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TEST 1 Flashcards

1
Q

Growth

A

increase in physical size

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2
Q

Development

A

process by which infants and children gain various skills and function

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3
Q

Maturation

A

Increase in functionality of various body systems or developmental skills

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4
Q

Avg newborn weights?
Which gender is typically heavier?

A

3400kg or 7.5lb
boys typically heavier

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5
Q

Infant loses 5-10% of body weight over 1st week of life. Then gains about —g/day and regains birth weight by —days?

A

20-30g/day
7-10days of age

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6
Q

infants double their birth weight by
triple their birth weight by

A

double - 4-6 months
triple - 1 year

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7
Q

Avg newborn length

A

50cm (20in) at birth

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8
Q

By 12 months infants length increased by

A

50%

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9
Q

Head circumference of full term newborn is ..
Head circumference increases —cm in first year?

A

35 cm (13.5in)
10cm

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10
Q

Object permanence

A

between 4-7 months

if object is hidden, infant knows it still exists
**essential for development of self image

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11
Q

Gross motor skills

develop in a —-fashion?

A

large muscles (head control, rolling, sitting, walking)
Develop in cephalocaudal fashion (head to tail)

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12
Q

Fine motor skills

developed in a —-fashion?

A

Maturation of hand and finger.
Develop proximodistal fashion (center to periphery)

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13
Q

What sense is fully developed at birth?

A

Hearing

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14
Q

Are newborns nearsighted or far?
How far can they see?

A

Nearsighted
can view 20-38cm (8-15inches)
perfer human face

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15
Q

What is binocularity and when does it develop?
When is full color vision, distance and tracking established

A

Ability to fuse two ocular images into one cerbral picture

Develops at 6 weeks, established by 4 months
Full color vision - 7months

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16
Q

Warning signs related to sensory development

A

infant does not respond to loud noises, not making sounds or babble by 4 months, doesnt turn to locate sound by 4 months, crosses eyes most of the time by 6 months

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17
Q

Warning signs related to language development
(4)
–By 4 mo
–By 6mo
–By 8 mo
–By 12 mo

A

Does not make sounds by 4 mo
Does not laugh or squeal by 6 mo
Does not babble by 8 mo
Does not use single words with meaning by 12 mo

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18
Q

When does a babies first real smile appear?

A

2mo

concerned if no smile by 3 mo

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19
Q

When do babies mimic parents facial features?

A

3 to 4 months

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20
Q

What are warning signs for social/emotional development
(4)

A

Child does not smile at 3 mo
Child refuses to cuddle
Child does not enjoy people
Child shows no interest in peek a boo at 8 mo

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21
Q

Temperament

A

Individuals nature, inborn traits that deteremine how they interact wtih world

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22
Q

When does stranger anxiety develop

A

8 months

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23
Q

What is transcultural nursing

A

nursing care directed by cultural aspects adn respects the individuals differences

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24
Q

Anticipatory guidance

A

educating parents and caregivers about what to expect int he next phase of development
purpose is to give parents tools

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25
Q

Solitary play

A

Does not share with others or directly play with others

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26
Q

Breast milk includes

A

LActose, lipids, polyunsaturated fatty acids, amino acids

Contribute to myelination of nervous system

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27
Q

Colostrum

A

First 2-4 days - thin waterly yellowish fluid that is easy to digest, high in protein and low in sugar and fat.

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28
Q

Foremilk

A

Milk that collects in lactiferous sinuses, which are small tubules serving as reserviours for milk located behind mipples

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29
Q

Let-down reflex

A

Responsible for release of milk from reservoirs.
When baby sucks, oxytocin is released and causes sinuses to contract which allows milk to let down into nipples

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30
Q

Why is cows milk bad for infants?

A

Not adequate balance of nutrients
May overload renal system with too much protein, sodium and minerals

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31
Q

Why is tounge extrusion reflex important when does it dissapear?

A

necessary for sucking to be an automatic reaction when nipple placed in mouth
dissapears at 4-6 months

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32
Q

What foods to avoid in infancy?

A

Honey
Eggs and meats
Excessvie fruit juice
Popcorn, hard foods, grapes
Citrus, strawberries, wheat, cows milk, eggs

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33
Q

Colic

resolves by

how long does an avg baby cry?

A

Inconsolable crying that lasts 3 hours or longer per day for more than 3 weeks and no physical cause

usually resolves bt 4 mo

avg baby 2.2 hours a day

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34
Q

States of consciousness
(6)

A

Deep sleep: Eyes closed, no movment
Light sleep: Eyes closed, Rapid eye movement, irregular movmeents
Drowiness: Eyes closed or half
Quiet alert state: eyes open, body calm
Active alert state: eyes open, body movements
Crying: cries or screams, difficult to gain attention

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35
Q

As the neuro system matures and myelination of the spinal cord continues, reflexive behavior is replaced with

and primitive reflexes disappear and what reflexes develop?

A

Purposeful action

Protective

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36
Q

Primitve reflexes are
Which ones are present at birth?

A

Subcortical and involve whole body response
Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step and babinski, startle reflex

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37
Q

Protective reflexes are

when do these reflexes develop?

A

gross motor and related to maintenance of equilibrium
-Righting - occurs when neck muscles strengthen, allowing to maintain normal position in relation to body

and parachute reactions tilted and baby extends arms as if to break a fall

develop around 6 months

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38
Q

The lack of what immunoglobulin is mucosal lining contributes to frequent infections?

A

IgA

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39
Q

PROTECTIVE REFLEX

What is neck righting?
When does it start?

A

Neck keeps head in upright position when body is tilited

starts at 4-6 months and persists

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40
Q

PROTECTIVE REFLEX

What is Parachute (sideways)

A

Protective extension with arms when tilted to the side in a supported sitting position

6 monhts - persists

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41
Q

PROTECTIVE REFLEX

Parachute (Forward)

A

Protective extension with arms when held up in the air and moved forward. Infant reaches forward to catch him/herself

6-7months - persists

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42
Q

PROTECTIVE REFLEX

Parachute (backward)

A

Protective extension with arms when tilited backward

9-10months - persists

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43
Q

The presence of natal or neonatal teeth may be assoc with

A

other birth anomalies

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44
Q

Primary teeth began to emerge at what age
What are first teeth to appear

A

6-8months

Lower central incisors followed by upper central incisors

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45
Q

Amylase (digest complex carbs) and lipase (fat digestion) is deficient and do not reach adult levels until

A

5 months

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46
Q

DEVELOPMENTAL THEORIES FOR NEWBORN AND INFANT

What is Erikson developmental theory

A

**Trust VS Mistrust (birth - 1yr)

Caregivers respond to infants basic needs. This creates sense of trust
As nervous system matures infants realize they are separate beings. Infants eventually learn even if gratification may be delayed it will eventually be provided

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47
Q

DEVELOPMENTAL THEORIES FOR NEWBORN AND INFANT

What is Piaget developmental theory
4 substages and ages

A

ownership develops 18-24 mo (MINE!)

Sensorimotor (birth - 2years)
Substage 1: use of reflexes (birth - 1 mo)
Substage 2: Primary circular reactions (1-4mo)
Substage 3: Secondary circular reaction (4-8mo)
Substage 4: COordinate of secondary schemes (8-12mo)

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48
Q

DEVELOPMENTAL THEORIES FOR NEWBORN AND INFANT

Piaget theory

Sensorimotor -
Substage 1
Substage 2
Substage 3
Substage 4

A

Sensorimotor - Uses senses and skills to learn about world
**Substage 1 **- Reflexive sucking bring nutrition, begin to gain control over reflexes and recognize objects, odors, sounds
Substage 2 - Thumn sucking, Imitiation begins, Object permanance begins, infant shows affect
**Substage 3 **- Repeats actions to get results
Substage 4 - Coordinate previously learned schemes wtih learned behaviors. Shake rattle, crawl. Anticpiate events, assoc symbols with events (waving goodbye when leaving)

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49
Q

DEVELOPMENTAL THEORIES FOR NEWBORN AND INFANT

Freud developmental theory

A

Oral stage (birth to 1 year)
Pleasure focused on oral activites. Feeding and sucking

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50
Q

Nutritional requirments for newborn

Fluid
Calories

A

Fluid - 140-160ml.kg.day
Calories

Calories - 105-108kcal/kg/day

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51
Q

Nutritional requirments for Infant

Fluid
Calories

A

Fluid - 100ml.kg.day for first 10kg. 50ML.kg.day for next 10kg

Calories - 1-6mo: 108kcal/kg
6-12 mo: 98kcal/kg

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52
Q

Infants grow more quickly in length during what time?

A

1st 6 months than not as quick during month 6-12

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53
Q

Head circumference is an important indicator of ?

A

brain growth

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54
Q

Percentiles

A

Measurements usually in approx the same growth percentiles over time

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55
Q

Ready to feed formulas can be stored in fridge for how long?

A

48 hours

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56
Q

What would you assess about an infants diet before taking any action?

A

feeding pattern, amount, tolerance

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57
Q

From birth to 12 months the mucosal lining in upper respiratory tract lacks immunoglobin ?? which places infant at higher risk for?

A

IgA
Risk for infection

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58
Q

What leads to a higher hemoglobin and hematocrit level in newborns?

A

maternal blood remaining in newborn after cord is cut

also increases with delayed clamping

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59
Q

When are maternal iron stores transferred to baby?
if born premature what is infant at risk of?

A

transferred 36-40th week
risk for iron deficiency anemia //must be supplemented

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60
Q

INfants with low iron appear?
Iron supplement cause stool?

A

pale, weak, fatiqued, eat less, low weight, freq resp and gi infections

iron supplement cause stool black or dark green

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61
Q

When does an infant respond to voices with coos?

A

4-5mo

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62
Q

When does an infant like to play patty cake?

A

6-8 mo

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63
Q

GRoss Motor skills appear in a ——fashion?

A

Cephalocaudal fashion = head to toe

able to life head before roll over and sit

64
Q

Fine motor skills appear in a —-fashion?

A

proximodistal fashion - center to periphery

1st bats arm then finger pointing

65
Q

When can infants have meat? honey?

A

No meat until 10-12 mo
No honey until 12

66
Q

How to soothe a crying baby

A

swaddle, hold, rock, lower lights, talk softly, sing, check diaper, burp, car rides,

baby swings are not primary ways to soothe

67
Q

What does breast feeding decrease incidences of

A

diarrheal diseases
asthma
otitis media
bacterial meningitis
botulism
UTI

68
Q

Exceptions to breast feeding

A

Infant with galactosemia, maternal on drugs, untreated TB, HIV in undeveloped countries

69
Q

TODDLER DEVELOPMENT

What is the avg weight gain per year in toddlers?
lenght/height?
head circumference?
head more proportional by what age?

A

weight gain 3-5lbs / year
lenght 3in/year (1/2 adult height by 2)
0.5/yr
head more proportional byt 3 years

70
Q

TODDLER DEVELOPMENT

Normal vision in a toddler?

A

20/40 to 20/50 in both eyes and continues to improve

70
Q

TODDLER DEVELOPMENT

Telegraphic speech

A

nouns and verbs present. but only the words necessary.

Ex. want cookie

71
Q

TODDLER DEVELOPMENT

How much play does a toddler need? structured and unstructured?

A

Structured - 30 mins
unstructured - 1-3hrs

72
Q

TODDLER DEVELOPMENT

How much sleep does a toddler need?
18 mo
24 mo
3 yr

A

18 mo: 13.5hrs
24 mo: 13 hr
3 yr: 12hrs

73
Q

TODDLER DEVELOPMENT

Food jag?

A

only one food for several weeks, then not again for a long time

74
Q

TODDLER DEVELOPMENT

When can time out be used effectively?

A

2.5-3years old

75
Q

TODDLER DEVELOPMENT

Self soothing is a function of

A

autonomy

76
Q

TODDLER DEVELOPMENT

Empathy develops at what age

A

3

77
Q

TODDLER DEVELOPMENT

Receptive language

A

ability to understand what is being said

78
Q

TODDLER DEVELOPMENT

Maternal depression gives babies a risk for poor____development

A

cognitative

79
Q

Car seat is forward facing in backseat until what weight?

A

40;bs

80
Q

TODDLER DEVELOPMENT

Magical thinking

A

Thoughts are all powerful

81
Q

TODDLER DEVELOPMENT

Transduction

A

Extrapolates from one situation to another even if events are unrelated

Ex. a package was delivered when its raining so when it rains again toddler thinks a package will be delivered

82
Q

TODDLER DEVELOPMENT

Animism

A

attributes life-like qualities from inanimate objects

83
Q

TODDLER DEVELOPMENT

What are some social skills developed by a toddler

A

Cooperation
Sharing
kindness
generousity
affection display
conversation
Expression of feelings
Helping others
Making friends

84
Q

TODDLER DEVELOPMENT

Overweight for a toddler

Obesity

A

BMI at or above 85th percentile or below 95Th percentile for age/sex

obesity - BMI greater than 95th percentile

85
Q

IgM levels reach adult level by
IgG levels reach adult by

A

IgM - 9 mo
IgG - 12mo

86
Q

SCHOOL-AGED CHILDREN

How does gross motor develop in school age children

A

Improved coordiantion, ba;ance adn rythym

-Riding bikes, skateboards, scooter, sports
-May be awkward as bodies grow faster than can accomadate

87
Q

SCHOOL-AGED CHILDREN

How does fine motor develop in school aged children?

A

Improved hand usage, hand eye coordiantion, can draw with detail, play instrument, help wtoih cooking/chores, build a model

88
Q

SCHOOL-AGED CHILDREN

What are signs of vision problems in school aged children?

A

Eye rubbing, squinting, avoiding reading, freq headaches, holding books close, problems with depth perception or hand eye coordination

89
Q

SCHOOL AGED CHILDREN

Amblyopia
Define
Causes

A

Lazy eye
One eye can focus better than the other
Causes: near or far in one eye, astigmatism in one eye, strabismus ( malalignment of eye muscles), cataracts

90
Q

SCHOOL AGED CHILDREN

ASTIGMATISM

A

Mismatched curves in the eye involving the cornea or lens causing blurry or distorted vision

91
Q

SCHOOL AGED CHILDREN

What is the normal vocabulary of a school aged child?

A

8000-14000 words
Understands metaphors (bad apple, night owl)
Metalinguistic - able to evaluate language (noun, verb)

92
Q

SCHOOL AGED CHILDREN

Limit screen and video games to how many hours / day

A

2 hours

93
Q

SCHOOL AGED CHILDREN

How much sleep in required in school aged children
6-8years
8-10years
10-12years

when do night terrors and sleep walking resolve?

A

6-8 = 12 hours
8-10 = 10-12 hours
10-12 = 9-10 hours

night terrors resolve by 8-10 years old

94
Q

ADOLESCENCE

Males and females have what 3 hormones?

A

Estrogen, progesterone, testosterone

95
Q

ADOLESCENCE

Phyiscal changes that happen in adolescence

A

Voice deepens
Limbs elongate disproportionately
GRowth plates at end of long bones begin to close
Apocrine glands secrete in axilla and genital areas
Skin changes (acne)
Increase in body hair
Hips widen in females, shoulders widen in males

96
Q

ADOLESCENCE

How to encourage communications with teens

A

Encourage to express fears and emotions
allow to open up
talk face to face, be aware of bdoy language
praise, admit mistakes, state expecations, set fair lmiits, set clear rules

97
Q

DIVERSE SETTINGS

Reason for majority of hospitalization in children younger than 5?

A

Respiratory distress

98
Q

DIVERSE SETTINGS

Reason for majority of hospitalization in older children ?

A

Respiratory, mental health, injuries, GI

99
Q

DIVERSE SETTINGS

Reason for majority of hospitalization in adolescents?

A

Problem related to pregnancy, childbearing, mental health, injury, suicide attempts, drug use/OD

100
Q

DIVERSE SETTINGS

What are the 3 stages of separation anxiety?

A

Protest - OCCURS WHEN INITIALLY SEPARATED/ CAN LAST HOURS-DAYS - crying, agitation, rejection of others, inconsolable grief

Despair - OCCURS WHEN PARENTS DO NOT RETURN W/IN a SHORT TIME- withdrawn, quiet w/o crying, apathy, depression, lack of interest, sadness

Detachment - DENIAL/WHEN LONG TERM SEPARATION - uses coping mech, may have developmental delays, may form superficial relationships

101
Q

DIVERSE SETTINGS

Separation anxiety occurs when what is developed?
Age?

A

object permenance
4-8 months

102
Q

DIVERSE SETTINGS

What are the 4 phases of nursing care for hospitalized children?

A

Introduction: establish rapport and trust
Building a trusting relationship: use approp language, games, play, explaination, encouragement, down to childs level
Decision-making phase: Give some control to child by allowing some decisions, *critical for manifesting trust
*Providing comfort and reassurance praise, opportunities to cuddle with toy,

103
Q

DIVERSE SETTINGS

7 rules for child restraints

A
  1. least restrictive
  2. fit properly
  3. Check (cap refill, pulses, temp) q 15 min then q hourly
  4. Must remove q 2hrs for ROM and repositioning
  5. Must document q 1 hr and removeal q 2
  6. Written order within 1 hour of application
  7. Face to face eval by provider within 1 hour of application
104
Q

DIVERSE SETTINGS

What are the right of medications

A

Right medication / checking expiration date
Right patient
Right time - give within 20-30 mins of time
Right route of administration
Right dose - check safe range
Right approach
Right documentation

105
Q

DIVERSE SETTINGS

Why is it important to be careful when giving meds that are excreted through kidneys for children under 2?

A

Immaturity of these organs

106
Q

DIVERSE SETTINGS

Factors affecting absorption of medications in child vs adult
ORAL MEDS

A

Slower GI emptying
Increased intestinal motility
Larger small intestine surface area
higher gastric pH
decreased lipase and amalyase compared to adults
*absorbs within 30-1 hour

107
Q

DIVERSE SETTINGS

Factors affecting absorption of medications in child vs adult
IM MEDS

A

Decreased due to smaller muscle mass, muscle tone
Tissue perfusion and vasomotor instability
*absorbs within 15 mins

108
Q

DIVERSE SETTINGS

Factors affecting absorption of medications in child vs adult
SUBQ MEDS

A

Any decreased perfusion = decreased absorption
*absorbs within10-15 mins

109
Q

DIVERSE SETTINGS

Factors affecting absorption of medications in child vs adult
TOPICAL MEDS

A

Increased due to greater body surface area and greater permeability of infants skin

110
Q

DIVERSE SETTINGS

How to give PO meds in children under 6

A

RISK FOR ASPIRATION
Ask pharmacist if pill can be crushed/opened
Put in applesauce or juice
Do not put in essential foods / formula
Ask for different form of med

111
Q

DIVERSE SETTINGS

Guidelines for giving meds via Gastrostomy or Jejunostomy tubes

A

-Verify placement of tube (check pH of contents)
if 5. or less = ok to give meds if more than 5.0 dont give med/consult provider

-Give liquid meds directly via syringe w/ small amount of air
-Mix powder with warm water, crush pills finely
-open capsules and mix with water
-Flush tube with water after given meds

112
Q

DIVERSE SETTINGS

How to give ophthalmic meds?

A

Keep eyes closed until ready
open eyes and look up
press down gently on lower lid
place drops in lower sac
apple** punctal occulsion (pressure in lower eye close to nose)**

113
Q

DIVERSE SETTINGS

How to give optic meds?

A

If under 3 - pull pinna down and back
if 4 years+ - pull pinna up and back

114
Q

DIVERSE SETTINGS

How to give Nasal meds?

A

Child lay down, head hyperextended
after drops, child lay still for 1 min
Infants are nose breathers so 1 nostril at a time

115
Q

DIVERSE SETTINGS

Where to give IM meds in infants and young children

A

give in middle 3rd of thigh
VASTUS LATERALIS

116
Q

DIVERSE SETTINGS

Difference between SUBQ and ID admin and meds

A

SUBQ - Med into fatty layers / used for insulin, heparin and certain immunizations
ID - Deposits just under epidermis / used for TB screening and allergy screening

117
Q

DIVERSE SETTINGS

Why are children more susceptible to med errors?

A

Varying heights
lack of organ immaturity
body surface area

118
Q

DIVERSE SETTINGS

IV THERAPY
–What size needle?
-Larger the number—-size of needle?
For infants, always use what size needle?

A
  • Always use smallest needle for shortest amount of time
    • -Larger the number = smaller the needle
  • Infants 24 or 26 guage IV catheter (blood transfusion might need to be bigger)
119
Q

DIVERSE SETTINGS

Do not start an IV where on a child without an order?

A

above elbows or knee
Do not start an IV on same extremeity as central line
*Attempt your iV at most distal part and work up

120
Q

DIVERSE SETTINGS

NUTRITIONAL SUPPORT
ENTERAL
OG/NG/NJ/ND/GT/JT

A

For children who can tolerate feeding but cannot eat normally (coma, oral aversion,s evere reflux)
OG - Orogastric / mouth to stomach
NG - Nasogastric / nasal to stomach
NJ - Nasojejunal / nasal to jejunum
ND - Nasoduodenal / nasal to duodenal
Gt - Gastrostomy / surgical opening
JT - Jejunostomy / surgical opening

121
Q

DIVERSE SETTINGS

NUTRITIONAL SUPPORT
PARENTERAL

A

Nutrition given through IV or TPN through central line

For chidlren who cannot tolerate food through GI tract (Nonfunctioning GI, postop, NEC, short gut)

122
Q

DIVERSE SETTINGS

Nursing care of a child with enteral tube
Confirming placement
Signs of misplacement

A

Placement confirmed
-Check color/pH of aspirate
-pH 5 or less = OK to feed, 5 or greater hold feeding and notify
-Check external marking of tube and verify length
-Always HOB up 30 degrees when feeding

Signs of misplacement
-Unexplained gagging, vomitting, coughing, signs of respiratory distress

123
Q

DIVERSE SETTINGS

Bolus feed
Continuous feeds

A

Bolus - over 30 min q 3- hours. allows child to be up and not tied down
Continuous - Continuous over a feeding pump / tied to pump can interfere with developmental

124
Q

DIVERSE SETTINGS

Complications with TPN

A

-Infused through central line which requires heparin for patency. TPN contains heparin and dextrose = can cause hyper/hypoglycemia = check blood lgucose levels
-Cannot change rate w/o order
-Strict aseptic techniques
-Closed system. Do not leave ports/caps open. Can cause infection (CLABSI)
-Closely monitor I&O

125
Q

DIVERSE SETTINGS

TPN - Daily fluid requirements

A

1st kg = 1000ml
2nd kg = 500ml
remaining kg = 20ml/kg

126
Q

PAIN MGMT in CHILDREN

When a childs pain is not managed what physical and emotional consequences can develop?

A

Physical - can delay healing/ can lead to increased oxyegen needs and alter blood glucose
Emotional - fear, anxiety and increased healing time

127
Q

PAIN MGMT in CHILDREN

Transduction

A

Process of nociceptor activation
-Nerve fibers extend from spinal cord to peripheral. At end of these fibers are nociceptors.
-Nociceptors become activated when exposed to harmful stimuli (chemical, mechanical, theramal)

128
Q

PAIN MGMT in CHILDREN

Transmission - define
-Large myelinated A-delta fibers
-Small unmyelinated C-fibers

A

Neurotransmitters pass pain to the brain through electrical impulses

Large myelinated A-delta fibers - transmit pain quickly causing reflex response to withdrawl from stimulus (mostly mechanical or thermal)
Small unmyelinated C-fibers - transmit pain slowly (chemical)

129
Q

PAIN MGMT in CHILDREN

Perception

A

Thalamus quickly sends pain signals to:
**cerebral cortex **(interpreted as sharp, dull, stabbing, burning)
limbic system (interpreted emotionally and memory occurs)
Brain stem (autonomic nervous system - BP,HR,RR, digestion)

130
Q

PAIN MGMT in CHILDREN

Modulation - define
Naturally occuring example??

A

Process by which body alters pain signal as it is transmitted along pain pathway (why individual response to pain is different)

Analgesics and anesthetics interrupt pain perception

Serotonin, endorphines, enkephalins, dynorphins

131
Q

PAIN MGMT in CHILDREN

A-delta fibers lead to pain feeling like
C fibers lead to pain feeling like

A

A-delta - sharp, stabbing, local pain
Cfibers - dull, diffuse, burning, aching

132
Q

PAIN MGMT in CHILDREN

Classifications of pain
Duration
Etiology
Source/location

A

Duration -
Acute- Rapid onset, resolves with healing, protective function
Chronic - Continues past point of healing, no protective function

Etiology -
Nociceptive - damage to body tissues, usually external
Neuropathic - nerve pain

**Source/location - **
Somatic - superficial or deep that develops in tissues
Visceral - develops in organs by disease / poorly localized may be referred

133
Q

PAIN MGMT in CHILDREN

Pain assessment using QUEST

A

Question the child
Use a reliable and vali dpain scale
Evaluate behavior/physiologic changes to esta baseline and determine effectivness
Secure patients involvment
Take cause of pain into account
Take action

134
Q

PAIN MGMT in CHILDREN

Reaction to pain
Toddler
preschool
School age
Adolescent

A

Toddler - may react to painless procedures as they do to painful ones
preschool - think pain is punishment
School age - appear brave to avoid more pain or embarassment
Adolescent- moody, fear of losing control

135
Q

PAIN MGMT in CHILDREN

-What are nonpharmacological pain mgmt -
behavioral -cognitive stratgies

A

Thought stopping
Imagary
Humor
Relaxation
Distraction

136
Q

PAIN MGMT in CHILDREN

-What are nonpharmacological pain mgmt -
biophysical stratgie

A

non-nutritive sucking/sucros
breastfeeding
massage
heat - increases blood flow, decrease nociceptor & swelling
cold - vasoconstrict, decrease edema, histamines and transmission of painful stimuli

137
Q

PAIN MGMT in CHILDREN

nonopioid analgesics
opioid analgesics

A

-acetaminophen and NSAIDS (do not use ASPIRIN for REYES SYNDROME)
-Morphine, fetanyl, dilaudid

138
Q

PAIN MGMT in CHILDREN

Adjuvant
Anesthetics

A

Adjuvant: benzo’s, anticonvulsant, antidepressant
Anesthetics: Local, EMLA cream (painful procedure), TAC (lacerations required suturing), vapocoolant spray

139
Q

Incubation

A

Time from entrance of pathogen to first symptom

140
Q

Prodrome

A

Time from appearance of nonspecific symptoms (fatique, malase) to more specific symptoms

141
Q

Illness

A

Signs and symptoms of disease are clearly evident

142
Q

Convalescence

A

Acute symptoms begin to disappear

143
Q

What is the chain of infection
Infectious agent -
Reservoir -
Portal of exit -
Mode of transmission -
Portal of entry -
Susceptible host -

A

**Infectious agent **- agent capable of causing infection
**Reservoir **- place where pathogen can grow
Portal of exit - mucous membranes, skin resp tract, Gi, GU)
Mode of transmission - way it travels
**Portal of entry **- mucous membranes, skin resp tract, Gi, GU)
**Susceptible host **- any person who cannot fight

144
Q

Limiting spread of infection
Tier 1
Tier 2

A

Teir 1 - Standard precautions (applies to everyone)
all body fluids except sweat / hand hygeine, gloves, ppe
**Tier 2 **- Designed for ppl with known pathogens
Airborne - Measels, rubella, TB / negative pressure, mask, door closed, N95
Droplet - flu. group a strep, mumps, rubella, pertussis, / wear mask w/in 3 ft,
Contact - diptheria, lice, scabies, MRSA / gown, glove, mask

145
Q

CBC elevated WBCs detect= inflammation and infection
Sed-rate indicator of =
CRP indicator of acute =

A

CBC elevated WBCs detect= inflammation and infection
Sed-rate indicator of chronic inflammation/infection
CRP indicator of acute inflammation/infection; rises with bacterial infection

146
Q

What is considered a fever?
Oral greater than
Temporal/tympanic greater than
Axillary greater than

A

Oral greater than 37.8C (100F)
Temporal/tympanic greater than 38C (100.4F)
Axillary greater than 37.2F (99F)

147
Q

What is a sign of sepsis in a neonate?

A

hypothermia

148
Q

If infant <3 months has fever (>38C rectal),…
Infants >3 months, fever less than 38.9C (102F) …

if petechiae is present =

A

If infant <3 months has fever (>38C rectal), possible sepsis, should be seen by HCP
Infants >3 months, fever less than 38.9C (102F) usually does not require treatment by
physician.

f petechiae is present =
Neisseria meningitidis

149
Q

CAMRSA=
Scarlet fever=
Diphtheria =
Pertussis (whooping cough) =
Tetanus=
Botulism=
Osteomyelitis=
Septic arthritis=

A

CAMRSA- skin/ tissue infections bump or skin is red, swollen, painful, and warm to the touch.
Scarlet fever - group A strep, children 5-15 years old, rash on face and strawberry tongue, usually occurs with strep throat
Diphtheria - edematous neck, infected tonsils, pseudomembrane forms
over the pharynx, uvula, tonsils, soft palate
Pertussis (whooping cough) - paroxysmal coughing
Tetanus - acute, often fatal neuro disease
Botulism- ingestion of spores from dust, improperly preserved home-canned foods,feeding raw honey to infant under 1 year old. S/S = poor feeding, listless, weak cry, poor
gag reflex (distinguishing symptom). Asking about honey takes priority over other information
Osteomyelitis- bacterial infection of the bones
**Septic arthritis **- bacterial infection in the joint space

150
Q

Viral exanthems=
Rubella =
Rubeola (measles) =
Varicella (chickenpox) =
Parvovirus B19 (fifth disease) =
Mumps =

A

Viral exanthems= skin rash
Rubella = rash begins on face and spreads head-to-toe
Rubeola (measles) = Koplik spots
Varicella (chickenpox) = clear fluid-filled vesicles that scab and crust, incubation period
of 10-21 days
**Parvovirus B19 (fifth disease) **= begins with slapped cheek flushing
Mumps = swelling in the neck bilaterally or unilaterall

150
Q

Rabies =
Cat scratch fever =
Lyme disease=
West Nile =

A

Rabies = s/s are confusion, anxiety, and hypersalivation, zoonotic
Cat scratch fever= lymph nodes, esp under the arms, become swollen and painful
Lyme disease = a ring-like rash at site of tick bite
**West Nile **= vector-borne from mosquito bit

151
Q

Pediculosis capitis (head lice) =
Scabies=
Pinworms=
Hookworm=

A

Pediculosis capitis (head lice)= not an indication of poor hygiene/poverty; pediculicide to treat head lice, pubic lice and scabies.
= extreme itching, behind ears/ nape of neck.
Scabies= specialized pediculicide cream must be worn for specified timeframe
Pinworms = good hand hygiene
Hookworm = prevent by having child wear shoes at all time

152
Q
A
152
Q

Albendazole and pyrantel pamoate drugs to treat=
Erythromycin used to treat
Acyclovir used to treat
Metronidazole used to treat
Permethrin used to treat
Azithromycin used to treat

A

Albendazole and pyrantel pamoate drugs to treat helminthic infections
Erythromycin used to treat bacterial infections
Acyclovir used to treat viral infections
Metronidazole used to treat trichomoniasis
Permethrin used to treat pediculosis
Azithromycin used to treat pertussis in infants older than 1 month

152
Q
A
152
Q
A

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