Pedatrics/Family Flashcards
1
Q
Family
A
individuals who are joined together by marriage, blood, adoption, or residence in the same household. Depend on each other for emotional, physical, and economic support. Families are guided by a set of values or beliefs
2
Q
Types of families
A
- Traditional Nuclear Family
- Two-Income Family
- Blended Family
- Extended Family
- Single-Parent Family
- Binuclear Family
- Heterosexual Cohabitating Family
- Gay and Lesbian Family
3
Q
Roles of the Family
A
- Caring, nuturing and educating children
- Maintaining the continuity of society by transmitting its knowledge, customs, values, and beliefs to children
- Recieving and giving love
- Preparing children to become productive members of society
- Meeting the needs of its members
- Serving as a buffer bwtween its members and environmental and societal demands while addressing the interests and needs of the individual family members
4
Q
Rooming In
A
Parents are allowed to stay with hospitalized children
5
Q
Family-centered care
A
mutually beneficial partnership develops between families and the RN, so the priorities and needs of the family are addressed when the family seeks healthcare for the child
6
Q
Elements of family centered care
A
- family is the constant
- family-professional collaboration
- family-professional communication
- cultural diversity of families
- comping differences
- family-centered peer support
- specialed service and support systems
- holistic perspective of family-centered care
7
Q
Family Structural Assessment Areas
A
- Family Composition
- Home and Community Environment
- Occupation and Education of Family Members
- Cultural and Religious Traditions
8
Q
Family Functional Assessment Areas
A
- Family Interactions and roles
- Power, decision making, and problem solving
- Communication
- Expression of feelings and individuality
9
Q
Well Child Care
A
includes health promotion and health protection. Health promotion refers to activities that increase the well-being and enhances wellness or health
10
Q
Examples of health promotion
A
- enhance nutrition
- integrate physical activity into daily events
- provide adequate housing
- promote oral health
- foster positive personality development
- provide anticipatory guidance - understand upcoming developmental stages and teach families how to create an environment to meet the milestones of the stages
11
Q
Primary Prevention
A
Activities that decrease opportunity for illness of injury such as immunizations and car seats
12
Q
Secondary Prevention
A
Early diagnosis and treatment of a condition to lessen its severity such as developmental screening and vision and hearing screening
13
Q
Tertiary prevention
A
Restoration to optimum function such as rehabilitation and disease management programs
14
Q
Common health problems in infants
A
- Nutritional disburances
- Feeding Difficulities
- Disorders of unknown etiology (apnea, SIDS)
15
Q
Common health problems in toddler and preschooler (1-5 years)
A
- Infectious Disorders
- Intestinal parasitic disease
- Ingestion of injurious agents
- Child Maltreatment
16
Q
Common Health Problems in School Age and Adolescent (6-18)
A
- Infectious mononucleosis
- Smoking
- Altered growth and maturation
- Disorders r/t the reproductive system
- Health problems r/t sexuality
- Eating Disorders
- Disorders with behavioral components
- Substance Abuse
- Suicide
17
Q
Infant Developmental
A
- By 6 months, infants have developed an awareness of themselves as separate from their parents
- They are unaware of the effects of illness, but are capable of sensing distress in their parents
18
Q
Toddler and Preschooler Developmental
A
- Begin to understand illness, but not its cause
- Two unrelated events may appear to have cause and effect relationship for young children
- Children may blame othe rpeople, events, or themselves for becoming ill
- The child’s concept of the body usually is limited to names and locations of some body parts
19
Q
School-age Developmental
A
- The child’s concept of body parts and function is maturing
- Older school-age children have a more realistic understanding of the reasons for illness and are able to comprehend explanations
20
Q
Adolescent Developmental
A
- After age 11, adolescents b ecome increasingly aware of the physiologic, psychologic, and behavioral casuses of illness
- Age 11-13, adolescents can describe the location and function of major organs
- Adolescents are concerned with appearance and perceive an illness or injury in terms of its effect on their body images
21
Q
Knowledge of physical and psychosocial development influences nursing care of the children by:
A
- guiding nursing assessment
- explaining behavior
- providing direction for therapeutic nursing interventions
- anticipate certain reactions, responses, and needs
- encourage client behavior that is appropriate for the developmental stage
22
Q
Effective Communication techniques Infant
A
- Do not block the infant’s view of parents
- Do not remove the infant from parent’s arms unless necessary
- Speak in a high-pitched, soft tone
- Establish eye contact with the infant
- Use swaddling, rubbing, patting, cuddling, or rocking to quiet a crying infant
- be arare that stranger anxiety may occur in infant’s age 6-12 months
23
Q
Effective Communication Techniques Toddler and Preschooler
A
- acknowledge the child, but interact with parents before communicating with the child
- communicate with the child at his or her eye level
- communicate using simple language and short sentences
- be honest in response to the child
- encourage the child to engage in imaginative play with dolls, drawings, or puppets to allow the child to act out feelings and thoughts
- Encourage preschoolers to engage in dramatic and associative play
- allow the child the opportunity to ask questions
- avoid using expressions and vocabulary that are likely to be misunderstood by the child
- offer the toddler choices when possible
24
Q
Effective Communication Techniques School-Age
A
- explain all procedures, techniques, and events
- speak directly to the child
- be honest in response to the child
- encourage the child to express thoughts and feelings through drawing, writing, or painting
- provide the child with third person conversation prompts such as sometimes kids have told me that they are afraid of having surgery
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Effective Communication Techniques Adolescent
* Use a straightforward approach and explain the purpose of the interaction
* Encourage the adolescent's participation by initating a topic unrelated to health
* reassure the adolescent that he or she does not have to talk until ready
* do no tinterrupt and avoid comments or expressions that convey disapproval or surprise
* be aware of laws and limits regarding confidentiality
* provide the adolescent the opportunity to interact with the RN in private, without the parents present
* Listen more than you talk
* Offer the adolescent choices when possible
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Prepare infant for procedures
* talk to the infant even though tthe infant may have no cencrete understanding of verbal communication, infants respond to a soothing voice
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Prepare toddler for procedures
* integrate the toddler's own words into the explanation
* explain the procedures immediately before they are carried out
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Prepare school-age child for procedures
* explain the procedures several days in advance if possible
* utilize reading materials, books, videos, and drawings to explain procedures
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Prepare adolescent for procedures
* Explain the procedures up to 1 week in advance
* Utilize peer mentoring to assist in explaining procedures
* Utilize reading materials and videos to assist in explaining procedures
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Most significant stressors for hosptialized children of all ages
1. Separation from parents or primary care giver (or peers)
2. Loss of self-control, autonomy, and privacy
3. Painful or invasive procedures
4. Fear of bodily injury and disfigurement
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TNI Infant Stress
* encourage parental presence
* adhere to infant's home routine
* utilize topical anesthetics or pre-procedural sedation
* promote a quiet environment
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TNI Toddler Stress
* Encourage parental presence
* Allow choices when possible
* Utilize topical anesthetics or pre-procedural sedation
* Explain all procedures
* Provide a nighlight or flashlight
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TNI Preschooler Stress
* Encourage parental presence
* Allow choices when possible
* Utilize topical anesthetics or pre-procedural sedation
* Explain all procedures
* Provide a nightlight or flashlight
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TNI School-Age Stress
* Encourage parental participation
* Allow choices when possible
* Explain all procedures and offer reassurances
* Utilize topical anesthetics or pre-procedural sedation
* Encourage peer interaction
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TNI Adolescent Stresss
* Include in the plan of care
* Encourage discussion of fears and anxieties
* explain all procedures
* ask about his or her desire for parental involvement
* encourage peer interaction
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Stages of separation anxiety
* Protest
* Despair
* Denial
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Protest Stage
Screaming, crying, clinging to parents, withdrawal from other adults
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Despair Stage
sadness, depression, withdrawal or compliant behavior, crying when parents appear
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Denial Stage
lack of protest when parents leave, appear happy and content with everyone, close relationships not established and developmental delay possible
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Treatment room
special room utilized for the pedatric population for procedures such as venipuncures, lumbar punctures, and blood draws
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Roles of Parent/Primary Caregiver in healthcare setting
* participate in prep of child for procedures and take part in care of the child
* assist siblings to understand parental absence and the need for additional responsibilities at home
* prepare for possible anger, resentment, jealously, and guilt of siblings who remain at home
* parental presence during hospitalization (or rooming in) during the course of hospitalization
42
Role of RN in child healthcare setting
* Develop a therapeutic relationship
* Serve as a family advocate
* Educate regarding health promotion and health protection
* Health education common reactions to illness and hospitlization including regression and guilt and shame
* Offer support and counseling
* Carry out the nursing process
* Coordinate and collaborate in care
* Participate in research
43
Factors leading to community and home healthcare
* Healthcare costs substantially less expensive than hosptial care
* Third-party payers favor home care to control costs
* Design of portable medical and infusion therapy equipment for home care use
* Ability of institutions and agencies to successfully deliver high tech services in the home
* Families who prefer to care for their child in the home rather than an institution
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Child Life Specialists
professional or volunteer staff that focuses on the psychosocial needs of hospitalized children
45
Roles of the child life sepcialists
* Plan activities to promote age-appropriate play
* Some of the planned activities are designed to assist children in working through feelings about illness including
* playing with medical equipment
* acting out procedures or treatments on dolls
* using games to act out feelings
* drawing pictures about hospital treatments
* a trusted child life specialist may stay with a child during a particularly frightening procedure such as a venipuncture
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Purposes of Play
* Component of childhood
* Work of children, language of children
* Confirms what children know about their world and allows them to explore the rest
* Normal development is faciliatated by play
* Cognitive, psychomotor, social functions
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Purposes of therapeutic play
* active role for children, allowing them to gain an increased sense of independence
* opportunity to relive, understand, and integrate fearful healthcare experiences
* sense of mastery by being in control of the occurences during play
* helps lessen the child's stress an anxiety
* gives the RN insights into what type of events are stress producing
* RN can assess the child's knowledge of his/her illness
* Dramatic play, medical situations are reenacated by the child, often assisting the child to cope with painful treatments and intrusive procedures
* The child can play with medical equipment allowing them to become familiar with the hospital environment
* Offers insight into the child's concerns and level of undering, providing the RN the opportunity to correct misconceptions
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