Growth & Development Flashcards
What age specific approaches do you use for assessment of an infant?
o Auscultate heart/lungs/abdomen while infant is asleep/quiet
o Allow parent to nurture/comfort vs. assisting
o Explain to caregiver each step as you do it
What age specific approaches do you use for assessment of a toddler?
o Concrete thinking – use appropriate language
o Allow freedom of movement when possible
o Perform most invasive parts last
What age specific approaches do you use for assessment of a preschooler?
fears body invasion and mutilation
o Concrete thinking – use appropriate language
o Give simple choices to sit or stand, etc.
o Medical play appropriate to explain or elicit cooperation – allow to touch equipment
What age specific approaches do you use for assessment of a school-age child?
o Increased language skills – explain in simple, realistic terms
o Include the child in the examination
What age specific approaches do you use for assessment of an adolescent?
o Respect privacy/Emphasize confidentiality
o Use mature language and appropriate terminology – clarify slang terms, but don’t use
o Allow for time to ask/answer questions without parent/caregiver present
What do you need to remember about temperature in kids?
● 35.5-37.5 C oral (95.9-99.5 F) - May vary by source/method. Always consistently use the same source/method and note in documentation.
● Temperature > 38.5 C (101.5 F) is considered to be elevated/febrile and should be treated.
● Temperature < 35.5 C (95.9 F) is considered abnormal and should be rechecked.
What do you need to remember about blood pressures in kids?
● Hypotension: Systolic BP < 70 + (2 x age) up to 10 years of age
● **Hypertension: Normal blood pressure varies by age/gender/height. Elevated systolic/diastolic pressures or wide pulse pressures should be rechecked and further evaluated.
What do you need to remember about weight? (timeline?)
● Doubles birth weight by 6 months; Triples birth weight by 1 year; Quadruples birth weight by 2 years
What do you need to remember about BMI?
● Body mass index (BMI) is age- and gender-specific based on height & weight.
● Underweight is defined as a BMI under the 5th percentile.
● Overweight is defined as a BMI between the 85th and 94th.
● Obesity is defined as a BMI at or above the 95th percentile.
Describe oxygen delivery systems
Too high a flow for small children————5——————37%
** each liter = approx. 4% 02——————–6*——————40%
Other Oxygen Delivery Systems
Simple Face Mask————————————-> 5 liters—–40-60%
Venturi Mask——————————————-Variable——24-60%
Non-Rebreather reservoir mask—————–> 10 liters —> 60%
High Flow nasal cannula———————–Up to 60 liters–21-80%
What is the 4-2-1 method for calculating fluid maintenance?
0-10 kg (1st 10kg) x 4
11-20 kg (2nd 10kg) x 2
21+ kg (above 21 kg) x 1
Example: Jeff is 33kg, so:
4 x 10 = 40, 2 x 10 = 20, 1 x 13 = 13
40 + 20 + 13 = 73 ml/hr
What techniques would you employ to administer an oral med to the following:
(a) infant
(b) toddler
(c) preschooler
(d) school age
a. Infant – use a syringe and place into the inside corner of the mouth and administer slowly. Stop if signs of choking to prevent aspiration. Enlist parent to assist if it helps with child cooperation. It is ok for the parent to administer the medication with the nurse observing.
b. Toddler - give choices when available, enlist parent to assist if it helps with child cooperation. It is ok for the parent to administer the medication with the nurse observing.
c. Preschooler – give choices when available, give them a job or allow them to help.
d. School-Age child – explain what medication is for in simple terms.
What developmental theories make up the infant age group (birth-1yr)?
Erikson: Trust vs. Mistrust
Piaget: Sensorimotor
What developmental theories make up the toddler age group (1-3 years)?
Erikson: Autonomy vs. Shame and Doubt
Piaget: Sensorimotor (end); Preoperational (beginning)
What developmental theories make up the preschooler age group? (3-6 years)
Erikson: Initiative vs. Guilt
Piaget: Preoperational
What developmental theories make up the school age group? (6-12 years)
Erikson: Industry vs. Inferiority
Piaget: Concrete Operational
What developmental theories make up the adolescent age group? (12-18 years)
Erikson: Identity vs. Role Confusion
Piaget: Formal Operational
What are the characteristics and nursing applications of Erikson: Trust vs. Mistrust
The baby established a sense of trust when basic needs are met.
Hold the hospitalized baby often. Offer comfort after painful procedures. Meet the baby’s needs for food and hygiene. Encourage parents to room in. Manage pain effectively with the use of pain meds and other measures.