Unit 29 Peds Health Supervision Flashcards
Where are settings for child healthcare?
- Private physician’s office
- Community Health Departments
- Sliding-scale clinics
- Homeless shelters
- Day Care Centers
- Schools
What are issues covered in a psychosocial assessment? (things covered in primary care settings)
- Health insurance coverage
- Transportation to health care facilities
- Financial stressors
- Family coping
- School’s response to chronic illness
What are the three components of Health Supervision and what needs to be done?
Developmental surveillance and developmental screening
Injury and disease prevention: PROVIDE EDUCATION
- universal screenings,
- risk assessments,
- selective screenings (based on risks)
Health promotion OFFER ANTICIPATORY GUIDANCE
What should the pediatric nurse providing health supervision focus on?
The wellness of the child, NOT the illness
What are components of developmental surveillance/screenings? and an example of one.
Noting and addressing parental concerns
Obtaining a developmental hx
Making accurate observations
Consulting with relevant professionals
-Developmental screening example: CDC Milestones
What is a universal screening?
Screening of an entire population regardless of the child’s individual risk
What is selective screening?
Done when a risk assessment indicates the child has one or more risk factors for a disorder (ex: Parent has MI, child is evaluated for cardiovascular risks)
What can constant lead exposure lead to?
Neuro Deficits
What are types of screenings performed?
Metabolic Hearing Vision Iron-deficiency anemia Lead Hypertension Hyperlipidemia
What are important factors for using a vision screening chart?
- Place a mark 20 ft from the chart
- Place the chart at child’s eye level
- Align child’s heels on the mark
- Have the child read each line with one eye covered and then with the other eye covered
- Have child read each line with both eyes
What are other injury and disease prevention methods and which is the most important?
- **SAFETY education, parents should always be safety role models
- Anticipatory guidance to prevent age related issues
- Immunizations
What is passive and active immunity?
Passive immunity is produced when the immunoglobulins of one person are transferred to another (ex: breastmilk)
Active immunity is acquired when a person’s own immune system generates the immune resonse
What is the absolute contraindication and others to receiving a vaccine?
Absolute = Allergic to the specific vaccine
Others
- Mederate to severe illness
- Egg allergy
- Live vaccines when you are immunosuppressed (ex: HIV, etc.)
What are types of vaccination routes?
IM, SC, Intranasal, PO
What are anticipatory guidance topics for health promotion?
- Oral health care
- Healthy weight
- Healthy activity
- Personal hygiene
What are the kinds of child abuse?
Physical
-injuries intentionally inflicted
Sexual
-involvement in any activity meant to provide sexual gratification to an adult
Emotional
- verbal denigration (constantly told you’re no good, growing up you might feel those words)
- child witnesses domestic violence
Neglect
-failure to provide food, clothing, shelter, medical care, schooling
What are the signs and symptoms of physical, sexual, and emtiional abuse in children?
Physical abuse: bruises, lacerations, burns, bite marks, hair loss, abdominal injuries, fractures, fearfulness of parents, little eye contact with adults,
Sexual abuse: healed lacerations of hymen of the anus, sore throat, sophisticated knowledge of sexual activities, older children might be promiscuous
Emotional abuse: child may become antisocial or destructive, may also develop learning disabilities or nervous habits
What is not considered physical abuse?
Folk remedies like cupping and coining
Injuries on boney prominences usually indicated what kind of injury?
Accidental injury
What are STI’s in children usually an indicator of?
Sexual abuse
How should the nursing care be for a child during a physical exam?
- Gentle, thorough
- Observe parent-child interaction
Describe the signs and symptoms of shaken baby syndrome.
- Decreased LOC
- Irritability
- Lethargy and vomiting
- Increased RR
- Low body temp
- Decreased HR
- Coma with fixed dilated pupils
- Bruising of head and face
- Retinal hemmorhage
- Fractures of the ribs, collarbone, or long bones.
Describe nursing documentation during suspected child abuse.
- Mandatory reporting to child protective services, social services, etc.
- Carefully document injuries
What is medical child abuse/munchausen syndrome?
Parent creates syndromes to gain sympathy/attention from others
Frequent medical care/hospitalizations due to parent