question

Trust vs. Mistrust

answer

Erikson; 0-1 year-> establishment of trust in people by parent or caregiver meeting needs of infant by feeding, clothing, touching, and comforting

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Autonomy vs. Shame & Doubt

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Erikson; 1-3 years-> toddlers sense of autonomy or independence shown by controlling secretions, saying no, and directing motor activity and play

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Initiative vs. Guilt

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Erikson; 3-6 years-> initiates new activities and considers new ideas, interested in exploring the world-creates a child who is involved and busy

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Industry vs. inferiority

answer

Erikson; 6-12 years->development of new interests and involvement in new activities , takes pride in accomplishments at school and sports

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Identity vs. Role confusion

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Erikson; 12-adult-> new sense of self, family, peers, groups, and community are all examined and redefined

question

Sensorimotor

answer

Piaget; 0-2years-> infants learn through their senses and motor activity

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Preoperational (preconceptual)

answer

Piaget; 2-4 years->vocabulary and comprehension increase, child is egocentric

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Pre operational (Intuitive)

answer

Piaget; 4-7 years->relies on transductive reasoning (karma)

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Concrete operational

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Piaget; 7-11 years->more accurate understanding of cause and effect relationships

question

Formal Operational

answer

Piaget; 11-adult-> fully mature intellectual thought, abstract thinking

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Fine and Gross motor ability Birth to 1 month

answer

Holds hand in fist, may lift head briefly if prone, follows objects

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Fine and gross motor ability 2-4 months

answer

Brings hands to midline, can turn from side to back, holds head up and supports weight with arms, decreased head lag when pulled to sitting position (head held at midline with some bobbing)

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Fine and gross motor ability 4-6 months

answer

Graps objects at will, manipulates objects, supports most weight when held standing- turns from abd to back at 4 months, and from back to abd at 6 months

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Fine and gross motor ability 6-8 months

answer

sits alone without support, transfers objects from one hand to another

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Fine and gross motor ability 8-10 months

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Crawling, pulls self to standing by 10 months, uses pincer grasp well

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Fine and gross motor ability 10-12 months

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Stands alone, sits down from standing, places object in container through holes

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psychosocial development 0-3 months

answer

visual stimuli of mobiles, auditory stimuli like music and soft voices, likes varying stimuli

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psychosocial development 3-6 months

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prefers noise making objects that are easily grasped, enjoys stuffed animals and contrasting colors

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psychosocial development 6-9 months

answer

likes teething toys , increased desire for social interaction with adults and children, soft toys that can be manipulated and mouthed

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psychosocial development 9-12 months

answer

enjoys large blocks, toys that pop apart and go back together, interactive games (peek-a-boo), push and pull toys

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fine and gross motor 1-2 years

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builds tower with 4 blocks, scribbles on paper, throws a ball, can undress self

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fine and gross motor 2-3 years

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jumps, kicks ball, learning to dress self, throws ball overhand, draw circles and other shapes

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Parallel Play

answer

two toddlers tend to play with similar objects side by side, occasionally trading toys and words

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Associative Play

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Preschoolers that interact while playing, one cuts paper they other glues it in a design

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Cooperative Play

answer

school aged children play a part and contribute as a unified whole

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Therapeutic Play

answer

planned play technique that provide an opportunity for children to deal with their fears , concerns, and stressors of health experiences related to illness and hospitalization

question

Dramatic Play

answer

child acts out the drama of daily life or in which medical situations encountered are reenacted by the child

question

Isotonic Fluids

answer

Osmolarity is near serum, fluids stay in vascular space, used to expand vascular space ex. hypovolemia

question

Examples of isotonic fluids

answer

Lactated Ringers->expands intracellular fluid, replaces ECF loss Normal Saline->Restores water and Na loss, maintains Na and Cl at present levels D5W-before absorption

question

Risks of Isotonic Fluids

answer

Fluid Overload

question

Hypotonic Fluids

answer

Fewer solutes in the fluid, moves fluids from IVS to interstitial space, as interstitial spaces get diluted water then moves to adjoining cells- used in hyperglycemia to replace fluids in cells that glucose has pulled out

question

Examples of Hypotonic Fluids

answer

0.45% Normal Saline 0.33% Normal Saline Dextrose 2.5%(D2.5W) D5W-after absorption

question

Risk of Hypotonic Fluids

answer

will worsen intracranial pressure, give carefully to avoid rapid shift of fluid from IVS

question

Hypertonic Fluids

answer

More solutes in the fluid than in the body, pulls fluids from the interstitial space and cells into the IVS, may reduce edema, increase urine output, or stabilize BP

question

Examples of Hypertonic Fluids

answer

D5W-> restores water loss, plasma volume, and calories; lowers sodium levels

question

Risks of Hypertonic fluid

answer

Circulatory overload, dehydrate cells, especially in DKA where cells are already dehydrated

question

Isotonic dehydration

answer

occurs when fluid loss is not balanced by intake, loss of water and sodium are in proportion- commonly manifested in illnesses of young children w/ vomiting and diarrhea

question

Hypotonic dehydration

answer

Occurs when fluid loss is characterized by greater loss of sodium than water-occurs with severe prolonged vomiting and diarrhea, burns and renal disease, also by administering IV fluids without electrolytes

question

Hypertonic dehydration

answer

Occurs when a greater loss of water than sodium, may be caused by diabetes or IV fluids and tube feedings with high electrolyte levels

question

Managing dehydration: mild&moderate

answer

Use oral rehydrating fluids start slowly, 3-5mL in a cup or spoon Mild- give 50mL/kg in first four hours Moderate- give 100mL/kg in first four hours if vomiting or diarrhea calculate loss, (10mL for each stool)

question

Managing dehydration: Severe

answer

IV fluids are indicated use lactated ringers or dilute saline; maintenance fluids plus, replacement fluids ; give half the total in the first 8 hours the rest in the next 16 hours

question

Phlebitis

answer

inflammation of the vein-less often in children until about age 10

question

Infiltration

answer

Leakage of non-vesicant IV solution/medication into extracellular space

question

Extravasation

answer

leakage of vesicant solution into extracellular space

question

Chemical or Mechanical Irritation

answer

burning or redness with or without pain and without phlebitis or infiltration-verify concentration, consider slowing the rate of infusion

question

Positional IV infusion

answer

Rate altered r/t change in position-consider readjusting and re-taping or adding arm board.

question

Nerve Damage

answer

Tingling, numbness, and pain, from piercing or transection of a nerve-contact physician

question

Speed Shock

answer

systemic reaction to a rapid infusion of a substance, causes drugs to reach toxic levels quickly- lightheaded, dizzy, chest tightness, flushed face, irregular pulse-stop infusion immediately

question

Biofilm

answer

Aggregate of microbes that adhere to each other on a surface, essentially present in every central line- resistant to treatment

question

Sepsis&Infection

answer

Culture before pulling; chills, fever, purulent drainage, hypotension, mental status changes, IV discontinued

question

Catheter migration(central line)

answer

arrhythmias if in heart, puncture of vessel or heart wall, delivery of fluid into pericardium or subclavian/jugular veins, pain, obstruction

question

Pinched off syndrome(central line)

answer

patient changed position, catheter gets pinched or compressed between the clavicle and 1st rib, can fracture catheter causing emboli

question

Endocarditis

answer

inflammation/infection of the lining membrane of the heart

question

Occlusion

answer

precipitates(med incompatibilities), or mechanical-clamped cord(happens frequently) Thrombus(most common) partial or complete

question

Stressors about hospitalization: Infant

answer

Painful procedures, stranger anxiety, separation anxiety,

question

Stressors about hospitalization: Toddler

answer

Immobilization, bodily injury or mutilation

question

Stressors about hospitalization: Preschool

answer

Fear of abandonment, Loss of self control, fear of the dark, separation anxiety

question

Stressors about hospitalization: School Age

answer

Loss of privacy& control of bodily functions, fear of death, separation of family and friends

question

Stressors about hospitalization: Adolescent

answer

Fear of altered body image and/or disfigurement, disability, death. Loss of identity

question

blood pressure norms

answer

90+(2 times age in years)

question

Point of maximal Impulse(PMI)

answer

7 years: 5th and 6th intercostal space at midclavicular line

question

Lymph Nodes in Peds

answer

Larger in children until about 12 years of age, should be small and firm, not hard; Nodes>1cm, hard, red, tender, warm, or fixed need further eval

question

External Auditory Canal

answer

3 years of age pull up and back on pinna

question

Esotropia

answer

eye angled in

question

Exotropia

answer

eye angled out

question

Hypertropia

answer

eyes angled up

question

Asthma Classification:Intermittent

answer

Symptoms: 2 or less a wk Nighttime awakenings: <2/month SABA for sx Control: <2days/week Interference with normal activity:None Exacerbations that require oral systemic steroids: 0-1/year

question

Asthma Classification: Mild

answer

Sym: 3-4 days a wk Nt awakenings: 3-4 days/month SABA for sx: 2 days/week Interference: Minor Exacerbations that require Oral systemic steroids: 2 or more/ year

question

Asthma classification: Moderate

answer

Sym:Daily Nt Awakenings: 1 night/week SABA for Sx: Daily Interference:Some Exacerbations that require oral systemic steroids: 2 or more times per year

question

Asthma Classification: Severe

answer

Sym: Throughout the day Nt. Awakenings: 7 days/wk SABA for sx:7 times/day Interference: Extreme Exacerbations that require oral systemic steroids: 2 or more per year

question

Ideal Fluid intake Formula

answer

1st 10 Kg=100mL/kg 2nd 10 Kg= 50mL/kg >20 kg up to 70 kg= 20mL/Kg >70 kg=1.5 liters/M^2

question

Expected Output

answer

1-2 mL/Kg/hour

question

Potassium Requirement

answer

2-3 mEq/kg/day

question

Why are infants at a greater risk for Respiratory Distress

answer

Small airways Nose breathers until approx. 6 weeks airway made of soft cartilage easier to collapse Shorter airway fewer alveoli enlarged lymph nodes large tongues & heads

question

Metabolic Acidosis

answer

Diarrhea getting rid of H+ from GI tract pHnormal(35-45) HCo3<22

question

Metabolic Alkalosis

answer

Vomiting getting rid of acid in the stomach pH>7.45 PaCo2>Normal(35-45) HCo3>26

LCC Nursing 265; exam 1 – Flashcards

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