Paediatric - Nursing Flashcards
1
Q
Identify and discuss principals of Family Centred Care
A
- recognizes the unit of care as the family and not just the patient, accepts the family’s own definition of what they consider “family”
- provides an environment & care that promotes strengths and individuality of the family to enable them to care for their child
- understanding and incorporating developmental and emotional needs into provision of care
- assurance to family that care is flexible, accessible and responsive to family needs, recognizes family life and structure
- family is central and constant, others fluctuate
- facilitation of parent / professional collaboration in all areas of health care, sharing complete information about their child in a supportive manner
- respect, collaboration, support, enabling, empowerment, parent professional relationship
- parental presence - staying in room, contact & communication, expectations, freedom of choice
- parental involvement - parental roles, nursing roles, expectations, communication, acceptance & support
- role of nurse - therapeutic relationship, family advocacy & caring, disease prevention, health promotion, health teaching, support / counselling, restoration, coordination, collaboration, ethics
- communication - open, honest, non judgmental, supportive, individualized
- not effective communication - conflicting information, too much information, inability to adequately listen & act, close ended questions, interrupting & finishing sentences, tone & body language
2
Q
Kids Care acronym
A
K - knock
I - introduce
D - determine
S - safety
C - clean hands
A - advocate
R - respond
E - explain
3
Q
Principals of infant & child safety in the pediatric setting
A
- falls - use of cot sides to prevent children falling out of bed
- supervision by family / nurses if out of bed & in room to minimize any potential harm
- ensure medications are locked away, not left nearby to the child
- supporting the head correctly when lifting a baby
- keep hazardous material out of reach, dispose of equipment as used, avoid leaving sharps within reach of children
- supervise washes, check bath temperatures
- safety locks on devices that can produce scalding water, avoid use of kettles or anything that can be pulled down
- supervised eating if at risk of choking
4
Q
Effective strategies for working and communicating with children
A
- be in a warm, well lit environment
- firm direct approach, give minimal options, use quiet confident voice
- inspect painful areas last
- develop rapport with child and parents, involve & support parents
- rewards and positive reinforcement
- speaking to children at a level they will understand, avoid medical jargon
- respond timely to any request from either parent or child, develop understanding that their requests are important and do need to be raised and responded to
- explain clearly if there are going to be any changes to what is happening, daily schedule, anything coming up that may induce fear
- explain clearly and calmly any procedures that you may be undertaking, ensure both child and parents understand
5
Q
Health & Physical Assessment of a child
A
- across the room - rapid overview of clinical condition, directs urgency of care & intervention
- pediatric assessment triangle
- appearance - inspection findings - cardiovascular, respiratory, neurological
- circulation to skin - colour / pallor of skin
- work of breathing - use of accessory muscles
6
Q
Pediatriac Assessment - Weight & Height
A
- weight & height
- who - any child admitted
- why - for drug calculations, checking for FTT
- when - during admission process
- how - has to be bare weight
7
Q
Pediatriac Assessment - Hydration status
A
- hydration status
- why - anyone admitted, anyone with complaint of fluid loss - burns, gastro, heat loss, vomiting
- what - fluid intake & output, excessive sweating loss
- when - admission, once per shift, FBC calculated half hourly
- why - to calculate fluid rehydration therapy, bolus amount / maintainance amount, to find out prognosis, how - standard FBC
8
Q
Paediatric Assessment - Respiratory
A
- respiratory assessment
- who - anyone with primary respiratory complaint, included in vital signs
- when - vitals, at least twice per shift
- why - strong indicator of childs condition, provides baseline data
- how - inspection, percussion, palpation, oscultation
- look - level of activity, letheragy, interest in surroundings, colour (any obvious hypoxia), conscious state, respiratory rate 25-30, respiratory effort
- listen - across the room, what can be heard - cough, wheeze, stridor, breath sounds - crackles, wheeze, decreased air entry
- feel - pulse oximetry, blood gases (carbon dioxide, oxygen, bicarbonate, pH, peak flow - high: alkalosis, low: acidosis, chest x-ray - fluid, foreign bodies, shape of chest
9
Q
Paediatriac Assessment - Cardiovascular
A
- who - anyone being admitted, any history of cardiac conditions
- why - baseline data, to plan treatment
- when - admission, twice per shift, as part of vitals
- look - what do you see - colour (capiliary refil, perfusion of face / body), degree of activity (if impairment, play will be impaired), respiratory effort, perspiration, oedema
- listen - what do you hear - heart sounds 1, 2 (standard), 3, 4 (third heart sound can be normal, fourth is rare), up to 120-130, regular or irregular, gallop sounds / murmur
- feel - pulses - apical (in 4th or 5th intercostal space), brachial (medial side of arm), femoral (groin, medial portion of upper thigh), pedal (on foot)
10
Q
Cardiac Failure
A
- tachycardia, tachypnoea, perspiration, decreased urine output, fatigue, weakness, restlessness, pale cool extremities, decreased blood pressure, weakened peripheral pulses, gallop rhythm, cardiomegaly
11
Q
Neurological Assessment
A
- who - anyone undergoing surgery, general admission, any conditions that may impair cognition
- why - neurological surgery, post anesthesia, DKA (type 1), seizures, severe respiratory distress, neurological compromise, overdose
A - alert
V - responds to voice
P - responds to painful stimuli
U - unresponsive
12
Q
Patient History
A
- present illness
- associated signs/ symptoms
- past history
- previous episodes
- prenatal & perinatal birth history
- growth and development
- family history
13
Q
Primary & Secondary Assessment
A
A - airway B - breathing C - circulation D - disability / deformity E - exposure (remove clothing for weight) F - full set of vitals G - give comfort H - head to toe examination
14
Q
Red Flags - Alarm Bells
A
- parents conserned child is acting out of character
- poor balance, inability to walk in a straight line
- child no longer recognises / responds to parents
- child that does not physically or verbally respond to invasive procedures
15
Q
Asthma
A
- narrowing of the small airways (bronchospasm), increased mucous production
- causes - URTI, dust, exercise, seasonal changes, pet hair, pollens
- presentation - shortness of breath, increased work of breathing, tachycardia, tachypnoea, cough, wheeze (unless airway is occluded)
- management - continual assessment of respiratory status, bronchodilators, corticosteroids (reduce inflammation), supplemental oxygen, aminophylline, hydration, can deteriorate quickly
