Pediatric Growth and Development Flashcards
1
Q
gross motor: 0-4 months
A
start to gain control of head by 2 months; able to turn from abdomen to back by 4 months
2
Q
physical growth: 0-4 months
A
gain 5-4oz/week for first 6 months; grow 2.5cm/1in per week in first 6 months; head circumference increases by 1.5cm/0.5in per week for first 6 months; posterior fontanelle closes by 2 months
3
Q
fine motor: 0-4 months
A
grasp reflex
4
Q
Erikson stage: 0-4 months
A
trust vs. mistrust; needs nourishment, attachment, and attention; learn whether people are reliable or not
5
Q
Health promotion: 0-4 months
A
APGAR scoring, eye care (erythromycin), vitamin K shot, hep b vaccine, newborn screening, bathing and umbilical care, circumcision, feeding, bonding
6
Q
physical growth: 5-8 months
A
first tooth may form (not reliable); gain 5-7 oz/week for first 6 months; grow 2.5cm/1in per week for first 6 months; birth weight doubles 5-6 months; responds to own name by 7 months
7
Q
gross motor: 5-8 months
A
turns from back to abdomen by 6 months; lift head up by 6 months; sits unattended by 7 months; locomotion, crawling, creeping by 8 months
7
Q
erikson stage: 5-8 months
A
trust vs. mistrust; infants learn to trust that caregivers will meet basic needs (nourishment, attention, attachment), if needs not consistently met then mistrust, suspicion, and anxiety develop; age birth until 1 year
8
Q
fine motor: 5-8 months
A
transferring objects from hand to hand by 6-8 months; grasp reflex progresses to pincer grasp from 8-9 months
9
Q
health promotion: 5-8 months
A
introduction of solid food from 6-12 months; keeping up with vaccine schedule (diptheria, tetanus, whooping cough, polio, hep B, hib (dose 3/3))
10
Q
physical growth: 9-12 months
A
birth length increased by 50% and anterior fontanelle almost closed by 12 months
11
Q
fine motor: 9-12 months
A
begins to use pincer grasp to pick up small objects; able to stack two blocks; may show dominance of one hand over another
12
Q
gross motor: 9-12 months
A
cruising and deliberate steps by 10 months; walking by 12 months
13
Q
erikson stage: 9-12 months
A
trust and mistrust
14
Q
health promotion: 9-12 months
A
vaccination compliance; injury prevention
15
Q
physical growth: 12-36 months (toddler)
A
height and weight trends; head circumference
16
Q
fine motor: 12-36 months (toddler)
A
can hold crayon by 1 year; can draw simple shapes by 2-3 years
17
Q
gross motor: 12-36 months (toddler)
A
jump, kick ball, pedal tricycle all by 3 years; take 2-3 steps independently by 1 year; pulls self up to stand
18
Q
erikson stage: 12-36 months (toddler)
A
autonomy vs. doubt and shame; learning to do things on own; become more independent; going to bathroom on own and learn to dress self on own; use words like “no, me, do” and develop sense of control
19
Q
health promotion: 12-36 months (toddler)
A
interest in toilet training, parallel play, temper trantrums are common, transitional objects for safety, need 11-2 hours sleep at night, remain in backward facing car seat (5 point restraint), can transition to forward facing car seat at 2 years, ritualism- setting routines and expectations
20
Q
physical growth: 3-5yo (preschool)
A
gain 4-5lbs per year, grow 2-3 in per year
21
Q
gross motor: 3-5yo (preschool)
A
develop running, jumping, kicking skills; develop swimming and biking; able to hop on one foot at 4-5yo
22
Q
erikson stage: 3-5yo (preschool)
A
initiative vs. guilt, magical thinking
23
Q
fine motor: 3-5yo (preschool)
A
dominant hand development; cutting, drawing straight and curved lines, discernible pictures at 4-5yo
24
health promotion: 3-5yo (preschool)
immunizations, motor vehicle safety, sleep 10-12 hours with possible nap, school readiness, dental health; pedestrian, drowning, fire, firearm
25
physical growth: 5-12yo (school age)
slow and steady pace of height and weight growth, in beginning growth boys height/weight > girls, end growth girls height/weight > boys; pre-adolescence (8-12) body issues begin; puberty onset 9-10 for girls and 9.5-14 in boys (consists of breast buds and testicular enlargement)
26
erikson stage: 5-12 yo (school age)
industry vs. inferiority; industry- stage of accomplishment, seeking to gain competence, acquisition of new skills, assume new responsibilities, develop sense of confidence in new skills
27
social: 5-12yo (school age)
strong identification with peers, associate with same sex, group activities, conformity and rules to be "in" or "out", social relationships are important, peer pressure is present, bullying can be an issue during this time
28
health promotion: 5-12yo (school age)
encourage persona responsibility for hygiene, nutrition, exercises, sleep, and safety; injury prevention like helmets, sports equipment, protective wear
29
physical growth: 13-18yo (adolescent)
puberty- girls grow 2-8 in height and gain 15-55lbs, boys grow 4.5-12 in height and gain 15-65lbs, increase in sex hormones causing secondary sex characteristics such as growth in breast tissues, scrotum, and body hair
30
social: 13-18yo (adolescent)
employment and education, eating, sexuality, activities, suicide/depression, home, safety, drugser
31
erikson: 13-18yo (adolescent)
identity vs. role confusion; search for sense of self and personal identity through intense exploration of personal value, beliefs, and goals
32
health promotion: 13-18yo (adolescent)
nutrition, sleep 8-10 hours, STD prevention, sex education, exercise, screen for substance use, screen for depression, screen for suicidal ideation
33
atraumatic care
providing therapeutic care through use of interventions that eliminate/minimize psychological and physical distress experienced by children and their families
34
overriding goal of atraumatic care
do no harm; prevent/minimize child separation from family, promote sense of control (ask which arm they prefer for injection), prevent/minimize bodily injury and pain
35
3 major factors of family centered care
recognize family as constant in childs life, considers needs of all family members in relation to care of the child, philosophy acknowledges diversity amongst family structures
36
9 elements of family centered care
1. incorporate into policy/practice recognition of family as a constant; 2. facilitate family-professional collaborations at all levels of care; 3. exchange information between family and professionals (fam knows pt best); 4. incorporate recognition and honor of cultural diversity, strengths and individuality within/across all families; 5. recognize/respect different methods of coping; 6. encourage family to family support and networking; 7. ensure home, hospital, and community support systems for child with specialized health and developmental care; 8. appreciate families as families and children as children
37
nursing care of the hospitalized child
preparation for admission, admission; introduction (parent first then pt), orientation (to the unit and answer questions), set expectations, history and assessment (want to know baseline of pt at home), patient and family support; prepare for discharge (begins on admission)
38
nursing interventions for hospitalized child
promote freedom of movement when applicable, maintain routine, encourage independence, promote understanding, provide developmentally appropriate activities, provide opportunities to play, provide socialization, foster parent-child relationships, provide educational opportunities
39
first vaccine given after birth
hepatitis B due to the transmission of the virus
40
treatment of reactions to vaccines
encourage fluids to stay hydrated; cool damp cloth to reduce redness, soreness, and swelling; reduce fever with cool sponge bath; ask about giving non-steroidal anti-inflammatory drug
41
eriksons stages of psychosocial development
infant to 18 months- trust vs. mistrust; 18 mo to 3 years- autonomy vs. shame and doubt; 3 to 5 years- initiative vs. guilt; 5-13 years- industry vs. inferiority; 13 to 21 years- identity vs. role confusion; 21 to 39- intimacy vs. isolation; 40 to 65- generativity vs. stagnation; 65 and older- ego integrity vs. despair
42
pediatric morphine dose
IV- 0.05-2 mg/kg q 2-4h; PO- 0.2-0.5 mg/kg q 4-6h
43
true or false: newborns do not feel pain
FALSE; newborns do feel pain; the neurologic and hormonal systems are sufficiently developed for transmission of pain stimuli
44
True or False: exposure to pain at an early age has little to no effect on the child
FALSE; prolonged or severe pain can lead to increased newborn morbidity; newborns who experienced pain during neonatal period respond differently to subsequent pain; repeated exposure to pain can have long-term consequences
45
True or False: infants and small children have little memory of pain
FALSE; memories of pain may be stored in childs nervous system influencing later reactions to painful stimulil
46
True or False: the intensity of a childs behavioral reaction indicates the intensity of the childs pain
FALSE; numerous factors affect a childs response to pain; each child is different
47
True or False: a child that is sleeping is not in pain
False; sleep may be a coping mechanism for a child in pain or it may reflect exhaustion from dealing with pain
48
True or false: children are truthful when they are asked if they are experiencing pain
False; often children deny pain to avoid painful stimulation, embarassment, procedures, or loss of control
49
true or false: children learn to adapt to pain and painful procedures
false; repeated exposure to pain or painful procedure can result in increase in behavioral manifestations
50
true or false: children experience more adverse effects of narcotics and analgesics then adults
False; risk of adverse effects of narcotics/analgesics is the same for children as adults
51
true or false: children are more prone to addiction to narcotics/analgesics
false; addiction to narcotics when used in children is very rare
52
observational pain measurements are...
assessing body expressions with validated tools; more reliable for short sharp pain; less reliable for recurrent/chronic pain; reliable for infants and young children; may not correlate with childs self-reported pain
53
when to use observational pain scales
neonates and children around age 4 or for children who are unable to report pain due to issue effecting communication
54
observational pain scale tools
FLACC, PIPP, NCCPC, COMFORT
55
FLACC pain scale
face, legs, activity, cry, consolability; used for ages 2 months - 7 years
56
PIPP pain scale
premature infant pain profile; used to determine pain in premature infants but depends on gestational age
57
NCCPC pain scale
non-communicating childrens pain checklist; need to know childs baseline (caretaker knows best)
58
COMFORT pain scale
behavioral and unobtrusive method of measuring distress in unconscious and vented infants/children/adolescents; consist of 8 indicators: alertness, calmness/agitation, respiratory response, physical movement, blood pressure, heart rate, muscle tone, facial tension; scored 1-5 for each category and is ranked from 8-40
59
self reporting pain scales
use faces chart for 3-7 years old; use NRS for 8 years and older
60
Wong-baker FACES pain scale
smiling face is no pain, tearful is worst pain; widely used in US; used for ages 3-7yr
61
NRS pain scale
numeric pain scale from 0-10; used for children 8+ years; widely used and easy to use
62
pediatric pain questionairre
assesses patient and parental perception of pain experienced in manner appropriate for cognitive development level of child/adolescent; consists of information about 8 areas: pain HX, pain language, colors children associate with pain, emotions children experience, worst pain experiences, ways which child copes with pain, positive aspects of pain, location of current pain
63
pain prevention with needles
DO NOT LIE TO CHILDREN, PROVIDE DISTRACTION, GIVE CONTROL OPTIONS, REWARD OPTIONS; if its going to hurt let them know; infants- breast feeding, sucrose, skin to skin, pacifier; toddlers/small children- comfort holds; older children- deep breathing, distraction, hypnosis, virtual reality
64
pharmacologic methods for pain management in children
anesthetic creams like EMLA or LMX which is topical analgesia for short term procedures (takes 1 hour for effect); needle-free jet injection with buffered lidocaine is j tip (10-30 second onset)
65
biobehavioral interventions for pain management in children
meditation, distraction, play therapy, relaxation, music
66
types of pharmacological pain management
non-opioid for mild to moderate pain; opioids for moderate to severe pain; epidural at any vertebral level; PCA/NCA where patient or nurse controls amount and frequency of administration; topicals like lidocaine
67
2 step process for pharmacological pain management in pediatrics
step 1- non-opioid analgesics for pt > 3 months and biobehavioral methods (acetaminophen and ibuprofen/motrin); step 2- opioids but used as step 1 if severe pain and step 2 if pain unrelieved by non-opioids and biobehavioral
68
acetaminophen/tylenol dosing for pediatrics
10-15 mg/kg q 4-6h
69
ibuprofen/motrin dosing for pediatrics
5-10 mg/kg q 6-8h (can be used for infants > 6mo
70
if giving tylenol and motrin together...
stagger every 2 hours
71
most common pediatric opioid
morphine
72
airway resistance
the effort of force required to move air into the lungs; depends on diameter of airway; narrowing of airway increases resistance and increases work off breathing
73
respiratory assessment criteria
movement- symmetrical, coordinated, retractions; rate- bpm; rhythm- regular, irregular, periodic; depth- deep or shallow; quality- effortless and automatic or difficult and labored; breath sounds- noisy, grunting, snoring, heavy
74
breath sounds assessment criteria
normal breath sounds- inspiration is longer, louder, higher pitched; infants are obligatory nose breathers until ~4 weeks
75
tachypnea
> 60 in infants under 2 months; > 50 in infants 2-12 months; > 40 in children 1 year and older
76
signs of respiratory distress in pediatrics
retractions, nasal flaring, head bobbing, grunting, cough, color changes, adventitious breath sounds
77
retractions locations
intercostal- in between ribs, suprasternal- right above sternal notch, supraclavicular- right above each collar bone, subcostal- below the rib cages on insides, substernal- below xiphoid process
78
meds for aerosol/nebulizer therapy
bronchodilators like albuterol, steroids and anticholinergics, antibiotic nebulizers
79
acute laryngo-tracheobrochitis (LTB)
aka croup; relatively minor and self-limiting upper airway obstruction; inflammation and obstruction of upper airway (larynx and trachea) d/t viral infection; preceded by URI like RSV, parainfluenza virus, influenza A and B
80
manifestations of LTB or croup
barking cough and stridor that worsens at night; can cause respiratory distress, low grade fever; anxiety and restlessness; can see hypoxemia, respiratory exhaustion, CO2 accumulation (acidosis)
81
management and nursing care of LTB/croup
maintain airway, adequate respiratory exchange; interventions are cool mist or humidified air, cool air, ice cream, sleep upright, racemic epi, oral steroids like dexamethasone
82
acute epiglottitis
serious obstructive inflammatory process of epiglottits which has potential for complete respiratory obstruction; usually affects ages 2-5yr; not very common
83
manifestations of acute epiglottitis
4 D's- dyspnea, dysphagia, dysphonia, drooling; abrupt onset, sore throat, fever, elevated WBC, tripod position to breath, apprehension
84
definitive diagnosis of acute epiglottitis
cherry red, swollen epiglottis is visualized; examining back of throat can cause total trachea occlusion; NEVER assess throat if suspecting epiglottitis; have intubation and tracheostomy set available if physician examining throat
85
epiglottitis nursing considerations
assist with intubation (can be very difficult); admin meds like epi to reverse inflammation, IV antibiotics to treat infection, anti-pyretics as ordered, admin oxygen as needed, suctions as needed, monitor for respiratory distress; anxiety/fear/copin- allow for positional comfort and use biobehavioral interventions
86
pharyngitis/tonsillitis
inflammation of pharynx and tosils (pharyngeal tonsils); caused by viruses and group A beta hemolytic strep (streptococcus pyogenes)
87
clinical manifestations of pharyngitis/tonsillitis
marked enlargement of "palatine" tonsils often known as "kissing tonsils"; risk for airway occlusion; can still swallow but causes pain
88
treatment of acute pharyngitis/tonsillitis
throat culture and group A strep- panicillin is antibiotic of choice (10 day course); macrolide or cephalosporin if allergies; kept isolate for 24 hours then return to school; if compliance issue then may be given IM penicillin G
89
if pharyngitis/tonsillitis not treated for GABHS...
risk scarlett fever or peritonsillar abscess
90
nursing care for acute pharyngitis/tonsillitis
collect throat culture, educate need to complete entire medication course, explain infection control measures, promote comfort measures, prep for surgery if needed
91
care of tonsillectomy and adenoidectomy
rarely performed under 3 yrs for d/t risk of bleeding and tonsillar regrowth, maintain airway with position, observe for bleeding and prevent recurrent bleeding, maintain quiet environment to minimize agitation/crying, soft cold food diet, manage pain, observe for post op hemorrhage (rare but serious)
92
acute otitis media
inflammation of ear/ear infection; presence of fluid in middle ear with acute signs of illness and symptoms of middle ear infection; can be bacterial or viral
93
reasons for children developing acute otitis media
short horizontal eustachian tube, enlarged lymphoid tissue, mechanical or functional obstruction of eustachian tube, immature humoral defenses
94
otitis media manifestations
irritability- pulling or tugging on ear, ear pain, purulent drainage from ear, fever, red bulging tympanic membrane, may have respiratory infection like rhinorrhea and cough; complications can be perforated ear drum or hearing loss
95
diagnosing otitis media
HX of OM, inspection with otoscope shows red bulging tympanic membrane
96
therapeutic management of otitis media
watcha dn wait for 48-72 hours for immune system to fight infection, pain control with analgesic (acet. and ibuprofen if > 6 mo), antipyretic; antibiotics if needed (amoxicillin for 5-7 days); surgical myringotomy if necessary
97
myringotomy
surgical opening in ear to remove trapped fluid and then insertion of myringotomy tubes to allow air and prevent fluid build up
98
nursing considerations for otitis media
pain and fever control, facilitate drainage, antibiotic adherence, reduce OM occurrence, promote immunization of Hib and prevnar 13 to reduce incidence of acute otitis media, educate feeding and positioning and avoiding cigarette smoke
99
otitis externa
aka swimmers ear; inflammation of ear canal; tenderness when touching outside of ear, canal filled with purulent discharge; rapid onset and treated with drops; usually bacterial
100
bronchiolitis
inflammation and obstruction of small airways; swelling and irritation of bronchioles; mucus settles and irritates; usually occurs after upper respiratory infection; caused by RSV or other viruses
101
patho of bronchiolitis
virus or other causes mucosal cells lining bronchi and bronchioles to die creating debris that clogs and obstructs bronchioles causing partial obstruction and bronchospasm; can cause wheezing and crackles
102
transmission of bronchiolitis
contact with respiratory secretions
103
DX of broncioloitis
symptoms, nasopharyngeal swab for RSV, chest xray shows hyperinflation of lungs that develop from trapped air
104
s/s of bronchiolitis
initial is rhinorrhea, pharyngitis (sore throat), coughing, sneezing, wheezing, ear or eye drainage possible, intermittent fever; progressing is increased coughing and wheezing, fever, tachypnea, retractions refusing to nurse/bottle feed, copious secretion
105
severe illness with bronchilitis
tachypnea greater than 70 bpm, listlessness, apneic spells, altered air exchange, diminished breath sounds
106
therapeutic management for bronchilitis
supportive measures, contact/droplet precautions, prevent RSV with vaccine that is available for high risk infants only (high risk is preterm under 6 mo born at less than 36 weeks and acute/chronically ill infants)
107
bronchiolitis nursing care
monitor oxygenation as ordered with pulse ox, monitor IV or NG fluids, monitor for fever, admin prescribed meds, family support and education
108
asthma
chronic reversible inflammatory disorder causing periodic airway obstruction and hyperresponsiveness; results from triggers; bronchoconstriction and inflammation; expiratory airflow decreases and traps gas causing alveolar hyperinflation
109
asthma manifestations
coughing, wheezing, mild SOB. yellow zone on peak flow; progressive symptoms are marked respiratory distress, changes in position, red zone on peak flow; emergent- status asthmaticus which is resistant to treatment
110
DX of asthma
clinical signs and history; peak expiratory flow, blood gases, pulse ox, RAST testing for allergens/triggers
111
RAST test
radio-allegro-sorbent test
112
asthma therapeutic management
want to maintain normal activity levels, maintain normal pulmonary function, prevent chronic symptoms and recurrent exacerbations, assist child to live normal happy life
113
long term control meds for astha
inhaled corticosteroids- fluticasone and pulmicort; long acting beta 2 agonists- severent via MDI; leukotriene modifiers- singulair PO
114
quick relief aka rescue meds for asthma
short acting beta 2 agonists- albuterol or xopenex; anticholinergics- atrovent (given with short acting beta 2 agonists); systemic corticosteroids given orally for 3-5 days and are fast acting but take 3-8 hours for effect
115
during acute asthma attack
check peak flow and if in yellow admin short acting beta 2 agonist; if in red go to ER
116
asthma nursing considerations
educate if deficient knowledge, assist with fear and anxiety, educate what happens during an attack like ineffective airway clearance or impaired gas exchange or fatigue or activity intolerance
117
cystic fibrosis
chronic autosomal recessive inherited disorder of exocrine glands that affects multiple organ systems; cystic fibrosis transmembrane conductacne regulator gene mutation; creates abnormality in sodium and water transport
118
patho of CF
mechanical obstruction caused by increased viscosity of mucous gland secretion; mucous gland produces thick mucoprotein that accumulates and dilates
119
altered functioning of bronchi, small intestine, pancreatic ducts, salivary/sweat glands, and reproductive system from CF
bronchi- chronic bronchitis, bacterial pneumonia, obstructive emphysema; small intestine- intestinal obstruction and failure of neonate to pass meconium; pancreatic ducts- malabsorption syndromes; salivary/sweat glands- increased sodium and chloride excretion; reproductive system- most patients infertile d/t increased viscosity of cervical mucous in females and blockage of vas deferens in men
120
diagnosing CF
family HX, prenatal DNA testing, newborn screening, sweat chloride test (most reliable) where sodium and chloride levels will be 2-5x higher d/t inability to reabsorb
121
respiratory manifestations of CF
dyspnea, dry nonproductive cough, wheezing, atelectasis, generalized obstructive emphysema d/t mucoid obstruction, chronic sinusitis, bronchitis, bronchopneumonia (inflamed alveoli), hemoptysis (potentially life-threatening)
122
progressed respiratory manifestations in CF
signs of chronic CO2 retention, barrel chest, finger clubbing, cyanosis, decreased CO2 and O2 exchange causing hypoxia hypercapnia and acidosis, compression of pulmonary blood vessels, progressive lung dysfunction causing pulmonary HTN and cor pulmonale and respiratory failure and potentially death
123
respiratory management for CF
want pulmonary hygiene with daily routine of chest PT usually 2x per day, airway clearance therapies (CPT and postural drainage), promote physical exercise, medications like pulmozyne, aggressive treatment of pulmonary infections
124
CF GI manifestations
need to take pancreatic enzymes with every meal; meconium ileus at birth, weight loss despite increased appetite, malnourishment and vitamin deficiency, malabsorptive syndrome with chronic diarrhea and large frothy smelling stools, long term GI complications
125
long term GI complications with CF
G-tube, liver disease from blocked bile duct, can develop diabetes, etc.
126
CF GI management
pancreatic enzymes with meals, high protein high calorie diet (150% or recommended amount), prevention/early management of intestinal obstruction, reduction of rectal prolapse, regular nutritional monitoring
127
CF nursing care management
assessment of all affected systems, primarily focused on respiratory and GI systems, interventions focused on hospital care home car family support and transition to adulthood
128
foreign body aspiration
partial or complete obstruction of upper airway: cough, cyanosis, wheeze, stridor, dyspnea, retractions, voice changes; obstruction of lower airway: 1-sided wheezing, diminished sounds on one side, asymmetry of chest
129
treatment and nursing care of foreign body aspiration
heimlich in emergency situation, bronchoscopy to remove object
130
pneumonia
inflammation of lung parenchyma; can be bacterial, viral, or from aspirate
131
pneumonia manifestations
low to high fever, cough, headache, malaise, infiltrates on xray, WBC > 20000, pt favors leaning on one side d/t pain on inspiration
132
treatment of pneumonia
antibiotics if bacterial, increase in fluids, antipyretics, cool mist humidifiers, avoid smoke exposure, decrease anxiety, promote rest
133
indications for artificial ventilation
progressive hypoxia, inadequate ventilation, excessive work of breathing, inadequate respiratory effort; BVM at bed side; respiratory assessment; mouth care
134
tracheostomy tube
surgical opening below 2 and 4 tracheal ring; indications are deformities from birth or trauma; always keep same size and smaller size trach next to bed; keep suction next to bed
135
upper airway consists of
nose, mouth, larynx, pharynx, oropharynx, epiglottis (trachea sometimes)
136
lower airway consist of
trachea, bronchi, bronchioles, alveoli
137
risk factors for respiratory distress
infectious agents like covid or RSV or flu, age d/t size, resistance in lungs, seasonal variations, excessive/thick secretions, stasis of secretions, CNS depression or immobility, extreme high or low humidity, sleeping positions in infants
138
differences in pediatric upper respiratory system
upper- smaller nares and nasal passages that are more prone to obstruction, small oral cavity and large tongue causing prone to blockages, tonsils and adenoid can obstruct if inflamed, larynx has epiglottis that is large and floppy in children; children have lower respiratory reserve
139
differences in upper respiratory system in children
tracheal cartilage is less developed and more prone to collapse; bronchioles are not as formed causing less surface area; alveoli where gas exchange occurs is less d/t less developed
140
side effects of morphine
nausea, vomiting, diarrhea, dry mouth, drowsiness, decreased respiratory
141
newborn and young infant responses to pain
crying, grimace, rigid/arching back, eyes closed mouth opened crying
142
older infant pain response
crying, more restless
143
young child pain response
verbalizing ow or ouch, may beg for procedure to end, may cry, may be clingy
144
school age child pain response
bargaining to waste time is common
145
adolescent pain response
less vocal, hide crying, may internalize pain by tensing body, less physical, more direct in statements
146
acute pain
less than 6 months; unexpected, more severe
147
chronic pain
over 6 months; pt is usually more adapted
148
recurrent pain
happens over and over again usually every 3 months
149
vaccines during pregnancy
Tdap for whooping cough, flu vaccines, covid-19, RSV, maybe hepatitis B
150
vaccines for newborns
Hep B to prevent liver damage and cancer (within first 24 hours of birth or within first 12 hours if mom has hep B), hep B immunoglobin if mom has hep B, RSV
151
vaccines for 1-2 months
DTaP (diptheria, tetanus, and pertussis), haemophilus influenzae type b disease (Hib), HepB, pneumococcal disease, Polio (IPV), rotavirus (RV)
152
vaccines for 3-4 months
DTaP, Hib, pneumococcal, polio (IPV), rotavirus (RV), RSV if in season
153
vaccines for 5-6 months
DTaP, Hib, Flu, pneumococcal disease, polio (IPV), Rotavirus (RV)
154
vaccines for 7-11 months
flu yearly
155
vaccines for 12-23 months
chickenpox (varicella), DTaP (4/5), Hib dose 3/3 or 4/4, Hep A, Hep B dose 3/3, flue, measle mumps and rubella (MMR), pneumococcal disease dose 4/4, Polio (IPV) dose 3/4
156
vaccines for 2-3 years
flue yearly,
157
vaccines for 4-6 years
chickenpox (varicella) dose 2/2, DTaP 5/5, flu, MMR dose 2/2, Polio (IPV) dose 4/4
158
vaccines for 7-10 years
human papillomavirus (HPV) 2 doses 6-12 months apart, flu yearly
159
vaccines for 11-12 years
HPV, flu, meningococcal disease (MenACWY) dose 1/2, TDaP booster
160
