Introduction to Pediatric Nursing Flashcards
Define morbidity
Prevalence of a specific illness in the population at a particular time
Define mortality
Number of individuals who have died over time
What is the most effective strategy to reduce childhood morbidity and mortality?
Education for children and families
What are the benefits of understanding mortality / morbidity? (3)
- Recognizing age groups at risk
- Prevention / treatment
- Planning / delivery of care
What populations have an increased morbidity? (5)
- Preemies (LBW)
- Children in day care
- Children with mental disabilities
- Homeless / poverty children
- Immigrant children
______ is the most common nutritional problem among American children
Obesity
What are the risk factors of obesity / type II diabetes? (5)
- American diet
- Sedentary lifestyle
- High cholesterol
- Hypertension
- Heart disease
What BMI is considered obese for children?
> 95 percentile for same age / gender
______ are the most common cause of death / disability to children in the U.S.
Injuries
Type of injury is often related to ______
Growth / development
Why are children at high risk of injury?
They are innately curious - predisposition for hazards
What are the risk factors of injuries in children? (4)
- Curiosity
- Developmental level
- Peer pressure
- Temperament
What is the primary risk factor associated with infants?
Putting things in mouth
What are the risk factors associated with toddlers / pre school children ? (2)
- Lack of awareness
- Not learning from experiences
What is concrete thinking?
Awareness regarding danger
When is concrete thinking developed?
In school aged children
What are the risk factors associated with school age children? (2)
- No regard for risks
- No planning
What are the risk factors associated with adolescents? (2)
- Feeling invincible
- Peer pressure
Describe the anatomy specific to young children (3)
- Large head
- Large spleen / abdomen (organs more superficial)
- Small, light body
65% of all unintentional poisonings are
reported in children younger than age ______
5
Pediatric nursing is …
Family centered – must recognize the family as a constant in a child’s life
Describe atraumatic care
Therapeutic care through interventions that minimize distress for children / families
Describe some examples of atraumatic care (3)
- Pain control - EMLA cream 30 min before needle stick
- Allowing caregivers to stay overnight
- Allowing children to play with medical equipment
What are the typical side effects associated with immunizations? (4)
- Low grade fever
- Injection site pain
- Redness
- Fussiness
How are immunization side effects managed for pediatrics?
Acetaminophen
Describe the process that occurs from an immunization (3)
- Introduces an antigen into the body to trigger an immune response
- Antibodies develop
- Antibodies respond to specific antigens - active immunity
What are the types of live vaccines? (2)
- MMR (measles, mumps, rubella)
- Varicella (chickenpox)
What are the contraindications of live vaccines? (3)
- Children with impaired immune system
- Children living with an immunosuppressed person
- Pregnancy / planning pregnancy within 3 months
Do not administer vaccines if the child has ______
Severe febrile illness
What are the guidelines for pediatric vaccines? (2)
- Preterm infants are immunized at appropriate chronological ages regardless of weight
- All states require immunizations prior to entry into licensed child-care / school (exceptions exist)
According to The National Childhood Vaccine Injury Act …
Children who have suffered injury / death from a vaccine may seek compensation
What is required under The National Childhood Vaccine Injury Act?
Personal immunization record within permanent record
What information must be recorded at the time of immunization? (5)
- Date of administration
- Vaccine / manufacturer
- Site / route of administration
- Lot number / expiration date
- Name of provider giving the vaccine
______ must be obtained before any immunization is given
Informed consent
How must information about the vaccine be given?
Verbally AND in writing
Describe adverse events (2)
- Any medical event following vaccination
- May be true reaction OR coincidental
Describe adverse reactions / side effects (2)
- Extraneous effects caused by vaccination
- Local, systemic, severe
Parental concerns associated with immunizations are often a result of …
Unfounded fears due to lack of knowledge
Describe nursing care related to parental concerns about immunizations (2)
- Provide complete, accurate information regarding vaccines
- MUST ultimately respect the parent’s wishes **
What are some methods to get further information from a child? (2)
- Direct observation (non-verbals)
- Asking the child to point to their pain
Describe communication with children / families (5)
- Use open ended questions
- Get down to the child’s level
- Talk directly to the child
- Speak in simple terms
- Offer choices
What are the major stressors encountered by young children? (4)
- Changes to routines
- Fear of pain / injury
- Loss of control
- Separation anxiety **
______ is the most prevalent stressor from middle infancy through pre-school years
Separation anxiety
Separation anxiety is also called ______
Anaclictic depression
How does separation anxiety change during older childhood through adolescence?
Shifts towards separation from peers rather than parents
Describe methods to decrease fear of bodily injury (2)
- Modify techniques based on age group
- Explain in developmentally appropriate terms
Describe an example of modifying a technique based on age group
Rectal thermometer may be traumtic for preschoolers - use another method
The FACE pain scale is used for what age group?
Pre schoolers (3 - 5 years)
The numeric pain scale is used for what age group?
> 5 years
What tool is used to assess pain in children unable to communicate verbally?
FLACC
Describe the FLACC scale
- Face
- Legs
- Activity
- Cry
- Consolability
Describe timing of procedure preparation based on age
The younger the child –> explain closer to procedure
When preparing children for procedures, ALWAYS consider ______
Developmental level
Describe the methods for preparing a child for a procedure (4)
- Allow child to yell / cry
- Never punish the child
- Praise for everything (even if not cooperative)
- Perform painful procedures in the treatment room only
What method of therapeutic holding is often used for children during procedures?
Swaddling / arm boards
Who can give informed consent? (2)
- Parent / legal guardian
- Authorized adult - must have written permission from parent
Describe verbal consent
Must have two witnesses listening simultaneously
Describe consent in an emergent situation
A minor can be examined, treated, stabilized, and transferred to another hospital for emergency care without consent
When is informed consent required? (7)
- Surgery
- Invasive diagnostic tests (lumbar puncture, bone marrow aspiration, biopsy, cardiac catheter)
- High risk treatments (chemo, dialysis)
- Research
- Photography
- Autopsy
- Release of medical information
It is considered ______ if informed consent is not obtained when required
Assault / battery
An individual under the age of 18 who is legally independent is considered ______
An emancipated minor
Under what circumstances can a minor be considered legally independent? (5)
- Married
- Pregnant / has a child
- Graduated high school
- Self supporting (living independently)
- Military service
Emancipated minors may …
Consent for themselves (and their children)
What is assent?
Indicates that a child has been informed about a treatment / procedure and is willing to allow it to happen
Older children should provide ______ along with parental consent
Assent
Describe solitary play
A child plays alone (infants)
Describe parallel play
Children play next to each other but do not interact (toddlers)
Describe associative play
Children play with shared toys, but have different ideas / goals (pre schoolers)
Describe cooperative play
Children work together to achieve a common goal (school age / adolescents)
