Perspectives In Pediatrics Flashcards
What is providing atraumatic therapeutic care
Minimizing physical and psychological stress
Factors affecting childrens health
Family
Genetics
Society
Cultural health practices
Spirituality and religion
Barriers to healthcare (money)
Health maintence and developmental surveillance/screenings
Preventative care in recommended intervals
Developmental surveillance:
Observation and parent concerns
Screenings (measurements)
Goal percentile
10-90%
Anticipatory guidance
Knowing what the developmental age is to understande their upcoming needs
Ex: bicycle safety
Types of screenings
MILVHHH
Metabolic (PKU)
Iron-deficiency anemia
Lead
Vision
Hearing
Hypertension
Hyperlipidemia
Leading cause of mortality in infants
Unintentional injuries
Most common health issues in children
Respiratory disorders
Gastrointestinal disturbances
Traditional nuclear family
Bi-nuclear
Blended family
Traditional nuclear family:
Married couple with biological child
Bi-nuclear:
Parents have seperated but continue parenting
Blended family:
One step-parent at least and step siblings or half siblings
Extended family
Foster family
Communal family
Extended family:
One parent, child and other family members (including grandparents, aunts, uncles)
Foster family:
Temporary family
Communal family:
Groups of people living together to raise children and manage houshold (unrelated by blood or marriage)
Parenting styles
Authoritarian (dictatorial)
Authoritative (democratic)
Permissive
Passive/neglectful
Authoritarian (dictatorial)
Try to control the childs behaviors and attitudes thru unquestioned rules and expectations
Authoritative (democratic)
Directs childs behavior by setting rules and explaining the reason for each rule setting
Permissive
Exert little or no control over child behaviors. Rules may be inconsistent, unclear, or non-existent
Passive/neglectful
Parents are often uninvolved, indifferent, and emotionally removed. Childs basic needs are met but parent is disconnected
3 principals of atraumatic care
Minimize seperation from family
Give sense of control
Minimize bodily injury or pain
Prepare child for procedure
Description appropriate for their age
Inform them of ant pain involved
Childlife therapy
Ways to interact with kids to prevent traumatizing them
Informed consent
Who can do it
The form has to be what
Who also has to sign the form
Must be of legal age in the state, with full civil rights and be competent
Must be simple, concise, appropriate to the level of education and language of the decision maker
Need a witness sign (usually a nurse)
Nurses role in consent signing
Make sure family understands what their signing
Make sure the form is complete
Serve as a witness
Pediatric assent (what should be done and why)
Let child be involved in decision
Helps them understand their condition and the treatment being done
Makes sure their not being influenced in their decision
If parents refuse life-saving treatment warrants what
A call to CPS for emergency treatment
How old do you have to be to sign informed consent unless these 6 things
18years old unless:
-pregnant
-parents
-married
-high school grad
-independent living
-military service
A minor may be consenting in kentucky if (4)
-Contracted a lawful marriage
-Borne or fathered a child
-Seeks disnosis/tx for sexually transmitted disease, pregnancy, alcohol or drug abuse
*(Treatment shall not include inducing of an abortion or performance of a sterilization operation)
-Victim of a sexual offense
Risk factors for mal treatment
Caregiver
Young father
Unrelated
Low income
Lack of education
Rf of maltreatment for child
1 year or younger
Hyperactive
Premature
Rf of maltreatment
Environment
Chronic stress
Divorce
Poverty
Unemployment
Alcohol/substance abuse
Indicators of abuse
Physical evidence
Vague explanation of injury
Delay in seeking care
Other injuries
Inconsistency between child and caregiver story
Repeated injuries requiring emergency tx
Physical abuse vs physical neglect
Abuse:
-burns, bruising, fx, different stages of healing, fear of parents, withdrawal aggression
neglect: (not meeting basic needs)
-FTT, malnutrition, lack of hygiene, delay in seeking care, school absences
Sexual abuse
Bleeding of genitalia/anus, STI, UTI,
reaggressive behaviors
withdrawal
personlity changes
Emotional neglect/abuse
FTT, eating disorders, enuresis, sleep disturbances, lack of social smile, delayed development, suicide attempts
TEN-4
Child 4 and younger look for bruised on:
-Torso, Ears, or Neck
Any nonmobile infant under 1 year of age any bruises anywhere
(if their not cruising they should be bruising)
Shaen baby syndrome can cause intracranial and retinal hemorrhages
Indicators:
VLBCAPS
May have no physical signs
-vomiting/poorfeeding
-listlessness (fussy)
-bulging fontanels
-seizures
-posturing
-change in LOC
-apnea/bradycardia
