Week 1 - Paediatric 1 Flashcards
What is family centred care?
Builds on the rights of the child and on legislation, to ensure the care children and young people receive is grounded in mutually beneficial partnerships between health care providers, patients, and families.
Two basic concepts in family centred care.
Enabling
Empowerment
The Declaration of the Rights of the Child is based around four principles:
- Non-discrimination
- Life, survival and development
- The best interests of the child
- Respect for the child’s preferences and viewpoints
What is child maltreatment?
The abuse and neglect that occurs to children under 18.
Child maltreatment includes all forms of:
- Physical abuse
- Emotional abuse
- Sexual abuse,
- Neglect,
- Exploitation that results in actual or potential harm to the child’s health, development or dignity in the context of a relationship of responsibility, trust or power
Examples of biological factors affecting development:
- Genetic influences
- Hormone levels
- Gender
Examples of psychological/psychosocial factors affecting development:
- Conflict and psychological trauma
- Hardship
- Neglect
Examples of environmental factors affecting development:
- Prenatal factors (exposure to substances before birth)
- Trauma
- Infection
- Toxins
- Family stress
How can we increase opportunities to build and support psychological, physical and social strengths in children/young people?
- Establish therapeutic rapport
- Actively involve the child
- Celebrate successes
What is childhood trauma?
The result of an event or a series of events which cause a child to feel helpless and pushed beyond their ability to cope.
What is autism spectrum disorder (ASD)?
A neurodevelopmental disorder which commonly involves problems with communication and social interactions, sensory sensitivities, and restricted or repetitive behaviours, interests and activities.
Diagnostic criteria of autism spectrum disorder:
- Persistent deficits in social communication and social interaction across multiple contexts
- Restricted, repetitive patterns of behaviour, interests or activities
Types of medications used for autism
- Atypical antipsychotics
- SSRIs
- Benzodiazepines
What does ADHD stand for?
Attention-deficit/hyperactivity disorder
What is ADHD?
A pattern of behaviour that begins in childhood and is characterised by inattention, hyperactivity and impulsivity that interferes with functioning or development
Symptoms of inattention in ADHD:
-Does not seem to listen when spoken to directly
-Does not follow through on instructions or fails to finish
work/chores/duties
-Difficulty organising tasks/activities
Symptoms of hyperactivity/impulsivity in ADHD:
- Fidgets/squirms or taps hands/feet
- Leaves seat when remaining seated is expected
- Runs about/climbs in situations where it is inappropriate (in adolescents/adults can be restless)
Therapeutic interventions in ADHD:
- Cognitive behaviour therapy
- Behavioural management strategies such as tokens/rewards
- Parent-led behavioural training
Therapeutic interventions in ASD:
- Educational interventions (schools specialise in working)
- Behavioural management/Applied behaviour analysis
- Positive behaviour support
Medication used for ADHD:
Psychostimulant
How to communicate with an infant:
Speak softly and communicate through touch
How to communicate with early childhood:
Focus communication on them, tell them what they can do or how they will feel
How to communicate with school-age children:
Give an explanation and reason for everything
How to communicate with young people:
Privacy and confidentiality are of great importance
Strategies for communicating with infants and children:
- Be honest with children
- Allow children to express their concerns and fears
- Allow children time to feel comfortable
Strategies for communicating with young people:
- Spend time together
- Respect their privacy
- Set a good example
What is the paediatric assessment triangle used for and what are the 3 variables?
The triangle is an initial assessment that is non-invasive and non-threatening that determines whether a patient is sick or not sick.
The three variables are appearance, work of breathing and circulation.
Techniques to use if a child refuses to cooperate during an assessment:
- Perform examination as quickly as possible
- Have the attendant gently restrain the child
- Minimize any disruptions or stimulation
- Limit the number of people in the room
How do you involve the child in the examination process::
- Provide choices, such as sitting on table or in parents lap
- Allow child to handle or hold equipment
- Encourage child to use equipment on a doll, family member, or examiner
- Explain each step of the procedure in simple language
Early indication of dehydration in children:
- Tachycardia
- Increased respiratory rate
- Dry skin and mucous membranes
What is dehydration?
It occurs whenever the total output of fluid exceeds the total intake, regardless of the underlying cause. Dehydration is also commonly referred to as volume depletion.
Percentage loss of body weight in normal, mild, moderate and severe:
Normal: no loss of body weight
Mild dehydration: 5-6% loss of body weight
Moderate: 7-10% loss of body weight
Severe: over 10% loss of body weight
Clinical features of mild to moderate dehydration:
- Restlessness or irritability.
- Sunken eyes (also ask the parent)
- Thirsty and drinks eagerly
Clinical features of severe dehydration:
- Abnormally sleepy or lethargic
- Sunken eyes
- Drinking poorly or not at all
What does TFI stand for?
Total fluid intake
What is maintenance volume?
The fluid required to maintain hydration in a child who isn’t eating or drinking
How is maintenance hydration calculated?
4.2.1 rule
How does the 4.2.1 rule used for maintenance hydration?
This calculation uses body weight to work out the hourly fluid rate.
Situations that require specific fluid management:
- Burns
- Chemotherapy hydration
- Diabetic ketoacidosis
- Renal impairment
- Electrolyte imbalances
Three ways to check an infants pulse:
- Brachial pulse (upper arm)
- Femoral pulse (upper leg)
- Radial pulse (wrist)
Blood pressure considerations in paediatrics
- Measure on right arm
- Use correct size cuff
- Position the child correctly
- Settle child before measurement
Ways to measure temperature in a paediatric:
- Axilla (under arm)
- Tympanic (in ear)
When is it not appropriate to use a tympanic thermometer?
- Younger than 6 months
- Ear infection
- Previous ear surgery
