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PEDS EXAM #1
Communication, Types of Care, TPN
| Question | Answer |
|---|---|
| Child and parent-centered communication | Enhances child outcomes and child and family satisfaction. |
| Effective Communication | The foundation of the therapeutic relationship, and leads to increased knowledge and health care behaviors on the part of the child and family. |
| Developmental Techniques with Children & Effective Communication | Allow them to warm up to you. Use specific, clear phrases, in an unhurried, quiet, yet, confident manner. Communicate at their eye level. Spend time and incorporate ways to play (if younger). |
| Atraumatic Care | Focuses on minimizing stressors and separation from the family and promoting a sense of control for the child and family. |
| Health & Supervision Services | Involves providing services proactively with the goal of optimizing the child's level of functioning. Ensures the child is growing and developing appropriate, and it promotes the best possible health of the child by teaching parents and children about preventing injury and illness. |
| Developmental Surveillance | An ongoing collection of skilled observations made over time during health care visits. They often include noting and addressing parental concerns, obtaining a developmental history, making accurate observations, and consulting with relevant professionals |
| Developmental Screening | Brief assessment procedures that identify children who warrant more intensive assessment and testing. May be observational or by caregiver report |
| Screening tests | Procedures or laboratory analyses used to identify children with a certain condition. |
| Risk Assessment | Performed by the physician or nurse practitioner in conjunction with the child and includes objective as well as subjective data for the likelihood that the child will develop a condition |
| Universal Screening | An entire population is screened, regardless of the persons risk. |
| Selective Screening | Done when a risk assessment reveals positive, or the patient has one or more risk factors for the disorder. |
| Immunizations | Essential cornerstone of pediatric disease prevention. |
| Anticipatory Guidance | Is guidance provided that involves common childhood health problems and seeks to prevent or improve the health of children. |
| Stress Reduction in the Hospitalized Child | Encourage parents and the child to work with a child-life specialist at the hospital who can give the child a comprehensive preparation for the hospitalization. |
| Minimizing Fear & Anxiety | Preparing the child, explaining everything, using age-appropriate communication, allow time for children to play out their fears and concerns. Talk to the child and parents in a soft, friendly, comforting tone. Have a calm, empathetic approach. |
| Addressing/Minimizing Separation Anxiety | Know the stage of separation anxiety, and remember that behaviors are demonstration during the first stage do not indicate that the child is "bad" Encourage family to stay with the child, and always use a family-centered approach to care. Help the child cope, and intervene before the behavior of detachment occur |
| Addressing Loss of Control | Minimize restrictions, altered routines, rituals, and dependency issues, as they produce loss of control. Allow as much independence as possible within constraints of diagnosis. Allow the child to participate in care and decisions regarding care whenever possible |
| Stressors Associated with Hospitalization and Illness | Include separation from family and routines, fear of the unknown environment, potential for pain, bodily injury, or mutilation, and loss of control |
| General Inpatient Unit | Are shorter stays, often involving more acute conditions. Such little time for admission preparation, that admission procedures and treatment often occur simultaneously. |
| Emergency & Urgent Care Department | Often result from a major cause or illness/injury from accidents. Procedures and tests are performed quickly, with minimal time for preparation. |
| Pediatric Intensive Care Unit (PICU) | Specialized for caring for children in crisis. |
| Outpatient or Special Procedures Unit | For individuals that do not require care in an acute setting. Delivers a convenient and cost-effective health care to children and families. They are used to keep hospital stays short and decrease costs. |
| Rehabilitation Unit or Hospital | Cares for children beyond the initial period of illness or injury. Involves an interdisciplinary approach that assists the child to reach their potential and achieve development skills. Can be from neurological injuries, serious burns, etc. |
| Safety During Hospitalization | Identification band, monitoring them closely, |
| Discharge Planning | Begins upon admission. Includes the families resources and knowledge to determine education and referrals. Both the child and parent should receive written instructions about home care. These should include: follow up appointments, guidelines about when to contact the provider (worsening or new symptoms), diet, activity level allowed, medications, additional treatments needed, specific dates to return to school/daycare, names and phone numbers of agencies the family has been referred to |
| Community Nursing | Focus on promoting and preserving health as well as preventing disease or injury. Help children and their families cope with illness and disease. Direct providers of care as well as advocates and educators working to minimize and remove barriers to allow the child to develop to his or her full potential |
| Care for Chronic & Illnesses | Develop a trusting relationship, case management and advocacy, screening and ongoing assessments, provision of home care, care of the technology dependent child, education and support of the child and family, and referral for resources. |
| Interventions for Optimal Functioning | Comprehensive and coordinated services from multiple professionals. These professionals work collaboratively to address the child's health, educational, psychological, and social service needs. |
| End of Life Care | Often involves ethical dilemmas for the child, family, and health care team. This is particularly true when the parent and child have opposite desires. Children should be involved in decision-making to the extent that they are able |
| Care for Terminal Illness | Palliative care whether at home, hospital, or hospice setting. Provide the best quality of life possible at the end of life while alleviating physical, psychological, emotional, and spiritual suffering. Should respect the child's goals, preferences, and choices. Acknowledgement and addressing of caregiver's concerns. Provision of a comprehensive, interdisciplinary continuum of care in the community. Competent and ethical care |
| Goals of the Nurse in the Home Care Setting | Promoting, restoring, and maintaining health of the child. Home care focuses on minimizing the effects of the illness or disability and providing the child or family with the means to care for the illness or disability at home. Nurses are direct care providers, child and family educators and advocates, and case managers. |
| Methods for Determining Pediatric Drug Doses | The child's body weight and Body Surface area. |
| Intramuscular Medication Administration | is used infrequently in children because it is painful and children often lack the adequate muscle mass. When used with infants 12 months or less, the preferred site is the vastus lateralis muscle or anterolateral thigh muscle. In infants and children greater than 12 months, the vastus lateralis or anterolateral thigh muscle remains the preferred site but the deltoid can be considered if sufficient mass is present. |
| Peripheral IV Medication Administration | is common with children, especially when a rapid response to the drug is desired or when absorption via other routes is difficult or impossible. Preferred sites are the hands, feet, and forearms. Scalp veins may be used in infants, but only if attempts at other sites have been unsuccessful. |
| Oral Medication Administration | Children younger than the age of 5 to 6 are at risk for aspiration when receiving tablets or capsules because they have difficulty swallowing them |
| Rectal Medication Administration | is not preferred because the drug’s absorption may be erratic and unpredictable and children find this route extremely upsetting or embarrassing. |
| Central Venous Therapy | usually is administered through a large vein, such as the subclavian, femoral, or jugular vein or vena cava. The tip of the device lies in the superior vena cava just at the entrance to the right atrium. Devices include single- or multiple-lumen short- and long-term catheters, peripherally inserted central catheters, tunneled catheters, and vascular access ports. |
| Nutritional Support | can be administered enterally via a nasogastric or orogastric tube (gavage feeding) or via a gastrostomy or jejunostomy device or administered parenterally through a peripheral or central venous access device. |
| Otic Medication Administration | pull the pinna downward and back if the child is younger than age 3, and up and back for older children. |
| Enteral Nutrition | indicated for children who have a functioning gastrointestinal tract but cannot consume adequate amounts of nutrients orally. --Prior to feeding, placement of the feeding tube must be confirmed. -- Through radiograph, pH of aspirate, external markings, tube length, and continually assessing for signs indicative of feeding tube misplacement, such as unexplained gagging, vomiting, or coughing |
| Total Parenteral Therapy | require close monitoring of the infusion rate and volume, intake and output, vital signs, and blood glucose levels. Strict aseptic technique is necessary when caring for the central venous access site and TPN infusion. |
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