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School Age Children- 9 Flashcards

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1
Q

School age range

A

6-12

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2
Q

Vital signs

A

Explain the procedures to the child and allow him or her to choose, as appropriate, which side blood pressure will be taken, oral versus axillary temperature, and which finger to use for pulse oximetry.

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3
Q

O2

A

same as adult values (93% to 100%).

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4
Q

Fever

A

generally considered to be a temperature greater than 101.4°F or 38.5°C

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5
Q

high Fever-infection

A

High fevers greater than 104°F or 40°C in children do not indicate that the infection is more serious, as they may in adults, because less-refined pediatric immune systems may produce higher fevers than needed

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6
Q

Height/weight

A

Gain 3 kg/year in weight

Gain 5 cm/year in height

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7
Q

growth spurt

A

10 to 12 years for girls and around age 12 years for boys

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8
Q

FACES scale

A

used for younger school-age children.

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9
Q

downside noted with the FACES scale

A

some children will choose the smile face because that is the most desirable. In addition, if a child is feeling pain, he or she may automatically be drawn to the crying face, number 10.

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10
Q

visual analog scale or numeric of 1 to 10

A

Older school-age children

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11
Q

Fluid Requirements by Weight

A

11-20kg: 1000+50mL per each kg over 10kg

> 20kg: 1500 + 20mL per each kg over 20kg

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12
Q

Expected Urine Output 6-7y

A

1-2mL/kg/hr

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13
Q

Expected Urine Output 8-12y

A

.5-1mL/kg/hr

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14
Q

Annual assessments

A

check height, weight, body mass index (BMI), blood pressure, hearing, vision, and anemia. Immunizations should also be given as recommended by the schedule

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15
Q

Somatic complaints without verified diagnostic clinical data

A

may be an indication of school or home avoidance/problems, anxiety and stress, or depression

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16
Q

Skin

A

signs of abuse

Assess for dryness, rashes, eczema, abrasions, and contusions or scratches.

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17
Q

Head

A

Lice
dry/brittle- nutrition
open lesions- signs of trauma

symptoms or recent history of head trauma, including headaches, difficulty concentrating, or loss of consciousness.

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18
Q

Eyes

A

glasses
visual acuity
broken blood vessels, dryness, jaundice

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19
Q

Ears

A

hearing aid
hearing acuity
buildup of earwax
excess fluid

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20
Q

mouth/teeth

A 
loss of baby teeth
Orthodontic treatment
Promotion of good dental hygiene
Dental checkups every 6 months
loose teeth
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21
Q

loss of baby teeth

A

starts with 6y molars

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22
Q

Tooth fairy

A

not everyone believes

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23
Q

Throat

A

Ensure the trachea is midline.
Inspect and palpate for an enlarged thyroid (goiter).
Assess for difficulty swallowing.

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24
Q

nose

A

blue/boggy- allergies
Assess for allergic rhinitis and treatments
Assess for frequent nosebleeds and mucosal dryness.
Assess for airflow, which may be restricted because of acute or chronic sinusitis.

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25
Q

Cardiovascular

A

Assess for any congenital cardiac anomalies by history and auscultation.
Innocent heart murmurs are very common in school-age children.
Normal S1 and S2

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26
Q

Innocent heart murmurs

A

Some cardiologists estimate that up to 90% of children aged 4 to 7 years have heart murmurs, often a result of turbulent blood flow at the aorta or pulmonary artery

27
Q

Respiratory

A

asthma
lungs-clear
S/S chronic respiratory issues such as barrel chest and clubbed fingers.
skin color- pallor or cyanosis

28
Q

encopresis

A

deliberate withholding of stool

29
Q

Gastrointestinal/Genitourinary

A

Assess for enuresis, or urine incontinence
encopresis
Assess for constipation/diarrhea, acute or chronic, and any treatments the patient may be receiving.

30
Q

Reproductive

A

Girls may experience menarche, the start of menses, near the end of this stage

The onset of puberty in boys will be accompanied by increased upper body mass, increased amount and thickness of hair on the body and genitalia, and nocturnal emissions, or the release of semen during sleep.

31
Q

precocious puberty

A

defined as experiencing puberty before age 7 years for girls and before age 9 years for boys

32
Q

Neurovascular/Musculoskeletal

A

Increased coordination
Increased fine motor skills
Increased balance
The ability to do complex tasks, such as riding a bike
Scoliosis checks beginning at age 12 years

33
Q

Cognitive

A

Piaget’s cognitive developmental theory
Mastery of mathematics and reading skills
Classification and serialization of numbers
Understanding cause and effect
The ability to decenter

34
Q

Psychological

A

Freud’s

Erikson

35
Q

Freud

A

psychosexual development theory—age 6–12 years: latency stage

36
Q

Erikson

A

psychosocial development-age 6 to 12 years: industry versus inferiority

37
Q

Kohlberg’s

A

moral development: preconventional level

38
Q

Social

A

Likes to forms clubs with rules and requirements
Likes to do favorite activities with a best friend
Usually socializes primarily with children of the same gender
Follows rules and understands consequences
Enjoys playing games
Enjoys having a collection of items, such as video games

39
Q

Good Touch/Bad Touch

A

Use inspection of the genital area during the physical assessment as a springboard for discussing good/bad touches. Indicate which areas the child should report to a trusted adult if anyone touches them, including the breasts, buttocks, and genitals.

40
Q

Medication dosing

A

Basing medication dosage on weight gives an accurate and safe dose for each patient.
Medication dosing should not be based on age because patient size may vary.

41
Q

Oral medication

A
  • syringe or cup
  • food or drink as a reward if appropriate
  • chaser
  • numb tongue with popsicle
  • pinch nose
  • use caution with mixing meds with things that taste like candy
42
Q

Subcutaneous Medications

A

-local anesthetics medicated cream when appropriate

43
Q

IV Meds

A
  • medical play helpful
  • child life specialist can help
  • non-dominant arm
  • let them pick which side
  • distractions
44
Q

Eutectic Mixture of Lidocaine and Prilocaine (EMLA) Cream

A

It should be in place at least 45 minutes. The longer it is in place, the deeper it will penetrate; 2 hours is best for intramuscular injection. After 4 hours, it begins to lose its effectiveness and should be removed.

45
Q

NURSING PROCEDURES

A

important to gain the trust of the child before beginning assessment or procedures. Explain procedures in an age-appropriate way. Do not lie if a procedure will be uncomfortable or painful; this will cause you to lose the child’s trust.

46
Q

nursing procedures step by step

A 
assess
talk with child about recent problems
nonthreatening touch
privacy
appropriate rewards
have instruments ready and inform immediately before
least to most invasive
47
Q

Safety

A 
Head injury prevention
(symptoms may be minimal)
bike/scooter safety
pedestrian safety
need for adult supervision
48
Q

independence

A
  • may be able to do many activities with less direct supervision.
  • Children are able to play alone with adults nearby but should not be left unsupervised for any extended period.
  • By the end of this phase, children will engage in unsupervised activities, such as staying home
  • may start babysitting
  • more team activities
49
Q

babysit safety

A

Knowledge of fire safety
Care for and observation of children in various stages of growth and development
Basic first aid and possibly CPR
Many of these skills are taught in babysitting classes offered by hospitals and other organizations, such as the YMCA

50
Q

nutrition

A

decreased caloric requirement compared with previous stages of development

51
Q

high BMI in children

A

linked with increased lipid levels, insulin levels, and blood pressure

52
Q

Exercise

A

Children should have at least 1 hour of physical activity a day

53
Q

school avoidance/refusal/phobia

A

Child displays somatic symptoms such as a “stomachache” without any clinical basis, but only on school days.
Child refuses to attend school.

54
Q

Various factors are associated with being a bully, a victim, or both, including:

A

Age
Lower socioeconomic status
Parents and caregivers with a high school or lower educational level
Poor health status, increased health needs, and mental health issues
Physical appearance
Poor academic achievement or social adjustment
Sexual orientation

55
Q

The nurse caring for a school-age child should:

A
  1. Assess for both physical and psychological signs of bullying.
  2. Help caregivers find resources to assist with bullying.
  3. For children with special needs, assess the resources available at the school.
56
Q

Sex ed the nurse should:

A
  • Assess whether the caregivers have started to discuss sex with older school-age children.
  • Be aware that discussing this subject can be difficult for caregivers.
  • Help caregivers find resources to teach their children and creative ways to open the discussion.
57
Q

two leading causes of death for children 5 to 14 years old

A

Unintentional injuries and cancer

58
Q

ACUTE-CARE HOSPITALIZATION

A
  • caregivers have active role
  • bring items from home
  • allow walks
  • encourage visitation of siblings if possible
  • siblings admitted together- near each other
  • separate room for care
59
Q

Pediatric Early Warning System (PEWS)

A

good tool to improve earlier identification of a deteriorating condition

behavior, Cardiovascular, respiratory

60
Q

Child life specialists

A

offer a variety of services for children who are hospitalized and their families.

61
Q

Pediatric Care Preferences

A
  • Older school-age children seek more autonomy and may want to assist with their own care.
  • All children in this age range will be curious about their care.
  • Nurses should answer questions honestly at an age-appropriate level.
62
Q

Role of the Primary Caregiver chronically ill child

A
  • fatigue common
  • active role
  • knowledgeable about disease
  • divorce more common
63
Q

Home-Care Considerations chronically ill child

A
  • need to have some control over their time and activities.
  • School work should be kept up to date
  • time for interaction with peers, either in person or over the phone or internet, should be allotted daily.

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