foundations of nursing care of children Flashcards

1
Q

what is family center care

A
  • partnerships between families of children, nurses, and providers, in which the families and children benefit.
  • Respecting cultural diversity, and incorporating cultural views in the plan of care.
  • Understanding growth and developmental needs of children and their families.
  • Working with all types of families.
  • Collaborating with families regarding hospitalization, home, and community resources.
  • Allowing families to serve as experts regarding their children’s health conditions.
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2
Q

family centered care

A
  • Nurses should perform comprehensive family assessments to identify strengths and weaknesses.
  • Members communicate well and listen to each other.
  • There is affirmation and support for all members.
  • There is a clear set of family rules, beliefs, and values.
  • Members teach respect for others.
  • There is a sense of trust.
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3
Q

pediatric physical assessment

A
  • The nurse must alter exams to accommodate chronological age and developmental needs.
  • Involve children and family members in examinations.
  • Praise children for cooperation during exams.
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4
Q

what behaviors are obsered to determine childs readiness to cooperate

A
  • Interacting with nurse
  • Making eye contact
  • Permitting physical touch
  • Willingly sitting on the examination table.
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5
Q

how to make a safe environment

A
  • Keep the room warm and well lit.
  • Perform examinations in nonthreatening environments.
  • Keep medical equipment out of sight.
  • Provide privacy.
  • Determine whether older school‑age children and adolescents prefer a caregiver to remain during examination.
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6
Q

start of the assessment

A
  • Take time to play and develop rapport prior to beginning an examination.
  • Explain each step of the examination to the child.
    +Use age‑appropriate language.
    +Demonstrate what will happen using dolls.
    +Allow the child manipulate and handle equipment.
    +Encourage the child to use equipment on others.
    -Examine the child in a secure, comfortable position. For example, a toddler may sit on a parent’s lap if desired.
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7
Q

during assessment

A

Examine the child in an organized sequence when possible.
If the child is uncooperative, assess reasons, be firm and direct about expected behavior, complete the assessment quickly, and use a calm voice.
Encourage the child and family to ask questions during physical exams.
Discuss findings with family after the examination

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8
Q

physiologic growth and pulse rate

A

Newborn: 80 to 180/min (depending on activity)
1 week to 3 months: 80 to 220/min (depending on activity)
3 months to 2 years: 70 to 150/min (depending on activity)
2 to 10 years: 60 to 110/min (depending on activity)
10 years and older: 50 to 90/min (depending on activity)

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9
Q

respirations

A
Newborn to 1 year: 30 to 60/min
1 to 2 years: 25 to 30/min
3 to 6 years: 21 to  25/min
6 to 12 years: 19 to  21/min
12 years and older: 16 to 19/min
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10
Q

assessment findings for eyes

color vision should be assessed with what test?

A

Irises should be round with the permanent color manifesting around 6 to 12 months of age.

Might not be symmetric in newborns.
● Corneal light reflex should be symmetric.
● Cover/uncover test should demonstrate equal movement of the eyes.
● Six cardinal fields of gaze should demonstrate no nystagmus.
Color vision
● Should be assessed using the Ishihara color test or the Hardy-Rand-Rittler test.
● The child should be able to correctly identify shapes, symbols, or numbers.

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11
Q

ears/ internal ear assessment

A
  • In infants and toddlers, pull the pinna down and back to visualize the tympanic membrane.
  • In children older than 3 years of age, pull the pinna up and back to visualize.
  • The tympanic membrane should be pearly pink, or gray.
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12
Q

mouth and tongue assessment findings

how many teeth by 1?

A
  • Infants can have white coatings on their tongues from milk that can be easily removed.
  • Children and adolescents should have pink, symmetric tongues that they are able to move beyond their lips.
  • Infants should have six to eight teeth by 1 year of age.
  • make sure pallet is closed by feeling it
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13
Q

hard and soft palates
tonsils and speach
what does speech delay start?

A

Hard and soft palates: Intact, firm, and concave

Tonsils

  • Infants: Might not be able to visualize
  • Children: Barely visible to prominent

Speech

  • Infants: Strong cry
  • Children and adolescents: Clear and articulate
  • speech delay after 24 months
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14
Q

heart sounds

A

S1 and S2 heart sounds should be clear and crisp.

Sinus arrhythmias that are associated with respirations are common.

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15
Q

pulses

A

Infants: Brachial, temporal, and femoral pulses should be palpable, full, and localized.
Children and adolescents: Pulse locations and expected findings are the same as those in adults.

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16
Q

abdomen

A
  • Without tenderness, no guarding. Peristaltic waves can be visible in thinner children.
  • Symmetric and without protrusions around the umbilicus
  • Infants and toddlers have rounded abdomens.
  • Children and adolescents should have flat abdomens.
  • Bowel sounds should be heard every 5 to 30 seconds.
  • listen than palpate
  • head and abdomen circumference should match
17
Q

genitalia

A

Anus: Surrounding skin should be intact
Routine rectal exams are not done with the pediatric population.
MALE: Hair distribution is diamond shaped after puberty in adolescent males.
No pubic hair is noted in infants and small children.

18
Q

3,6,12 month milestorn

A

3: turn head
6: sitting up
12: walking standing

19
Q

penis

A
  • Should appear straight.
  • Urethral meatus should be at the tip of the penis.
  • Foreskin might not be retractable in infants and small children.
  • Enlargement of the penis occurs during adolescence.
    Scrotum
  • The left testicle hangs slighter lower than the right.
  • The inguinal canal should be absent of swelling
20
Q

vagina

A

FEMALE:

  • No pubic hair should be noted in infants or small children.
  • Labia: Symmetric, without lesions
  • Clitoris: Small, without bruising or edema
  • Urethral meatus: Slit-like in appearance with no discharge
  • Vaginal orifice: The hymen can be absent, or it can completely or partially cover the vaginal opening prior to sexual intercourse.
21
Q

spine

toddlers and young children gait
older children gait

A
  • Infants: Spines should be without dimples or tufts of hair. They should be midline with an overall C-shaped lateral curve.
  • Toddlers appear squat with short legs and protuberant abdomens.
  • Children should develop the cervical, thoracic, and lumbar curvatures like that of adults.
  • Adolescents should remain midline (no scoliosis noted).

Gait

  • Toddlers and young children: A bowlegged or knock-knee appearance is a common finding. Feet should face forward while walking.
  • Older children and adolescents: A steady gait should be noted with even wear on the soles of shoes.