Week 1 - Intro to Peds Flashcards
What are the ages associated with each of the Developmental Age Groups?
KNOW THIS!!!!
- Neonate = < 28 days old
- Infant = 0 - 12 months
- Toddler = 1-3 years
- Preschooler = 3-6 years
- School Age = 6-12 years
- Adolescence = 12-18 years
What is the age range of kids in the Infant Developmental Age Group?
KNOW THIS!!!!
0 - 12 months
Neonate = < 28 days old
What is the age range of kids in the Toddler Developmental Age Group?
KNOW THIS!!!!
1 - 3 years
What is the age range of kids in the Preschool Developmental Age Group?
KNOW THIS!!!!
3 - 6 years
What is the age range of kids in the School Age Developmental Age Group?
KNOW THIS!!!!
6 - 12 years
What is the age range of kids in the Adolescent Developmental Age Group?
KNOW THIS!!!!
12 - 18 years
Emancipated Minor
Typically a self-supporting adolescents or married, pregnant, incarcerated, not subject to parental control
- minor parents in their child’s care
Book definition: Legally under age but is recognized as having the legal capacity of an adult under circumstances prescribed by state law
Mature Minors
Adolescents who may give independent consent to receive or refuse treatment for a limited number of conditions
- ages 14-18
- Tx include STI testing & treatment, contraception, substance abuse, mental health, etc.
Book Definition: Allows adolescents who are under age to give consent as long as they understand the consequences of treatment
Age range of a Mature Minor
14-18
The nurse is planning educational interventions to reduce the incidence of the number one cause of mortality in children ages 1-4. Recognizing the developmental needs of this age group, the nurse should focus the session on which topic?
a.) Recognition of congenital malformation
b.) Car seat use
c.) Safe sleeping practices
d.) Child abuse prevention
b.) Car seat use
MVAs are one of the most common causes of unintentional injury & the most common cause of death in ages 1-4
Treatment without consent
- exception when prompt medical care is needed
- In an emergency consent is not needed, it is implied by law
What is assent?
Need for informed concent for proposed treatments or research involving children with a mental age of 7 or older that requires a child be informed & agree with decision
Morbidity & leading causes of morbidity for each age group
Morbidity = illness/injury; limits activity, required medical attention / hospitalization, results in change in condition
* Under 1: suffocation
* 1-4: drowning
* 5-9; 10-14; & 15-19: MVAs
Mortality & leading causes of mortality for each age group
Mortality = death
- SIDS, congenital malformations, & unintentional deaths are a very serious concern for infants
Explain a safe sleep environment & why we care about it
ABC
- Alone
- Back
- Crib
No extra blankets, stuffed animals or pillows, side rails up
Effects of hospitalization on infants
1.) Unaware of illness + effects, deviation from normal life
* encourage normal wake/sleep cycles, feeding times, & typical daily activities
2.) Can sense stress & anxiety in loved ones
* provide family centered care & encourage participating from family to decrease anxiety
3.) Awareness of self as separate from parents by 6-8 months –> separation + stranger anxiety which is exacerbated if parents are not staying with the infant
* Encourage participation when able
* Allow parents to touch infant, remain in view & talk to calm infant when possible
Effects of hospitalization on toddlers / pre-schoolers
1.) Separation from parents + disruption of routine = major stressors + fears
* encourage participation & maintenance of home routines
2.) May see illness as punishment
* due to toddler having incorrect cause-and-effect perceptions
* calmly explain source of illness & no fault to child
Effects of hospitalization on school-aged children
1.) Beginning to understand body functions
2.) Foster sense of industry
* encourage participation in care, continued schoolwork, & arts / crafts
3.) Stressful procedures can lead to regression or behavior changes
Effects of hospitalization on adolescents
1.) Understands complex nature of illness & often fear is a result of it
2.) FOMO with friends & peers
* encourage participation in play room, school, etc.
3.) Concerned with effects of illness on appearance / body image
* respect need for privacy & independence
* careful listening by nurse
4.) Partner with family & adolescent in care
* encourage family to include the pt in decision making & empower the pt w/ choices
How does hospitalization affect parents?
1.) Feelings
- disbelief, anger, guilt – especially if illness = sudden
- fear, anxiety – r/t child’s pain & seriousness of illness
- frustration – r/t need for information
- depression
2.) Other impacts
* family process interrupted
* changes in parental roles
* burdens = missed work, $$$, sibling care
How do hospitalizations affect siblings?
- confusion
- guilt – may believe something they did caused the illness (like an argument w/ sibling)
- anger
- jealousy
- rejection – siblings may feel lef out
How are medications given to pediatric patients? Describe for IM, oral, IV, otic, & ophthalmic.
KNOW THIS!!!!
IM: use z-track method
* vastus lateralis, NO > 1-2 mL
* deltoid, NO > 0.5 mL
IV:
* hourly IV checks are required due to high risk of infiltration
* careful site maintenance – hand, feet, AC, scalp
Ophthalmic:
* immobilize
* place wrist on child’s head for stabilization
* have medications at room temperature
Otic:
* immobilize
* wrist on child’s head
* > 3 yr = pull pina UP
* < 3 yr = pull pina down
How do you administer an IM injection in a pediatric patient?
Z-track method
- vastus lateralis = 1-2 mL
- Deltoid = NO > 0.5 mL (or less)
How are ophthallmic medications administered in pediatric patients?
- immobilize
- place wrist on child’s head for stabilization
- have medications at room temperature
How are otic medications administerd in pediatric patients?
- immobilize
- wrist on child’s head
- > 3 yr = pull pina UP
- < 3 yr = pull pina down
What things do we monitor for in pediatric patients with IVs? How often do we check them? What sites do we use?
- careful site maintenance
- common sites = hand, foot, AC, head
- HOURLY CHECKS due to high risk of infiltration
How can we prepare children at each age for procedures?
1.) Infants – none; parents get info
* allow parents to be present for procedure
* allow parents to touch / talk / sooth infant
2.) Toddler – give explanation pre-procedure; explain child they did nothing wrong & procedure is necessary
* reward child after procedure & allow crying / screaming
3.) Pre-Schooler – simple explanation & simple drawing; supervise child while they touch / play w/ equipment
4.) School-Aged – clear, thorough explanation; stress-reduction; reward once procedure is completed
5.) Adolescents – clear explanation; stress-reduction; explore fears r/t procedure
What are some invertentions hospitals can use to ease the burden of hospitalizations on families?
- Rooming in – 24/7 visitation, parent involvement
- Child-Life Specialist – planned play, collab w/ therapists
- Therapeutic Play – dramatic & medical
- Therapy – art, music, animal, recreation (utilize play room)
- Educational Needs – comfortable work environment, interactions w/ classmates, child / family teaching, teaching plans, teaching for children w/ special needs
- Discharge – family ability to provide care (equipment training), financial burden, educational needs, prepare family (procedures, meds, emergency, etc.), prepare parents to act as case managers
What are important considerations with pediatric medications?
safe dosing & calculations
How do pediatric medication errors occur?
Math errors
Explain Safe Sleep
KNOW THIS!!!!
- Alone
- Back
- Crib
* No blankets / stuffed animals / bumpers
Leading causes of death in each age group
KNOW THIS!!!!
- under 1 y/o: suffocation & homicide
- 1-4 years: drowning & MVA
- 5-9 years: MVA & drowning
- 10-14 years: MVA, suicide
- 15-19 years: MVA, homicide
Mobidity
An illness or injury that limits activity, requires medical attention or hospitalization, or results in a chronic condition
Most common = respiratory / injury / poison, increasing mental health issues
Assent
KNOW THIS!!!!
Voluntary agreement to accept treatment or participate in research
Infant response to illness
KNOW THE BOLD!!!!
- Unaware of illness & its effects on deviation from normal life
- Able to sense stress in loved ones
- 6-8 months develop separation anxiety or stranger anxiety
At what age do children develop stranger danger (anxiety) & separation anxiety?
KNOW THIS!!!!!
6-8 months
Toddler response to illness
KNOW THE BOLD!!!!
- Separation from parents & disruption in routine = major stressors
- Illness = punishment (to the child)
School-Age response to illness
KNOW THE BOLD
- Start understanding body function
- Encourage participation in treatment
- Stress can lead to regression / behavior changes
Adolescent response to illness
KNOW THE BOLD!!!!
- Understand complex nature & fear results
- FOMO w/ friends / peers
- Effects on body image
- Encourage decision-making & empowering choices
Sibling response to illness
Understand & know the main topics
Confusion
* may not understand what is happening & why
Guilt
* may think they caused the hospitalization
Anger
* may be angry at patient for getting sick
Jealousy
* may act out or perform attention seeking behaviors
Rejection
Infant Procedure Prep
KNOW THE BOLD!!!!
- Explain procedure to parents, the reason, & their role
- Allow option fo being present
- Encourage interaction (rubbing cheek / foot)
- Parents do NOT hold the infant
- Can soothe infant afterwards
0 - 12 months
Toddler Procedure Prep
KNOW THE BOLD!!!!
- Give explanation just before because concept of time is limited
- Explain they did NOTHING wrong, the procedure is necessary
- Avoid giving choices
- Allow crying / screaming
- Comfort after procedure, offer treat
1-3 years
Preschooler Procedure Prep
KNOW THE BOLD!!!!
- Simple explanations & drawings for understanding
- Supervision
- Use bandages to ensure child’s body will not “fall apart”
- Encourage counting to 10 or spelling name
- Allow crying
- Positive feedback & encourage to draw afterwards to reflect
3-6 years
School Age Procedure Prep
KNOW THE BOLD!!!!
- Clear explanations with drawings, books, pictures or equipment
- Stress reduction techniques (breathing or visualization)
- Explain what is happening during the procedure
- Choice of reward when finished
- Praise for cooperation
