question

Why is nursing of children different?

answer

- don't treat children as little adults - differences relate to both growth and development patterns - differences exist in motor skills and coordination, and in anatomical metabolic, psychosocial, behavioral, language and cognition areas

question

Children vs Adults

answer

- pediatric vital signs vary with age - children eat more food, drink more fluids, and breathe more air in proportion to their body weight than adults - children's neurological, immunological, digestive, and other bodily systems are still developing - child's metabolism may be less capable than an adult's of breaking down, inactivating or activating medications or offer substances

question

Pediatric VS

answer

- as child grows RR & HR go down but BP goes up - temp: axillary or rectal - warm up to child first - document child behavior during VS - tachycardia- 1st sign of underlying cause - BP is the last to change

question

Pediatric dosages differ from adult medication dosages as a result of

answer

- immature liver function - immature kidney function - decreased gastric function - decreased plasma protein concentration - decreased fat - increased water

question

System strategies to reduce pediatric medication errors

answer

- use the child's weight in kg - look for the child's weight and age, the calculated dose and mg/kg - do not store medications with similar sounding names close together, look at labels for capital letters that a pharmacy may use to help distinguish between medications with similar sounding names

question

In order to administer a medication safely to a pediatric client, what drug information must the nurse be aware of that is not always essential when administering a medication to an adult?

answer

recommended dose per kg of body weight

question

Oral medication administration

answer

- children under 5 years generally can't swallow pills - meds are usually given in liquid form (use syringe for most accurate measurement) - if choosing to crush tablets (check with pharmacy first) use only one spoonful of applesauce, pudding, jelly so that it is easier to ensure that the entire dose will be taken - let children choose the type of fluid to drink after, but do not ask if they will take their medicine now

question

Rectal medication administration

answer

- colon is small in size - lubricate the tip of the suppository before placement - place the suppository at the rectal opening and advance past the sphincter - for children younger than 3 yo, the nurse's gloved fifth finger is used for insertion; after this age the index finger can usually be used

question

Opthlamic and otic medication administration

answer

- adequate immobilization is needed to avoid injury - nurse's hand can be stabilized by resting the wrist on the child's head - have medication at room temperatrure

question

Topical medication administration

answer

- skin of infants is thin and fragile - covering the area or keeping the child's hands occupied may be necessary to ensure adequate contact of medication with the skin

question

Intramuscular medication administration

answer

- anatomy and physiology of children differ from those of adults - vastus lateralis site is preferred for children - deltoid muscle is rarely used except for the small amounts injected in some vaccines - z track technique

question

Intravenous medication administration

answer

- veins are small and fragile, fluid balance is critical - common sites include hands and feet, although the scalp veins are sometimes used in infants

question

Total daily IV fluid for children

answer

- 100 mL per kg per day for the first 10 kg of body weight - 50 mL per kg per day for the next 10 kg of body weight - 20 mL per kg per day for each kg above 20 kg of body weight

question

Pediatrics

answer

branch of medicine that deals specifically with children, their development, childhood diseases, and their treatment

question

Pediatric nursing

answer

the art and science of giving nursing care to children from birth through adolescence with a holistic family-centered approach, including emphasis on their physical growth, mental, emotional, psychosocial, and spiritual development

question

Nursing care of children focuses on improving a child's quality of care by:

answer

providing an environment for optimal growth and development

question

Roles of the pediatric nurse

answer

- direct nursing caregiver: healthcare planning & delivery; ethical decision making - patient education: health teaching, anticipatory guidance - patient advocacy: support/ counseling, health services - case management: coordination/ collaboration - research: evidence- based practice

question

Two primary goals of pediatric care in all roles/ settings:

answer

1. health promotion 2. health maintenance

question

Which role would the nurse be serving when helping parents understand and response to the needs of an ill child's siblings?

answer

advocate

question

Family- Centered Care Approach

answer

** focus of nursing process is that of the child & family * recognize the family as the constant in the child's life - family is the expert in the care of their child - family is vital in helping the child recover from an illness or injury - family is an essential part of the healthcare team - family IS the patient - family should stay with the child even if the child codes (get another nurse to be with family)

question

Enable & empower the family:

answer

- child AND family primary focus of the nursing process - needs of child AND family taken into account - child AND family treated as a unit - meeting family's needs helps meet the child's needs - aim: strengthen family's ability to provide care for their child

question

Which of the following outcomes of family-centered care is most illustrative of the concept? A. the nurse and parents mutually develop strategies of care B. the child is viewed as the most important family member C. all family members enjoy unlimited visiting hours D. Health professional implement a sensitive plan of care for the child and family

answer

A. the nurse and parents mutually develop strategies of care

question

Atraumatic Care

answer

Use of interventions that eliminate or minimize psychological and physical distress or trauma that is experienced by children and their families in the healthcare system

question

Three principles of atraumatic care:

answer

1. prevent/minimize separation from the family 2. promote a sense of control 3. prevent/minimize bodily injury and pain

question

What can be used for a numbing agent in neonates up to 3 months?

answer

Sucrose

question

Function of play in the hospital

answer

- facilitates mastery over an unfamiliar situation - provides opportunity for decision making and control - helps to lessen stress of separation - provides opportunity to learn about parts of body, their function, and own disease/disability - corrects misconceptions about the use and purpose of medical equipment and procedures - provides diversion and brings about relaxation - helps the child feel more secure in a strange environment - provides a means to release tension and express feelings - encourages interaction and development of positive attitudes toward others

question

What is the best nursing approach to decrease a preschooler's anxiety about having his BP measured?

answer

Demonstrate the procedure on a doll prior to performing it on the child

question

Health promotion

answer

activities that increase well-being and enhance wellness or health -strengths and goals: seeks to attain greater wellness - anticipatory guidance

question

Health maintenance

answer

activities that preserve an individual's state of present health; prevent disease or injury - known potential health risks; seeks to prevent them - three levels of prevention

question

Health maintenance prevention

answer

any activity that reduces the burden of mortality or morbidity from disease services performed in a clinical setting that are designed to prevent disease, injury, or disability, prolong life and promote health are known as preventive health service

question

Primary prevention

answer

a disorder is actually prevented from developing - injury prevention (car safety, poison prevention) - child abuse prevention - reduce disease transmission (hand hygiene, sanitize toys & surfaces) - immunizations - exercise programs - comprehensive tobacco prevention program - nutritional assessment & guidance

question

Secondary prevention

answer

disease that has NOT yet become symptomatic is detected and treated early, thereby minimizing serious consequences - screenings throughout childhood - newborn screenings - vision & hearing screenings - iron-deficiency anemia screening - developmental screening (denver II assessment) - autism screening - lead screening - hypertension school screenings

question

Denver II Assessmnet

answer

screening test for developmental issues, doesn't diagnosis & doesn't prevent

question

A 4 yr old scores two failures in the Denver II. Which of the following statements is most accurate? A. The child is not as intelligent as expected for age and should be referred to a learning specialist B. The child has a speech problem and should be referred to a speech therapist C. The child is at risk for school problems and should be retested D. The failures are to be expected in preschoolers who may not be cooperative with testings

answer

C. The child is at risk for school problems and should be retested

question

Tertiary prevention

answer

an existing, usually chronic disease is managed to prevent complications or further damage - manage clinical diseases to prevent them from progessing - Diabetes management - peds rehab unit - disaster preparedness **Asthma, cystic fibrosis, diabetes, obesity, developmental disabilities, cerebral palsy, consequences of low birth weight/ prematurity & mental illness)

question

While interviewing the parents of a 2 yr old female, the nurse notes the mother is pregnant. At the end of the visit, the nurse decides to give a new pamphlet to the parents about car seat usage for newborns. This action is an example of:

answer

Primary prevention health maintainence

question

The nurse is planning educational interventions to reduce the incidence of the number one cause of mortality in children ages 1-4. Recognizing the developmental needs of this age group, the nurse would focus the session on which topic?

answer

unintentional injury awareness

question

What is an indicator of how healthy the nation is:

answer

infant mortality- number of deaths per 1000 live births during 1st year of life

question

Top 5 causes of death in infants:

answer

1. congenital malformations 2. short gestation/ low birth weight 3. SIDS 4. Maternal complications 5. unintentional injury (mortality decreases after age 1)

question

Childhood morbidity

answer

an illness or injury that limits activity, requires medical attention or hospitalization, or results in a chronic condition

question

Leading causes of hospitalization

answer

1-9 yrs: Respiratory distress 15-21 yrs: Mental disorders, injuries, digestive diseases, complications pregnancy/childbirth * Respiratory illness accounts for 50% of acute conditions

question

The nurse recognizes the need to update knowledge related to the most common cause of hospitalization in children. On which body system should continuing education focus?

answer

Respiratory

question

Autosomal Dominant

answer

- both males and females are affected in equal numbers - 50% chance offspring affected - a single abnormal gene on one of the autosomal chromosomes (first 22 "non-sex") from either parents can cause the disase

question

Autosomal Recessive

answer

- both males and females are affected in equal numbers - unaffected mother & father= 25% offspring - BOTH genes in a pair must be defective to cause the disease - People with only one defective gene in the pair are considering carriers - childhood onset

question

X-linked recessive conditions

answer

- almost always occurs in males, since males have only one chromosome - transmitted by female carriers & expressed in males - an affected male will have all carrier daughterss - if mother is a carrier there is a 50% chance of a boy with disease with every pregnancy with a male fetus

question

Multifactorial inheritance

answer

- many factors are involved in causing a condition (genetic & environmental factors) - often one gender is more affected more frequently than the other in multifactorial traits - tends to recur in families - first degree relative mainly affected

question

What types of disorders are abnormalities that result from inherited abnormal genes and environmental factors?

answer

Multifactorial

question

Examples of autosomal dominant

answer

- neurofibromastosis - achondroplasia (dwarfism) - marfan syndrome - huntington disease - familiar hypercholesterolemia - osteogeneis imperfecta

question

Examples of autosomal recessive

answer

- cystic fibrosis - sickle cell anemia - Tay-Sachs disease - phenylketourina (PKU)

question

Examples of X-linked:

answer

- Duchene muscular dystrophy - hemophilia

question

Examples of multifactorial

answer

- neural tube defects - congenital heart defects - cleft lip & palate - autism spectrum disorder - diabetes mellitus

question

Which of the following heredity disorders is transmitted by autosomal dominance? A. cystic fibrosis B. duchenne muscular dystrophy C. Huntington disease D. neural tube defects

answer

C. Huntington disease

question

Peds VS Newborn

answer

RR- 30-55 HR- 100-170

question

Peds VS 1 year

answer

RR- 25-40 HR- 90-140

question

Peds VS 3 years

answer

RR- 20-30 HR- 80-120

question

Peds VS 6 years

answer

RR- 16-22 HR- 70-120

question

Peds VS 10 years

answer

RR- 16-20 HR- 60-110

question

Peds VS 17 years

answer

RR- 12-20 HR- 60-100

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