Test 1 (Mod 1 and 2) Flashcards
1 Year Old Vitals
P 120, R 30, BP 90/56
10 Year Old Vitals
P 90, R 20, BP 100/61
14 Year Old Female Vitals
P 85, R 16, BP 114/65
14 Year Old Male Vitals
P 80, R 16, BP 114/65
18 Year Old Female Vitals
P 75, R 16, BP 121/70
2 Year Old Vitals
P 110, R 25, BP 91/55
4 Year Old Vitals
P 100, R 25, BP 92/55
6 Year Old Vitals
P 100, R 22, BP 96/57
18 Year Old Male Vitals
P 70, R 16, BP 121/70
Acute Pain
Sudden onset and continuing for a limited period. Experienced during and after procedures, postoperatively, from fractures, and from other bodily insults or injuries.
Adjusted Age
Used when describing developmental age of premature infants. The number of weeks premature is subtracted from the chronological age to determine infants developmental age or level. Stopped by age 2 years
Adolescent Nutrition Requirements
60-80 kcal/kg/day- 1500-3000 kcal/day (11-14) 2100-3900 kcal/day (15-18). Protein 34-52 grams/day Require increased calcium for skeletal growth Final molars erupt at end of adolescent period. May need orthodontist
Always measure head circumference of a child suspected of having
A neurological problem or developmental delay
Affective Function of Families
Psychological needs
Adolescents may consent for treatment related to
sexually transmitted diseases, contraception, and alcohol and drug abuse
Anterior Fontanel closes by
18 months
Anterior Fontanel closes by
12 to 18 months
Amblyopia
Blindness caused by weak eye muscle
Apical pulse found at ________ until age 7
4th intercostal space
Apical pulse found at _______ after age 7
5th intercostal space
Assent
obtain an agreement with the child if they are over the age of 7
Assess for congenital hip dislocation until
1 year of age
Assess the following lymph nodes
Head and neck. Supraclavicular. Axillary Region. Arms. Inguinal Region.
Assess the head for
Symmetry. Movement. Control. Shape.
Associative Play
play together engaging in similar type of activity without organization or goals. Rely on own wants/desires to dictate activities. May borrow toys or follow activities but no leader or rules. Characteristic of preschoolers.
Authoritarian Parenting
Expect obedience without any questioning about the reasoning behind the rules.
Authoritative Parenting
tend to show the respect for the opinions of their children by allowing them to be different.
Autonomy vs. Shame and Doubt
1 to 3 years. Increased ability to control self and environment. Practices and attains new physical skills, and develops autonomy. Symbolizes independence by controlling body secretions, saying “no” when asked to do something, and directing motor activity. Develops self-confidence and willpower, and develops shame if criticized or unsuccessful.
Avoid honey until
1 year of age
Calculate body mass index (BMI) for children over
Age 3
Barlow’s Maneuver
Test for congenital hip dislocation 1. With infant supine, flex knees while holding thumbs on mid-thighs and fingers over greater trochanters. 2. Adduct legs until thumbs touch.
Babinski Reflex
stroke up lateral edge and across ball of foot. Positive reflex is fanning of toes. May have adult reflex of flexion of toes. Should have same response bilaterally.
Calcium levels may be increased in
Multiple fractures, or Hyperparathyroidism
Calcium levels may be decreased in
lack of calcium or Vitamin D intake, burns, or diarrhea
AWHONN
Association of Women’s Health, Obstetric and Neonatal Nurses
Cephalocaudal development
Process by which development proceeds from head downward through body towards feet
Cerumen
ear wax
Child should be able to differentiate colors by age
5 years
Check for scoliosis in
school age and adolescent children
Child should have ______ teeth by late ________
32, adolescence
Children who are immunologically compromised…
Should not receive live bacterial or viral vaccines
Children with mild to moderate pain should receive
Acetaminophen
Children with moderate to severe pain should receive
Opioids
Chloride levels may be decreased in
Diarrhea, vomiting, acute infections, burns, or metabolic alkalosis
Chloride levels may be increased in
Dehydration, high serum Na levels, metabolic acidosis
Chronic Illness is defined by
A condition that is long-term, lasting for more than 3 months. Does not spontaneously resolve. Is without a complete cure. Has residual characteristics. Limits activities of daily living.
Chronological Age
age in years
Chronic Pain
Unpredictable time limit, unlikely to resolve quickly, affecting child’s ability to live a normal life, experienced in conditions such as juvenile rheumatoid arthritis, sickle cell disease, and cancer.
Communicating with a child that speaks another language
Identify an interpreter. Use communication board. Learn commonly used words of items Learn about the culture. Use play strategies, since this is a universal language.
Communicating with a child with a profound neurologic impairment
Address the child when entering and exiting the room. Gently touch the child while saying the child’s name. Speak softly, calmly, and slowly to allow the child time to process what you are saying. While in the room with the child, talk to the child. Do not talk as if the child is not there. Talk about activities and objects in the room. Allow adequate time to respond to questions. Pay attention to gestures.
Communicating with child with hearing impairment
assess self help skills. Identify families method of communication and use it if possible. Encourage family to stay with child. If sign language is used, learn most commonly used signs. Keep a chart of signs near the bed. Develop communication board. Gently touch child before speaking. Always face child when speaking. Child may be a lip reader. Nonverbal communication can speak as loudly if not louder than speech.
Communicating with child with visual impairment
Walk child around room to orient to surroundings. Encourage family member to stay with the child. Identify self when walking in room. Allow child to handle equipment as procedure is explained.
Concept of death for 0-2 year olds
Death as loss of the caretaker
Concept of death for 2-7 year olds
Death as a reversible and temporary separation
Concept of death for 12 year olds (adolescents)
Death as inevitable and irreversible but often as a distant event.
Concept of death for 7-12 year olds
Death as sad and irreversible but not necessarily inevitable
Concrete Stage of Piaget
Thoughts become increasingly logical and coherent. Able to shift attention from one perceptual attribute to another (decent ration). Concrete thinkers: view things as “black or white, right or wrong, no in between or gray areas.” Able to classify and sort facts, do problem solving. Acquires conservation skills.
Cooperative Play
organized group play with rules, goals, and a plan. There is a leader responsible for division of labor and direction of activities. Characteristic of children and adolescents.
Creativity
experiment and try out ideas can be supported or stifled
Deciduous teeth by age 2 1/2 to 3 years
20
Deciduous teeth erupt by
about six months of age
Decreased RBC may be seen in
Anemia, leukemia, and after hemorrhage
Development
Continuous, orderly series of conditions that lead to activities, new motives for activities, and eventual patterns of behavior
Developmental Age
Age based on functional behavior and ability to adapt to the environment
Differentialtion
Development from simple operations to more complex activities and functions
Dramatic, symbolic or pretend play
act out and practice roles and identities modeled by member of family and society. “Medical situations encountered are reenacted by the children.”
Elevated RBC may be seen in
Severe diarrhea or dehydration
Economic Function of Families
Allocation of economic resources
Family hx is for
discovering potential or actual existence of hereditary or familial diseases in child or parents
Facies
facial expression and appearance of child
Epicanthal Folds are common in
Asian children, suggestive of Down’s Syndrome in others.
Female internal exam and Pap test start
within 3 years of beginning vaginal intercourse, or by 21 years of age
Fine motor development for toddler (1-3 years)
Uses cup well by 15 months Builds a tower of two cubes or blocks by 15 mo. Holds crayon with fingers by 24-30 months Good hand-finger coordination by 30 months Copies a circle by 3 years
Formal Operations Stage of Piaget
Able to logically manipulate abstract and unobservable concepts. Adaptable and flexible. Able to deal with contradictions. Uses scientific approach to problem solve. Able to conceive the distant future.
Fremitus
Conduction of voice sounds through respiratory tract
Games
progresses from imitative to formal to competitive
General Consent
routine procedures such as medication administration
Genogram
Needs three generations. “Family Tree”
Gross motor development for toddler (1-3 years)
Walks without help by 15 months Jumps in place by 18 months Goes up stairs (with 2 feet on each step) by 24 mo. Runs fairly well (wide stance) by 24 months
Growth
An increase in physical size of a whole or any of its parts
Growth during Adolescence (13 to 18 years)
Weight is rapid- girls 15 to 55 lbs. Boys 15-65 lbs. Height- attain final 20% of mature height- Girls 3 in/yr Boys 4 in/yr (spurt at 13)
Growth during Preschool years (3 to 6 years)
Weight is slow and steady (4 to 5 lbs per year) Height increases 2 to 3 inches per year
Growth during school age years (6 to 12 years)
Weight steady slow. 5 lbs per year Height increases 1 to 2 inches per year
Growth slows at
12-18 months
Head circumference is the best indicator of
Brain growth
Head circumference exceeds chest circumference until
between 1 and 2 years of age.
Healthy People 2020 focus of child health care
Prevention and health promotion
Health Care Function of Families
Provision of physical necessities of life
Height at 2 years
50% of future adult height
Hematocrit may be decreased in
Anemias or after blood loss
Hematocrit may be elevated in
Dehydration
Hemoglobin may be increased in
Polycythemia, or COPD
Hemoglobin may be decreased in
Anemias, after blood loss, or excessive fluid intake
Hep B immunization schedule
1st- after birth 2nd- 1 to 4 months 3rd- 6 to 18 months
Hib (Haemophilus Influenzae type B) immunization schedule
1st- 2 months 2nd- 4 months 3rd- 6 months 4th- 12-18 months
Hepatitis A immunization schedule
1st- 12-23 months 2nd- at least 6 months later in selected areas
Hirschberg Test
Shine light on cornea while child looks straight ahead. Light should reflect symmetrically in center of both pupils. Unequal reflection may indicate strabismus
How to promote relaxation during abdominal exam
Have child place one hand under yours
Identity vs. Role Confusion
12 to 18 years. Rapid and marked physical changes. Preoccupation with physical appearance. Examines and redefines self, family, peer group, and community. Experiments with different roles. Peer group very important. If successful, develops confidence in self-identity and optimism. If unable to establish meaningful definition of self, develops role confusion.
If restraints are used…
remove them every 1-2 hours for range of motion movement, repositioning and to offer the child food or opportunity to use the bathroom
If uncircumcised, foreskin should be retractable by
3 months
Industry vs. Inferiority
6 to 12 years. Middle years of childhood. Development of new interests and involvement in activities. Learns to follow rules. Acquires reading, writing, math, and social skills If successful, develops confidence and enjoys learning about new things. When compared to others, may feel inadequate, inferior, if too much is expected.
