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91 Cards in this Set
- Front
- Back
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what is the developmental task of an adolescent? |
Four fold according to Errikson: development of a sense of worth or value, emancipation from parents, new body language and closing a vocation. Pregnancy conflicts this. |
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how are pregnancy and STD's prevented? |
- Getting accurate information can be challenging: education in schools is limited.] - Pregnancy prevention: low dose pill, condom. - STD prevention: the use of condoms, abstinence. |
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what is chlamydia and how is is transmitted? |
- Often asymptomatic, transmitted through vaginal intercourse. |
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what is gonorrhea and how is it transmitted? |
- Symptoms: green/yellow purulent discharge, dysuria, polyuria. - Treatment: cephtriaxone. |
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what bodily changes occur in a normal pregnancy? |
- Haematolytic changes: 30 to 50 per cent increase in blood volume. Same increase in cardiac output. - Respiratory system: increased O2 consumption, raised diaphragm. - Renal: glomerular filtration rate increases 40 to 50 per cent in first trimester. |
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what drugs are commonly administered in labour? |
- Oxygen, prostaglandins, nitrous oxide, pethidine, epidural and lignocaine. |
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what are a woman's birth rights? |
- Choose place of birth, how to give birth, practice cultural beliefs, choice of birth practitioner. |
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what happens after birth? |
- Adolescents often have unrealistic expectations in regards to feeding, crying, sleeping and other ongoing demands of parenthood. |
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Antidepressants during lactation |
- Only small amounts pass into breastmilk. - Low dose does not mean the infant will be unaffected. - Can delay lactation and inhibit sucking reflex. |
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improving breastfeeding safety
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- Breastfeed immediately before drug intake. - Give lowest effective dose of medications. - Observe child for adverse effects. |
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what are mental health disorders that can occur in infancy? |
- Feeding/eating disorders, pervasive developmental disorders, relationship problems or attachment disorders, separation anxiety or motor skills disorders. |
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benefits of early intervention |
- Evidence suggests young people are poorly informed about mental health issues. |
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bone anatomy and physiology of children |
- Young children have more cartilage than bone. Thicker periosteum limits bone displacement. - Healing more rapid in children. Rapid replacement of bone cells. High level of activity stimulates growth and remodelling. |
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growth plates and fractures |
- Growth plates in long bones are weakest area. Forces that would cause a sprain in adults would cause fractures in children. - Fractures can occur across physes. Epiphyses and metaphases. |
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fractures in toddlers |
- Toddler ligaments are stronger than bones. - Toddlers are not fully balanced – their falls may not be witnessed. |
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treatment of fractures |
- Closed manipulation /reduction, plaster, immobilisation. - Usually in outpatient setting. - May need operating theatre. - ? OD if open reduction and external fixation. |
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what is compartment syndrome? |
- Increase in compartment content (bleeding, swelling).- Decrease in size of compartment (bleeding or pressure from another area into compartment surrounds). - At risk: children with open fractures, crush injuries or vascular problems.- Signs and symptoms: throbbing pain, anxious and unsettled and requests not touching a particular areas. |
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what are some of the objectives of a child health record? |
- Promote issues such as immunisation. - Enables health professionals to obtain details of previous consultations - Facilitates communication between parents and professionals. |
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what are the stages of development? |
Prenatal, neonatal, infancy, early childhood, middle childhood and later childhood/adolescence.
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what are the different types of play? |
- 0-2 years: solitary, plays alone. - 2-2.5 years: observes other children but won’t play with them.- 2.5-3 years: plays alongside others but not with them.- 4 years: starts to interact with others in play. - 4-6 years: co-operative.
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development according to freud
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- The id (pleasure principle), the ego and the superego (moral part of us). - Stages: oral (eating), anal (pleasure in anal area - control of bowel movements), phallic (masturbation), latency (latent sexual energy), genital (sexual maturation, finding relationships).
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development according to piaget
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- The Sensorimotor Stage: During this stage, infants and toddlers acquire knowledge through sensory experiences and manipulating objects.
- The Preoperational Stage: At this stage, kids learn through pretend play but still struggle with logic and taking the point of view of other people |
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development according to piaget continued |
- The Concrete Operational Stage: Kids at this point of development begin to think more logically, but their thinking can also be very rigid. - The Formal Operational Stage: The final stage of Piaget's theory involves an increase in logic, the ability to use deductive reasoning, and an understanding of abstract ideas. |
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emergency guess of a child's weight
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(age + 4) x 2
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five steps of respiration |
- Pulmonary ventilation – breathing. - External gas exchange/respiration – O2 absorption air to blood. CO2 from blood to air. - Gas transport - O2 lungs to tissues, CO2 tissues to lungs. - Internal gas exchange / respiration: O2 frim blood to cells, CO2 from cells to blood. - Cellular respiration: O2 uptake and CO2 production to generate ATP. |
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upper airway differences child vs adult |
- Child’s trachea smaller – increased length, not diameter in first 5 years. - Burification angle more acute in children.- Babies obligatory nose breathers until 4 weeks. - Trachea shorter and narrower. |
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respiratory function in children |
- Rapid muscle fatigue. - Increased O2 consumption. - Intercostal muscles and diaphragm control breathing. |
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respiratory acidiosis |
- Build-up of CO2. - Acid base balance disrupted - Symptoms: fatigue, SOB, confusion. - Treatment: bronchodilators, CPAP, O2. |
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respiratory alkalosis |
- Increased breathing, decreased C02. - Caused by anxiety, fear and hyperventilation. - Symptoms: dizziness, peripheral numbness. |
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respiratory assessment |
- Hands off.- Observe: activity level, position, colour, accessory muscle use and respiratory use. |
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cardiovascular assessment |
- Colour, pallor, level of activity, pulse, capillary refill and blood pressure. |
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nutrition |
- Children can have cows milk after one year of age, should be full cream up to three years of age. |
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drug calculations |
- Based on the size of a child. - Each medication has a threshold for optimum usage. |
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The average newborn |
- Weight: 2500 to 4000 grams. - Length: 45-52.5cm. - Chest circumference: 30.5-33cm. - Head circumference: 33-35.5cm. - Reflexes: grasp, rooting, sucking. |
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How are salter harris fractures classified? |
I – Slide or suspect: fracture of the cartilage of the physis (growth plate). II – Above: the fracture lies above the pyses into metaphysis. III – beLOW: fracture is below the physis into the epiphysis. IV – Thru: the fracture is through pysis and exits thru metaphysis and epiphysis. V – Rammed (crushed) |
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what is a closed fracture? |
a broken bone that does not penetrate the skin |
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what is an open fracture? |
a fracture in which the bone is sticking through the skin. |
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what is a greenstick fracture? |
when a bone bends and cracks, instead of breaking completely into separate pieces |
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what is an osteoblast? |
a cell that creates bone. |
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what is an osteoclast? |
a cell that breaks down bone |
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what is a bone matrix? |
The intercellular substance of bone tissue consisting of collagen fibers, ground substance, and inorganic bone salts. |
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what are osteocytes? |
The intercellular substance of bone tissue consisting of collagen fibers, ground substance, and inorganic bone salts. |
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what are chondrocytes? |
mature cells found in cartilage. They make up the cellular matrix of cartilage, performing a number of functions within the tissue, including facilitating the exchange of fluids through the gelatinous layers. |
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what is the epiphysis? |
The end of a long bone that is originally separated from the main bone by a layer of cartilage but later becomes united to the main bone through ossification. |
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what is the metaphysis? |
the transitional zone at which the diaphysis and epiphysis of a bone come together. |
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what is a neurone? |
A nerve cell which enables receipt of information from sensory receptors and transmission to organs and muscles. |
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what are synapses? |
The junction between neurones enabling the transfer of information. |
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what are nocioceptors? |
Free nerve endings, responsive to painful stimulus. |
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what are neurotransmitters? |
Substances that enable chemical transmission of information across the synapses i.e. noradrenaline, serotonin, dopamine. |
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what are the four stages of normal pain production? |
Transduction: The detection of stimulus by a nociceptor. Transmission: The transmission of an impulse from the nociceptor to the cerebral cortex. Perception: The interpretation of an impulse by the brain causing a conscious experience. Modulation: The modification or inhibition of painful impulses i.e. the production of noradrenaline. |
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what is allodynia? |
A hypersensitive pain form of low-intensity stimulation which normally would elicit only non-pain sensation. |
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what is dyesthesia? |
Unpleasant abnormal sensation. |
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what is hyperalgesia? |
Increased sensitivity to pain stimulus with lowering of the pain threshold. |
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what happens to pain receptors with the administration of opioids? |
Mu opioid receptors are blocked by the administration of opioids and naturally produced endorphins. The pain signal is thus lessened and inhibited along the pain pathways, thus inhibiting the sensation of pain in the brain. |
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what is the function of the pharynx? |
transfer food from the mouth to the esophagus and to warm, moisten and filter air before it moves into the trachea |
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what is the function of the larynx? |
allows air to be directed into the respiratory organs for gas exchange. The larynx is also the organ that is responsible for producing vocal sounds (phonation) and therefore it is commonly known as the voice box. In addition, the larynx also plays a role in preventing food and drink from entering the respiratory system. |
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what is the function of the bronchi? |
transition structures that air travels through between the right and left main bronchus, and the very small bronchioles. |
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what is the function of the bronchioles? |
carry oxygen to alveoli, or air sacs, in the lungs and help stabilize breathing in the respiratory system, |
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what do the alveoli do? |
exchange of carbon dioxide for oxygen in the lungs. |
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what is the Medulla oblongata? |
the portion of the brain that controls how we breathe. |
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what is the function of the pons? |
Connects upper and lower parts of the brain. |
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what happens in the developmental stage, trust vs mistrust? |
a baby trusts its parents to provide basic needs such as food and shelter. if these needs aren't met then they will mistrust. |
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what happens in the developmental stage, autonomy vs shame and doubt? |
early childhood - the begin to show signs of independence. they learn to say no and control their body secretions. |
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what happens in the developmental stage, initiative vs guilt? |
early to middle childhood - initiation of new activities and ideas. negative criticism results in feelings of guilt |
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what happens in the developmental stage, industry vs inferiority? |
middle childhood - taking pride in new accomplishments. feelings of inferiority if unable to succeed. |
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fine and gross motor skills |
refer to the table at the back of the 257 lecture notes? |
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what assessment is required for a 4 day old neonate? |
a head to toe assessment is conducted: weight, length, head circumference, peripheral circulation, feeding, colour. reflexes, eyes, hydration and assessment of the umbilicus. |
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what are the developmental markers of a 6 week old neonate? |
- being able to recognise mum and dad. - being awake and alert between naps, - can support head when placed on belly. |
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how would you assess pain in a four year old? |
- type and severity - pain scales - observation of behaviour - management |
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how do you measure the normal growth and development of a four year old? |
- BMI - growth charts - nutritional assessment - play observation - family interaction |
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how do you tell if a child's bruising is normal or not? |
- shape and location - size and cluster |
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what is the importance of play for a child? |
- assists with developmental assessment - can act as a distraction - a child can learn through play |
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how does a nurse determine the severity of a child's asthma |
inspection auscultation palpation percussion interview |
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what are the expected findings of a growth and development assessment of a 10 year old child? |
- increased strength and muscle co-ordination - friendship development - language development; more complex thinking. - start noticing the opposite sex more - enjoys group activities |
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nutrition |
refer to lecture and tutorial notes |
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what is important about immunizations in asthma prevention? |
- vaccines prevent illness that can cause asthma - vaccines may contain ingredients that trigger asthma. - viral illnesses are the leading cause of asthma exacerbation |
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what are the fine motor developmental milestones of a 5 year old child? |
- Use spoon, fork, and knife - Kicking a ball without falling down - Use scissors - Draw circle, square, cross - Tie shoes - Button clothes - Brush teeth |
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what are the gross motor developmental milestones of a 5 year old child? |
- Throw a ball overhand - Climb well - Ride bicycle |
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cognitive development of a 5 year old |
- thinking, learning, awareness, judgment, and processing information - rapid development in their thinking abilities - learn to mentally use objects through images, words, and drawings |
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psycho-social development of a 5 year old |
- family is still very much the centre of their world as that is what they know and are familiar with. - Attachment to parents may become an issue when they start school. - starting to understand the terms of following rules and playing fairly. - often start to seek permission before commencing certain activities. - beginning to understand the difference between right and wrong. |
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what is the root reflex? |
This reflex begins when the corner of the baby's mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and "root" in the direction of the stroking. This helps the baby find the breast or bottle to begin feeding. |
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what is the suck reflex? |
When the roof of the baby's mouth is touched, the baby will begin to suck. This reflex does not begin until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. |
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what is the moro reflex? |
a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out the arms and legs, cries, then pulls the arms and legs back in. A baby's own cry can startle him or her and trigger this reflex. This reflex lasts about 5 to 6 months. |
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what is the tonic neck reflex? |
When a baby's head is turned to one side, the arm on that side stretches out and the opposite arm bends up at the elbow. This is often called the "fencing" position. The tonic neck reflex lasts about 6 to 7 months. |
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what is the grasp reflex? |
Stroking the palm of a baby's hand causes the baby to close his or her fingers in a grasp. The grasp reflex lasts until about 5 to 6 months of age. |
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what is the babinski reflex? |
When the sole of the foot is firmly stroked, the big toe bends back toward the top of the foot and the other toes fan out. This is a normal reflex up to about 2 years of age. |
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what is the step reflex? |
the walking or dance reflex because a baby appears to take steps or dance when held upright with his or her feet touching a solid surface. |
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what is the gross motor development of a 4 year old? |
- Skips on one foot. - Throws ball well overhand. - Jumps a short distance from standing position. |
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speech and language development of a 4-5 year old |
- speak clearly on the whole, but they may still not use some sounds correctly, e.g. say ‘th’ for ‘s’ or ‘w’ for ‘r’ - ask ‘Why’, ‘When’, ‘How’ questions and ask what words mean - tell long stories which may be partly true and partly made up are interested in questions - can argue and give their own ideas about things - talk about what might happen or what they would like to have happen - uses 1000 to 1600 words and speak 3 - 4 word sentences. - understands 1500 words |
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what is the disease process/pathophysiology of asthma? |
The mechanism of inflammation in asthma may be acute, subacute, or chronic, and the presence of airway edema and mucus secretion also contributes to airflow obstruction and bronchial reactivity. Hence the child is unable to breathe properly. |
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what is the disease process/pathophysiology of compartment syndrome? |
Increases in intracompartmental tissue pressure result from increases in fluid pressure plus the contributions of cells, fibers, gels, and matrices. The result is an increased venous pressure that lowers the arteriovenous pressure gradient, resulting in decreased local blood flow. |
