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Family Nursing > Yikes > Flashcards

Yikes Flashcards

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1
Q

Nursing process to implementing care

A

Assess
Plan
Implement
Evaluate

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2
Q

Assess

A 
Structure and function
Family as Context
Family as Client
Family as a System
Family As component of society
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3
Q

Assess - AFSNAG (8)

A

Australian family strengths nursing assessment guide

  1. Communication
  2. Togetherness
  3. Sharing activities
  4. Affection
  5. Support
  6. Acceptance
  7. Commitment
  8. Resilience
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4
Q

Plan

A

Short and long term goals
Open discussions
SMART goals
Who will be responsible

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5
Q

Implement

A

Delivering care directly to patient (in hospital)
Who is responsible for implementing goals
Need to have knowledge, skill and ability

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6
Q

Evaluate

A 
Recognise changes in family
Identify need for any modifications 
Have goals been achieved
Were they effective
Goals need revision and updates
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7
Q

Airway anatomy in children

A 
Large occiput 
Neck flexion caused airway to be cut off
Head bobbing in respiratory distress
Teeth can be loose
Infant (less than 12 months) 
Less than 6 months means they breathe through nose only
Large tongue and large amount of soft tissue - cause oedema 
Larynx is soft
Cricoid ring is narrowest part of airway
Trachea is shorter. Less bronchioles
Prone to ear infections etc
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8
Q

Airway Assessment

A

Stridor- upper airway obstructing due to group or foreign object
Look, listen, feel
How hard are they working to get air in
Intensity of stridor does NOT indicate severity of obstruction

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9
Q

Airway positioning

A

Infants - put in neutral position

Children from ages 1-9 - sniffing position

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10
Q

Breathing physiological and anatomy

A

Air tissue SA is less in infants
Diaphragm principal respiratory muscle in infants - children are abdominal breathers
Thin chest wall so hard to hear lung sounds
Ribs positioned more horizontal (decreased tidal volume)
Can’t lift ribs up and out
Increased effort for breathing

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11
Q

When assessing child breathing

A

Check for
Effort of breathing - LOOK nasal flaring, head bobbing, respiratory rate and depth, accessory muscle use, tracheal tug and chest recession
Effectiveness of breathing - LOOK chest expansion, symmetry, trachea midline, abdominal excursion. LISTEN breath sounds, air movement, grunting, wheezing stridor
Effects of respiratory inadequacy - mental status (drowsiness or adjetated) heart rate (increased), skin colour (pale), oxygen saturation

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12
Q

Effects of respiratory inadequacy (pre terminal)

A 
Exhaustion
Bradycardia
Cyanosis (central) 
Silent chest
Hypotension
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13
Q

Fixed SV in children

A

1.5mL/kg infants
75mL/kg adults
SV increases as heart size increases therefore HR decreases with age
Hypotension in children is pre terminal

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14
Q

Circulation

A

Children exchange more than half of their extra cellular fluids daily - increased potential for dehydration
Must measure intake and output
BP and SVR increase with age
Higher metabolic rate
Renal tubule immaturity - can’t concentrate urine
Poo is more runny

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15
Q

Norms for HR and BP

A

Infant - 110-160, 70-90
2-5 - 95-140, 80-100
5-12 - 80-120, 90-110
>12 - 60-100, 100-120

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16
Q

Primary assessment process

A

Airway
Breathing
Circulation
Disability

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17
Q

AVPU

A 
Alert
Responds to voice
GCS is less than 8 when in the pu (worry about respiratory rate)
Responds to pain
Unresponsive
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18
Q

QUESTT pain assessment

A 
Question the child
Use a pain rating scale
Evaluate the behaviour and physiological changes
Secure parents involvement 
Take cause of pain into account
Take action and evaluate results
19
Q

3 stages of separation anxiety

A

Protest - reluctance to leave area
Despair - withdrawn “settled in”
Detachment- stop attaching to others

20
Q

Phase of protest

A 
Cry
Scream
Search for parent with eyes
Cling to parent
Rejects contact with strangers
Verbal/physical attack strangers
Force parent to stay - “I’m gonna hate you if you go”
Protests may only stop when the child is exhausted
21
Q

Phase of despair

A 
Be inactive
Withdrawn from others
Depressed
Uninterested in environment
Uncommunicative 
Regress to earlier behaviour
May start sucking thumb or wetting bed
Refuse to eat and drink
22
Q

Nurse care for separation anxiety

A 
Set expectations 
Development of trust
Familiar objects
Build anticipation 
Parents can always say goodbye
23
Q

Phase of detachment

A

Appear happy
Form new but superficial relationships
Show an increase interest in their surroundings
Interacts with strangers or familiar care giver

24
Q

Paediatric mortality highest in children under 1 year

Stats:

A

Neonates: congenital, prematurity
Infants: SIDS, sepsis
Toddlers: trauma
Adolescents: risk taking behaviours

25
Q

4 main reasons why kids get seriously unwell and die

A
  1. Fluid maldistribution - sepsis, anaphylaxis and spinal shock
  2. Fluid loss - gastroenteritis, burns and blood loss
  3. Respiratory distress - croup, asthma and foreign body
  4. Respiratory desperation - seizure, poisoning and CNS depression
26
Q

Erickson’s

A 
Infant - trust vs mistrust
Toddler - autonomy vs doubt
Pre schooler - initiative vs guilt
School kid - industry vs inferiority 
Adolescent - identify vs role confusion
27
Q

Piaget’s stages

A

Semimotor stage
Preoperational stage
Concrete operations stage
Formal operations stage - abstract, idealist and logic

28
Q

Gillick competence

A

Child achieves sufficient understanding and intelligence to understand the proposed treatment and consequences of the treatment their parents right to consent of their behalf ceases
Doctor decides competence
Treatment and consequences are understood and in best interest for patient

29
Q

HEADSSS Assessment

A 
Home or housing
Education or employment 
Activities
Drugs/ dieting
Sex and sexuality 
Suicide and depression
Safety
30
Q

Family Systems Theory

A

Change in one individual will impact all persons within a family.
Family as a social and emotional unit
Helps with genograms
Family can create balance between change and stability
Contains boundaries (values, beliefs etc)
Doesn’t prove explicit guidance for nurses and doesn’t provide a view of the family over time
1. All parts are interconnected; 2. Whole is more than sum of its parts; 3. There are boarders and family controls who goes in and out; 4. Systems sorted into subsystems

31
Q

Family development theory

A

Family move through expected stages
Face predictable developmental tasks
Nurses can assess the extent to which developmental milestone has been achieved by the family
Doesn’t consider the experience of non-nuclear families or families facing impacts of non-normal events

32
Q

Structural/ Functional Family Theory

A

The structure facilitates the function
Understanding family dynamics and how these influence the families purpose
Doesn’t explain how families develop and manage over time
Doesn’t have a cross cultural component nor reflects diverse family types
Manifest Functions: placed intentionally to keep society moving forward
Latent functions: unintended consequences

33
Q

Health priorities and social policies in Australia

A

National evidence-based antenatal care guidelines (care for healthy preg women)
Australian National breastfeeding strategy (improve health of infants)
National framework for universal child and family health services (0-8 year children and fam access to healthcare)
National framework for protecting Australia’s children (reduce levels of child abuse and neglect)
Family and domestic violence strategy (government response to violence)

34
Q

Tools used in child and family nursing (6)

A
  1. Genograms
  2. Ecograms (circle with multiple lines one)
  3. Calgary Family Assessment Model (structural, developmental and functional)
  4. Friedman Family Assessment Model (fam is subsystem and assesses values and stress)
  5. Family Systems Stressor-Strength Inventory (big table showing from not applicable to high stress)
  6. Australian Family Strengths Nursing Assessment guide (8 activities eg sharing activities)
35
Q

Natal definitions

A 
Preconception: prior to pregnancy 
Prenatal: pregnancy to labour
Gestation: number of weeks pregnant
Perinatal: 20 weeks pregnant to 28 days after birth
Postnatal: first 6 weeks after birth
Neonate: first 4 weeks of life
36
Q

Pregnancy phases

A 
Trimester 1 (0-12 weeks): hormones released
Trimester 2 (13-27 weeks): begin to show
Trimester 3 (28-40 weeks): random tightening of uterus (braxton hicks) increased movement of baby
37
Q

Stages of vagina birth

A

1st stage: 12-19 hours of labour. Regular contractions every 5-20 mins. Water breaks and mucus plug is discharged
2nd stage: labour lasts 20min-2hours. Cervix dilates 10cm. Baby delivered and umbilical cord cut
3rd stage: 5-30min mild contractions assist placenta to be delivered. During this stage baby can begin bonding through skin to skin touch and breast feeding. Uterus shrinks to control bleeding.

38
Q

Principles of growth and development

A

It is a continuous process from conception to death
It proceeds in an orderly sequence but happens at different rates
It is cephalocaudal (head to feet)
It proceeds in a proximodistal manner (center outwards)
Development of gross motor skills develops before fine motor skills

39
Q

Child abuse

A

4 types: emotional, neglect, physical and sexual
Child protection act 1999 says nurses are mandatory reporters required to report a suspicion on whether a child has suffered, is suffering or risk of suffering significant harm caused by abuse and do not have a parent or guardian willing to protect child

40
Q

8 stages Erickson’s

A 
Trust vs mistrust
Autonomy vs shame
Initiative vs guilt
Industry vs inferiority 
Identity vs role confusion
Intimacy vs isolation
Generativity vs stagnation
Integrity vs despair
41
Q

Piaget’s 4 stages

A

Sensory motor stage
Preoperational stage
Concrete operational stage
Formal operational stage

42
Q

6 stages of play

A 
Unoccupied 
Onlooker
Solitary
Parallel
Associative
Cooperative
43
Q

APGAR Assessment

A

0-3 is severe distress, 4-7 moderate distress, 7-10 all good
Appearance (skin colour)
Pulse (heart rate)
Grimace (reflex response)
Activity (spontaneous movement/ muscle tone)
Respiration (breathing)

Family Nursing (1 decks)

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