Peds Exam 1 Front Loading Flashcards
Atraumatic care prevents or minimizes physical stressors including ______, discomfort, immobility, ______ deprivation. inability to ____ or ______, and changes in elimination
pain
sleep
eat or drink
It is important to minimize parent-child _________
separation
Techniques for Providing Atraumatic Care
- Therapeutic ______________
- ________ play
- Child _____________
- Parental ____________
communication
Therapeutic
education
education
It is important to minimize physical ________ during procedures
distress
The role of a Child Life Specialist is to:
- Educate child and family about health ____________
- Provide programs to prepare children for ________________ and painful procedures
- Provide support during medical procedures
-Therapeutic play and activities to support normal __________ and ________________
- Teach and support coping and pain management strategies
conditions
hospitalization
growth and development
When communicating with parents, you should:
- ___________ yourself. Establish parental roles; ask how to address the parents
- Ensure privacy and confidentiality
- Encourage talking; use _______-ended questions
- Be sure parents understand the purpose of the visit
- Establish __________
Introduce
open
rapport
When communicating with children, make sure to:
- Have ________________ appropriate conversation
- Get on the child’s eye level
- Approach child _______ and _________ while involving parent or caregiver
- Always be __________
- Give the child choices when appropriate
- Include play whenever possible
Developmentally
quiet and gently
Truthful
Infants are nonverbal and use __________ as a form of communication. You should respond to crying in a timely manner and use a _________ and _______ tone
crying
soothing and calming
When communicating with a toddler, you should use _______ the child can recognize, repeat info in simple, consistent terms, allow them to _______ medical equipment, and allow them to participate in _________ play
words
touch
parallel
When communicating with a Preschooler, you should use _______, puppets, or story telling. You should speak _______ and use simple concrete words. Participate in ___________ play to help open communication. You should prepare them about 1 _______ prior to a procedure
play
honestly
imaginative
hour
When communicating with a school-age child, you should explain the what, how, and why. You should allow the child to touch and “__________” with medical equipment. You should also use therapeutic ______. You should prepare the child a few _______ in advance for a procedure
practice
play
days
When communicating with an adolescent, remain ________ and ______________. They may require a detailed __________. Allow time away from _________ to answer questions. Do not force them to talk. Prepare teen up to 1 __________ before a procedure
honest and nonjudgmental
explanation
parents
week
What are the 3 components of Health Supervision?
Developmental Surveillance and Screening (checkups)
Injury and Disease Prevention
Health Promotion
The Health Supervision Visit consists of:
- ________&_________ Assessment
- Behavioral / ___________ Assessment
- _________ Screening (Vision and Hearing)
- Appropriate At Risk Screening
- Immunizations
- Health Promotion/ Anticipatory Guidance
History and Physical (H&P)
Developmental
Sensory
What kind of assessment determines the likelihood a child will develop a condition (e.g. led assessment)
Risk Assessment
What kind of screening consists of a screening of an entire population regardless of the child’s individual risk (e.g. newborn screening, BP, hearing)
Universal Screening
What kind of screening is completed when a risk assessment indicates the child has one or more risk factors for a certain disorder (e.g. EKG for child who passes out at soccer practice)
Selective Screening
__________ ____________ focuses on maintaining or enhancing physical and mental health
Health Promotion
Principal Components focuses on:
- Identifying ______ factors for disease
- Facilitating ________changes to reduce risk factors
- Empowering children to optimize their _______
risk
lifestyle
health
_____________ _________ focuses on:
Oral health
Healthy weight and activity
Personal hygiene
Safe sun exposure
Anticipatory Guidance
Diphtheria, Tetanus, and Pertussis
Intramuscular
Haemophilus influenzae type B
Intramuscular
Hep A and B
Intramuscular
Pneumococcal (PCV) and Influenza
Intramuscular
Human papillomavirus (HPV)
Intramuscular
Meningococcal Conjugate vaccine
Intramuscular
Influenza
Intramuscular
Measles, mumps, rubella (MMR)
SubQ
Polio (IPV)
SubQ
Varicella (Chicken pox)
SubQ
Meningococcal polysaccharide vaccine
SubQ
Rotavirus
Oral
History taking consists of the following:
- _____ ________ (CC)
- History of _____ ______ (HPI)
- Allergies, Medications
- Past Medical History and Perinatal History
- Family History (FH)
- ______ & ____________
- _________ history in female patients
- ________ activity in adolescent patients
Chief Complaint
Present Illness
Growth and Development
Menstrual
Sexual
Functional History consists of:
- Diet/_____ - 24 hour recall
- Routine healthcare, vision/hearing, immunizations, dental care
- _______ Activity - daily routine
- _____ behavior and bedtime
- Relationships, safety, and home environment
Nutrition
Physical
Sleep
Growth Measurements
- Up to 24 months: Length and weight should be taken with the patient ________ ______
- Up to 36 months: The patient will have their ______ __________ measured
Lying Down
Head circumference
Physiologic Measurements:
6
Temperature (Axillary)
Heart Rate
Blood Pressure
Respiratory rate (Full minute)
Pain
Pulse Ox
As a patient grows, their
- Respirations will ______
- Blood pressure will ______
- Heart Rate will_______
Decrease
Increase
Decrease
HR for an infant
80-150
HR for a toddler
70-120
HR for a preschooler
65-110
HR for school age
60-100
HR for an adolescent
55-95
RR for an infant
25-55
RR for toddler
20-30
RR for Preschooler
20-25
RR for School Age
14-26
RR for adolescent
12-20
Physical Assessment Includes:
- General __________
- Skin
- Hair, nails, Hygiene
- _______ nodes
- Head and neck
- ____ ____ ____ ____ (EENT)
- Chest
- Heart
- Lungs
- Abdomen
- _________ (only expected for infants)
- Back and extremities
- Neuro assessment
Appearance
Lymph
Eyes, ears, nose, throat
Genitalia
The posterior fontanel closes up around __ months
2
The anterior fontanel closes up around ___months
18
The Cover-Uncover test is used to test for:
Strabismus
Heart murmurs are uncommon in children and should be treated as an emergency (True or False)
False - Murmurs are common in children and are usually not an emergency
The _______ scale is used for both males and females to measure sexual development
Tanner
You should never mix medication with formula (True or false)
TRUE- you should never mix meds with formula because the child will associate the bad taste with their formula and will now want to take it anymore
The ______ _________ or anterolateral thigh is used as the injection site for infants up to 24-36 months
vastus lateralis
The ________ is used as the IM injection site for children >3years
deltoid
Any amount that is >__mL should be divided between injection sites
1
_______ checks for IVs with documentation is crucial
HOURLY
Indicators of pain in infants include:
Behavioral ( Facial expressions, body movements, crying) and Physiologic signs ( changes in HR, RR, BP)
Nonpharmacologic techniques for pain management:
- R
- D
- Guided Imagery
- Biofeedback
- Thought Stopping
- Positive Self Talk
Relaxation
Distractions
Biophysical Techniques for Pain Management :
- Sucking and s______ (infants)
- _____&______ application
- Massage and pressure
sucrose
heat and cold
________ should NOT be used in infants or children for analgesic or antipyretic purposes – high risk of Reye syndrome
_______ are first-line agents for those under 6 months old
Aspirin
NSAIDs
Brachial pulses are felt in _______ for emergency situations
Infants
Carotid and femoral pulses are felt in ________ for emergency situations
Children
In an emergency, use the _____ ________ on the wall, not the call bell
Code button
Expects obedience and follow family rules. Discourages children from questioning the family rules
Child is never allowed to watch TV on school nights
Authoritarian
Democratic style, respect for the child’s opinion. Allows children to be different. Firmly enforces family rules and standards without emphasizing punishment
Child is able to watch TV on school nights after completing chores and homework
Authoritative
Laissez-faire; little control over the behavior of their children. Rules or standards may be inconsistent, unclear, or nonexistent. Discipline can be lax, inconsistent, or nonexistent
Child assists with deciding whether they will watch TV
Permissive
Indifferent and emotionally removed. Do not provide rules or standards. The child’s basic needs are often met, but the parent is disconnected from the child’s life.
Child watches TV whenever they want
Uninvolved/ Rejecting/ Neglecting
Even-tempered, predictable behavior, and positive attitudes
Easy Tempered
Hyperactive at times, intense emotions/ behaviors, and gets frustrated easily or withdraws to new experiences
Difficult Temper.
Moody, less active, irregular reactions to events, reacts to new experiences indifferently, and sometimes needs more time to adjust
Slow to warm up temper.
Term that refers to the number of individuals that have died
Mortality
Term that refers to the measure of the prevalence of disease or degree of disability
Morbidity
Accidents
Congenital malformations, deformations, chromosomal abnorm.
Assault (homicide)
Leading causes of death in children ages :
1-4 years old
Accidents
Cancer
Congenital malformations, deformations, chromosomal abnorm.
Leading causes of death in children ages:
5-9 years old
Accidents
Intentional self harm
Cancer
Leading causes of death in children ages:
10-14 years old
Drug _____ is the same in children as it is in adults
Action
What kind of assessment determines the likelihood a child will develop a condition
Risk Assessment
What kind of screening is of an entire population regardless of the child’s individual risk (e.g. newborn screening, hearing, BP)
Universal Screening
What kind of screening is performed when a risk assessment indicates the child has one or more risk factors for a disorder
Selective Screening
Where do you feel for a pulse in an infant?
Brachial pulses
Where do you feel for a pulse in a child?
Carotid/ femoral
This type of permission is obtained from PARENTS
Consent
This type of permission is obtained from the CHILD
Assent
_________ is teaching and rewarding desirable behavior and decreasing or eliminating undesirable behavior – an ongoing process
Discipline
__________ is a negative consequence applied for undesirable behavior – no teaching
Punishment
What pain scale is a behavioral pain assessment used for nonverbal or preverbal patients who are unable to self-report their level of pain
FLACC
Face
Legs
Activity
Cry
Consolability
What pain scale is for ages 3+ and used emoticon-like faces
FACES
What pain scale is for ages 3+ and used actual photos of children
** must know number values for this pain measurement
OUCHER
The ________________ __________ pain checklist is used for children 3+. Behaviors are observed for 10 minutes the 6 subcategories are rated 0-3
Noncommunicating Children’s
