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54 Cards in this Set
- Front
- Back
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what may shape a child/family's illness/hospitalization experience (4)?
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- nature (acute/chronic, expected/unexpected)
- past experiences - meaning - values, capacities, identity, practices |
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common sources of stress for families - ACUTE conditions? (5)
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- fear of unknown
- fear of pain/injury - separation - loss of control - unexpected |
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common sources of stress for families - CHRONIC conditions? (5)
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- uncertainty
- family strain - demands for resources - child's future - isolation |
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common sources of stress for children? (4)
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- separation
- fear of injury/pain - loss of control - guilt, shame, worry |
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what is family centered care?
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mutually beneficial HC partnerships between pt, family, and providers
(an approach that respects the central role of the family) |
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*** core concepts of family-centered care? (8)
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"FRICCESS"
Flexibility Respect & Dignity * Information sharing * Collaboration & Participation * * Choice Empowerment Support family Strengths |
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2 effective nurse-parent interactions? (describe each)
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1. establishing RAPPORT:
- showing INTEREST in child - CONNECTION between nurse's knowledge of child, and parent's knowledge of nurse 2. SHARING the child's care -negotiated partnership |
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3 ways to build confidence in caregivers?
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1. acknowledging as a PERSON
2. acknowledging as the CAREGIVER/EXPERT 3. addressing UNCERTAINTY and demonstrating CONCERN |
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*** 3 Rights of the Child?
(from the UN Convention) |
1. Survival and Development
2. Protection 3. Participation |
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describe/give some examples of each of the Children's Rights
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Survival and Development:
---Necessary resources, skills, and contributions for survival and full development ---E.g. food, shelter, water, education, HC, recreation, cultural activities, information Protection: ---From abuse, neglect, exploitation, cruelty ---Special protection during war ---Protection from abuse in criminal justice system Participation: ---Expressing opinions (having a say in matters affecting their social, economic, religious, cultural, and political life) ---Right to information ---Freedom of association |
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what are some focis of assessment when creating a care plan for a family with a hospitalized child?
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o Factors affecting adjustment
o Compare assessment with concerns expressed in admission history o Emergency admission? o Previous admissions? (How did parents perceive?) o Severity of illness/trauma o Unknown factors (e.g. cause of disease, prognosis i.e. likely course of disease) o Special attention to info from admission interview o Stress and coping of parents and siblings o Open-ended statements encourage communication (“This must be difficult for you”) o Parents’ need for sleep, nutrition, information |
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what is a possible nursing dx for a family with a hospitalized child?
what are some possible expected outcomes for the parents? (5) |
Interrupted family processes related to the child’s hospitalization and illness
expected outcomes: the parents will... • Participate in child’s care • Meets needs of other family members • Use appropriate support systems • Identify ways to cope • Assist child to move from sick→well role |
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what are some interventions for the family with a hospitalized child? explain rationales. (5)
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Orient parents to hospital; provide info r/t physical needs (food, sleep, bathing)
• Parents’ needs must be met for them to meet child’s needs • Shows caregiver support Encourage family to express feelings and ask questions • Decreases anxiety • Clarifies misconceptions Provide info about child’s condition, treatment, support systems; begin discharge planning • Gives parents a sense of control • Decreases anxiety Identify coping mechanisms; support parenting skills • People not always aware of their coping mechanisms • Nurse can help evaluate the effectiveness of their coping mech’s Refer to other HCPs (social work, psychologist, psychiatrist, spiritual care) • Early identification of family problems prevents escalation • Collaboration → holistic care |
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what are 2 flaws of the Nissiping developmental screening tools? (why are they not completely useful as screening tools)
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- do not pick up on developmental issues
- may intimidate children |
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define "growth"
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increase in physical size
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what 3 parameters are used to measure growth?
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1. height
2. weight 3. head circumference |
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why use growth charts?
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- sign of normal development
- good indication of health (helps identify abnormalities) |
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*** when do the 2 fontanelles close?
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anterior: 18 mo
posterior: 3 mo |
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what are the 4 patterns of growth?
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- cephalocaudal
- proximodistal - general to specific - simple to complex |
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what are some primitive reflexes? (6)
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- moro
- grasp - stepping - tonic neck - rooting - babinski's |
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what result of the babinski reflex would you expect in infants? why?
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positive babinski's (toes fan)
because neurological development not complete |
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at what age does each gender typically enter puberty?
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girls: 10-12
boys: 12-14 |
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what are some developmental milestones of newborns? (2)
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-suck
-primitive reflexes |
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what is a developmental milestone of 1-2 months? (1)
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smiles
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what are some developmental milestones of 3 months? (2)
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-vocalizes
-increasing hand control |
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what are some developmental milestones of 4 months? (2)
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-head control
-purposeful grasp |
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what are some developmental milestones of 4-5 months? (3)
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- rolles from front to back (prone to supine)
- some primitive reflexes disappear - start to react to the world |
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what are some developmental milestones of 6-7 months? (3)
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- rolls from back to front (supine to prone)
- sits - begins solid foods (reflexes gone) |
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what is the recommended age for breastfeed to continue until?
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-breastfeeding exclusively for first 6 months
-then up to 2 years -afterwards as long as the mother and baby want to. Encouraged and very beneficial under 2 years |
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at what age can you introduce cow's milk? why is it not as favorable as breastmilk? (3)
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after 1 year
not as much fat (needed for brain dev.) or iron not as easily digested less bioavailable |
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at what age can you begin to introduce solid foods?
what happens if you start before this point? what are some good starting foods? |
after 6 months
could develop allergies cereals, rice |
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why is juice not recommended?
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lots of simple sugars
can drink a lot and become full - risk for malnourishment |
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what are some developmental milestones of 8-9 months? (3)
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crawls
pulls up on objects tooth eruption |
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what are some developmental milestones of 10-11 months? (1)
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walks with support
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what are some developmental milestones of 12 months/1 year? (2)
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-walks independently
-pincer grasp |
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what are some developmental milestones of 15-18 months? (5)
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- climbs stairs
- drinks from a cup - stacks blocks - identifies familiar people/objects - vocab: 10 words |
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what are some developmental milestones of the "terrible twos?" (5)
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- negativism "NO"
- runs, kicks a ball, walks up steps - walks forward and backward - puts 2 words together - empties containers |
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what are some developmental milestones of 30 months (2.5 years) ? (4)
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-links 3 words
-jumps -starting to toilet train -20 deciduous teeth |
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about what age do you want to start toilet training? why not earlier?
what is the average time it takes for a child to be continent during the day? |
- optimal time: 27 months
- before 2-2.5 years, sphincters not well developed - average time to daytime continence: 34 months |
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what are some considerations when deciding when to start toilet training? (3)
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Physiological readiness
Physical readiness – weight bearing: walking/ambulating to toilet, standing and sitting, pull down pants Psychological readiness – wanting to please parent, seeing other kids or adults doing it |
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what is the main developmental milestones of 3 years? what are some others? (3)
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Main: rapid speech development (speaks in short sentences, asks "why/how", lengthy monologues)
- personal care: can dress/undress, brush teeth - daytime continence - can stand on one foot briefly |
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what are some developmental milestones of 4 years? (2)
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-incessant talking
-can hop/skip on one foot briefly |
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what are some developmental milestones of 5 years? (2)
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-swim, skate, jump rope
- proficient storytelling (mixing fantasy w/reality) |
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what is regression?
what are some causes? |
temporary loss of mastery of a skill/developmental milestone that was previously achieved
Unfamiliar, unpredictable environment Exposure to uncomfortable or painful stimuli Loss of control Loss of routine |
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according to Object Relation/Attachment Theory, what are the 2 types of anxiety in a child?
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stranger anxiety
separation anxiety |
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what are the stages of Erickson's psychosocial developmental theory? (5)
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1. Infancy: trust vs. mistrust
2. Toddlerhood: autonomy vs. shame/doubt 3. Preschool: initiative vs. guilt 4. Schoolage: industry vs. inferiority 5. Adolescence: identity vs. role confusion |
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What are some of the National Scientific Council's Six Core Concepts of Development?
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1. Child development is a foundation for community and economic development
2. Brains are built over time 3. Interactive influences of genes and experience literally shape the architecture of the developing brain 4. Both brain architecture and developing abilities are built “from the bottom up” 5. Cognitive, emotional, and social capabilities are inextricably intertwined throughout the life course. 6. Toxic stress in early childhood is associated with persistent effects on the nervous systems and stress hormone systems that can damage developing brain architecture and lead to lifelong problems in learning, behaviour, and both physical and mental health. |
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What are pediatric differences that cause children to be more vulnerable to respiratory problems? (8)
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Weaker and less developed musculature
Less alveoli Soft, more compliant/pliable chest wall Higher metabolic needs (higher O2 consumption) Infants under 6 weeks are obligate nose breathers (almost exclusively) nasal suctioning may be very effective in raising O2 sats Irregular respirations, higher RR Underdeveloped supporting cartilage (softer, more likely to have obstruction) Smaller lung size proportional to body height |
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What does significant drooling without swallowing indicate?
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Sign of obstruction in airway or esophagus
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If hypoxic, what happens to muscle tone?
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Muscle tone decreases (get "floppy")
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3 stages of resp compromise and brief description of each?
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1. distress (compensated state)
2. failure (inadequate elim of O2/CO2, desatting, not fully compensating) 3. arrest (lack of resp effort, usually leads to cardiac arrest) |
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what are 3 nsg priorities r/t resp compromise?
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1. ineffective airway clearance
2. ineffective breathing pattern 3. impaired gas exchange |
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what are some dx tests for resp compromise? (7)
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xray
ct scan scopes c+s flow rates blood gases pulse oximetry |
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what does and doesn't pulse oximetry tell us?
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tells us O2 saturation of Hb, but not of tissues
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