UNIT 6 Growth and Development Flashcards
Does family have an influence on the Child’s growth and development? Would they’re influence fall under primary or secondary social groups?
A. No
B. Yes
B. Yes
Primary
What is the objective of Family-centered care in Pediatric Nursing?
- enabling – families are given opportunity to display their caring abilities and gain new ones
- empowerment – families are given the ability to maintain or acquire sense of control and make positive
changes.
What is the objective of providing Atraumatic care to a pediatric patient?
Prevent separation from parents
Promote sense of control
Minimize bodily injury
What is the role of Pediatric Nurse
Role of Pediatric Nurse
Therapeutic relationship
Family advocacy
Health promotion and teaching
Injury prevention
Family support
Which of the following has an influence on child health? SELECT ALL THAT APPLY
A. Social Roles (PRIMARY & SECONDARY)
B. Self esteem & Culture (Cultural background)
C. Communities (Environment)
D. Peer Groups(friends
E.Cultural & Religious Health Beliefs & Practices
All
Social Roles
Primary vs Secondary
Self Esteem and Culture
Communities
Peer Groups
Cultural and Religious beliefs
What is the definition of Growth?
Increase in number and size of cells as they divide and synthesize new proteins
Physiological size (height, weight, bone length, etc.
What is DEVELOPMENT
DEVELOPMENT
Advancement from lower to more advanced stage of complexity; increased
capacity through growth, maturation, and learning
Acquisition of skills and functioning
What is the importance of sequential trends
sequence:
a particular order in which related events, movements, or things follow each other.
example “ first the baby must know how to crawl before they walk”
Based on the concept that each child will normally pass through each stage of
growth and development in a predictable sequence
Universal and basic to all human beings, but each person accomplishes these
individually
What are the two directional patterns of growth?
Cephalocaudal
Head to toe direction
Proximodistal
Near to far
Midline to peripheral concept
Which of the following can effect the rate and time growth and development in children?
A. Single mother
B. Malnutrition
C. Single father
D. Non-existence grandparents
B. Malnutrition
Severe illness or malnutrition will affect the rate of both growth and
development
Does growth only occur externally in children?
A. Yes
B. No
B. No
Growth occurs both internally and externally
When does Dramatic growth take place? SELECT ALL THAT APPLY
A. birth to 4 years old
B. birth to 3 years old
C. year 12 during puberty
D. year 10 to year 18
E. birth to 18 years of age
A. birth to 4 years old
C. year 12 during
When does most of Neurological maturation take place?
A. before birth
B. after birth
C. from birth to year 20
D. year 20 to year 40
A. before birth
most occurs before birth
Periods of rapid neurological growth between 15-29 weeks gestation
Rapid growth from birth to 1 year; continues through early childhood
More gradual rate through childhood into adolescence
What is referred to as the work of children?
PLAY
Through the universal medium of play, children learn what no one can teach them.
They learn about their world and how to deal with this environment of objects, time, space, structure, and people.
They learn about themselves operating within that environment—what they can do, how to relate to things and situations, and how to adapt themselves to the demands society makes on them.
Play is the work of children. In play, children continually practice the complicated, stressful processes of living, communicating, and achieving satisfactory relationships with other people.
What is the function of Sensorimotor development (PLAY) PG 702
Active play is essential for muscle development and serves a useful purpose as a release for sur- plus energy.
SENSES PLAY
Through sensorimotor play, children explore the nature of the physical world. Infants gain impressions of themselves and their world through tactile, auditory, visual, and kinesthetic stimulation.
What is the function of Intellectual development (PLAY)
Through exploration and manipulation, children learn colors, shapes, sizes, textures, and the significance of objects. They learn the signifi- cance of numbers and how to use them; they learn to associate words with objects; and they develop an understanding of abstract concepts and spatial relationships, such as up, down, under, and over.
EXAMPLES
Activities such as puzzles and games help them develop problem-solving skills. Books, stories, films, and collections expand knowledge and provide enjoyment as well.
What is the function of Creativity (PLAY)
Children can experiment and try out their ideas in play through every medium at their disposal, including raw materials, fantasy, and exploration.
Creativity is stifled by pressure toward conformity; therefore striving for peer approval may inhibit creative endeavors in school-age or adolescent children.
What is the function of Self-awareness (PLAY)
*Children learn who they are and their place in the world. They become increasingly able to regu- late their own behavior, to learn what their abilities are, and to compare their abilities with those of others.
*Through play, children can test their abilities, assume and try out various roles, and learn the effects that their behavior has on others.
*They learn the sex role that society expects them to fulfill, as well as approved patterns of behavior and deportment.
What is the function of Therapeutic value (PLAY)
Play is therapeutic at any age (Fig. 28.10). In play, children can express emotions and release unacceptable impulses in a socially acceptable fashion.
Children reveal much about themselves in play. Through play, children can communicate to the alert observer the needs, fears, and desires that they are unable to ex- press with their limited language skills.
What is the function of Moral value (PLAY)
Unoccupied play (INFANT)
child is not mobile and has random movements with
no purpose.
Solitary Play (INFANT/TODDLER)
play alone with their interest centered on their
own activity
PLAYING BY ONESELF
Onlooker play (infant/toddler)
Looking to play observing (with others)
Onlooker play (infant/toddler) -watch what other children are doing but do not
make any attempt to enter the play activity
Parallel play (toddler)
children play independently but with other children
playing with toy indecent sitting by people (helps with social interaction)
Associative Play (preschooler)
(preschooler)-children play together with no group goal (NOT GOAL ORIENTED)
starts making friends
Cooperative play (school-age)
play is organized and children play in a group with other children working to complete a goal (GOAL ORIUENTED)
*TEAM WORK
*ORGANIZED SPORTS
*HELPS WILL WORK TOGETHER
How do you communicate with an infant? 1-3 YEARS OLD
by acknowledging and responding to their non-verbal cues
such as cooing and crying
respond to non-verbal cues - cannot understand verbal ones yet. Cooing and
crying are their main forms of communication
How you you communicate with a toddler/ Early Childhood (Preschool) 1-3 OR 3-6 YEARS OLD
By highlighting how they will be affected if this(something) is not done
ex- You will not be able to play with your friends or mom if you don’t take this shot
Early Childhood: egocentric, respond best when you discuss how THEY will be
effected. Experience of others has no interest to them.
How do you communicate with a school age patient? 6-12 YEARS OLD
School-Age: want explanations and reasons for everything. Need to know why
How do you communicate with an Adolescent (12-18 years old)?
Adolescence: confidentiality is important
example “as a nurse you ask them if they are sexually active and they respond truthfully , and they ask you to not tell they’re parents”
How is a Physical Assessment normally done in what sequence?
A. toes to eyes
B. Toe to head
C. fingers to head
D. head to toe
D. head to toe
How you successfully assess the ears of the 12 year old child?
A. pull pinna up and back
B. pull pinna down & back
C. straighten the ear canal
D. use a penlight for clarity of ear canal
A. pull pinna up and back
What are the 4 common pain scales used from birth to adulthood?
*NIPS
*FLACC
*Wond Baker faces
*Numeric Scale (0-10)
You suspect that your 2 day old newborn patient is in pain , what pain scale would be most appropriate to measure the intensity of their pain?
A.NIPS
B.FLACC
C.Wond Baker faces
D.Numeric Scale (0-10)
A.NIPS
(facial expression, cry, breathing pattern, arms, legs, state of arousal)- neonates
<2mo
You suspect that your 4 month old patient is in pain , what pain scale would be most appropriate to measure the intensity of their pain?
A.NIPS
B.FLACC
C.Wond Baker faces
D.Numeric Scale (0-10)
B.FLACC
(Face, legs, activity, cry, consolability)- infants >2mo
You suspect that your 3 year old patient is in pain , what pain scale would be most appropriate to measure the intensity of their pain?
A.NIPS
B.FLACC
C.Wond Baker faces
D.Numeric Scale (0-10)
C.Wond Baker faces
You suspect that your 5 year old patient is in pain , what pain scale would be most appropriate to measure the intensity of their pain?
A.NIPS
B.FLACC
C.Wond Baker faces
D.Numeric Scale (0-10)
D.Numeric Scale (0-10)
Numeric Scale (0-10)- 8 years and older. May be used as early as 5 (as long as they
can count and understand values of the numbers
Non-pharm management of of pain for Pediatrics
Containment
Ex: Blanket rolls to provide a “nest”
Positioning
Ex: Swaddling
Sucking
Ex: Providing pacifier
Kangaroo care
Ex: Skin to skin contact with a parent
Distraction
Relaxation
Music/pet/art therapy
Pharm management for pain for pediatrics
For mild to moderate:
Acetaminophen
NSAIDS (Ex: Ibuprofen)
For moderate to severe:
Opioids (morphine, dilaudid, fentanyl)
Adjuvant:
Antianxiety: Diazepam (valium) & midazolam (versed)
Tricyclic antidepressants (amitriptyline)
Antiepileptics (gabapentin, clonazepam)
Stool softeners/Laxatives
Antiemetics
Diphenhydramine
Steroids
benefits of adjuvant pain management
enhance the effects of pain medications, treat concurrent symptoms, and provide analgesia for other types of pain
What is a common adverse effect of Morphine
Respiratory depression
Severe Hypotension
What’s a common side effect of Morphine?
Constipation
Drowsiness
Reaction to hospitalization - INFANT
*Reliant on parent
Assign primary nurse, stick to routine
Reaction to hospitalization- TODDLER
*Hospitalization disrupts autonomy; may cause regression
Follow daily routin
Reaction to hospitalization- PRESCHOOL
*Egocentric; may view hospitalization as punishment. Fear body mutilation
Need reassuranc
Reaction to hospitalization- SCHOOL AGE
*Strive for independence, fear abandonment, injury and death
Need reassurance
Reaction to hospitalization-ADOLESCENT
*Struggle for independence; hospitalization may cause anger
Benefit from contact with peers
Complications of Obesity in Pediatrics
consequences/Complications:
elevated blood cholesterol,
high blood pressure,
respiratory disorders,
orthopedic conditions,
cholelithiasis,
fatty later disease,
cancer,
Type II diabetes,
poor body image,
low self-esteem,
social isolation,
depression,
and rejection.
What is the difference between being overweight and obese?
Obese
Increase in body weight resulting from an excessive accumulation of body fat relative
to lean body mass.
Overweight=BMI between 85th-95th percentile
Obesity= BMI greater than or equal to 95th percentile
Risk factors of Obesity
Influencing factors:
1. Environmental Conditions
Abundance of food, limited access to low-fat foods, reduced or minimal activity,
snacking, family/cultural views, socioeconomic status
2. Community Factors
Unsafe neighborhoods, increased availability of fast food restaurants, overzealous
food advertising
3. Institutional factors
School lunches, vending machines, allowing students to leave for lunch
4. Physical Inactivity
Video games, TV
5. Psychologic factors
Positive reinforcement and comfort
Failure to thrive
Weight (and sometimes height) below the 5th percentile for age
Risk Factors & Causes:
Organic: Preemie, IUGR, CHD
Nonorganic: Poverty, neglect, knowledge deficit
Clinical manifestations
Growth/developmental delays
Withdrawn, apathetic
Minimal smiling, avoidance of eye contact
Treatment: reverse the cause
Immunization reactions
Immunization reactions
Immunizations among the safest and most reliable drugs available
Serious reactions rare; mild side effects more common
Side effects usually occur within a few hours or days
Local tenderness, erythema, swelling at injection site
Low-grade fever
Drowsiness, eating less, prolonged crying
Treatment of side effects- cold compress to area, comfort measures
Should you get consent before administering a vaccine?
Yes
No
Yes
Administration
Must have consent signed
VIS provided to parent
Contraaindications of vaccine
Contraindications for vaccines
Severe febrile illness
Known allergy to vaccine
** minor illness such as a cold is not a contraindication**
Severely immunocompromised children should not receive live viruses
Children receiving immunoglobulin therapy should not get MMR and varicella vaccines for minimum of 3 months
