PRESCHOOL Flashcards
VS: temp
63.7-37.7
VS: BP
92/55
VS resp
20-30
VS HR
70-120
IMMUN: 4-6
Tdap, IPV booster,MMR, Varicella
Walking, running, climbing, jumping
by age 3
Skips and hops on one foot, catches ball
by age 4
Skips on alternate feet, jumps rope, learns to skate and swim
by age 5
Copy a circle
3yo
Tie shoes, use scissors well
5 yo
Erikson
initiative vs Guilt: Development of superego (conscience) sense of guilt and anxiety when act or behave inappropriately, learning right/wrong, energetic learners -PLAY is their work, may overstep limits creating guilt. Nursing tip: include child in own nursing care when possible.
Freud
Phallic: Oedipal and Electra complexes, sex differentiation: realize differences in sexes. conflicts starts when boy realizes dad is much stronger than him, wishes father dead & be with mom, goes away when child identifies with same sex parent
Cognitive Piaget
preoperational 2-7, fall into 2 stages Preconeptual (2-4yo) -discovering the world, ITS ME
Intuitive 4-7 yo, relating to the world, i see whats happening.
shift from egocentric to social awareness, Think one idea at a time not as a whole.
Play
associative. imitating, adjusting, udnerstanding: enjoy limitations and dramatic play, magical thinking, thinking more realistic and logical. associte time with events, Nursing tip: reasure child is not sick bc of something they did wrong
2100 words
5 years
from 3-4 word sentecnes, speak telegraphically (concisely) with lack of regard of surroundings
age 3-4
use longer sentences with more important words-4-5 word sentences
age 4-5
Understand all parts of speech, identifity opposites
age 6
spiritual development
knowlege of faith learned, devloping concrete images of God as an imaginery friend, can associate illiness with god’s punishment
dental health
2 x a year
Car seat
3-5 still in car seat, car seat on 8 years of age or 80 lbs, 4’9
calories
1800
sleep average a night
12 hrs
lead posioning
kids 6 years and younger at most at risk, crosses BBB, kids absorb 50%, more receptive to lead
Lead can be found in
food air water toys
Therapy for lead
chelation therapy: BLL greater than 70 ug/dl Bal and EDTA is used together
Potential adverse effects: inc BP, tachycard, N&V, burning sensation of mouth, lips and throat, abd pain dysuria
Other therapies for LEad
BAL: biritish antilewisite or dimercprol, IM
Calcium disodium edtate
EDTA give IV or IM.
Give when BLL is 44ug/dl or greater
EDTA adverse effects
Proteinuria, hematuria, nephrotoxicity,
never give in absense of Urine output
tingly, numb, anorexia, Nausea, inc LFT, MONITOR for BUN, electrolytes. BAL is prepared in peanut oil, assess for peanut allergy
infectious diseases
chicken pox, roseola, erythemia infectiosum, rubeola, pertussis, scarlet fever, conjunctivitis
Chicken pox
Varicella Zoster Virus
VZIG tx for high risk kids
Transmision: direct contact, droplet, contamin objects
Incubation: 2-3 weeks
Communicablility: 1 day before erupted until all lesions have crusted
Roseola (6th disease)
Human Herpes Virus type 6
Primary effects 6mo to 3 yo
incubation 5-15 days
perisistent fever for 3-4 days, after fever subsides rash appear, self-limiting, non-puritic rash, goes away on own, rash appears first on trunk, then face and extremities
erythemia infectiosum (5th disease)
Human Parvovirus
Rash in 3 stages: “slapped face” appearance disappears in 1-5 days, maculopapular rash appears on extremities and lasts 7 days or more; rash subsides but may reappear if skin irritated or traumatized by heat, cold, friction; Nursing tip: very dangerous to unborn fetus, warn preggers women
Rubeola (measles)
Virus
Tranmission by secretions, droplets
Incub: 10-20 days, communicab: from 4 day bfore to 5 days after appearance of rash
koplik sports appear 2 days before rash (small irregular red spots w/ small bluish white center seen on buccal mucosa)
Incidence is on the rise bc immunity wearing off in baby boomers
Pertussis
Bordetella pertussis
Trans: droplet or direct contact; incub: 6-20 days
cough: short, rapid coughs followed by a crowing or “whoop” sound,
Complications: penumnia (usual cause of death)
Nursing tip: keep head of bed elevated, assure suction, bag, mask, o2 working at bedside, stay close to pts
Scarlet Fever
Group A hemolytic streptococci;Trans: droplet or direct contact; incub 1-7 days, complications: carditis, peritonsillar abscess, glomerulonephritis: Tip: teach parents to watch for S&S after a strep infection esp if not getting better.
Conjunctivitis
In NB: chlamydia, gonorrhea or herples simplex
Infants: may be a sign of tear duct obstruction
children: causes are bacterial, viral, allergic or foreign body
Tip: apply prssure on inner canthus to prevent unwanted taste of medicine
child maltreatment
intentional physical abuse 17% or neglect 63%
Emotional abuse or neglect 7%
sexual abuse 9%
Physical abuse
Shaken baby syndrome = traumatic brain injury
Munchausen syndrome by proxy=factitious disorder by proxy or medical child abuse
Denver
WIdely used, standardized measures
screening tests
Detects potential developmental problems in young children
birth - 6 years
denver assesses 4 areas of functioning
Peronal-social: getting along with people and caring for personal needs
Fine motor-adaptive: hand-eye coordination, manipulation of small objects, and problem solving
language: hearing, understanding, and using language
Gross motor: sitting, walking, jumping, large muscle movement
Immunizations for preschooler:
dtap, IPV, MMR Varciella, flue