitus * Oliguria * Respiratory distress * Chronic lung disease
How do you calculate the output in a diaper
weigh all dry diapers to be used and note in an indelible marker the dry weight of the diaper; when there is fluid (urine or liquid stool) in the diaper, the amount of output can be approximated by subtracting the weight of the dry diaper from the weighed amount of the wet diaper.
The volume of fluid in milliliters is equivalent to the weight of the fluid measured in grams.
How do you use urine to assess whether a pt is hydrated
The specific gravity as a measure of urine osmolality assists in assessing the degree of hydration.
Describe A traditional nuclear
A traditional nuclear family consists of a married couple and their biologic children. Children in this type of family live with both biologic parents and, if siblings are present, only full brothers and sisters (i.e., siblings who share the same two biologic parents). No other persons are present in the household (i.e., no steprelatives, foster or adopted children, half-siblings, other relatives, or nonrelatives).
Describe The nuclear family
The nuclear family is composed of two parents and their children. The parent-child relationship may be biologic, step, adoptive, or foster. Sibling ties may be biologic, step, half, or adoptive. The parents are not necessarily married. No other relatives or nonrelatives are present in the household.
Describe a blended family
A blended family or household, also called a reconstituted family, includes at least one stepparent, stepsibling, or half-sibling. A stepparent is the spouse of a child’s biologic parent but is not the child’s biologic parent. Stepsiblings do not share a common biologic parent; the biologic parent of one child is the stepparent of the other. Half-siblings share only one biologic parent.
Describe a extended family
An extended family or household includes at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling. Parent-child and sibling relationships may be biologic, step, adoptive, or foster.
Describe a single-parent family
The contemporary single-parent family has emerged partially as a consequence of the women’s rights movement and also as a result of more women (and men) establishing separate households
Describe a binuclear family
the binuclear family refers to parents continuing the parenting role while terminating the spousal unit. The degree of cooperation between households and the time the child spends with each can vary. In joint custody, the court assigns divorcing parents equal rights and responsibilities concerning the minor child or children. These alternate family forms are efforts to view divorce as a process of reorganization and redefinition of a family rather than as a family dissolution.
Describe an authoritarian parenting style
Authoritarian parents try to control their children’s behavior and attitudes through unquestioned mandates. They establish rules and regulations or standards of conduct that they expect to be followed rigidly and unquestioningly. The message is: “Do it because I say so.”
often results in rigidly conforming behavior in the children, who tend to be sensitive, shy, self-conscious, retiring, and submissive.If not, this style of parenting may be associated with both defiant and antisocial behaviors.
Describe an permissive parenting style
Permissive parents exert little or no control over their children’s actions. They avoid imposing their own standards of conduct and allow their children to regulate their own activity as much as possible. These parents consider themselves to be resources for the children, not role models. If rules do exist, the parents explain the underlying reason, elicit the children’s opinions, and consult them in decision-making processes. They employ lax, inconsistent discipline; do not set sensible limits; and do not prevent the children from upsetting the home routine. These parents rarely punish the children.
Describe an authoritative parenting style
Authoritative parents combine practices from both of the other parenting styles. They direct their children’s behavior and attitudes by emphasizing the reason for rules and negatively reinforcing deviations. They respect the individuality of each child and allow the child to voice objections to family standards or regulations. Parental control is firm and consistent but tempered with encouragement, understanding, and security. Control is focused on the issue, not on the withdrawal of love or the fear of punishment.
Parents’ realistic standards and reasonable expectations produce children with high self-esteem who are self-reliant, assertive, inquisitive, content, and highly interactive with other children.
Describe the impact of social media on preschool age children
frequent use carries risks for increased rates of obesity; disrupted sleep; and delays in cognitive, social, and language development, potentially related to diminished parent-child interaction in preschoolers (Table 27.2).
Research has demonstrated that there is limited benefit of digital technology for children younger than 2 years of age, also likely related to diminished parent-child interaction. The benefits of digital technology use are related to the type of content viewed and used. For example, high-quality programming, such as Sesame Street, can bolster cognitive and social outcomes in preschool-age children, and applications from similar organizations (e.g., PBS or Sesame Workshop) can promote literacy skills.
What is the difference between growth, development, maturation, and differentiation
Growth— an increase in number and size of cells as they divide and synthesize new proteins; results in increased size and weight of the whole or any of its parts
Development— a gradual change and expansion; advancement from lower to more advanced stages of complexity; the emerging and expanding of the individual’s capacities through growth, maturation, and learning
Maturation— an increase in competence and adaptability; aging; usually used to describe a qualitative change; a change in the complexity of a structure that makes it possible for that structure to begin functioning; to function at a higher level
Differentiation— processes by which early cells and structures are systematically modified and altered to achieve specific and characteristic physical and chemical properties; sometimes used to describe the trend of mass to specific; development from simple to more complex activities and functions
Describe the 3 phases of the prenatal period
Germinal: Conception to approximately 2 weeks old
Embryonic: 2– 8 weeks old
Fetal: 8– 40 weeks old (birth)
Describe the 2 phases of the infancy period
Neonatal: Birth to 27 or 28 days old
Infancy: 1 to approximately 12 months
The infancy period is one of rapid motor, cognitive, and social development. Through mutuality with the caregiver (parent), the infant establishes a basic trust in the world and the foundation for future interpersonal relationships. The critical first month of life, although part of the infancy period, is often differentiated from the remainder because of the major physical adjustments to extrauterine existence and the psychologic adjustment of the parent.
Describe the 2 phases of the early childhood period
Toddler: 1– 3 years old
Preschool: 3– 6 years old
This period, which extends from the time children attain upright locomotion until they enter school, is characterized by intense activity and discovery. It is a time of marked physical and personality development. Motor development advances steadily. Children at this age acquire language and wider social relationships, learn role standards, gain self-control and mastery, develop increasing awareness of dependence and independence, and begin to develop a self-concept.
Describe the middle childhood period
Middle childhood— 6– 11 or 12 years old
Frequently referred to as the school age, this period of development is one in which the child is directed away from the family group and centered around the wider world of peer relationships. There is steady advancement in physical, mental, and social development with emphasis on developing skill competencies. Social cooperation and early moral development take on more importance with relevance for later life stages. This is a critical period in the development of a self-concept.
Describe the 2 phases of the late childhood period
Prepubertal: 10– 13 years old
Adolescence: 13 to approximately 18 years old
The tumultuous period of rapid maturation and change known as adolescence is considered to be a transitional period that begins at the onset of puberty and extends to the point of entry into the adult world— usually high school graduation. Biologic and personality maturation are accompanied by physical and emotional turmoil, and there is redefining of the self-concept. In the late adolescent period, the young person begins to internalize all previously learned values and to focus on an individual, rather than a group, identity.
Describe the cephalocaudal, or head-to-tail, directional trend of growth in infants
The head end of the organism develops first and is large and complex, whereas the lower end is small and simple and takes shape at a later period. The physical evidence of this trend is most apparent during the period before birth, but it also applies to postnatal behavior development. Infants achieve control of the heads before they have control of their trunks and extremities, hold their backs erect before they stand, use their eyes before their hands, and gain control of their hands before they have control of their feet.
Describe the the proximodistal, or near-to-far, developmental trend in infants
embryonic development of limb buds, which is followed by rudimentary fingers and toes. In infants, shoulder control precedes mastery of the hands, the whole hand is used as a unit before the fingers can be manipulated, and the central nervous system develops more rapidly than the peripheral nervous system. These trends or patterns are bilateral and appear symmetric— each side develops in the same direction and at the same rate as the other.
Describe the the differentiation, developmental trend in infants
describes development from simple operations to more complex activities and functions, from broad, global patterns of behavior to more specific, refined patterns. All areas of development (physical, cognitive, social, and emotional) proceed in this direction.
Describe the different theories (freud/psychosex, erikson/psychosocial, Piaget/cognitive, and Kohlberg/Moral judgement) opinion on the development of personality and cognitive function from:
(birth to 2 years old)
FREUD: ORAL
ERIKSON: TRUST/MISTRUST
PIAGET: SENSORIMOTOR
Describe the different theories (freud/psychosex, erikson/psychosocial, Piaget/cognitive, and Kohlberg/Moral judgement) opinion on the development of personality and cognitive function from:
(2-4 years old)
FREUD: ANAL
ERIKSON: AUTONOMY VS SHAME/DOUBT
PIAGET:PREOPERATIONAL THOUGHT, PRECONCEPTUAL PHASE (SPECIFIC TO SPECIFIC THOUGHT)
Describe the different theories (freud/psychosex, erikson/psychosocial, Piaget/cognitive, and Kohlberg/Moral judgement) opinion on the development of personality and cognitive function from:
(4-7 years old)
FREUD: PHALLIC
ERIKSON: INITIATIVE VS GUILT
PIAGET: PREOPERATIONAL THOUGHT (REASONING)
Describe the different theories (freud/psychosex, erikson/psychosocial, Piaget/cognitive, and Kohlberg/Moral judgement) opinion on the development of personality and cognitive function from:
(7-11 years old)
FREUD: LATENCY
ERIKSON: INDUSTRY VS INFERIORITY
PIAGET: CONCRETE OPERATIONS (BEGINNING REASONING/LOGIC)
