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Pediatric Nursing > Unit 1 > Flashcards

Unit 1 Flashcards

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1
Q

Define: Growth

A

Increase in size.

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2
Q

Define: Development

A

An increase in skills and functions.

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3
Q

Why do we need to monitor children more closely than adults?

A

Children decompensate differently than adults. They will compensate for a long time and then suddenly go down and they are very difficult to get back.

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4
Q

What are some nontraditional families?

A

Nuclear: Dad, mom + kids
Step: One parent has children from a previous relationship
Extended: grandparents etc
Adoptive: adoption

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5
Q

Define: Maturation

A

An increase in body systems or developmental skills.

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6
Q

In general, in what fashion does growth and development occur.

A

Usually it will occur in a cephalocaudal (head-toe), distal to proximal, and gross to fine.

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7
Q

What are some factors that can influence a child’s growth?

A 
Access to healthy families and resources.
Caregiver health literacy. 
Social security. 
Community. 
Environment.
Genetics. 
Nutrition.
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8
Q

What are the different ages associated with the terms neonatal, infancy, toddler, preschooler, school-aged and adolescence.

A 
Neonatal: Birth until 28 days. 
Infancy: Birth until 12 months.
Toddler: 12 months to 36 months. 
Preschool: 3-5 years. 
School-aged: 6-11 years. 
Adolescence: 12-18 years.
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9
Q

What age is associated with the trust vs. mistrust stage of Eriksons.

A

Infancy, which is birth to 12 months. The role of the caregiver is critical.

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10
Q

What age is associated with the autonomy vs. shame or doubt stage of Erikson’s.

A

Toddler, which is 12 months to 36 months.

They cannot take turns until age 3. Is very emotionally liable and can withstand some delayed gratification.

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11
Q

What age is associated with the initiative vs. guilt stage of Erikson’s.

A

Preschool, which is 3-5 years old. These children and inquisitive and enthusiastic about new things. They engage in full play. They take pride in their accomplishments and feel remorse when they make bad choices.

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12
Q

What age is associated with the industry vs. inferiority stage of Eriksons.

A

School aged, which is 6-11.

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13
Q

What is a Schema as defined by Paiget?

A

The basic building blocks of knowledge.

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14
Q

What age range is associated with Paigets sensorimotor stage? How many substages are there?

A

The sensorimotor stage occurs from birth to 2 years of age. There are 4 substages. Object permanence occurs by 8 months. It is marked with trial-and-error and experimentation.

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15
Q

What age range is associated with Paigets Preoperational stage?

A

Ages 2-7. They can start to have sophisticated symbolic thought (4-7 years) and can develop a sense of ownership. They can play make believe. And they accept words literally.

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16
Q

What age range is associated with Paigets Concrete Operational Stage stage?

A

Ages 7-11.

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17
Q

What age range is associated with Paigets Formal Operational stage?

A

12 and up.

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18
Q

What age is associated with Kohlberg’s pre-conventional morality stage?
What are hallmarks of this stage?

A

This is seen during the toddler stage (aged 12 months - 36 months)
Obedience and punishment- The need to do right to avoid punishment.
Individualism and exchange- I give you this, so you give me that.
They are learning right from wrong and are their emotional understanding are underdeveloped.

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19
Q

What age is associated with Kohlberg’s Conventional morality stage?
What are hallmarks of this stage?

A

This is seen in preschool to school-aged children. (3- 11 years old)
Good interpersonal relationships- wants to be seen as nice.
Maintaining the social order- we have to do right so that everything functions well.

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20
Q

What age is associated with Kohlberg’s post-conventional morality stage?
What are hallmarks of this stage?

A

This is seen in adolescents aged 12-18 years.

Social contracts and individual rights- people create “social contracts” and have rights and freedoms

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21
Q

What age is associated with the identity vs. role confusion stage of Eriksons.

A

This is seen in adolescence. 10-20 years old.

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22
Q

How much does the average newborn weight? What is the trend in their weight for the first year of life.

A

Newborn average is 7.5 lbs, with boys being a bit heavier than girls.
They can lose up to 10% of their body weight in the 1st week.
They gain about 30g a day and regains birth weight by 10-14 days of age.
They double in weight by 4-6 months and will triple by 1 year.

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23
Q

What is the average length at birth?

A

They average 50 cm and grow quickly.

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24
Q

What is the average head circumference at birth? What are the trends within the first year?

A

The average head circumference is 35 cm.
It increases rapidly in the first 6 months.
Slows slightly at 6-12 months.

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25
Q

When do the fontanelles close?

A

The posterior fontanelle usually closes at 1-2 months and the anterior fontanelle can close any time after 8-9 months. This allows for brain growth, at 1 year the brain is adult sized.

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26
Q

What are some developmental milestones of neurological maturation?

A

Week 3: Neural tube forms, beginning development of the brain and spinal cord.
Week 4: Brain differentiates
Week 5: Some cranial nerves are visible
Week 6: Brain waves detected, Central nervous system is formed
Weeks 17-20: Rapid brain growth occurs
Weeks 29-32:Increased CNS control over body functions

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27
Q

What are some developmental milestones of cardiovascular maturation?

A

Week 3: Beginning development of the heart
Week 5: Heart now beats at a regular rhythm
Week 6: Fetal circulation is established
Week 7: Fetal heartbeat can be heard
Weeks 17-20: Fetal heart tones can be heard with a stethoscope

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28
Q

What are some developmental milestones of respiratory maturation?

A

Week 6: Beginning formation of lungs
Weeks 21-24: Alveoli are forming in lungs and the lungs produce surfactant
Weeks 29-32: The lungs are not fully mature

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29
Q

What are some developmental milestones of gastrointestinal maturation?

A

Week 3: Beginning development of the GI tract
Week 4: Stomach and pancreas begin to form
Week 7:Mouth with lips and early tooth buds
Week 8: Rotation of the intestines
Weeks 9-12: Buds for all 20 temporary teeth laid down and the digestive system shows activity
Weeks 13-16: Sucking motions are made, amniotic fluid is swallowed
Weeks 29-32: Fetus stores iron, calcium, and phosphorus

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30
Q

What are some developmental milestones of genitourinary maturation?

A

Weeks 9-12: Sexual differentiation continues (sex detectable) and the urogenital tract completes development and urine begins to be produced and excreted

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31
Q

What are some developmental milestones of hematopoietic maturation?

A

Week 4: Liver begins to form
Week 6: The liver produces RBC
Weeks 25-28: Blood formation shifts from the spleen to bone marrow

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32
Q

What are some developmental milestones of immunologic maturation?

A

Weeks 33-38: The fetus receives antibodies against disease from the childbearing person

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33
Q

What are some developmental milestones of integumentary maturation?

A

Week 3: Leg and arm buds form
Week 4: Limb buds grow and develop more
Week 5: Beginning structures of eyes and ears
Week 6: Primitive skin forms
Week 7: Nipples and hair follicles form, elbows and toes are visible
Week 8:Facial features continue to develop and it looks human
Weeks 9-12: Face and neck are well formed
Weeks 13-16: Fetal skin is almost transparent and fingernails and toenails are present.
Weeks 17-20: Vernix caseosa covers the fetus and sebaceous glands form
Weeks 21-24: Eyebrows and eyelashes are formed and skin is translucent and red
Weeks 25-28:Fingerprints are set
Weeks 33-38:Lanugo begins to disappear and small breast buds are present on both sexes.

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34
Q

What are some developmental milestones of musculoskeletal maturation?

A

Week 5: Muscles are innervated
Week 6: Primitive skeleton forms
Week 7: Arms and legs move and straightening of the trunk occurs
Week 12: Limbs are long and thin and digits are well formed
Weeks 13-16: Bones become harder and the fetus makes active movements (fetal quickening may be felt by childbearing person)
Weeks 17-20: Muscles are well developed
Weeks 21-24: Body is lean but fairly well proportioned
Weeks 25-28: Fetus reaches a length of 15 inches and usually assumes a head down position

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35
Q

What is the moro reflex? When does it appear and dissapear?

A

The moro reflex occurs with sudden extension of the head, the arms abduct and move upward and the hands form a “c.” It is present at birth and disappears at 4 months.

36
Q

What is the root reflex? When does it develop and when does it disappear?

A

When the infants cheek is stroked it turns to that side and searches with its mouth. This is present at birth and disappears at 3 months.

37
Q

What is the suck reflex? When does it appear and disappear?

A

Reflexive sucking when something is placed in the infants mouth. It is present a birth and disappears at 2-5 months of age.

38
Q

What is the asymmetrical tonic neck reflex? When does it appear and disappear?

A

While laying supine, extremities are extended on the side of the body to which the head is turned and opposite extremities are flexed. This is present at birth and disappears around 4 months.

39
Q

What is the palmar grasp reflex? When does it appear and disappear?

A

Infant reflexively grasps when the palm is touched. This is present at birth and disappears at 4-6 months.

40
Q

What is the plantar grasp reflex? When does it appear and disappear?

A

Infant reflexively grasps with bottom of foot when pressure is applied to the plantar surface. Present at birth and disappears at 9 months.

41
Q

What is the Babinski reflex? When does it appear and disappear?

A

Stroking along the lateral aspect of the sole and across the plantar surface results in fanning and hyperextension of the toes. This is present at birth and disappears at 12 months.

42
Q

What is the step reflex? When does it appear and disappear?

A

With one foot on a flat surface the infant puts the other foot down to “step.” It is present at birth and disappears at 1-2 months.

43
Q

What are some gross and fine motor skills present at 1 month?

A

Gross: Lifts and turns head to the side, head lag when pulled to sit and rounded back present when sitting.
Fine: Fists mostly clenched and involuntary head movements.

44
Q

What are some gross and fine motor skills present at 2 months?

A

Gross: Raises head and chest, holds position and shows improving head control.
Fine: Same as one month.

45
Q

What are some gross and fine motor skills present at 3 months?

A

Gross: Raises head to a 45 degrees in prone and slight head lag in pull to sit.
Fine: Holds hands Infront of face with hands open.

46
Q

What are some gross and fine motor skills present at 4 months?

A

Gross: Lifts head and looks around, rolls from prone to supine and head leads body when pulled to sit.
Fine: Bats at objects.

47
Q

What are some gross and fine motor skills present at 5 months?

A

Gross: Rolls from supine to prone to supine again, sits with back upright when supported.
Fine: Grasps rattle.

48
Q

What are some gross and fine motor skills present at 6 months?

A

Gross: Tripod sits
Fine: Releases object in hand to pick up another.

49
Q

What are some gross and fine motor skills present at 7 months?

A

Gross: Sits alone with some use of hands for support.
Fine: Transfers object from one hand to another.

50
Q

What are some gross and fine motor skills present at 8 months?

A

Gross: Sits unsupported.
Fine: Gross pincer grasp (thumb and 1st finger)

51
Q

What are some gross and fine motor skills present at 9 months?

A

Gross: Crawls with abdomen off of the floor.
Fine: Bangs objects together.

52
Q

What are some gross and fine motor skills present at 10 months?

A

Gross: Pulls to stand and cruises.
Fine: Fine pincer grasp and puts objects into a container and takes them out.

53
Q

What are some gross and fine motor skills present at 11 months?

A

Fine: Offers objects to others and releases them
Gross: Cruising

54
Q

What are some gross and fine motor skills present at 12 months?

A

Gross: Sits from a standing position and walks independently.
Fine: Feeds self with cup and spoon, makes simple marks on paper and pokes with index finger.

55
Q

Describe language development in the first year of life?

A 
2 months: cooing, differentiating cries
3 months: laughs out loud 
6 months: vowel sounds
8 months: first words 
12 months: A couple more words
56
Q

When is a common time during the first year of life when infants can experience separation anxiety? Why does this happen?

A

This occurs around 8 months of age. This indicates that the infant recognizes its self as separate from their parents.

57
Q

How can we promote infant safety in cars, during sleep, at home and near the water.

A

Cars: Ensure that parents use a proper sized car seat and that they can demonstrate how to properly use it.
Sleep: Ensure that babe sleeps on a firm mattress in an empty crib.
Home: Ensure that as babe grows older that the house is babyproofed.
Water: Never ever leave a child unsupervised by any body of water, no matter how small.

58
Q

When is babe ready to move on to solid foods? What age? What are the three things we look for? What is a good starting food?

A

We want to start babe on solid food around 6 months. A good starting food can be iron fortified cereal. We want to assess:

  1. The ability to swallow
  2. Disappearance of the tongue extrusion reflex
  3. Sufficient Digestive enzymes
59
Q

Describe growth of a toddler

A

Growth during the toddler stage occurs more in spurts, with an average 10-12 cm height increase, and weight increase of 3-5 pounds yearly.

60
Q

In toddlers, what does respiratory system maturation look like?

A

Alveoli increase in number up to age 7.

Trachea and airways continue to grow but they are still small.

61
Q

In toddlers, what does neurological system maturation look like?

A

Brain and spinal cord reach full size by age 2.

62
Q

In toddlers, what does cardiovascular system maturation look like?

A

Heart rate decreases.

Blood pressure increases.

63
Q

In toddlers, what does gastrointestinal system maturation look like?

A

Stomach increases in size.
Small intestine grows in length.
Stool passage decreases in frequency to 1-2 per day.

64
Q

In toddlers, what does genitourinary system maturation look like?

A

Kidneys reach adult function by 2 years of age.

Bladder capacity increases, allows for longer retention.

65
Q

In toddlers, what does musculoskeletal system maturation look like?

A

Bones increase in length.

Pot bellied appearance until 3 years old due to weak abdominal muscles.

66
Q

What are some gross and fine motor skill developments that we expect from toddlers.

A

Gross: running, climbing, jumping, pushing or pulling a toy, throwing a ball and pedaling a tricycle.
Fine: reaching, grasping, releasing, stacking, turning pages, removing socks and shoes, and holding utensils and crayons.

67
Q

What are the trends of language development in toddlers? What are some things that are commonly reported?

A

During early toddlerhood receptive language is more developed then expressive language. A younger toddler can understand common words and follow gestures, but can only speak a few words and communicates by gestures. A toddler in the middle of this stage can comprehend about 200 words but only can verbalize 5-20. A toddler in the end of this stage can understand most sentences and may participate in short conversations, they can ask why and state their name, age and gender.
Some commonly reported things include:
Echolalia: Repetition (echoing) of words and phrases without understanding.
Telegraphic speech: Speech that contains only the essential words to get the point across.

68
Q

What sort of sensory development occurs during toddlerhood?

A 
Vision is still progressing.
Depth perception matures. 
Hearing level is that of an adult. 
Sense of smell matures. 
Taste discrimination is not completely developed.
69
Q

What are some typical behaviors of toddlers?

A
  • Emotional Liability
  • Becomes aware of gender differences
  • Becomes more self aware
  • May express separation anxiety again
  • Expresses temperament
70
Q

At what age can toddlers begin cooperatively playing with others? How is that different from parallel play? What are the benefits of playing?

A

Toddlers can start playing cooperatively at around 3 years of age. Parallel play is playing alone alongside the child. Playing is the way in which children learn about the world, it is essential for social, emotional and physical development.

71
Q

How much sleep does an 18 month old need? A 2 year old? A 3 year old? When should naps stop?

A

18 months: 13.5 years
2 years: 13 hours
3 years: 12 year old’s
These infants should be sleeping through the night and have one daytime nap. Napping should be discontinued around 3 years old. A consistent bedtime routine is important.

72
Q

When do toddlers develop a full set of teeth? What would you teach a parent about dental health for their toddler?

A

Toddlers usually develop all of their teeth by age 3. The first dental office visit should be around 1 year of age. Start early by introducing a cloth with water to clean teeth, progress to toothbrush around 3.

73
Q

How do we know if a toddler is ready for toilet training? What teaching would you provide to parents?

A

Desired behaviors or actions:
-Have regular bowel movements
-Expresses knowledge of the need to urinate or defecate
-Is willing to follow instructions
-Walks well alone and can pull down pants
-Climbs onto potty chair
Toilet training cannot be forced. Regression is normal and ignoring the behavior should solve the problem.

74
Q

How can you help a parent who reports problems of a sibling rivalry with a toddler?

A

Explain to the parents that this is normal at that age. Suggest ensuring the toddler remains on a strict schedule and ensure parents give the toddler quality one on one time.

75
Q

Describe growth of the preschooler

A

Preschoolers grow an average 2.5-3 inches per year and gain around 4-5 pounds a year. There is loss of baby fat and growth of muscles.

76
Q

What are expected fine and gross motor skills in a 3 year old?

A

Fine: undresses self, copies a circle, builds a tower of 9 or 10 cubes, holds a pencil while writing, can screw and unscrew and turn pages of a book.
Gross: climbs well, pedals tricycle, runs easily, walks up and down the stairs with alternating feet and bends over easily without falling.

77
Q

What are expected fine and gross motor skills in a 4 year old?

A

Fine: uses scissors successfully, copies capital letters, draws circles and squares, traces a cross or a diamond, draws a person with 2-4 body parts and laces shoes.
Gross: throws ball overhand, kicks ball forward, catches bounced ball, hops on one foot, stands on one foot for up to 10 seconds

78
Q

What are expected fine and gross motor skills in a 5 year old?

A

Fine: prints some letters, draws person with a body and at least six parts, dresses and undresses without assistance, can learn to tie laces, uses cutlery well, copies triangles and other geometric patterns and mostly cares for own toileting needs
Gross: stands on one foot for 10 seconds or longer, swings and climbs well, may skip, summersaults, and may learn to skate or swim

79
Q

What are some common occurrences in preschoolers related to communication?

A

They are able to speak adult like sentences, they will have increased fluency, they will be able to understand their parents moods. They do not understand abstract concepts such as death.

80
Q

What are some things that preschoolers should be taught?

A
  • The difference between good and bad touch
  • Stranger danger
  • Emergency service identification
  • How to report bullying/ what is bullying
81
Q

Describe growth of a school aged child

A

They will grow on average 2.5 inches and gain 4-6 lbs. per year. Secondary sexual characteristics appear.

82
Q

What are some common language and communication development in school aged children.

A

They will have an increased vocabulary, reading efficiency improves, and metaphors are beginning to be understood.

83
Q

What are some common emotional and social developmental activities in school aged children.

A

They are developing self esteem (think Erikson’s), they may have an idea of body image, they are trying to form peer to peer relationships, and their family is the most influential.

84
Q

What are some gross and fine motor skills expected from school aged children

A

Fine: Writing, printing, sewing, and building.
Gross: Bicycling, jumping rope, dancing, skating and swimming.

85
Q

What are some safety issues related specifically to school aged children?

A
  • Car Safety
  • Pedestrian Safety
  • Bicycle and sport safety
  • Fire safety
  • Water safety
  • Abuse in children
86
Q

What are some developmental concerns in school aged children?

A

Television, video games, and the internet, school refusal, stealing, lying, cheating, bullying and tobacco and alcohol

87
Q

How long should a 6 year old sleep for? A 9 year old? A 12 year old?

A

6-8: 12 hours
8-10: 10 hours
10-12: 9-10 hours

Pediatric Nursing (2 decks)

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