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250 Peds/ob > Peds Exam 1 (cont) > Flashcards

Peds Exam 1 (cont) Flashcards

1
Q

Communication with parents

A

Ask open ended questions!

Provide anticipatory guidance

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2
Q

Communication with infant (0-1)

A 
Speak to child in soft calm voice. 
Explain procedures to caregiver.
Keep child appropriate toys.
Keep child with parent of possible.
Encourage questions
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3
Q

Communication with child (1-3)

A

same as 0-1.
Talk to child at eye level.
Allow to touch equipment.
Animism.

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4
Q

Communication with child (3-5)

A

Explain procedure and unfamiliar objects.
Allow to touch equipment.
Allow choices if possible.
Encourage use of comforting objects (animism)
Offer a badge of courage (stickers)
Reassure that procedures aren’t punishment.

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5
Q

Communication with child 6-12

A

Explain procedures and how they can help
Allow choices when possible
Explain if procedure is painful and why it is necessary
Use correct terminology
Watch for nonverbal signs an need for support
Praise for good support

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6
Q

Infant milestones

A

5-6mo- can roll from abdomen to back
Beginning of tooth eruption
12-15mo- begins to walk (concern if not walking by 18 months)

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7
Q

Infant safety

A

Always keep crib rails up.

Car seat rear facing until 1 ur or 20lbs

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8
Q

Toddler milestones

A 
Uses stairs.
Runs clumsily.
Throws objects to floor
Points to objects 
Dresses self
May attend to toilet needs
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9
Q

Toddler safety

A 
Lock cabinets
Check size of toy parts an food particles
Use safety plugs in outlets
Use safety gates on stairs
Use child safety seats
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10
Q

Preschooler milestones

A 
Dresses without help.
Builds tower of blocks.
Ties shoes (age 5)
Throw ball overhand
Hops on one foot 
Skips (age 5)
Uses full sentences 
Increased attention span
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11
Q

School age milestones

A 
Develops sense of morality
Plays with Peers
Develops body image
Begins Lying, cheating, stealing
Gross and fine motor skills are well developed
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12
Q

Adolescent milestones

A

Sexual maturation
Physical growth spurt
Compares self with others
Wild mood swings

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13
Q

Adolescent safety

A 
High risk behaviors: 
Driving
Sex
Smoking
Drug abuse
Alcohol abuse
Suicide 
Homicide
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14
Q

Importance of play

A

Child’s work
Learn their roles
Learn how to relate to things and situations
Essential to mental, emotional, social well-being

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15
Q

Play activities

A

Infant- solitary play
Toddler- parallel play
Preschooler- cooperative play with other children. Dramatic play.
School age- able to play games by rules. Great physical activity. Sports. Puzzles, board games.
Later school age- gangs of same sex. Likes competitive games.
Adolescent- peer group contact extremely important. Boy girl relationships in social activities. Sports events. Dances. Games.

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16
Q

Erikson stages
Trust vs. mistrust
Infant (0-1)

A

Establishment of basic trust dominates the first year of life And describes all of the child’s satisfying experiences at this age.
Mistrust develops when trust-promoting experiences are deficient or basic needs are in adequately met.

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17
Q

Autonomy vs. Doubt and shame

Toddler (1-3)

A

Autonomy durin the toddler period is centered on children’s increasing Ability to control their bodies, themselves, and environment. Doubt and shame arise when children are made to feel self conscious, when their choices are disastrous, when others shame them.

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18
Q

Initiative vs. guilt

Preschooler (3-5)

A

Initiative is characterized by vigorous, intrusive behavior, enterprise and strong imagination. They develop a conscious (inner voice). When they feel their activities are bad it produces a sense of guilt.

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19
Q

Industry vs. inferiority

School-age (6-11)

A

In industry, children are ready to work and produce. They want to feel sense of achievement.
Feelings of inferiority may develop if too much is expected of them or if they believe they cannot measure up to the standards set for them
By others

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20
Q

Identity vs. role confusion

Adolescent (12-18)

A

Identity is characterized by rapid physical changes. Adolescents struggle to fit the roles they hope to play with the current roles and fashion adopted by peers. Inability to solve core conflicts result in role confusion.

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21
Q 
Tylenol poisoning (acetaminophen)
Treatment
A

Activated charcoal or concentrated mucomyst.

Tr to mix charcoal with coke or sugary substance.

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22
Q

Where to keep poisonous substances (cleaning products, meds)

A

Out of reach and Locked up

23
Q

Lead poisoning

A

Travels to brain and causes developmental delay.
Affects renal and liver functions.
Also is toxic and causes anemia.
Anemia is often first sign of lead poisoning.

24
Q

Tx for lead poisoning

A

Chelation therapy- EDTA given IM, causes free lead to be excreted in urine. Also removes calcium.

25
Q

Medications to an infant

A

Place syringe or dropper along the side of the tongue
IM injections in vastus lateralis (thigh) try to have someone with u
Mix med with small amount of sugary substance
Do not give meds to crying child for fear of aspiration.

Ear- infant- down and back
Older child - up an out

26
Q

Most common type of burns

A

Scalding is common, flash is most deadly!

27
Q

Chemical burns

A

Acids or alkali - flush with large amounts of water

28
Q

First degree burns (sun burn)

A

Epidermis
Protective fx of skin is intact
Pain is predominant
Heals in 5-10 days without scarring

29
Q

Second degree burn (partial thickness)

A

Epidermis and varying degree of dermis.
Painful to air!
Wound is moist, red, blistered
Heals in 14 dAys, some scarring

30
Q

Third degree (full thickness)

A

Entire epidermis, dermis, subq tissue
Nerve endings, sweat glands, hair follicles destroyed.
No pain at site of injury
As healing occurs pain becomes severe
Surgical intervention removes Eschar and graft

31
Q

Fourth degree ( full thickness and underlying tissue)

A

Involves muscle, fascia, and bone.
Appears dull and dry
Ligaments, Tendon and bones exposed.
Nerve endings are damaged so pain receptors don’t work.

32
Q

Severity of burns determined by

A

Total body surface area- all body parts divided into % of the whole. Account for small children’s larger heads and smaller extremities.

33
Q

Severe burns may cause

A

Growth retardation because of lack of movements and not getting nutrients you need.

34
Q

Most important Major burn management

A

Airway!!!
100% oxygen
Intubate if respiratory distress
Facial burns- elevate HOB 80-90 to reduce swelling and risk of airway obstruction.

Signs of airway swelling: strider, cough, hoarseness.

35
Q

1 pain med for burns

A

Morphine via IV or fentanyl

36
Q

Nutrition for burns

A

High calorie and high protein

37
Q

What complications to avoid with burns

A

Infection and hypovolemia (increase HR and sunken fontenel)

38
Q

Shaken baby syndrome (s/s)

A 
Large head to body ratio
Weak neck muscles 
Large amounts of h2o in brain 
ICP- widened pulse pressure, Bradycardia, irregular resp status.
Vomiting/ not eating. 
Retinal bleeds
Irritable
Abnormal temp
39
Q

Sexual abuse (abuser is normally)

A

Usually male.
Usually familiar to family
Gains trust
Demands secrecy.

40
Q

Nurses job for child abuse

A

Nurse is the mandated reported. They must report to proper authorities. Objective facts only and be careful not to contaminate witness.

41
Q

Varicella vaccine (chicken pox)

A

Given at 12-15mo
2nd dose 4-6 yo

Not given with aids or leukemia because it is live vaccine

42
Q

Hep B vaccine

A

First dose at birth
2nd- one month later
3rd- 6 months after 1st dose

43
Q

HIB vaccine

A

(Protects against bacterial meningitis, epiglottis, bacterial pneumonia, sepsis)

Given at 2,4,6 and 12-15 months

44
Q

MMR vaccine

A

Given at 12-15 months, booster given at 4-6 years old

45
Q

Varicella (chicken pox)

A

Transmission- thru direct contact, droplet, contaminated objects
Incubation period- 2-3 weeks
They are not considered contagious once they are crusted over.

46
Q

Epiglottis

A

Emergency situation! No throat culture until airway is clear.
Abrupt onset, severe stridor, high fever, hoarseness, very sore throat.
Drooling/ difficulty swallowing. Sits upright, leans forward, chin trust out, mouth open
Most likely will be intubated bc complete obstruction may occur.

47
Q

Cystic fibrosis genetics

A

Both mom and dad are carriers. 1 in 4 children will have CF.

48
Q

Cystic fibrosis

A

Results in MECHANICAL OBSTRUCTION due to increased viscosity of mucous gland secretions.

Respiratory tract and pancreas affected. Prevents pancreatic enzymes to enter duodenum resulting in steatorrhea and azotorrhea.
They look like a mini COPDer: barrel chest, clubbing, cyanotic look

49
Q

Cystic fibrosis diet

A

Well balanced. High in calories and high in protein.

Fat soluble vitamins ADEK

50
Q

Respiratory syncytial virus (RSV)

A

Can lead to bronchiolitis and asthma.

Occurs in bronchioles usually during winter and spring in children less then 2yo.

51
Q

How to clear airway on an infant

A

Saline drops and bulb syringe

52
Q

How to promote cough and deep breathing for children

A

Blow bubbles

53
Q

Anticipatory guidance

A

Teach parents what’s going to happen next

Ex. Baby will begin to walk start baby proofing

250 Peds/ob (3 decks)

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