Introduction to pediatric nursing Flashcards

1
Q

Birth-20 years
Roughly ¼ of the population
Kids = adults
Major goal of pediatric nursing is to improve quality of health care for children and their families
Health promotion: Healthy People 2030

A

Pediatric pop

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2
Q

Health and care provided last throughout adulthood
Huge emphasis on health ped pop esp first 5 yrs - which then lasts throughout adulthood
Kids falling behind missed because not in school yet
Habits/Chronic Health Conditions
Adverse Childhood Experiences (ACEs) - big impacts on mental health and kids

A

Kids = adults

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3
Q

Goal: increase quality and length of healthy life and eliminate health disparities
Looking how improve things
Prenatal care? - lack this - children increased risk birth issues/trauma
Development: meeting milestones? - are they meeting milestones - means something going on; earlier intervene quicker help child meet milestones and get therapy needed to be more successful kid can be
Nutrition: access so food? Resources? - single most predictor of childhood growth; have nutrition needed?; food desert or not?; edu on type food and nutrition needed and have; lot ped nursing focused on edu parents and reassuring them
Oral health: chronic illness/minority children - huge concern esp minor pops

A

Health promotion: Healthy People 2030

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4
Q

Children may not be able to follow directions or make decisions to keep them away from danger during a disaster. - explore world and not know when putting themselves at risk
Children’s bodies use energy quicker than adults’ do, and they need food and water more often. - not sustain BG; not sleep 12 hrs - need stay hydrated
Children have thinner skin and breathe faster than adults do, making them more likely to take in harmful substances through the skin or breathe them in. - newborn skin very thin - no sunscreen until 6 months - absorb straight into circ sys - same in meds topical
Children are more likely to put their hands in their mouths, and spend more time outdoors and on the ground, making them more likely to come into contact with dangers in the environment. - good: build up microbiome; bad - always sick, and put everything in mouth - never wash hands
Children may not be able to explain how they are feeling, which can make it harder to identify a medical problem and treat them quickly. - cannot adequately tell you what going on; cannot give descriptions or exact issue or explain in way we understand; communication barrier issue
Children have more contact with others, and they have less developed immune systems to fight off infections. This means they are more likely to catch an illness that can spread from person to person. - high risk for infection; awhile build-up immune sys; daycare - sick less often when go to school because exposed to diff viruses already

A

Vulnerability

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5
Q

Obesity and Type 2 Diabetes
Childhood injuries
Violence
Bullying
Mental health problems

A

Childhood health problems - Health concerns

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6
Q

Accidents

A

Childhood injuries

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7
Q

Stress
Social media

A

Mental health problems

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8
Q

Infant mortality
Birth weight
Ages 5 to 14 have the lowest death rate
15–19 years
Injuries - predict in certain age group at risk for based on development and age group

A

Childhood mortality

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9
Q

United States lags behind other nations
African Americans have more neonatal deaths than white; treating pain issue with race

A

Infant mortality

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10
Q

Major determinant of neonatal death
Full term but below weight - chances survival less; directly related to prenatal care - see with US if growing properly; not growing properly - induce labor so can feed baby
Earliest gestation - 22 weeks

A

Birth weight

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11
Q

Relatively safe age

A

Ages 5 to 14 have the lowest death rate

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12
Q

Sharp increase occurs in adolescence
Suicide
They are invincible and nothing happen to them - accidents, drinking and driving, gun use, nothing happen to me since good at this; prefrontal cortex not fully developed and think invincible

A

15–19 years

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13
Q

Specific groups of children have increased morbidity (illness) - social determinants of health - huge impact on ped pop

A

Childhood morbidity

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14
Q

Homeless
Living in poverty
Low birth weight
Chronic illness
Foreign born adopted children
Children in day care centers

A

Specific groups of children have increased morbidity (illness) - social determinants of health - huge impact on ped pop

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15
Q

Healthy People 2030 “Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.”
Examples:

A

Healthy people 2030

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16
Q

Increase the proportion of infants who didn’t pass their hearing screening who get evaluated for hearing loss by age 3 months (Improving!) - every newborn has hearing screening; not 100% accurate - lot false negatives; fail test in hospital need follow-up in couple months; impacts speech and ability communicate - need correct quickly; hearing aids/cochlear impants depending on what is - earlier diagnosis better is for info; people missing the follow-up
Decrease the amount of premature births. (Getting worse)
Increase the proportion of high school students who graduate in 4 years (was improving!) - COVID may see decrease
Increase the proportion of children whose parents read to them at least 4 days per week (Getting worse) - HUGE; comfort thing; builds relationships; IMP

A

Examples:

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17
Q

Therapeutic relationship
Family advocacy and caring
Disease prevention and health promotion
Health teaching
Injury prevention
Support and counseling
Coordination and collaboration
Ethical decision making*
Research
Evidence-based practice

A

Role of the pediatric nurse

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18
Q

Ped pat - treating whole fam; parents not agreeing/not on board/not understand - noncompliance - meet in middle - see what agree with and what follow and why not agreeing; team with whole fam

A

Coordination and collaboration

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19
Q

Under 18 - decision made by parents
16 yo want start birth control but parents say no
Comes to: Mental health treatment, med, pregnancy, birth control - emancipated regardless age and parents age
NICU baby - blood transfusion - Jahova’s witness
Know baby die without blood transfusion - Goes before ethics committee and often give blood against parents wishes
Typ parents not get mad but not want make decision - not reject child

A

Ethical decision making*

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20
Q

An increase in number and size of cells as they divide and synthesize new proteins; results in increased size and weight of whole or any of its parts

A

Growth:

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21
Q

A gradual change and expansion; advancement from lower to more advanced stage of complexity; increased capacity through growth, maturation, and learning

A

Development:

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22
Q

An increase in competence and adaptability, usually described as a qualitative change to function at higher level

A

Maturation:

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23
Q

The processes by which early cells and structures are systematically modified and altered

A

Differentiation:

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24
Q

Very defined groups
Infant Stage birth-1 years
Toddler Stage 1-3 years
Preschool Stage 3-6 years
School Age 6-12 years
Adolescence 12-20 years

A

Divided into 5 stages

25
Development How develop - head to toes Head control before can wiggle toes - move head around before bladder control
Cephalocaudal
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Near to far Start to move arms and slowly move hands then move fingers Slowly gain control as age
Proximodistal
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Sit then crawl then walk then run
General to specific
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Sets the standard by which all children are measured – ranges in percentiles - every well visit - measured, length (depending on age), weight; plotted on growth curve and tells where at related to others in age Why are there different growth charts? (Ex. CDC, WHO) Which percentiles do you think we would worry about? What is FTT?
Growth chart
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WHO - used for first two years CDC - after 2 years
Why are there different growth charts? (Ex. CDC, WHO)
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Lower 5% and upper 5% Concerned if drop significantly - all based on age - pay attention to their curve - curve should stay same - concerned about big drops/rises
Which percentiles do you think we would worry about?
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Failure to thrive - infant regularly 5th percentile in BOTH height and weight Call for concern; red flag; not always mean cause of concern; r/o something else going on 3 diff categories lead to this See if meeting milestones - if are then not concerned
What is FTT?
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Inadequate calorie intake - not eating enough; psychosocial thing; not enough nutrients in food Inadequate absorption - Celiac or milk protein allergy Body requiring more so metabolic needs higher than what getting - r/t issue going on: hyperthyroidism, cardiac disease - working harder than healthy child to meet daily requirements; caloric needs of body too great - body spending more than can do; body spending more energy than taking in
3 diff categories lead to this - What is FTT?
33
VS and measuring height and weight are taken at a well-child check-up. The nurse then plots the child’s growth on the growth chart that the clinic has maintained since the client’s birth. Which information is MOST important for the nurse to share with the HCP regarding the findings on the growth chart? 1. The child’s height is at 25th percentile for her age 2. The child missed appointments between ages 7 and 12 months 3. The child’s height is at the 25th percentile but her weight is at the 10th percentile. 4. The child’s weight has dropped from the 25th percentile in the last 6 months.
Answer: 4 Concerned about dropped weight Ok for height and weight to be diff percentiles Missed appts between 7 and 12 months fine
34
Which considerations would be included in caring for an infant who is FTT? SATA 1. Dietary hx 2. Signs of malnutrition 3. Familial stress factors 4. 75th percentile for weight 5. Parent and infant interaction 6. Sustained growth under 5th percentile
Answer: 1,2,3,5,6 Rationale: parent stress and that interaction - PPD - interaction very hurt and impact child’s diet and relationship
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Single most important influence on growth Appetites fluctuate related to growth periods
Nutrition
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Toddlers - also not like sit stil which compounds that
What age group is most picky?
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Infants Adolescents biggest growth spurts
Which age groups have the highest nutritional requirement? (Hint: there are two)
38
Lack food r/t limited edu
How does someone's socioeconomic status impact their nutrition?
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Types of play Play most imp thing - encourage play and free play as much as possible Functions of play - why need them to play
Role of play
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Solitary play Onlooker play Parallel play Associative play Cooperative play
Types of play
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Most common in infants Playing by self
Solitary play
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First 2-3 yrs Watching other kids play; not participating; watching other kids interact and play
Onlooker play
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Toddlers - egocentric - not care about others unless take things from them; unrealistic expect understand sharing and taking turns Kids together - playing with same thing but not playing with it together Not playing together - looking same thing but not interacting with each other
Parallel play
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Preschool - starting to Play together Magical age group - magical is how they are thinking Lots dress up and costumes
Associative play
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School age and on Working together to score goal; clear rules and guidelines; working together to meet one goal
Cooperative play
46
Sensorimotor development Intellectual development Socialization Creativity Self-awareness Therapeutic value Morality
Functions of play - why need them to play
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Erik Erikson- Psychosocial Development** Jean Piaget- Cognitive Development**
Theorists
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How interacting with world Crisis with each developmental stage 1. Trust vs Mistrust 0 -1.5 years 2. Autonomy vs Shame and Doubt 1.5 – 3 years 3. Initiative vs Guilt 3-6 years 4. Industry vs Inferiority 6-12 years 5. Identity vs Identity Confusion 13-21 years
Erikson - psychosocial development
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Trust or not environment - how interact with world impacts self-esteem Needs met
1. Trust vs Mistrust 0 -1.5 years
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Toddler On own
2. Autonomy vs Shame and Doubt 1.5 – 3 years
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Preschooler wants be involved Wants be involved Likes winning (participation medals awesome)
3. Initiative vs Guilt 3-6 years
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Want real wins Want know successful and win things Helpful Loves volunteer Love making others happy and trying things; Learners - learning fun
4. Industry vs Inferiority 6-12 years
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School age Who are we in the world; who am I going to be Who going to be world - big questions; aligns with what parents, religious beliefs (own and parents)
5. Identity vs Identity Confusion 13-21 years
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1. Sensorimotor birth-2 years = Object permanence 2. Preoperational 2-7 years = Symbolic thinking 3. Concrete operational 7-11 years = Logical thought 4. Formal operational 11- adult = Abstract thought Cognitive development: Cognition or the ability to know
Piaget - cognitive development
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Using senses to explore their world Not see an object know still there Until understand object permanence then gone - lot fear in infants when parents leave - not know still there; less than 6 months not understand this; not see something then gone Senses to explore world
1. Sensorimotor birth-2 years = Object permanence
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Egocentric, magical thinking Very magical thinking
2. Preoperational 2-7 years = Symbolic thinking
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Thought process becomes logical, inductive reasoning Learn cause and effect Rationalize things; learn how things work and impact things
3. Concrete operational 7-11 years = Logical thought
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Thinking in future - understand how multiple things impact one thing and how our choices impact others Become adaptable and flexible
4. Formal operational 11- adult = Abstract thought