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Paeds > Lecture Day 1 The child in hospital > Flashcards

Lecture Day 1 The child in hospital Flashcards

1
Q

How many children are admitted to hospital before starting school?

A

1/3

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2
Q

Most common age to be admitted to hospital

why?

A

< 1

  • difficult to assess
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3
Q

Most common causes for medical admission in childhood?

A
  1. Resp: URTI, asthma
  2. Environment: Head injury, poisoning
  3. GI: Gastroenteritis
  4. Infection
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4
Q

Advantages of admission

A 
observation
diagnosis 
Investigation
Tx 
Reassurance for doctors &amp; paretns
rapid senior review
team involvement
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5
Q

Disadvantages of admission

A 
seperation/psychologcial 
infection 
disruption to family expense
worry
cost
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6
Q

What is attachment behaviour

A 
individual attaining proximity to other
Seperation -> 
1. Protest
2. Despair 
3. Detachment
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7
Q

When is attachment behaviour prominent

A

6 - 36 months

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8
Q

When is differential smiling present

A

6 months

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9
Q

Stranger anxiety

A

9 months

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10
Q

How to avoid attachment behaviour?

A

If aged 1-3 and sitting on parents lap, do not remove child.

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11
Q

What promoted attachment?

A 
Maternal sensitivity
Warmth
Emotional responsiveness
Involvement
Reciprocity
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12
Q

What are the features of secure attachment

A

Secure base effect, distressed on separation, greets positively on return

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13
Q

What are the features of insecure attachment

A

Difficult to settle/angry/ ignores on reunion
Explores with no anxiety,
Little distress on separation, ignore on reunion
Fear of or for the care giver

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14
Q

What is associated with insecure attachment?

A

Poor parenting/abuse

  • post natal depression
  • drug & alcohol issues
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15
Q

Assessment of attachment

A

Observe how young children react to separation & reunion with caregivers.

Behaviours on separation and reunion
Patterns of comfort seeking when hurt/ upset
Reliance on caregivers when help needed
Affection shown to caregivers
Exploratory behaviour in different settings
Co-operativeness
Controlling behaviour (seeking to control caregiver)

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16
Q

How to manage attachment issues in hospital

A

Look for ways to include attachment figures and/or promote new attachments to help children manage distress

17
Q

How to 5-7 interpret ppl getting ill

A

Done something wrong, magic or punishment

  • Can name few body parts they can see
  • Doctor deliberate set out to hurt children
18
Q

8-11 interpret ppl getting ill

A

Belief of contagious, bugs & germs

  • don’t mean to hurt but don’t care about pain that’s caused
  • if u don’t scream doctors won’t know it hurts
19
Q

13-14 years

A

More sophisticated models:

Bio-psycho-social

Paeds (20 decks)

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