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286 Cards in this Set

  • Front
  • Back
what does child health reflect
physical, mental, emotional and social well being
when are children at highest risk for death
infancy and adolescence
what is the leading cause of death in children
injury
what are the most frequent causes of death due to injury
MVA, drowning, burns
what are the leading causes of death for infants under 1 year
birth defects, SIDS, prematurity
what are the consequences for poverty
higher mortality from all causes except MVA and suicide. Higher morbidity from acute and chronic illness, decreased school achievement, greater risk of behavioral and emotional problems
what are some contemporary health challenges
poverty, insurance/ healthcare barriers, busy families, childhood-onset obesity, increasing rates of chronic illness
what is the most significant risk factor for childhood obesity
inactivity
what is the most prevalent cause of disability in children
asthma
what is family for dependent children
a social and biological unit with financial, emotional, and behavioral responsibilities for dependent children
family is the source of children's sense of what
security and belonging
what is a traditional definition for family
2 or more persons related by birth, marriage, or adoption, and residing together
what is an inclusive definition for family
whoever the person says it is
what is family structure
how family is organized
what is a nuclear family unit
parents and offspring
what is a binuclear family
separated/divorced parents sharing parenting roles
what is an extended family
relatives and significant others beyond the nuclear unit
how came up with the family functions
friedman
what are the family functions
affective, socialization, economic, healthcare and reproductive
what is affective
meeting emotional/psychologial needs of each member (love and belonging)
what is socialization
helping children assume adult roles and become productive members of society
what is economic
provision and allocation of resources
what is health care
meeting fundamental and special needs such as food, clothing, shelter and healthcare
what is reproductive
continuity of family and society
what is the family systems theory derived from
the general systems theory
what is the foundation of the family systems theory
a system as a whole is different from the sum of its parts.
what does the function of a system reflect
interaction among its parts
what is a system defined by
its boundaries
what does a system change in response to
feedback
what are the units created by relationships among members in a system
dyads, triads and larger groups
what is a dyad
parents, mother/child
what is a triad
mother/father/child, intergenerational
what are larger groups
all siblings, extended family
what do family boundaries vary from
open to closed
what does working with family require
recognizing their complexity, acknowledging their boundaries, intervening within relationships, not with an individual
what is stress
inevitable and is caused by both positive and negative events or change
stressors may be what
predictable or unpredictable
effects of stress are what
cumulative
what determines how well family adjusts to stress
resources and nature of stressor
what are the four stages of the family stress theory
crisis, disorganization, recovery, and reorganization
what is the family developmental theory
Like individuals, families progress through predictable stages with critical psychosocial tasks
what is the marker for transition between stages
Age of the first child is the marker for transition between stages
what are the 8 developmental stages
Marriage
Families with infants
Families with preschoolers
Families with schoolchildren
Families with teens
Families as launching centers
Middle-aged families
Aging families
what is the family developmental theory useful for
Useful for anticipating transitions and the new tasks/demands they generate
what is a major determinant of the child's physical and emotional stress
The quality of the relationships between the child, the family, and the health care system
what are the goals of family assessment
Identify the players
Evaluate strengths and limitations
Determine the need for additional assessment/ intervention/referral
what are the categories for the calgary family assessment model
structure, development and function
what is structure
composition (nuclear & extended), systems, boundaries, social/cultural contexts
what is development
stage, critical tasks, priorities
what are the subcategories of function
instrumental and expressive
what is instrumental function
meeting tangible needs
what is expressive function
emotions, communication ect.
what are the categories for the friedman family assessment model
Identifying data - composition, social/cultural context, etc.
Developmental stage
Environment - social support, community
Family structure - roles, values, communication, power
Function
Family coping - stressors, strengths, adaptive and maladaptive strategies
parental roles are established by what
legal system
social and cultural expectations
personal goals
Good parenting is what
culturally mediated and contextual
how do parents influence childrens behaviors
direct instruction
modeling
structuring the environment
what is authoritarian parenting style
emphasis on obedience, respect for authority
what is authoritative
combine warmth and validation with clear expectations and firm boundaries
what is indulgent
- maximize personal freedom, limited restraints
what is indifferent
minimize time and energy spent in parenting
how came up with the parenting styles
Macoby
what are the goals of disciplining children
SAFETY
socialization – learning what’s right and wrong within the specific society/culture
developing self-control
what are the elements of positive discipline
takes place within a supportive, nurturing relationship
emphasis on desirable behaviors
clearly identify undesirable behaviors
what is a time out
interrupts undesirable behavior
removal of positive reinforcement, particularly social interaction
location must be safe and unstimulating
< 1 minute/year of age
what is a time in
positive feedback and social interaction when child is not misbehaving
acknowledge desirable behavior
avoid qualifying statements
reward with relaxed time together
what does it mean that development is systematic and hierarchical
new accomplishments build on previously mastered skills
children's development is both what
predictable and individula
physical growth and development is what
cephalo-caudal and proximao-distal
what does cephalo-caudal mean
growth form head down
what does proxio distal mean
controlled movements closets to center of body before controlled movements distant to the body
who came up with the cognitive development theory
piaget
what is the cognitive development theory
children progress through predictable stages of reasoning towards mature, logical thinking
what are the mechanisms of development
assimilation and accommodation
what is accommodation
re-organizing existing schema to solve more difficult problems
what is assimilation
incorporating new knowledge and skills
individual capabilities reflect what
both biological potential and environmental interaction
what are the 4 developmental stages
sensorimotor, preoperational, concrete operational, formal operational
what is the age for the sensorimotor stage
birth to 2 years
what is the age for the preoperational stage
2-7 years
what is the age for the concrete operational stage
7-11 years
what is the age for the formal operational stage
11-15
what is the evolution in the sensorimotor stage
evolution from innate survival reflexes to simple problem solving though imitation
how does learning take place
takes place as senses develop, responses to stimuli become more organized
what do motor skills and visual acuity do
set limits on behavioral and cognitive performance
what do children begin to grasp in the sensorimotor stage
cause and effect-how to make things happen
what are the principles of the pre-operational stage
Development of language
Egocentric thought
Symbolic play
Literal interpretation of events
Easily fooled and easily confused
what emerges in the concrete operational stage
understanding of complex relations: classification into simultaneous categories
conservation, reversibility, seriation
how is problem solving done in the concrete operational stage
through trial and error
what is logical reasoning limited to in the concrete operational stage
own experience
what happens in the the formal operational stage
Systematic and abstract thought
deductive reasoning
inductive reasoning
Appreciation of the hypothetical
Future projection/orientation
who created the psychosocial theory
erickson
how does the psychosocial theory say that individuals mature
through a series of critical stages
what must happen to progress to next stage
must master each critical period
what are the 5 stages during childhood of the psychosocial theory
trust vs mistrust
autonomy vs. shame and doubt
initiative vs. guilt
industry vs. inferiority
identity vs. role confusion
what age is the trust vs mistrust stage
birth to 1 year
what age does autonomy vs shame and doubt occur
1-3 years
-toddlerhood
what age does initiative vs guilt occur
3-6 years-pre-school
what age does industry vs. inferiority occur
6-12 years
-school aged children
what age does identity vs role confusion occur
12-18 years
-adolescence
what happens in trust
world is good, needs will be met
what happens in mistrust
world is chaotic, unpredictable
what happens in autonomy
independence, exertion of self, choice
what happens in shame
assertiveness considered unacceptable
what happens in doubt
mistrust of own capabilities and immediate environment
what happens in initiative
trying our new ways of doing things, creativity, assuming responsibility
what happens in guilt
behaviors reflecting initiative are discouraged, passivity develops
what happens in industry
mastery of social, physical and academic skills, focus on peers/society
what happens in inferiority
don't measure up to expectations of self, peers, adults
what happens in identity
coming to know self, establishing personal ideology
what happens in role confusion
unable to acquire sense of self
who made the moral development theory
kohlberg
how does moral reasoning develop
through an invariant sequence that parallels cognitive development
where do principles guiding behavior evolve from in moral development
externally driven (immediate consequences) to individual and abstract
when does birth weight double
5 months
when does birth weight triple
1 year
how much does height increase in the 1st year
50%
when is chest and head circumference equal
1 year
rapid head growth is what
neurological development
when does the posterior fontanel close
6-8 weeks
when does the anterior fontanel close
12-18 months
what happens to RR and HR and BP during infancy growth
RR and HR decrease
BP increases
what enhances thermoregulation
adipose tissue deposition
what are fluid balance issues in infants
risk for dehydration secondary to high proportion of extracellular fluid, immature renal structures
what happens in the GI system in infants
immature digestion - colic, regurgitation, incomplete digestion of solid foods
increasing stomach volume, eruption of teeth, swallowing prepare older infant for solid foods
how long does passive immunity from mother persist
3 months
what production in the immune system increases in infants after 3 months
IgM, IgG then other immunoglobins
what is the gross motor development in infants
gradual improvements in balance, posture and locomotion
what is the gross motor development milestone at 2 months
supports weight on forearms
what is the gross motor development milestone at 4 months
good head control while sitting, supports chest and abdomen on hands
what is the gross motor development milestone at 6 months
rolls from back to abdomen, bears weight in standing position
what is the gross motor development milestone at 8 months
sits alone without support
what is the gross motor development milestone at 10 months
go from prone to sitting with little or no help, pull to stand
what is the gross motor development milestone at 12 months
crawling to creeping to cruising and walking
what is fine motor development in infants
Coordination of hands and eyes to explore and manipulate environment
when do infants grasp go from reflex to voluntary
5 months
when does the primitive grasp occur
5 months
what is the primitive grasp
holds bottle, grabs feet
when does the palmar grasp occur
7 months
what is the palmar grasp
tranfers objects between hands, two hands simultaneously
when does the pincer grasp occur
11 months
what is the pincer grasp
picks up finger foods, small objects, objects into and out of container
how do you describe the social interactions of infants
egocentric, narcissism-own needs are primary
what should you allow the infant to do
manipulate social environments
infants have increasing preference for what
toys, sensory stimulation and caregivers
when does stranger anxiety manifest
8 months
what does play during infancy do
development of language and sensorimotor skills
what is essential in play during infancy
interpersonal contact
what kind of interaction is important in play during infancy
quality of interaction more important than types of toys
what should infant acitivites do
stimulate developing skills
how is physical growth in early childhood development characterized
slower but steady increase in height and weight
when is the height half of adult
5 years
how much brain growth is complete at 2 years
75%
how much brain growth in complete at 3 years
90%
when in myelinization of spinal cord nearly complete
2 years
what happens in the musculoskeltal system in early childhood development
increasing bone length
muscles mature and strengthen
what happens in the GI system in early childhood development
enlarging stomach size
primary dentition complete by 30 months
slowed growth requirements reduce intake
what happens in the GU systems in early childhood development
bladder capacity increases to near-adult function
sphincter control
what is the gross motor development in early childhood development
Locomotion - walking, running, climbing, jumping
what are the gross motor development milestones at 2 years
running, jumping with both feet, few steps on tip toes
what are the gross motor development milestones at 3 years
riding tricycle, balancing on one foot, kicking stationary ball
what are the gross motor development milestones at 4 years
skipping, hopping on one foot
what are the gross motor development milestones at 5 years
riding bike with training wheels, walking in straight line, hopping on alternating feet
what is fine motor development in early childhood development
Refinement of hand-eye coordination, establishment of handedness
what are the fine motor development milestones at 2 years
self-feeding with spoon, draws vertical line
what are the fine motor development milestones at 3 years
self-feeding with fork, draws crude facial features, copies circle
what are the fine motor development milestones at 4 years
independently with dressing/undressing, draws stick figure with 3 parts
what are the fine motor development milestones at 5 years
ties shoelaces, competent with scissors, pencils, draws person with 6 parts
what happens in language development
Comprehension out-paces communication
what are the milestones in language development at 18 months
25 word vocabulary
what are the milestones in language development at 2 years
300 word vocabulary, 2-3 word phrases
what are the milestones in language development at 3 years
: 900 word vocabulary, short complete sentences
what are the milestones in language development at 4 years
1500 word vocabulary, longer sentences, prepositions, questions
what are the milestones in language development at 5 years
2100 word vocabulary, past tense, adjectives, story telling
what happens in social interaction in early childhood development
Increasing independence & self control
Learning socially acceptable behaviors & language
Individuation/separation allows for emerging sense of others
stranger anxiety
transitional objects for security
peer relationships
what does play during early childhood facilitate
cognitive, motor and social development
what does play during early childhood allow
exploration of the environment, tension release, role-playing for later in life
what happens in play across the stage
increasingly more social
what are the stages of play
solitary
parallel
associative
cooperative
what is physical growth in middle childhood development influenced by
genetics and the environment
what kind of physical growth occurs in middle childhood
skeletal growth
what happens to the oran systems in middle childhood
nearing adult capacities
what increases in the physical growth of middle childhood
muscular strength and size
what differences emerge in the physical growth of middle childhood
Gender differences emerge
Boys: more muscle cells
Girls: better fine motor control
the first signs of what occur in middle childhood
First signs of sexual development
what happens to gross and fine motor development in middle childhood
increasing coordination and strength
what are the milestones for gross and fine motor development at 6-7 years
rides 2-wheel bike, throws overhand, prints legibly, cuts & pastes
what are the milestones for gross and fine motor development at 8-9 years
increasing flexibility & fluidity, team sports, cursive writing, 3-dimensional drawing
what are the milestones for gross and fine motor development at 10-12 years
balances on 1 foot for 15 seconds, catches fly ball; awkwardness as growth spurt begins
what moves to the forefront of social interaction in middle childhood
School moves social relationships to the forefront
what do peers provide in middle childhood social interaction
support for increasing independent from parents
what occurs in middle childhood social interaction
Strong sense of belonging, desire to be liked and accepted
Best friendships
Often segregate by gender
Bullying emerges
what does play in middle childhood develop
Continued development of cognitive, motor, and social skills
what is the emphasis on in play in middle childhood
Emphasis on group activities, rules and standards
what emerges from play in middle childhood
Friendships emerge from shared interests
what types of activities are important in middle childhood
Importance of both solitary and participatory activities
adolescent physiological development is second to infancy in what
amount of change encountered
how long do adolescent growth spurts occur
4-5 years
what occurs first in adolescent growth spurts
weight first, then height
what is the difference in adolescent weight gain by gender
weight gain in girls = fat, in boys = muscle
what is achieved in the physiological development of adolescents
Achievement of full bone length, muscle mass & strength
what is an increased need of adolescents
sleep
what is girls tanner staging
breast development, pubic hair
what is boys tanner staging
pubic hair, penis, testes
when does menarche begin
Menarche follows about 2 years after breast development starts
when does ejaculation begin
Ejaculation about 1 year after penis begins to lengthen
what are the stages of tanners breast staging
preadolescent (before age 8)- nipple is small, slightly raised
early adolescent stage- breast bud development (after age 8), nipple and breast form a small mound, areola enlarges, height spurt begins

adolescent stage- (10-14 years), nipple is flush with breast shape, breast and areola enlarge, menses begins, height spurt peaks

late adolescent stage (14-17 years)- Nipple and areola form a secondary mound over the breast, height spurt ends

Adult stage-nipple protrudes, areola is flush with the breast shape
what is the characterization of social interaction in adolescence
Preparing for the transition to adulthood
Identity formation
sexual identity
academic/vocational achievement
attracting romantic partner(s)
what are the primary peer relationships in adolescents
dyads, cliques, crowds
what increases in social interaction in adolescence
Increasing segregation by ethnicity/culture
family relationships are a source of both of these in adolescence
security - nurturance, acceptance, values
conflict - priorities, responsibilities, choices
what is positive peer influence
supportive relationships
healthy choices
what is negative peer influence
risk-taking
age-inappropriate associations
desire to move from periphery to core of group
play during adolescence is an outlet for what
tension and anxiety
what are the acute effects of hospitalization for children
significant illness
first hospitalization
what are the chronic effects of hospitalization for children
prolonged illness
repeated hospitalizations
what are major illness stressors for kids
Separation anxiety
Loss of control
Uncertainty
Bodily threat
Intrusion of illness/care regimen into everyday life
Changes in family roles/relationships
separation anxiety is particularly important for who
toddlers (16-30 months)
separation anxiety in manifested with what
even short periods of separation (minutes)
what may happen if separation from familiar caregiver is prolonged
may progress through different stages
what are the stages of separation anxiety
protest, despair, detachment
what happens in the protest stage
manifested in young children as screaming, inconsolable crying, resistance to comforting by others
can last minutes to days
what happens in the despair stage
looks a lot like depression; crying stops, child appears sad & lonely
what happens in the detachment phase
resignation to separation improves behavior but challenges on-going relationships with primary caregivers
uncommon unless separation is prolonged (days to weeks)
what is the significance of older children in separation anxiety
not as susceptible to major trauma from separation but still stressed by it
Most likely response is withdrawal, sadness, behavioral regression
when does loss of control occur
Unfamiliar/unpredictable environment
lack of cues to behavior, meaning
what happens with loss of control
Loss of autonomy: little say in what happens when
true regardless of age, although particularly frustrating for older children
Loss of dignity
loss of control is heightened by what
restrictions
disruption of routines
enforced dependency
who is particularly vulnerable to threat of bodily injury and pain
younger children
why are younger children vulnerable to threat of bodily injury or pain
limited grasp of anatomy, body boundaries, physical integrity
how does sense of threat fall
As environment becomes more familiar
why are Hospital environment not conducive to sleep
disruptions of routines
environmental cues (noise, light, activity, etc.)
mood disturbances
pain or other symptoms
what are some common chronic illness stressors
illness intrudes into everyday life, threat to body image, uncertainty, prolonged dependency on others, changes in family roles and relationships
what are some Specific Chronic Illness Stressors
stigma
invasive procedures
treatment side effects
what becomes more important as children mature
social domain
what are some variations to children's responses to stresses of illness and hospitalization
Individual temperament
Family strengths/limitations
Developmental level
Level of experience
what are some Typical behavioral responses to acute stressors/aversive experiences
Violent protest/avoidance
Delaying tactics
Outright refusal to cooperate
what can happen in childrens responses to chronic illness
Adjustment disorders, e.g., depression, anxiety)
particularly in first year of illness
older children most at risk
Diminished self-esteem
Poor adherence to medical regimen
Emphasis on normalcy, pathways to success
what are some parental responses to illness
Anger: particularly at health care providers, spouses
Guilt: what did I do wrong? I can’t do enough!
Fear/worry/anxiety
Depression
Overprotection
what may be the initial response of problems or death at birth
avoidance/withdraw
what are some profound changes in the parents role with child illness
loss of other life roles (professional, spouse, etc.)
sadness over impact on sick child and sibling
what are some sibling reactions to child illness
fear
guilt
jealousy
loneliness/rejection
confusion
how can nurses reduce stress of illness during initial/stressful hospitalizations
minimize unnecessary separation
help parents balance other demands
support parents in being honest about leaving and returning
maintain home routines/familiar belongings/ normal daily activities (hygiene, meals, play/school, napping, etc.)
provide information/explanations at developmentally appropriate level
play!
what are some nursing interventions to reduce impact of illness
Encourage self-care
Encourage parental involvement
Increases parents’ sense of mastery
Promotes continued closeness/intimacy
Offer assistance to avoid exhaustion
Give choices WHENEVER possible

Listen and reflect
Model acceptance
Provide parents with information and coaching
support for the ill child
support for well siblings
Referral for psychological support
Promote emphasis on normalcy
why are children vulnerable to inadequate pain management
Limited by language and development in their ability to communicate about pain
Misconceptions about how children perceive and respond to pain
Exaggerated fears of opioid side effects
Medical, cultural, and individual expectations and values
when do neural mechanisms to perceive pain in play by
20 weeks gestation
why does pain tolerance increase with age
neurological maturation
Experience
what are some exaggerated fears of opioids
Respiratory depression - extremely rare in appropriately dose patients, and easily managed
Addiction - also extremely rare in appropriately treated patients
when is metabolism of opioids similar to adults
3 months
what are some common barriers to pain management in children
Developing language skills or cognitive impairment may limit child’s ability to communicate effectively
Caregiver overconfidence in “objective” (behavioral and physiological) markers of pain
Consequences for reporting pain may seem aversive
Social context may inhibit child’s free expression
what is the most reliable indicator of pain
verbal self-report
what are the verbal self-reports of pain for children
FACES scale by ~ 3-5 yrs
VAS (0-10) by ~ 8 yrs
what should be done in the absence of a self-pain report
consider behavioral indicators of pain
facial expression
level and quality of motor activity
cry/consolability
why should physiological indicators of pain be employed very cautiously
non-specific – could be influenced by disease process, fever, etc.
VS changes in response to acute pain attenuate over time
absence of indicators does NOT mean child’s not in pain
what is the only first step of a pain assessment
documentation
what allows for optimal pain management
Systematic assessment and documentation of results of interventions allow for optimal management
what is the goal of Non-pharmacological pain management techniques
alter pain perception and thereby minimize pain
how can Non-pharmacological pain management techniques be used
Can be used alone or in combination with analgesics
what can non-pharmacological pain management techniques do
May offer secondary benefits of decreased anxiety, greater sense of control, reduced helplessness
when are non-pharmacological pain management techniques most successful
Most effective if introduced in advance of painful event or during period of relative comfort to allow for familiarization/training
what does distraction do
interferes with activation of pain signaling pathways
what are some types of pain distraction
progressive muscle relaxation
guided imagery/hypnosis
technology assisted imagery – virtual reality devices
what does Cognitive-behavioral training do for pain
empowers child to take action in response to pain
what are some types of Cognitive-behavioral training
biofeedback
positive self-talk, cognitive reframing
there is emerging evidence for what kind of pain control
Acupuncture/acupressure
Therapeutic massage
Music therapy
what are some TLC measures to reduce pain
Position changes
Transitional objects
Adhesive removers
Emotional support
Parental encouragement
what are the Goals of Effective Communication with Children and Families
Establish rapport and promote trust
Demonstrate understanding of children’s & families’ developmental status and individual differences
Elicit accurate and meaningful information
Active listening
what are some general guidelines for effective communication
Introduction/role clarification
Initiate contact with child first unless developmentally, culturally, or individually unwelcome
Place yourself at child’s eye level
Use specific, understandable terminology
Establish expectations for cooperation, duration, privacy, etc.
what are the guidelines for effective communication in infants
quiet, sing-song tone; respond to baby’s social cues
what are the guidelines for effective communication in toddlers
approach cautiously! Limit information and anticipate short attention span
what are the guidelines for effective communication in preschoolers
incorporate play, imagination; focus explanations on sensory experience
what are the guidelines for effective communication in school aged children
incorporate written/visual information; elicit specific questions/concerns
what are the guidelines for effective communication in adolescents
be authentic, straight-forward; respect boundaries
what are the principles of physical assessment with children
Minimize anxiety/threat:
Least to most invasive/aversive
Maintain contact with parent
Work around clothing whenever possible
Enlist participation of parent/older siblings as appropriate
Every interaction is an opportunity for assessment
Compare findings to previous assessment(s)

Provide choices where possible and as age-appropriate
order of exam
positioning
privacy vs. parent present
Be patient but firm:
let the child know what’s expected
reinforce appropriate behavior
praise specific behavior, NOT character
what is the physical growth assessment in children
Consider purpose and frequency of assessment
Note conditions under which values obtained
Height/length: supine up to 2-3 yrs, then upright
Weight:
limited or light clothing (unclothed if small variations critical)
subtract adult weight from combined infant/adult weight
Head circumference: widest diameter (occipital prominence, center of forehead); part of standard measures up to 36 months
what is the vital signs assessment in children
Remember: least to most invasive
Temperature:
rectal: up to 1 year; note exceptions!
oral: assure child understands and follows directions
axillary: chart environmental conditions
Pulse: apical whenever possible and always up to 2 years; palpate radial/brachial to count along
Respirations: watch/palpate chest rise and fall for infants/toddlers
Blood pressure: use of electronic device problematic in younger children – verify abnormal findings with manual technique
what is the skin assessment in children
Children at greater risk for skin breakdown from medical intervention
Closely monitor diaper area for rash/breakdown
what is the head and neck assessment in children
note muscle control, symmetry of external structures (eyes, ears, etc.), presence of discharge
what is the chest assessment in children
Nipple line as landmark
Superficial (transmitted) sounds common in younger children – should clear with cough/crying
Sinus arrhythmia common in children – should clear when breath held
what is the abdomen assessment in children
Listen at least 30 seconds before noting absent/diminished bowel sounds
Sandwich child’s hand between yours to reduce ticklishness
Note whether abdominal hernia present
what is the genital assessment in children
Expect/accommodate shyness by pre-school
Retract foreskin GENTLY
what is the neuromuscular assessment in children
Focus on symmetry, mobility, strength, and tone
Evaluate throughout entire interaction
For ambulatory children: note abnormalities in gait, posture, balance, and coordination
how do you give oral meds to kids
may require crushing tablets
camouflage taste
mix in smallest volume possible to assure it all gets in
how do you give IM meds in kids
know age-based norms for site, needle length & gauge
plan on requiring restraint except in oldest kids
what are some challenges in feeding hospitalized kids
loss of appetite
refusal
nausea/vomiting/diarrhea
what are some suggested approaches to help feed reluctant children
favorite foods/accommodate personal preferences
limit pressure from staff and parents
be creative
consider nutritional value in light of goals of hospitalization
how are kids kept safe in the hospital
Identification bands
Hospital must be child-proofed just like home
When the environment can’t be made safe -
supervision
restriction/containment
Cribs & beds
should be a safe haven
can be used to “contain” active toddlers but still require supervision