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40 Cards in this Set

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  • Back
What is infant morality, neonatal mortality, and postnatal mortality?
Number of deaths per 1000 live births during:
Infants: the first year of life
Neonatal: <28 days of life
Postnatal: >28 days - 1 year
What does infant mortality predict in a country?
health access and resources
What are the major causes of neonatal death in the US?
Low Birth Weight <2500g
the lower the weight, the higher the mortality risk
What are the leading causes of death in infants?
congenital anomalies
short gestation/LBW
SIDS
Newborns of complicated labor
What are the risk factors of infant mortality?
African American Race
Male Gender
Short or long gestation
Maternal Age (young or old)
Maternal Education
What is the leading cause of death in children >1yr old?
Motor Vehicle Accidents (unrestrained)
Drowning
Burns (1-14)
Poisoning (<6)
Firearms (5-14)
What risk factors increase morbidity in children?
Homeless
Poverty
LBW
Chronic illness
Foreign, adopted
Daycare kids
What is the leading cause of childhood illness?
respiratory infections
What are the pediatric morbidity health care concerns?
Obesity
DM type 2
Injuries
Violence
Substance abuse
Mental Health Concerns
What is family centered care?
holistic not problem focused
allows family members to express feelings and concerns
Enables and empowers family
Includes subjective and objective concerns
What are the parts to ensuring atraumatic care?
prevent seperation
promote a sense of control
prevent injury and pain
What age group is separation anxiety the worst for?
6 months to 5 years old
What are the phases of separation anxiety?
Protest
Despair
Detachment
What occurs in the protest phase of separation anxiety?
cry and scream, cling to parent
What occurs in the despair phase of separation anxiety?
crying stops, evidence of depression
no food or playing
What occurs in the detachment phase of separation anxiety?
denial
resignation but not contentment
may seriously affect attachment to parent after separation
What are the parents reaction to the detachment phase?
visit less
short stays
deceiving child

all are bad
What does separation anxiety depend on?
age
past experience
degree of stressor
What are some major stressors for hospitalized children?
separation
loss of control
bodily injury
pain
What are nursing interventions for infants with loss of control?
Trust developmental stage
Consistent caregivers
Keep daily routines
Name ways to keep an infants routine the same
eating habits the same
same brand of diapers
same type of bottle
same nipple type
What nursing interventions can be used when a toddler has loss of control?
age 1-3
Autonomy - so any restriction or limitation can threaten a child
Daily routines and rituals
What behaviors are common in toddlers when they loose control?
regressive behavior
negativity
temper tantrums
may try to plead with parents
How do preschoolers react to loss of control?
age 3-5
Egocentric and have magical thinking
may view illness or hospitalization as punishment (want to be obedient)
preoperational thought (no abstract thinking)
How do school age children respond to loss of control?
striving for independence and productivity - boredom
Fears of death, abandonment, permanent injury
What are nursing interventions for school age children in loss of control?
Identify their fears
provide play or distraction (child life specialist)
allow them to take control - making bed, choose activity: respond better
How do adolescents respond to loss of control?
have struggle for independence and liberation
Separation from peer group tough
Anger or frustration
Need information about condition - don't like to ask
What are some nursing interventions for adolescents loosing control?
Provide factual information
Set boundaries
Encourage independence in self care, time structuring, clothes, or rooming
What are nursing interventions for fears of bodily injury and pain?
manipulate techniques - no rectal T
address issue, can persist into adulthood
What are common misconceptions about bodily injury and pain in children?
<4 think that insides will fall out with surgery
Larger the bandaid the larger the problem
CAT scan is a cat that scratches
When do the effects of hospitalization occur?
before admission, during, and after discharge
What predicts a childs response to hospitalization?
the way the child perceives the illness, rather than the childs intelligence
What are some individual risk factors that increase vulnerability to stressors of hospitalization?
Difficult temperment
Lack of fit between child and parent
Age (6months-5yrs) - age is not the same as developmental age
Males
Below average intelligence
multiple and continuing stressors (frequent hospitalizations)
What are the benefits of hospitalization?
Recovery from illness
master stress and feel competent in coping
new socialization experience
foster parent child relationship
education opportunities
What are the parental responses to hospitalization?
disbelief, anger, guilt (esp if sudden)
Fear, anxiety (pain and seriousness of illness)
Frustration (need for information)
Depression
What are sibling's reaction?
loneliness, fear, worry
anger, resentment, jealousy
guilt (might have said I hate you, and then they got sick)
What influences a sibling's reaction?
age, younger
cared for by new people
not informed
favoritism of other kid
What are altered family roles with a hospitalized child?
Ill child obligated to play the sick role
Parents continue pattern of overprotectiveness and indulgent attention
How do you prevent separation?
*primary goal for kids under 5
family centered care - parent not a visitor
Familiar items from home
maintain routine
time structuring
self care (for age appropriate kids)
School work
Friends and visitors
What is important in caring for the family at discharge?
available resources
understand directions
respite care is essential