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Peds Exam 2 > Safety > Flashcards

Safety Flashcards

1
Q

Health Promotion for Infants

A

birth to 12 mths

  • support breastfeeding
  • powder formula
  • breastfeed babies need vit D
  • no baby food until 4-6 mths
  • choking precautions
  • consider cultural food preferences

-freq well baby
checkups

  • screenings
  • sleep
  • ability to self-regulate or self-soothe
  • physical activity “tummy time”
  • social interactions with parents and others
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2
Q

Safety for Infants

A
  • SIDS prevention: back-to-sleep
  • proper use of infant car seat
  • choking: small toys, food
  • drowning: bath tub, toilet, bucket
  • baby proof home: electrical cords, meds, cleaning supplies, stove
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3
Q

Proper car seat rules

A
  • Birth – 2 years: rear facing (up to 3 recommended)
  • 2 years- 5 years: forward facing car seat
  • Age 5 + : Booster with belt positioning
  • No booster: Once seat belt fits properly AND 57inches tall
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4
Q

Health Promotion for Toddlers

A

1-3 years

  • metabolic rate slows, so appetite decreases
  • screenings, 12-15 mths for autism
  • sleep, 10-12 hrs a night
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5
Q

Safety for toddlers

A
  • falls
  • poisoning
  • burns
  • drowning, more likely somewhere else and not at home. when you think multiple people are watching and drinking involved
  • MVA

**Most important: drowning!

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6
Q

Health Promotion for Preschooler

A

3-6 yrs

  • growth is slow and steady
  • picky eaters
  • safety in the kitchen
  • screening (speech clear at 4, preschool skills)
  • no more nap, 9-11 hours at night
  • sleep: night terrors vs. nightmares (don’t have to wake them up)
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7
Q

Safety for Preschoolers

A
  • MVAs
  • drowning
  • burns

**Most important: car seats, MVA

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8
Q

nurse is providing discharge education related to injury and death prevention for parents of a 4 month old. It would be most important to include info on which of the following?

  • suffocation injuries
  • SIDS
  • Drowning
  • baby proofing house
A

SIDS and Suffocation

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9
Q

Health Promotion for School Age

A
  • quality of diet related to family’s pattern of eating
  • screening, obesity
  • less sleep may lead to irritability, lack of concentration, hyperactivity
  • sleepwalking and sleep talking, bell at top of door,
  • sports
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10
Q

School Age Safety

A
  • pedestrian injuries
  • bicycle injuries
  • school safety - bullying
  • water safety - swimming skills, diving precautions
  • appropriate safety equipment for all sports

**Most important: seat belt, car safety!!

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11
Q

Adolescent Health Promotion

A
  • aim teaching at adolescent, but include parent
  • screening, suicide, obesity
  • sleep (9 hrs, avg 6 grs)
  • sports, burnout, over use injuries
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12
Q

Adolescent Safety

A 
• MVAs number one cause of injury and death • Drugs, alcohol—more likely to try if peers do • Males at higher risk for risky behavior
• Date rape
• Prevention of sports injuries
• Prevention of pregnancy
and STDs
• Smoking prevention

**seat belt safety most important

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13
Q

SUID

A

sudden unexpected infant death

-most SUIDs are reported as: SIDS, unknown cause accidental suffocation and strangulation in bed

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14
Q

SIDS

A
  • crisis
  • under 1 years
  • delay in maturation of the brainstem responsible for arousal

RF:
-age 2-4 mths

  • sex:male
  • time/season: winter, but no seasonality anymore
  • socioeconomic: low economic status
  • birth: PT, LBW
  • sleep habits: overheating, prone sleeping
  • maternal: drug use, smoking, young parent
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15
Q

AAP Recommendations for SIDS

A
  • back to sleep, for naps and at night
  • firm sleep surface

• Keep soft objects, toys, and loose bedding out of your
baby’s sleep area.

  • Do not allow smoking around your baby.
  • Keep your baby’s sleep area close to you, but separate
  • Consider using a clean, dry pacifier
  • Avoid overheating
  • Avoid products that claim to reduce the risk of SIDS
  • Do not use home monitors to reduce the risk of SIDS
  • Avoid development of positional plagiocephaly
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16
Q

New SIDS guidelines

A

-co-room sleeping minimum 6 mths up to 1 year

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17
Q

Who makes requirements for vaccines?

A

each state and health department

18
Q

Mild URI with no fever…

A

does not warrant delay of immunizations

19
Q

Always a risk of ____ with vaccines

A

anaphylaxis although severe and uncommon

20
Q

If a person has a previous severe rxn…

A

should be given very cautiously or is contraindicated

21
Q

Hep B contraindications and ADR

A

contraindicated: severe rxn to previous dose, allergy to yeast, moderately or severely ill

ADR: soreness at site, temp of 99.9 or higher

22
Q

DTaP contraindications and ADR

A
  • Diptheria, Tetanus, Pertussis
    contraindications: brain or nervous system dz within 7 days of previous dose, seizure or collapsed, cried nonstop for 3 hours, or had a fever over 105 after a dose

ADR: redness, fussiness, vomiting, seizures, non-stop crying for 3 hours, fever over 105, permanent brain damage (rare)

23
Q

HIB contraindications and ADR

A
  • haemophilus influenza type b
  • contraindicated: severe rxn to previous dose, moderately or severely ill, less than 6 wks of age
  • ADR: redness, warmth at site, fever over 101
24
Q

Pneumococcal contraindications and ADR

A

contraindications: allergy to vaccine containing diptheria toxoid/previous dose

ADR: drowsy, swelling, fussiness, mild fever as high as 102.2

25
Q

Inactivated Polio contraindications and ADR

A

contraindicated: neomycin, streptomycin or polymycin B allergy

ADR: soreness at site, high fever or unusual behavior

26
Q

MMR contraindications and ADR

A

contra: allergy to gelatin, neomycin, HIV, steroids, cancer, low platelet count, recent blood transfusion, sick, pregnant
- as the added antibodies impede the vaccine from taking effect, vaccination should be given at least 3 months after any blood or plasma transfusion or administration of human immunoglobulin

ADR: fever, rash, neck swelling, temp jt pain,

severe/very rare: deafness, brain damage, coma

27
Q

Varicella contraindications and ADR

A

contra: allergy to previous dose gelatin, neomycin, HIV, steroids, cancer, pregnant, low platelet count, recent blood transfusion

ADR: sore at site, fever, rash, seizures, pneumonia (rare)

28
Q

Ingestions of injurious agents

A
  • most commonly occurs in the 2 year old group
  • improper storage is most common reason
  • plants, meds, household cleaning items
  • require as little as 1/4 tsp to 1/2 tab to cause serious or fatal consequences
  • may or may not be an emergency
  • call poison control before initiating interventions
29
Q

What is no longer recommended as immediate tx of ingested poisons?

A

syrup of ipecac

30
Q

Most important principle of dealing with poisoning…

A

tx the child first, then the poison

  • stabilized first, assess ABC’s
  • PE, apply cardiac monitor, start IV, draw blood toxicology
31
Q

Child RF for Child Abuse

A
  • separated at birth
  • fussy infants/sick children
  • developmental disabilities
  • behavior problems
  • under age 3
32
Q

Parent RF for Child Abuse

A
  • adolescent, single
  • drug use, poverty, mental illness
  • unwanted pregnancy
  • parents with a hx of being abused
33
Q

Behavioral indications of child abuse in children

A
  • behavioral extremes
  • alcohol or drug abuse
  • school problems/runaways/freq absences
  • depression/suicide
  • poor social interaction
34
Q

Red flags signaling possible abuse

A
  • inconsistent hx or story
  • no explanation for injury
  • delay in seeking care
  • inconstant injury with child’s developmental age
  • blaming siblings
  • previous suspcious injury
35
Q

Immersion burns

A
  • suspect child abuse
  • clear lines, glove or stocking distribution
  • consistent with motor development
36
Q

Fractures in child less than 1 year old

A

suspect child abuse

37
Q

Nursing responsibility with child abuse

A
  • must call if suspected (solid suspicion is enough)
  • interview parent and child separately
  • open ended non-leading questions
  • leave details to child protective services (CPS)
  • nurse’s are mandatory reporters. must leave name but is held confidential
38
Q

infections: Infants less than 3 months

A

maternal antibodies

39
Q

infections: 3-6 mths

A

infection rate increases

40
Q

infections: toddler and preschool

A

high rate of viral infections

41
Q

Children with immunodeficiency

A
  • receiving steroid therapy or immunosuppressive therapies
  • generalized malignancies
  • immunologic disorder

Peds Exam 2 (5 decks)

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