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

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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
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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
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4
Q

Rooming In

A

Parents are allowed to stay with hospitalized children

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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

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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
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7
Q

Family Structural Assessment Areas

A
  • Family Composition
  • Home and Community Environment
  • Occupation and Education of Family Members
  • Cultural and Religious Traditions
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8
Q

Family Functional Assessment Areas

A
  • Family Interactions and roles
  • Power, decision making, and problem solving
  • Communication
  • Expression of feelings and individuality
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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

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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
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11
Q

Primary Prevention

A

Activities that decrease opportunity for illness of injury such as immunizations and car seats

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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

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13
Q

Tertiary prevention

A

Restoration to optimum function such as rehabilitation and disease management programs

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14
Q

Common health problems in infants

A
  • Nutritional disburances
  • Feeding Difficulities
  • Disorders of unknown etiology (apnea, SIDS)
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15
Q

Common health problems in toddler and preschooler (1-5 years)

A
  • Infectious Disorders
  • Intestinal parasitic disease
  • Ingestion of injurious agents
  • Child Maltreatment
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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
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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
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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
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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
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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
25
Q

Effective Communication Techniques Adolescent

A
  • 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
26
Q

Prepare infant for procedures

A
  • talk to the infant even though tthe infant may have no cencrete understanding of verbal communication, infants respond to a soothing voice
27
Q

Prepare toddler for procedures

A
  • integrate the toddler’s own words into the explanation
  • explain the procedures immediately before they are carried out
28
Q

Prepare school-age child for procedures

A
  • explain the procedures several days in advance if possible
  • utilize reading materials, books, videos, and drawings to explain procedures
29
Q

Prepare adolescent for procedures

A
  • 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
30
Q

Most significant stressors for hosptialized children of all ages

A
  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
31
Q

TNI Infant Stress

A
  • encourage parental presence
  • adhere to infant’s home routine
  • utilize topical anesthetics or pre-procedural sedation
  • promote a quiet environment
32
Q

TNI Toddler Stress

A
  • Encourage parental presence
  • Allow choices when possible
  • Utilize topical anesthetics or pre-procedural sedation
  • Explain all procedures
  • Provide a nighlight or flashlight
33
Q

TNI Preschooler Stress

A
  • Encourage parental presence
  • Allow choices when possible
  • Utilize topical anesthetics or pre-procedural sedation
  • Explain all procedures
  • Provide a nightlight or flashlight
34
Q

TNI School-Age Stress

A
  • Encourage parental participation
  • Allow choices when possible
  • Explain all procedures and offer reassurances
  • Utilize topical anesthetics or pre-procedural sedation
  • Encourage peer interaction
35
Q

TNI Adolescent Stresss

A
  • 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
36
Q

Stages of separation anxiety

A
  • Protest
  • Despair
  • Denial
37
Q

Protest Stage

A

Screaming, crying, clinging to parents, withdrawal from other adults

38
Q

Despair Stage

A

sadness, depression, withdrawal or compliant behavior, crying when parents appear

39
Q

Denial Stage

A

lack of protest when parents leave, appear happy and content with everyone, close relationships not established and developmental delay possible

40
Q

Treatment room

A

special room utilized for the pedatric population for procedures such as venipuncures, lumbar punctures, and blood draws

41
Q

Roles of Parent/Primary Caregiver in healthcare setting

A
  • 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
Q

Role of RN in child healthcare setting

A
  • 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
Q

Factors leading to community and home healthcare

A
  • 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
44
Q

Child Life Specialists

A

professional or volunteer staff that focuses on the psychosocial needs of hospitalized children

45
Q

Roles of the child life sepcialists

A
  • 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
46
Q

Purposes of Play

A
  • 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
47
Q

Purposes of therapeutic play

A
  • 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
48
Q
A