Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Peds > Pediatric Assessment (Health Supervision only) > Flashcards

Pediatric Assessment (Health Supervision only) Flashcards

Exam 2

1
Q

Principles of Health Supervision- What are the three components?

A
  1. Developmental surveillance and screening
  2. Injury and disease prevention
  3. Health promotion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Principles of Health Supervision involves what?

A

Involved providing service proactively with the goal of optimizing the child’s level of functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Principles of Health Supervision ensures what?

A

Ensures the child is growing and promotes health through education- anticipatory guidance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When does health supervision begin and continue through?

A

Health supervision begins at birth and continue through adolescence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the focus of pediatric health supervision?

A

The focus of pediatric health supervision is wellness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Settings for health supervision- What kind of place?

A

Any place that can be publicly accessed by children and their families

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Settings for health supervision- Examples?

A

Private physician offices
Freestanding clinics in retail stores
Community health department clinics
Nonprofit community-based clinics with sliding scale payments
Homeless shelters
Daycare centers
Schools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Medical home is what kind of approach to care?

A

A medical home is an approach to care that builds a long-term and comprehensive relationship with the family.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Medical home: The continuing relationship between family and care team leads to what?

A

This continuing relationship promotes trust between the care team and the family leading to comprehensive, continuous, coordinated, and cost-effective care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Medical home: Provider has what kind of relationship with the patient?

A

Provider has a long-term, trusting and comprehensive relationship with patient and family from infancy through adolescence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Medical home: What kind of care is provided?

A

Family-centered care; providers are respectful of family’s customs and beliefs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Medical home: How accessible is care in a medical home?

A

Care is accessible, affordable, and comprehensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Medical home: How is specialty care received?

A

Delivery of specialty care is coordinated in the medical home

Provider is accessible for and responsive to questions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Medical home: Partnerships

A

The child is the focus.

Child’s health is linked to needs and resources of the family and community.

Partnerships between community agencies, schools, churches, other health facilities, programs can enhance the health of the child.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Slides 25

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Components of health supervision include:

A

History and physical assessment, including head circumference until 2 years old, height, and weight.

Developmental/behavioral assessment.

Sensory screening (vision and hearing).

Appropriate at-risk screening (lead, anemia, tuberculin, hypertension, cholesterol)

Immunizations

Health promotion/anticipatory guidance (injury prevention, violence prevention, nutrition counseling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

History and physical assessment, including head circumference until 2 years old, height, and weight.

When should this info be collected?

A

Recommendations are: within first week of life, 1 month, 2 months, 4, 6, 9, 12, 15, 18, 24, 30 months, and then yearly until age 21.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Developmental surveillance

A

Developmental surveillance: ongoing collection of skilled observations made over time during health care visits. These include:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Developmental surveillance includes:

A

Noting and addressing the parental concerns

Obtaining a developmental history

Making accurate observations

Consulting with relevant professionals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Developmental screenings:

A

brief assessment procedures that identify children who warrant more intensive assessment and testing. May be observational or by caregiver report.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

APA recommends screening for autism when?

Risk of Drug Abuse when?

Risk of Depression when?

A

*AAP also recommends screening for autism 18-24 months and risk assessment for drug and alcohol abuse, as well as depression screening 11 -21 years of age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What kind of child would need an immediate evaluation?

A

Any child that “loses” a developmental milestone needs an immediate evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Risk factors for developmental problems

List first 6:

A
  1. Birthweight <1.5kg
  2. Gestational age <33 weeks
  3. Central nervous system abnormality
  4. Hypoxic ischemic encephalopathy
  5. Maternal prenatal alcohol or drug abuse
  6. Hypertonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Risk factors for developmental problems

Next 6:

A

Hypotonia
Hyperbilirubinemia requiring exchange transfusion
Kernicterus
Congenital malformations
Symmetric intrauterine growth deficiency
Perinatal or congenital infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Risk factors for developmental problems

Next 7:

A

Suspected sensory impairment

Chronic (>3mos) otitis media with effusion

Inborn error of metabolism

HIV

Lead level >5 mg/dL

Inappropriate parental concern about developmental issues (not allowing 3 year old to feed themselves)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Risk factors for developmental problems

Last 4

A

Parent with less than high school education

Single parent

Sibling with developmental problems

Parents with developmental disability or mental illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Injury prevention: How is it accomplished?

A

accomplished through education, anticipatory guidance, and physical changes in the environment. (unintentional vs. intentional)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Disease prevention- why are interventions preformed?

A

Disease prevention –> interventions performed to protect children from a disease or to identify at an early stage and lessen its consequences. (ex: Screening tests, immunizations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Screening Tests are what

A

Screening tests are procedures or lab analyses used to identify children with a certain condition.

These tests are done to ensure that no child is missed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Screening tests have a high what and a low what?

A

They have a high sensitivity (high false-positive) and low specificity (low false negative rate).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the screening types:

A
  1. Risk assessments
  2. Universal screening
  3. Selective screening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Risk assessments- includes what and what does it determine

A

Includes objective and subjective data to determine the likelihood that the child will develop a condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Universal screening

A

Screening of an entire population regardless of the child’s individual risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Selective screening

A

Done when a risk assessment indicates the child has one or more risk factors for a disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Metabolic screening- who is it determined by?

A

Metabolic  determined by state law.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

All states screen for how many health conditions? How many more do others screen?

A

All states screen for 26 health conditions, some screen for over 50.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

March of Dimes recommends screening for how many health conditions?

A

March of Dimes currently recommends 30 for which there are effective treatment options.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Hearing- Who does the AAP recommend this screening for?

A

Hearing –> AAP recommends screening for all infants.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is a common condition in newborns?

A

Hearing loss is a common condition in newborns, and even if mild can cause serious developmental delays.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Mild hearing loss can lead to what in newborns?

A

mild can cause serious developmental delays.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Universal hearing screening with objective testing is recommended at ages:

A

Universal hearing screening with objective testing is recommended at ages 4, 5, 6, 8, and 10.

At ages 7, 9, and 11 through 21, appropriate risk assessment should be performed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

For preverbal children (newborns and older) how are screening tests conducted?

A

Auditory skill monitoring by assessing reaction to sounds–does the child react to parent voice or loud noise appropriately?

Developmental surveillance–does the child try to vocalize?

Parental concerns–do the parents have concerns about the child hearing? Any changes in hearing?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

For later hearing (older than 4 years) why are screening tests conducted?

A

Assessment of parental concerns
Difficulty hearing on the telephone
Difficulty hearing people in a noisy background
Frequent asking of others to repeat themselves
Turning the television up too loudly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Vision screening: When is this test done?

A

Vision –> performed at every visit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Vision skills less than 3 years old

A

<3 years old –> ability to fixate and follow objects (neonate 10-12inches; by 2 months, follow 180 degrees)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Vision skills greater than 3 years old

A

> 3 years old –> screening vision charts: ex: tumbling E, Allen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Vision skills 5-6 years old

A

5-6 years old –> know alphabet, use Snellen chart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Steps of using snellen chart with a child

A
  1. Place chart at eye level
  2. Sufficient lighting
  3. Must be 10-20 feet from the chart (depends on which tool using)
  4. Align heel on the mark
  5. Have child read each line with one eye covered and then other eye covered.
  6. Explain to keep the eye covered but open.
  7. Have the child read each line with both eyes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Slide 35

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the leading cause of nutritional deficiency in the US?

A

IDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Iron deficiency anemia can cause what?

A

Can cause cognitive and motor deficits resulting in developmental delays and behavioral disturbances.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

The AAP recommends assessing risk factors of IDA when?

A

AAP recommends assessing risk factors at 4, 15, 18, and 30 months, then annually.

Checking Hgb/Hct at 12 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What kind of kids are more at risk for iron deficiency anemia?

A

Kids who go through rapid growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Lead screening: what levels are considered dangerous?

A

Elevated blood levels >5 microgram/dL is a preventable environmental health threat.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Lead poisoning can lead to a variety of symptoms including:

A

Headaches
Stomach pain
Inattentiveness
Irritability
Hyperactivity
Decreased bone and muscle growth
Poor muscle coordination
Problems with language and speech
Cognitive impairments
Hearing problems
Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Lead can be where?

A

Homes or buildings built before 1978

Contaminated soil and dust

Water that flows through old lead pipes or faucets

Food stored in containers painted with lead paint (pottery)

Canned food (international)

Folk remedies

Old toys painted in lead paint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Hypertension screening: When does universal blood pressure screening start?

A

Universal blood pressure screening starts at 3 years old as recommended by AAP and Bright Futures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Why would Hypertension screening be done on kids?

A

Obesity and resulting hypertension is on the rise and can lead to cardiovascular disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Risk Factors for hypertension:

A

Prematurity
Very low birthweight
Renal disease
Organ transplant
Congenital heart disease
Other illnesses associated with HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Hyperlipidemia screening- Why is it done?

A

Atherosclerosis has been identified in children.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Hyperlipidemia screening- When is it done?

A

Guidelines recommend screening once between 9 and 11 years and again between 18 and 21 years old.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Hyperlipidemia screening- When does screening start?

A

Risk assessment screening is appropriate starting at 24 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Immunity

A

Ability to destroy and remove a specific antigen from the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Passive immunity

A

Produced when the immunoglobulins of one person are transferred to another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Active immunity

A

Acquired when a person’s own immune system generates the immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Types of vaccines (5 types)

A

Live attenuated vaccines
Killed vaccines
Toxoid vaccines
Conjugate vaccines
Recombinant vaccines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Vaccine Routes:

A

IM and SubQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Types of vaccines

A

Diphtheria, tetanus, and pertussis (DTaP, TdaP)

Haemophilus influenzae type B (Hib)

Polio, measles, mumps, and rubella (IPV, MMR)

Hepatitis A and B (HepA, HepB)

Varicella (Var)

Pneumococcal (PCV, PPSV) and influenza (IIV, LAIV)

Rotavirus

Human papillomavirus (HPV2, HPV4)

Meningococcal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

If you are allergic to egg, you should not get what vaccine?

A

Flu

70
Q

What is the only permanent contraindication to a vaccine?

A

The only permanent contraindication to a vaccine is an anaphylactic or systemic allergic reaction to a vaccine component.

71
Q

Who specifically should not receive vaccines?

A

Children who are severely immunocompromised or women who are pregnant should not receive live vaccines.

72
Q

When would postponing vaccines be recommended?

A

Temporarily postponing vaccinations is recommended due for moderate to severe illness, immunosuppression, pregnancy, or recently received blood products or other antibody-containing products.

73
Q

When should vaccines NOT be postponed?

A

Vaccination should not be postponed due to minor respiratory illness or low-grade fever.

74
Q

Rights of Pediatric Medication Administration:

A

Right medication
Right patient
Right time
Right route of administration
Right dose
Right Approach
Right documentation, Right to be educated, Right to refuse, Right form

75
Q

Factors Affecting Absorption of Medications in Children versus Adults

Oral Meds?
Gastric emptying, intestinal motility, size of small intestine, pH, secretions?

A

Oral medications: slower gastric emptying, increased intestinal motility, a proportionately larger small intestine surface area, higher gastric pH, and decreased lipase and amylase secretion compared with adults

76
Q

Factors Affecting Absorption of Medications in Children versus Adults

IM absorption

A

Intramuscular absorption: decreased due to smaller muscle mass, muscle tone; other individual factors are perfusion and vasomotor instability

77
Q

Factors Affecting Absorption of Medications in Children versus Adults

Subcutaneous absorption:

A

Subcutaneous absorption: any decreased perfusion = decreased absorption

78
Q

Factors Affecting Absorption of Medications in Children versus Adults

Topical absorption of medications:

A

Topical absorption of medications: increased due to greater body surface area and greater permeability of infant’s skin

79
Q

Factors Affecting Distribution of Medication in Children versus Adults

How is water is children v adults?

A

Higher percentage of body water than adults (amount of water relative to the amount of body fat)

80
Q

Factors Affecting Distribution of Medication in Children versus Adults

Extracellular fluid exchange?

A

More rapid extracellular fluid exchange

81
Q

Factors Affecting Distribution of Medication in Children versus Adults

Body fat?

A

Decreased body fat

82
Q

Factors Affecting Distribution of Medication in Children versus Adults

Liver

A

Liver immaturity, altering first-pass elimination

83
Q

Factors Affecting Distribution of Medication in Children versus Adults

Plasma proteins?

A

Decreased amounts of plasma proteins available for drug binding

84
Q

Factors Affecting Distribution of Medication in Children versus Adults

BBB

A

Immature blood–brain barrier, especially neonates, allowing movement of certain medications into the CSF

85
Q

Determining Pediatric Doses by Body Weight. Steps

A

Weigh the child
If the child’s weight is in pounds, convert it to kilograms (divide the child’s weight in pounds by 2.2)
Check a drug reference for the safe dose range (e.g., 10 to 20 mg/kg of body weight)
Calculate the low safe dose
Calculate the high safe dose
Determine if the dose ordered is within this range

86
Q

Different IV accesses:

A
  1. Peripheral lock/heparin lock/saline lock
  2. Central venous access devices
  3. Peripherally Inserted central catheters (PICCs)
87
Q

Central venous access devices include:

A

Short-term/nontunneled catheter

Long-term tunneled catheter

Implanted infusion ports

88
Q

Providing Atraumatic Care When Administering Medications

What must be done?

A

Using comforting positions
Encourage child to participate in care
Give child developmentally appropriate options
Using topical anesthetic prior to injections

89
Q

Guidelines for Administering Medications via Gastrostomy or Jejunostomy Tubes

What are the first 3 rules?

A
  1. Verify placement of tube
  2. Give liquid medications directly via syringe along with small amount of air
  3. Mix powdered medication with warm water; crush pills as finely as possible and mix with water prior to adding to tube
90
Q

Guidelines for Administering Medications via Gastrostomy or Jejunostomy Tubes

What are the last 2 rules:

A
  1. Open up capsules and mix with water to dissolve contents
  2. Flush tube with water after administering medications
91
Q

Nursing Care of the Child With an Enteral Tube:

First two rules:

A

Placement must be confirmed prior to adding anything

Nonradiologic methods to check include (if not high for aspirations)

92
Q

Nursing Care of the Child With an Enteral Tube

Last two

A

Always assessing for signs indicative of feeding tube misplacement

Be aware of developmental needs that may be inhibited by tube feedings

93
Q

Nursing Care of the Child With an Enteral Tube:

Nonradiologic methods to check include (if not high for aspirations):

A

Checking color and pH of aspirate

Checking external markings on the tbue and verifying external tube length

94
Q

Nursing Care of the Child With an Enteral Tube

Always assessing for signs indicative of feeding tube misplacement

means looking out for:

A

Unexplained gagging, vomiting, or coughing

Signs and symptoms of respiratory distress

95
Q

How can safety be achieved in a hospital setting:

A

can be achieved through environmental measures, limit setting, infection control, and safe transportation

Name bands/ Patient identity

Fall precautions –>place call light and desired items within reach and have child wear appropriate size gown and nonskid footwear

Activity supervision

96
Q

How does the Joint Commission define retraint?

A

The Joint Commission defines restraint as “any method, physical or mechanical, which restricts a persons movement, physical activity, or normal access to his or her body.”

97
Q

Two broad groups of restraints:

A
  1. Behavioral restraints
  2. Physical restraints
98
Q

Type of Behavioral Restraint

A

Therapeutic hugging can avoid the use of restraints

99
Q

Physical restraints include:

A

Jacket restraints
Mummy or swaddle restraint
Limb restraints

100
Q

COLLECTION OF SPECIMENS:

How to obtain small amounts of urine from a diaper?

A

To obtain small amounts of urine, use a syringe without a needle to aspirate urine directly from the diaper.

101
Q

COLLECTION OF SPECIMENS:

How to obtain small amounts of urine from a diaper with superabsorbent gel?

A

Diapers with superabsorbent gels absorb the urine;

if these are used, place a small gauze dressing or cotton balls inside the diaper to collect the urine, and aspirate the urine with a syringe.

102
Q

COLLECTION OF SPECIMENS

What else other than diaper/syringe can be used to collect urine?

A

Urine bag

103
Q

COLLECTION OF SPECIMENS

How to stop bleeding?

A

Applying pressure to the site of venipuncture stops the bleeding and aids in coagulation.

Pressure should be applied before a bandage or gauze pad is applied.

104
Q

Oxygen Administration: How can oxygen be administered?

A

Oxygen can be administered by hood, mask, nasal cannula, incubator, or oxygen tent

105
Q

Oxygen Administration: How should oxygen be administered to infants?

A

Oxygen delivered to infants is well tolerated by using a plastic hood

106
Q

Oxygen Administration: how should humidified oxygen NOT be used?

A

The humidified oxygen should not be blown directly into the infants face

107
Q

Oxygen Administration: Older infants and children should use what form of oxygen?

A

Older, cooperative infants and children can use a nasal cannula or prongs, which can supply a concentration of oxygen of about 40%

108
Q

Oxygen administration: What to use if a mask is not tolerated well?

A

A mask is not well tolerated by children. For children beyond early infancy, the oxygen tent is a satisfactory means for administration of oxygen.

109
Q

What kind of experience is pain?

A

Pain is individualized, subjective experience, affects person of any age.

Unpleasant sensory and emotional experience that is associated with actual or potential tissue damage or described in terms of such damage.

Pain is whatever the person says it is, existing whenever the person says it does.

110
Q

Who is the only one who can identify pain?

A

Person experiencing pain is the only one who can identify pain and know what the pain is like.

111
Q

Physiology of painSequence of events in the nervous system:

A

transduction –> transmission –> perception –> modulation

112
Q

Transduction

A

Process of nociceptor activation

113
Q

Transduction –> Process of nociceptor activation

How does it occur?

A

Spinal cord –> Peripheral nerve fibers (skin, joints, bones, organs) –> Nociceptors

114
Q

Where are nociceptors located?

A

Nociceptors are at the end of the nerve fibers

115
Q

When do nociceptors become activated?

A

Nociceptors are at the end of the nerve fibers and become activated when exposed to noxious stimuli.

116
Q

What kind of stimuli activate nociceptors?

A

Mechanical:

Chemical:

Thermal:

117
Q

Mechanical stimuli

A

Mechanical: intense pressure to an area, strong muscular contraction, pressure muscular overstretching

118
Q

Chemical stimuli:

A

involve release of mediators, histamine, prostaglandins, leukotrienes, bradykinin as response to tissue trauma, ischemia, inflammation

119
Q

Thermal stimuli:

A

extremes of hot and cold

120
Q

Physiology of pain: How does transmission occur?

A

Nociceptors –> activated –> stimuli converted to electrical impulses –> peripheral nerves –> spinal cord and brain

121
Q

What kind of nerves move impulses alone in transmission:

A

Specialized afferent nerves move impulses along:

122
Q

What specifically are the afferent nerves that move impulses along in transmission:

A

Myelinated A-delta fibers

Unmyelinated C fibers

123
Q

What kind of nerves are myelinated A-delta fibers?

What kind of stimuli do they handle??

A

LARGE AND RAPID

Fast pain

mechanical or thermal stimuli

124
Q

What kind of nerves are Unmyelinated C fibers ?

What kind of stimuli do they handle??

A

 small and slow 

Slow pain 

chemical or continued mechanical/thermal

125
Q

Physiology of pain:

How does Perception occur?

A

Nerve fibers –> Dorsal horn of the spinal cord –> divide –> cross to opposite side and rise –> thalamus

126
Q

Physiology of pain: What is the role of the Thalamus in perception?

A
  1. Messages somatosensory cortex of brain
  2. Messages Limbic system
  3. Messages brain stem centers
127
Q

Physiology of pain:

Perception: When the thalamus messages somatosensory cortex of brain what then happens?

A

Impulse interpreted as physical pain

128
Q

Physiology of pain:

Perception: When the thalamus messages the limbic system what then happens?

A

Interpreted emotionally

129
Q

Physiology of pain:

Perception: When the thalamus messages the the brain stem what then happens?

A

Autonomic nervous system responses

130
Q

Pain threshold

A

Pain Threshold: the point where the person feels the LOWEST intensity of the stimulus

131
Q

Myelinated A delta fibers: What does the pain feel like?

A

sharp, stabbing local pain

132
Q

Unmyelinated C delta fibers: What does the pain feel like?

A

diffuse, dull, burning, aching pain

133
Q

Physiology of pain: Modulation

A

Neuromodulators modulate the pain sensation.

134
Q

What are naturally occurring examples of neuromodulators that modulate the pain sensation in modulation?

A

Naturally occurring examples include serotonin, endorphins, enkephalins, and dynorphins.

135
Q

What can interrupt for modulate the perception of pain?

A

Pharmacologic treatments can interrupt or modulate the perception of pain.

136
Q

Where can pain sensation be modified?

A

Pain sensation can be modified peripherally (at the site) or centrally (in the brain).

137
Q

stopped at slide 65

A
138
Q

How is pain classified?

A
  1. Duration
  2. Etiology
  3. Location
139
Q

What are 2 categories for duration of pain?

A
  1. Acute
  2. Chronic
140
Q

What does acute pain usually indicate?

What does it stimulate?

A

Usually indicates tissue damage and resolves with healing of the injury

Stimulates nociceptors and is protective

141
Q

How long does chronic pain occur?

What is the purpose of chronic pain?

A

Continues past the expected point of healing

Provides no protective function.

142
Q

How does chronic pain occur?

What does it impair?

A

Continuous or intermittent, with and without periods of exacerbation or remission.

Impairs a person’s ability to function

143
Q

What are the two etiologies of pain?

A
  1. Nociceptive
  2. Neuropathic
144
Q

What occurs in nociceptive pain?

A

Noxious stimuli damages normal tissues (or can do so) if pain is prolonged.

145
Q

How is the nervous system in nociceptive pain?

A

Nervous system functioning is intact

146
Q

What are examples of nociceptive pain?

A

Examples: chemical burns, sunburn, cuts, appendicitis, and bladder distention

147
Q

What is neuropathic pain due to?

A

Due to malfunctioning of the peripheral or central nervous system

148
Q

What are examples of neuropathic pain?

A

Examples: posttraumatic and postsurgical peripheral nerve injuries, pain after spinal cord injury, metabolic neuropathies, phantom limb pain after amputation, and post-stroke pain.

149
Q

What are the locations of pain?

A
  1. Somatic
  2. Visceral
150
Q

What is somatic pain?

A

Develops in the tissues

151
Q

What are the types of somatic pain?

A
  1. Superficial
  2. Deep
152
Q

What is superficial pain?

A

Cutaneous, stimulation of nociceptors in skin, subcutaneous tissue, or mucous membranes.
Well localized

153
Q

What is deep pain?

A

Involves the muscles, tendons, joints, fasciae, and bones

154
Q

What is visceral pain?

A

Develops in organs: heart, lungs, GI tract, pancreas, liver, gallbladder, kidneys, or bladder.

Often fromdisease

155
Q

Factors Influencing Pain

A

Age
Gender
Cognitive level
Temperament
Previous pain experiences
Family and cultural background

156
Q

Slide 67

A

SOOOO many words!!!

157
Q

Myths and Misconceptions About Children and Pain:

A

Newborns don’t feel pain

Exposure to pain at an early age has little or no effect later

Infants and small children have little memory of pain

Intensity of the child’s reaction to pain indicates intensity of pain

A child who is sleeping or playing is not in pain

Children are truthful when asked if they are in pain

Children learn to adapt to pain and painful procedures

Children are more prone to addiction to narcotic analgesics

158
Q

HEALTH HISTORY AND PAIN ASSESSMENT

A

Location, quality, severity, and onset of the pain, as well as the circumstances in which the child experiences the pain.

Conditions, if any, that preceded the onset of pain and conditions that followed the onset of pain.

Any measures that increase or decrease the pain.

Any associated symptoms, such as weight loss, fever, vomiting, or diarrhea, that may indicate a current illness.

Any recent trauma, including any interventions that were used in an attempt to relieve the pain.

159
Q

Key Principles of Pain Assessment What does (QUESTT) stand for?

A

Question

Use

Evaluate

Secure

Take

Take

160
Q

Q in (QUESTT)

A

Question the child.

161
Q

U in (QUESTT)

A

Use a reliable and valid pain scale.

162
Q

E in (QUESTT)

A

Evaluate the child’s behavior and physiologic changes to establish a baseline and determine the effectiveness of the intervention

163
Q

S in (QUESTT)

A

Secure

Secure the parent’s involvement

164
Q

T in (QUESTT)

A

Take

Take the cause of pain into account when intervening.

165
Q

Pediatric Pain Assessment Tools

What tools are used for ages 3+?

A

FACES pain rating scale (ages 3+, emoticon-like faces)

Oucher pain rating scale (ages 3+, actual photos of children, must know number values)

Visual analog and numeric scales (ages 3+, scales of 0–10)

165
Q

second T in (QUESTT)

A

Take

Take action.

166
Q

Pediatric Pain Assessment Tools: For ages 4-7

A

Poker chip tool (ages 4-7, uses 1 to 4 poker chips to describe pain)

167
Q

Pediatric Pain Assessment Tools: For ages 8-15

A

Word-graphic rating scale (ages 8 to 15, child selects pain rating)

Adolescent pediatric pain tool (ages 8 to 15, measures pain location, intensity and quality)

168
Q

Physiologic and behavioral manifestations of pain:

What should be looking at in child?

A

Observe the child, keeping in mind the developmental level.

Watch movements and monitor vital signs.

169
Q

Slide 73

A

Start here.

170
Q
A
171
Q
A

Peds (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions