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168.362 > Peadiatrics > Flashcards

Peadiatrics Flashcards

1
Q

What is family-centered care?

A
  • Based on the tenets of Attachment Theory
  • Recognizes family as constant in child’s life
  • Systems must support, respect, encourage and enhance the family’s strength and competence
  • Need so family must be addressed
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2
Q

What are some stressors of Hospitalization?

A

Separation anxiety
- Protest phase - crying and screaming, clinging to parent
- Despair phase - crying stops; evidence of depression
Detachment (denial) phase - resignation but not contentment; superficial adjustment, may seriously affect attachment to the parent after separation

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3
Q

What are some things infant needs when there is a loss of control?

A
  • Trust
  • Consistent loving caregivers
  • Daily routines
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4
Q

What are preschooler needs when there is a loss of control?

A
  • Egocentric and magical thinking is typical of this age
  • May view illness or hospitalization as punishment for misdeeds
    Preoperational thought
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5
Q

What are school-age children needs?

A
  • Striving for independence and productivity
    Fears of death, abandonment, permanent injury
  • Boredom
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6
Q

What are adolescent needs?

A
  • Struggle for independence and liberation
  • Separation from the peer group
  • May respond with anger and frustration
  • Need for information about their condition
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7
Q

How to normalise the hospital environment?

A
  • Maintain the child’s routine, if possible
  • Time structuring
  • Self-care (age appropriate)
  • Schoolwork
  • Friends and visitors
  • Introductions to other patient’s and their families
  • Helping out the staff
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8
Q

What are the normal values after 1 week of birth?

A

RR: 30-60
PR: 100-160
Systolic BP: 50-70

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9
Q

What are the normal values of a 1-6 week infant?

A

RR: 30-60
PR: 100-160
Systolic BP: 70-95

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10
Q

What are the normal values of a 6 months infant?

A

RR: 25-40
PR: 90-120
Systolic BP: 80-100

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11
Q

What are the normal values of a 1-year-old?

A

RR: 20-30
PR: 90-120
Systolic BP: 80-100

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12
Q

What are the normal values of a 3-year-old?

A

RR: 20-30
PR: 80-120
Systolic BP: 80-110

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13
Q

What are the normal values of a 6-year-old

A

RR: 18-25
PR: 70-110
Systolic BP: 80-110

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14
Q

What are the normal values of a 10-year-old

A

RR: 15-20
PR: 60-90
Systolic BP: 90-120

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15
Q

What are some important factors for normal values?

A
  • Patients normal should always be considered
  • HR, BP & RR will increase during fever and stress
  • RR on infants count for 60 seconds
  • In clinically decompensating child BP last to change
  • Bradycardia in children- ominous sign - usually from hypoxia
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16
Q

How to prepare a child for procedures?

A

Main goal is to decrease anxiety, promote cooperation, and support coping skills

  • Psychological preparation
  • Establish trust and provide support
  • Parental presence and support
  • Explanation to the child
17
Q

How to perform procedures for children?

A
  • Use of the treatment room for procedures
  • Expect success, best person for the job
  • Involve the child - let the child help if able
  • Provide distraction; use of play in procedures - age appropriate
  • Encourage expression of feelings
  • Provide support and encouragement through procedure; rewards help
  • Prepare the family
18
Q

What are the risks for developing illnesses throughout the ages?

A
  • Younger than 3 months - maternal antibodies offer protection
  • 3-6 months - the infection rate increases
  • Toddlers and preschoolers - high rate of viral infections
  • Older than 5 years- increase in GABHS and Mycoplasma pneumoniae infections
  • Increased immunity develops with age
19
Q

What is the difference between a child’s airways or an adults?

A
  • Diameter of airways are smaller
  • Distance between structures is shorter, allows organisms to rapidly move down
  • Short and open eustachian tubes
20
Q

What are some respiratory problems in children?

A
  • Croup syndromes
  • Bronchitis
  • Bronchiolitis
  • Asthma
  • Epiglottis
21
Q

What are the clinical manifestations of respiratory infections?

A
  • Varies with age
  • Generalised signs and symptoms and local manifestations differ in young children
  • Fever
  • Anorexia
  • Cough, sore throat, nasal blockage or discharge
  • Adventitious respiratory sounds
22
Q

What are some nursing interventions for respiratory infections?

A
  • Ease the respiratory effort
  • Manage fever
  • Promote rest and comfort
  • Control infection
  • Promote hydration and nutrition
  • Provide family support and teaching
23
Q

What are Croup Syndromes - URTI?

A
  • Characterized by hoarseness, barking cough, inspiratory stridor, and varying degrees of respiratory distress
  • Affects the larynx, trachea, and bronchi
  • Problematic in infants and small children due to smaller diameter of airways
24
Q

What is acute epiglottitis?

A
  • Sore throat, pain, tripod positioning, retractions
  • Inspiratory stridor, mild hypoxia, distress
  • Potential for respiratory obstruction
25
Q

How to prevent acute epiglottitis?

A

Haemophilus influenzae type b (Hib) vaccine

26
Q

What is the therapeutic management for acute epiglottitis?

A
  • Presumptive diagnosis of epiglottitis constitutes a medical emergency
  • Should not be examined until anesthetist presents as immediate intubation or tracheostomy may be indicated for airway obstruction
  • Keep patient calm, comfortable and minimise any distress
27
Q

What is bronchiolitis?

A
  • Respiratory syncytial virus (RSV)
  • Causes childhood pneumonia as well
  • Acute viral infection, bronchiolar level
  • Rare in children over 2 years; usually 3-6 months
  • Spread by hand to eye, nose and other mucus membranes
28
Q

What is febrile convulsion/ seizures?

A
  • Most occurs 6 months to 3 years
  • Boys are affected twice as often
  • Most are generalised, last least than 5 minutes
  • 30% of children have one occurrence
  • Cause uncertain, rarely any long-term effects and are relatively harmless
  • > 38.8 degree and occurs during temp rise
  • Accompanying illness; otitis media, respiratory infections
29
Q

What is the nursing management for febrile convulsions/seizures?

A
  • Stay calm
  • Think safety during and after seizure
  • Call for help
  • If lasting more than 5 minutes, doctor consultation
  • Observe and examine for origin of fever
  • Parental support and education - don’t put anything in the mouth, don’t put them in a cold bath or shower; loosen clothes around face and neck
30
Q

What are signs of distress to look out for in a child?

A

Appearance:

  • Abnormal tones
  • Decreased interactiveness
  • Decreased consolobility
  • Abnormal look/gaze
  • Abnormal speech/cry

Circulation to skin

  • Pallor
  • Motting
  • Cyanosis

Work of breathing

  • Abnormal sounds
  • Abnormal position
  • Retrations
  • Flaring
  • Apnea/gasping
31
Q

What does CUPS stand for in paediatrics?

A 
Measures the severity of the illness
C - critical
U - unstable
P - potentially unstable
S - stable
32
Q

What are key assessments you need to consider when caring for a child?

A
  • Health history - previous hospitilisation, immunisation status, medications
  • Nutrition - Feeding appetite, allergies, food diary
  • Family structure - family dynamics, culture (family norms), potential abuse
  • Physical - weight, vital signs, level of consciousness, skin color, temperature
  • Developmental - sensor & motor movements for age, interaction, physiological development
33
Q

What is AVPU?

A

A - awake and alert
V - responsive to verbal stimuli
P - responsive to painful stimuli
U - completely unresponsive

168.362 (8 decks)

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