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Nursing: BSN classes > General Ped's and Growth/Development > Flashcards

General Ped's and Growth/Development Flashcards

0
Q

What do the Healthy People 2020 Goals want to Decrease?

A
  • Developmental disabilities
  • Obesity
  • Iron deficiency in kids/childbearing females
  • Tobacco use by kids
  • Tobacco smoke exposure in homes
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1
Q

What do the Healthy People 2020 Goals want to increase?

A
  • Vaccinations
  • Exercise 30min/5days/week for adolescents
  • Good overall nutrition by kids obtaining meals/snacks at school
  • Percentage of full term infants to sleep on their backs
  • The age and proportion of kids who remain alcohol/drug free
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2
Q

Parents or guardians have authority to make choices about their child’s healthcare except in which situations?

A

If it’s an emancipated minor; if minor is parent of child receiving treatment; If child is seeking birth control, substance abuse treatment, STD treatment, pregnancy help, or mental health treatment

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3
Q

What type of genetic test do we do here in KY when a newborn is born?

A

A Newborn Screening test that screens for about 7 or so diseases that will require immediate treatment to prevent death or disability.

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4
Q

If a child/family is identified with a possible genetic disorder, what can we do?

A

Referral to genetic specialist, support for them regarding potential diagnosis, education regarding potential health problems/issues

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5
Q

What is the leading cause of death for kids over 1 year?

A

MVA’s

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6
Q

What is the #1 cause of death for all ages?

A

Unintentional injury.

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7
Q

What is a philosophy of care for kids?

A

Care of the child is family-centered, atraumatic, and culturally sensitive.

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8
Q

What are some hospital safety measures for kids?

A

Keep rails up at all times, prohibit spark-producing toys near O2, don’t leave meds or syringes at bedside, watch small objects, teach parents/families.

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9
Q

What are some leading causes of death for young kids?

A

MVA’s are #1 for all ages; next come drowning, fire/burns, suicide, suffocation, homicide/firearm

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10
Q

What are some safety and prevention techniques for kids?

A

Utilize growth/development level; anticipate child’s motor abilities and curiosity; teach safety precautions; supervise child’s activities; childproof home environment.

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11
Q

What are some types of genetic tests for newborns?

A

Diagnostic testing, Prenatal testing, Newborn Screening, Preimplantation testing, Carrier testing, Predictive testing

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12
Q

Used to establish a diagnosis of a genetic disorder in an individual who is symptomatic or has had a positive screening test=

A

Diagnostic Testing.

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13
Q

Testing to identify a fetus with a genetic disease or condition; usually done due to family history or maternal factors; sometimes routinely offered.

A

Prenatal Testing.

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14
Q

Testing of a newborn to identify the presence of a condition that needs immediate attention to prevent death or disability =

A

Newborn Screening.

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15
Q

Following in vitro fertilization, testing is done on embryos to identify the presence of a genetic condition =

A

Preimplantation Testing.

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16
Q

Testing in an asymptomatic individual to identify carrier status for a genetic condition =

A

Carrier Testing.

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17
Q

Offered to asymptomatic individuals to detect genetic conditions that occur later in life; may be presymptomatic (ie Huntington’s) or predispositional (ie BRCA 1 & 2) =

A

Predictive Testing.

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18
Q

What is the importance of “play” for people of all ages?

A

Gives child choices and sense of control, safety, & security; Fosters growth and development; provides stress relief and distraction; alleviates separation anxiety; allows child to act out fears and concerns.

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19
Q

Why is pain confusing for pediatric patients?

A

it can be frightening and confusing; don’t understand why it occurs or that relief is right around the corner; lack language skills to tell where it hurts; may think it’s their fault.

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20
Q

What are some pediatric pain misconceptions?

A

Newborns don’t respond to pain (nervous systems immature); Infants and children cannot tell you where they hurt; Children don’t remember pain; parents exaggerate pain/aggravate it; repeat pain helps kids learn to cope with it better; active children are not in pain; children always tell the truth about pain; we should restrict meds because they can become addicted.

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21
Q

What are some facial s/s of an infant in pain?

A

bulged brows, brows lowered/drawn together, eyes squeezed shut, furrowed nasolabial creases, taut tongue, open/angular/squarish lips and mouth, quivering chin

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22
Q

Pain scale used to evaluate neonates less than 6 weeks old =

A

NIPS (Neonatal Infant Pain Scale)

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23
Q

What are the characteristics evaluated with the NIPS scale?

A

Facial expression, cry, breathing pattern, arm & leg movements, state of arousal

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24
Pain scale used for kids 6 weeks old and up and any non verbal child =
FLACC (face, legs, activity, cry, consolability).
25
The NIPS pain scale is rated with 0-___; FLACC has a scale of zero-___
7; 10; zeroes are the best scores.
26
Name some self-report pain scales for kids:
Body outline, Faces, Oucher, Poker Chip
27
The Poker Chip self-report pain scale is for ages ____
4-7 year olds.
28
What age group should use the Faces pain scale?
3-5 years and up
29
What are some indicators of child abuse and neglect?
Hx inconsistent with injuries; hx incompatible with child's development; hx that changes with time; delay in seeking tx; pathognomonic injuries (patterns of injury so specific that child abuse can be diagnosed regardless of history).
30
Pain scale based on ethnicity (hispanics, caucasians, AA's) =
Oucher Pain Scale
31
What are some pain interventions for a child?
Medication, Comfort measures (holding), Reassurance pain is not a punishment, Band-Aid, Distraction, Sense of Control (give choices), Positioning, Swaddling, Involve parents.
32
Child abuse "Red Flags" =
Unusual bruises/welts/fractures/burns/bite marks; multiple fractures in various stages of healing; Cranial or abdominal injury can be suspect; Over sedation; Concealing clothing; usual shyness; changes in bx or school performance; avoiding physical contact with adults; fearful around parents
33
Possible Indications of Abuse:
Contradictory history that doesn't explain injury; projects cause of injury on sibling or 3rd party; delay in seeking care; inappropriate awareness of seriousness of situation; "Hospital shopping"; unrealistic expectations of child; inappropriate or inadequate care to child's hygiene or dress
34
The FDA recommends at least ___ mins of physical activity a day for kids and less than ___ sedentary time.
60; 2 hours.
35
One chart used to monitor a child's developmental progress =
Denver II
36
What are some of the items measured on the Denver II Developmental Screening Test?
Personal-Social; Fine Motor-Adaptive; Language; Gross Motor
37
Name some factors that can influence growth and development:
Genetics, prenatal care, environment (ie lead in home), nutrition, health status, family, culture.
38
What things are charted on a growth chart?
Weight, length, and head circumference with the child's age; except head circumference isn't charted after 2 years of age
39
What do you look for on a growth chart?
consistency of the curve; should fall within 10%-90% consistently; deviations from curve are a red flag
40
What are Piaget's Stages of Development?
1) The Sensorimotor Period: birth to 2 years: child's cognitive system is limited to motor reflexes at birth, but the child builds on these reflexes to develop more sophisticated procedures. Learn to generalize their activities to a wider range of situations and coordinate them into increasingly lengthy chains of bx. 2) PreOperational Thought: 2-7 years: Kids acquire representational skills in the areas of mental imagery, and especially language. They are self-oriented and have an egocentric view. 3) Concrete Operational: 7-11: Able to take another's point of view now. More accurate view of cause and effect. The child can reason quite well if concrete objects are used in teaching. The concept of conservation (that matter does not change when its form is altered) is learned at this age. 4) Formal Operational: 11-Adult: Fully mature thought has been attained; can think abstractly about objects or concepts and consider different outcomes.
41
A child's who's weight is significantly below that of other kids at the same age or can be a sudden decline in growth/weight =
Failure to Thrive (FTT).
42
Failure to thrive (FTT) can be from what types of causes?
Organic, nonorganic, or mixed causes.
43
Piaget formulated a theory of ___ development.
Intellectual/Cognitive
44
Who came up with assimilation and accommodation?
Piaget
45
Ability to understand that when something is out of sight it still exists =
Object permanence.
46
Ability to see things only from one's own point of view =
Egocentrism
47
Connecting two events in a cause-effect relationship simply because they occur together in time =
Transductive Reasoning
48
Focusing only on one particular aspect of a situation =
Centration
49
Giving lifelike qualities to nonliving things =
Animism
50
The belief that events occur because of one's thoughts or actions =
Magical Thinking
51
Knowledge that matter is not changed when its form is altered =
Conservation
52
What are the two substages of Piaget's Preoperational Stage?
Preconceptual (2-4 years); Intuitive (4-7 years)
53
Which one of Piaget's Stages is characterized by Egocentrism, transductive reasoning, magical thinking, centration, and animism?
Preoperational Stage
54
Drawing conclusions from one general fact to another =
Transductive Reasoning.
55
What are some nursing applications for Piaget's Sensorimotor Stage?
This is when the baby learns from movement and sensory input: Use crib mobiles, manipulative toys, wall murals, and bright colors to provide interesting stimuli and comfort; Use toys to distract the baby during procedures and assessment; Ensure safe surroundings to allow opportunities to manipulate objects; name objects and give simple explanations.
56
What are some nursing applications for Piaget's Preoperational Stage?
Offer explanations about all procedures and treatments; clearly explain that the child is not responsible for causing the illness.
57
Piaget's stage when the child learns from movement and sensory input; the child later shows increasing curiosity and explorative behavior; language skills improve
Sensorimotor stage
58
Piaget's stage when the child is increasingly verbal but has some limitations in thought processes. Causality is often confused, so the child may feel responsible for causing an illness =
Preoperational Stage
59
What are some nursing applications for Piaget's Concrete Operational Stage?
Give clear instructions about details of treatment; show the child equipment that will be used in treatment
60
Piaget's stage when the child is capable of mature thought when allowed to manipulate and see objects =
Concrete Operational Stage
61
Piaget's stage when the adolescent is capable of mature, abstract thought =
Formal Operational Stage (12-18)
62
Nursing Applications for Piaget's Formal Operational Stage:
Give clear/complete info about healthcare/treatments; offer both written and verbal instructions; Continue to provide education about the disease to those with chronic illness, as mature thought now leads to greater understanding.
63
Examples: babies will not look for toys or other objects out of sight; they are concerned when a parent leaves because they are not sure that they will come back. What are these examples of?
Object permanence.
64
Examples: peers who have gone through an experience will not impress the child; teaching should focus on what an experience will be like to the child. Examples of what?
Egocentrism
65
Examples: Asking the child what he thinks caused an occurrence; ask how the 2 events are connected; correct misconceptions to lessen the child's guilt. Examples of what?
Transductive Reasoning
66
Examples: listen to the kid's comments and deal with concerns in order to be able to present new concepts to the child
Centration
67
Examples: Ask children to describe how a machine works, or how the trees move. Provide opportunities to learn about machines that may move and make noises (IV pumps, MRI's) to decrease fears.
Animism
68
Examples: Ask the young child how they became ill, what caused a parent or sibling's illness. Correct misconceptions when the child blames self for causing problems by wishing someone ill or having bad behavior. Examples of what?
Magical Thinking.
69
Examples: Before ____ is reached, the child may think that gender can be changed when hair is cut; the leg under the cast is broken in separate pieces; Ask perceptions and clarify misconceptions.
Conservation.
70
Babies acquire gross motor skills in a _____ & ____ pattern.
Cephalocaudal (head to toe) & Proximodistal (near to far)
71
____ motor skills are acquired before ___ motor skills.
Gross; fine
72
Weight changes for infant: gain ___ pounds a month for the first __ months; weight should double by ____ months; weight should triple by ___ months.
1.5 pounds/month; first 5 months; 5-6 months; 12
73
Height increases for babies is __ inch(es) per month; Birth length increase by 50% by ___ months.
1 inch/mo; 12
74
Head Circumference of the infant increases by __ per month and by 1 year, head size has increased by __%.
1.5 cm; 33%
75
Binocularity (fusion of 2 ocular images into one cerebral picture) begins to develop by ___ weeks and is well developed by ___ months.
6 weeks; 4 months
76
In what Piaget stage does Object Permanence occur?
Sensorimotor. 8-12 months.
77
In what Piaget stage does Conservation occur?
Concrete Operational (7-11)
78
What are Erikson's 8 Stages of Psychosocial Development?
1) Trust vs. Mistrust (birth to 1 year): Must form a loving, trusting relationship with caregiver, or develop a sense of mistrust. 2) Autonomy vs. Shame/Doubt (1-3 years): Child's energies directed toward the development of physical skills like walking, grasping, and rectal sphincter control. The child learns control but may develop shame and doubt if not handled well. 3) Initiative vs. Guilt (3-6 years): The child continues to become more assertive and take initiative, but may be too forceful, leading to guilt feelings. 4) Industry vs. Inferiority (6-12): The child must deal with demands to learn new skills or risk a sense of inferiority, failure, and incompetence. 5) Identity vs. Role Confusion (12-18): The teen must achieve a sense of identity in occupation, sex roles, politics, and religion. 6) Intimacy vs. Isolation (19-40): Young adults need to form intimate, loving relationships. Success leads to strong relationships. Failure leads to loneliness and isolation. 7) Generativity vs. Stagnation: Adults need to create or nurture things that will outlast them, often by having kids or creating a positive change that benefits other people. Success leads to feelings of usefulness/accomplishment; failure results in shallow involvement in the world. 8) Ego Integrity vs. Despair (65 to death): Older adults need to look back on life and feel a sense of fulfillment. Success at this stage leads to feelings of wisdom, while failure results in regret, bitterness, despair.
79
Erikson's stage when the adolescent's search for self-identity leads to independence from parents and reliance on peers =
Identity vs. Role Confusion Stage (12-18)
80
Erikson's stage when the child gains a sense of self-worth from involvement in activities =
Industry vs. Inferiority (6-12)
81
Erikson's stage when the child likes to initiate play activities =
Initiative vs Guilt stage
82
Erikson's stage when the child is increasingly independent in many spheres of life =
Autonomy vs. shame and doubt
83
What are some nursing applications for Erikson's Initiative vs. Guilt Stage?
Offer medical equipment for play to lessen anxiety about strange objects; Assess children's concerns as expressed through their drawings; accept the child's choices and expressions of feelings
84
What are some nursing applications for Erikson's Autonomy vs. Shame and Doubt Stage?
The child is increasingly independent in many spheres of life: Allow self-feeding opportunities; encourage to remove own clothes, brush teeth, or assist with hygiene; if restraint for a procedure is necessary, proceed quickly, providing explanations and comfort
85
What are some nursing applications for Erikson's Trust vs. Mistrust phase?
This is when the baby establishes a sense of trust when basic needs are met; Hold the baby often; Offer comfort after painful procedures; meet food and hygiene needs; Encourage parents to room in; Manage pain effectively; when baby is NPO, offer a pacifier if not contraindicated; after painful procedures, offer a bottle or pacifier or have mother breast-feed.
86
Erikson's developmental stage when the baby establishes a sense of trust when basic needs are met =
Trust vs. Mistrust Stage (birth to 1 year)
87
Nursing applications for Erikson's Identity vs. role confusion stage?
Provide a separate recreation room for teens who are hospitalized; take health history/exams without parents; Introduce them to other teens with the same problem
88
Erikson's theories are ____ stages that focus on ____ development.
Psychosocial; lifespan
89
What are some nursing applications for Erikson's Industry vs. Inferiority stage?
Encourage kid to do school work while hospitalized and bring favorite past times to the hospital; help child adjust to limitations on favorite activities
90
What is the important events of Trust vs. Mistrust stage?
Feeding and Receiving Care
91
What is the important event of the Autonomy vs. Shame/Doubt stage?
Toilet Training and Imitation
92
What is the important event of the Initiative vs Guilt Stage?
Exploration and Identification
93
What is the important event of the Industry vs. Inferiority stage?
School and Education
94
What is the important event of the Identity vs. Role Confusion Stage?
Social Relationships
95
What is the important event of the Intimacy vs. Isolation?
Relationships and Caregiving
96
What is the important event of the Generativity vs. Stagnation stage?
Work, Creativity, and Parenthood
97
What is the important event of the Ego Integrity vs. Despair?
Reflection on life=Introspection
98
3 Developmental tasks of Trust vs. Mistrust Stage?
Social attachment Maturation of sensory, perceptual, and motor functions Primitive causality
99
4 Developmental tasks of Autonomy vs. Shame and Doubt stage?
Locomotion Fantasy Play Language Development Self-Control
100
5 Developmental tasks of Initiative vs Guilt Phase?
``` Sex-role identification Early moral development Self-esteem Group play Egocentrism ```
101
4 Developmental Tasks of Industry vs. Inferiority?
Friendship Team Play Skill learning Self-evaluation
102
4 Developmental tasks of Identity vs. Role Confusion?
Sexual relationships Membership in peer group Emotional development Physical Maturation
103
Developmental tasks of Intimacy vs. Isolation?
Stable relationships Child rearing/Parenting Work Household
104
How long does a baby from birth to one month old sleep?
20 hours
105
When can a baby focus both eyes together?
birth to one month old
106
When can a baby detect smells?
Birth-1 month old
107
What age does a baby cry, coo, grunt?
2-3 mo
108
What age does a baby smile at a face?
2-3 mo
109
When does a baby begin babbling?
4-6 mo
110
What age does a baby recognize parents?
4-6 mo
111
When does a baby pay attention to its own name?
4-6 mo
112
What age does a baby reach, grasp, and put object in mouth?
4-6 mo
113
What age does a baby laugh?
4-6 mo
114
What age does a baby sit without support?
7-9 mo
115
What age does a baby crawl?
7-9 mos
116
What age does separation anxiety begin?
7-9 mo
117
When does object permanence begin?
7-9 mos
118
When can a baby stand?
10-12 mos
119
When does a baby respond to simple commands?
10-12 mos
120
What age does a baby say its first real word?
10-12 mos
121
When does a baby feed himself?
1-1.5 years
122
When does toilet training begin?
1-1.5 years

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