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20 Cards in this Set

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preschooler's understanding of death
Thoughts are sufficient to cause death.
Have some understanding of the meaning of death.
May feel guilty of the death of a sibling.
greatest fear concerning death is separation from parents.
Otitis Media
(Teaching)
stop smoking. do not bottle prop, d/c bottle and pacifier as early as possible.
Chronic OM- hearing loss due to fluid in the middle ear and possible scarring.
Relieve pain, facilitate drainage.
Swimming without earplugs usually OK.
Otitis Media
OM is one of the most prevalent diseases of early childhood
Incidence is highest in ages 6 months to 2 years
Gradually decreases with age except a small increase at 5 or 6 years of age
Otitis Media
(etiology)
Can be viral/ bacterial/ fungal
Often the result of blocked Eustachian tube
Impaired drainage= retention of secretions in the middle ear
Risk Factors
Day care attendance
Living with a smoker
Supine position during feeding
Discipline methods for toddler
Because a toddler can move swiftly and skillfully, a caregiver must watch the
toddler at all times and provide a child-proof environment for safe exploration.
General guidelines for implementing discipline for a toddler include consistency,
timing, commitment, and an age-appropriate approach.
FIRM DISCIPLINE GIVES A FEELING OF FREEDOM WITHIN BOUNDS
Signs of toilet training readiness
Comes looking for diaper change.
Basic vocabulary for task.
CAN COMMUNICATE URGE TO GO.
Motor skills-sit, squat, walk.
Motivation and desire.
motivation to hold on-please parent vs let go and please self.
Preschool dental care
BEGIN BRUSHING AS SOON AS FIRST TOOTH ARRIVES.
PRIMARY DENTITION COMPLETE BY AGE 2 YEARS (30 MONTHS)
STOP BOTTLE AT 12-15 MONTHS-LEADING CAUSE OF CAVITIES IN TODDLERS.
Can use “disclosing tablets” to show a child what was left.

Helps to motivate.

T - Brush after each meal NEED HELP . When not practical the swish and swallow.

PS CAN BRUSH WITH SUPERVISION
Scarlet Fever
Group A Beta Hemolytic Streptococci
Caused by a toxin carried by some strains of strep
Rash
Strawberry tongue
Scarlet fever
Pin head generalized rash-(sand paper) circumoral pallor
May have to reassure parents or educate parents not to confuse with rheumatic fever

Rash first appears on face and neck. Then downward. Pinkish, red, maculopapular
( has both flat and elevated bumps/pimples = papules) exanthema.
Disappears in the same order. Gone by the third day.

Prodrome
enanthema - eruption on a mucous membrane (as the inside of the mouth)

Exanthema – rash – fine sandpaper like on torso. Sloughing on the palms and soles.
Sloughing may last up to 3 weeks.
Scarlet Fever
FEVER, VOMITING, HEADACHE, CHILLS, PHARYNGITIS, RASH OVER ENTIRE BODY(SANDPAPER)

CAUSED BY A TOXIN FROM GROUP A BETA-HEMOLYTIC STREP INFECTION

INCUBATION PERIOD 1-7 DAYS

DOES NOT INCREASE RISKS OF COMPLICATIONS FROM STREP INFECTIONS

PARENTS OFTEN ANXIOUS BECAUSE THEY CONFUSE IT WITH RHEUMATIC FEVER

TREATED WITH PENICILLIN/AZITHROMYCIN
T&A concerns
FREQ SWALLOWING = BLEEDING
T&A
Side/abdomen to facilitate drainage of secretions
Careful sx to avoid trauma
Discourage coughing, clearing the throat, blowing the nose or any activity that may aggravate the operative site.
Check all secretions for signs of fresh bleeding. (Teeth might have caked blood, emesis = old dark blood) Prepare parents.
Pain control – sore throat
Can use an ice collar
Can use local anesthestics lido lollipops
Liquids – clear, cool, crushed ice, diluted fruit juice . No red or brown. NO STRAWS THEN
Soft foods but No milk ice cream pudding > increase secretions> bleeding
Bronchiolitis
management
Treatment is supportive
Humidified oxygen
Usually mist /hood tent

Use of bronchodilators, corticosteroids , and cough suppressants are controversial and may or may not help

May require intubation
Bronchiolitis
(more)
Contact isolation

Tx symptomatically

Ribavirin = antiviral. Controversial. AAP, 2003 indicated that its used should be based upon individual clinical presentation and MD experience.

Prevention = RSV immune globulin and palivizumab used to prevent RSV infection. ? Sunergist? Give q mo just before flu season
Chronic OM w/ effusion can lead to what problem?
Deafness
Purpura
any rash in which blood cells leak into the skin or mucous membranes, usually at multiple sites.
Often are associated with disorders of coagulation or thrombosis.
Pinpoint purpuric lesions are called petechiae. Larger hemorrhages into the skin are called ecchymoses.
Petechiae
small, purplish, hemorrhagic spots on the skin that appear in patients with platelet deficiencies and many febrile illnesses.
Poisoning Management
Treat child firs-VS, airway, circulation.
Corrosives-dilute with water or milk. Don't neutralize. Maintain airway.
Hydrocarbons-immediate danger for aspiration. treatment of chemical pneumonia.
ALL POISONINGS CALL POISON CONTROL.
Corrosives
S&S
severe buring in mouth, throat, stomach
White swollen mucous membranes
edema of lips, tongue, pharynx
Violent vomiting
Drooling and inability to clear secretions
Hydrocarbons
S&S
gagging, choking, coughing.
Nausea, vomiting, alterations in semsorium. Weakness. Tachypnea, cyanosis, retractions, grunting.