Pediatric Nursing - Week 1 - The Basics

Front 1

First 3 causes of infant death. (<1yo)

Back 1

1. Congenital anomalies
2. Disorders related to short gestation and LBW
3. SIDS

Front 2

Baby dies at 30 days of life. Is this considered a neonatal, infant, or childhood death?

Back 2

infant

- neonatal - first 28 days of life
- infant - 1st year of life
- childhood - >1yr

Front 3

What is major determinant of neonatal/infant death?

Back 3

low birth weight
- lower birth weight, higher mortality
- many birth defects associated with LBW

Front 4

Describe death rates across races.

Back 4

- infant mortality much lower for caucasians than any other race
- a.a. infant mortality much higher than any other group
- difference between cauc and noncaucasion (not incl a.a.) have decreased

Front 5

Primary cause of death of children >1yo

Back 5

MV accidents

Front 6

three leading causes of death. 1-4, 5-9, 10-14, 11-19

Back 6

1-4 = accidents, congenital, cancer
5-9 = accidents, cancer, congenital
10-14 = accidents, cancer, suicide
15-19 = accidents, homicide, suicide

Front 7

Problem with long gestation

Back 7

meconium (infant stool) is aspirated

Front 8

Top 3 acute conditions in children

Back 8

1. Respiratory illness
2. injuries
3. infections and parasites

Front 9

How to provide atraumatic care?

Back 9

1. prevent or minimize separation from family
2. promote sense of control
3. prevent or minimize bodily injury or pain

Front 10

Describe Sepearation Anxiety

Back 10

- occurs in 3 phases
1. protest
- crying, screaming for parents, refuse any other attention
2. despair
- stop crying
- depressed, withdrawn
3. detachment
- appears as if child is adjusted
- actually, is detachment from parent to escape emotional pain
- may reject parents or cling

Front 11

When a child enters a hospital, what stressors may they experience?

Back 11

- separation anxiety
- a loss of control
- bodily injury and pain

Front 12

How to minimize loss of control for infants

Back 12

- establish trust by giving consistent loving care

Front 13

considerations for minimizing loss of control for toddlers

Back 13

- autonomy vs shame and doubt
- egocentric - see things from their own point of view only
- negativism - no no no, don't ask yes no questions
- ritualism - ask parents
- regression

Front 14

considerations for minimizing loss of control for preschoolers

Back 14

- initiative vs guilt - why replaces no. answering q's of preschoolers reinforces intellectual initiative.
- egocentrism and magical thinking with preoperational thinking - easily misinterpret. clarify as to not scare child.

Front 15

preoperational thinking

Back 15

- only able to understand explanations in terms of real events
- no abstract thinking
- can only think in terms of what senses tell them

Front 16

considerations for minimizing loss of control for school age children

Back 16

- industry vs inferiority - opinions of peers, parents teachers becomes important. if praised for good work, industry and mastery of school work. no mastery of school work may lead to feelings of failure and inferiority.
- enforced bed rest and patient role is direct threat to security
- give them work to do - make their own beds, choose schedule of activities
- inc sense of control from feeling of usefulness and productivity

Front 17

considerations for minimizing loss of control for adolescents

Back 17

- identity vs role confusion - struggle for independence and self assertion for quest for personal identity
- condescending manner of talking intimidates them
- assess level of intelligence, and learn their language so more relatable

Front 18

Minimizing fear of bodily injury

Back 18

- for inserting IVs, papooses may help to constrict, but inc anxiety. better to restrain with touch and talk to them
- toddlers and preschoolers may need a bandaid for reassurance
- teens may be more concerned about resulting scar than procedure

Front 19

minimize separation anxiety

Back 19

- transitional objects
- allow children to cry during protest
- even if child rejects strangers, rn can provide support through presence
- remind about parents when detached

Front 20

minimize loss of control

Back 20

- maintain the child's routine
- make sure school work is continuted
- promote freedom of movement

Front 21

birth weight doubles by

Back 21

4-7 mo

Front 22

birth weight triples by

Back 22

first year

Front 23

quick way of determining adult height

Back 23

height at 2 yo x 2 = adult height

Front 24

piaget cognitive development for children

Back 24

1. sensorimotor (birth to 2) - object permanence - knowing that object exists even when not visible
2. preoperational (2-7) - egocentrism - inability to put oneself in place of another
3. concrete operations (7-11) - conservation - volume, weight, number is same even if change in appearance
4. formal operations (11-15) - abstract thought

Front 25

determine kind of play. one child beads necklace. one beads bracelet.

Back 25

associative - engaged in similar activity, but not organized

Front 26

determine kind of play. children building clay castles together.

Back 26

cooperative play - organized group play

Front 27

kinds of play

Back 27

onlooker
solitary
paralllel
associative
cooperative

Front 28

erikson stages of development

Back 28

1. trust v mistrust (birth to 1 yr)
2. autonomy vs shame and doubt (1 -3 yr)
3. initiative vs guilt (3-6 years)
4. industry vs inferiority (6-12)
5. identity vs role confusion (12-18)

Front 29

FLACC scale

Back 29

- behavioral pain scale
- five categories - face, legs, activity, cry, consolability
- 0-2 for each category
- 0-10, 10 being worst

Front 30

NIPS scale

Back 30

- neonatal infant pain scale - behavioral
- from 0 to 7, 7 being worst

Front 31

what are physiologic responses to pain

Back 31

- inc HR, BP, resp
- dec O2
- palmar sweating