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Pediatric Nursing

Module's 7 & 8

What are some at risk behaviors for adolescents? Problems getting along with others, outburst of uncontrolled behavior, socially isolated, bullying tendencies, poor school performance, preoccupation with weapons, violence to pets/other living creatures
What are some drug-seeking behaviors in adolescents? Stealing, shoplifting, dealing drugs, sexual promiscuity, and prostitution
Includes a craving for and a compulsive need to use a substance Psychological dependence
Occurs with drugs such as a heroin and alcohol Physical dependence
Develops when a user's body becomes accustomed to certain drugs Tolerance
What is the best way to keep kids off drugs? Promote a positive self-image
What are the four predominant coping patterns of children of alcoholics? Flight, fight, perfect child, savior/super coper
Who needs intervention when there is a alcoholic in the family? Entire family
What increases amino acids and tyrosine, which will break down into nor-epinephrine in the brain & results in increase alertness? Protein rich meals
How can adolescents help with their nutrition? Meal plan
What are fast foods high in? Fat, calories, protein, sugar, sodium
What are fast foods low in? Fiber
Attempt at suicide without injury Suicidal gestures
Thoughts of suicide Suicidal ideation
Attempts that is intended to cause death; can be unsucessful Suicidal attempt
Which sex completes more suicides? Males
Which sex attempts more suicides? Females
What three measures increase the risk of a successful suicide? Plan of action, means to carry out the plan, and absence of obvious resources to turn for help
What are the manifestations of suicidal behavior? Flat affect/"fixed" facial expressions, deterioration in school performance, isolation from friends & family, changes in physical appearance, giving away prized possessions, and talk of death
Prolonged behavioral change from baseline that interferes with schooling, family life, and/or age-specific activities Depression
What are some symptoms of depression in a adolescent? Loss of appetite, sleep problems, lethargy, social withdrawal, and sudden drops in grades
What are the nursing responsibilities for adolescent depression? Recognize the signs of depression and initiate appropriate and prompt referral
What are some red flag warnings for internet usage/predators? Pornography, hiding passwords, hiding content when adult walks in room
An inflammation of sebaceous glands and hair follicles of the skin due to oily skin Acne Vulgaris
What is one treatment for acne vulgaris? Accutane
Why should females avoid pregnancy if taking Accutane? Possible fetal deformity
What is the nursing care/teaching for acne vulgaris? Eat regular well-balanced diet, sunshine, general hygienic (cleanliness), rest, and avoidance of emotional stress
When is acne usually more severe? Winter
Known as the Epstein-Barr virus or kissing disease Infectious Mononucleosis
What are signs & symptoms of mono? Low grade fever, malaise, jaundice, and enlarged spleen
How long is the incubation period for mono? 2 - 6 weeks
What is the nursing care/teaching for mono? Avoid contact with saliva, don't share utensils. Spread through direct contact; rest and supportive treatment; isolation is not required
Malignancy of they lymph system that primarily involves the lymph nodes Hodgkin's disease
What cells are present in Hodgkin's disease? Reed-Sternberg
What is the nursing care/teaching for Hodgkin's disease? Symptomatic relief of the side effects of radiation and chemotherapy
Form of self-starvation seen mostly in girls; criteria is failure to maintain normal weight for age and height Anorexia Nervosa
What is the treatment for anorexia nervosa? Antidepressants
What is the cause of obesity? Related to diet and inactivity; some causes can be related to illness syndromes
What BMI range is considered obese for 13-17 yr old? More than 22-24
Recurrent episodes of uncontrolled binge eating followed by self-induced vomiting & misuse of laxatives and/or diuretics Bulimia
What is the nursing care/teaching for bulimia? Prevent, identify, educate, and refer
Poor posture Functional Scoliosis
Changes in shape of the vertebrae or thorax Structural Scoliosis
What are symptoms of scoliosis? One shoulder higher than the other, one arm may be longer than the other, and hip may protrude out
What is the best treatment for a sports related soft tissue injury? RICE - Rest, Ice, Compression, Elevation
Infections that spread through direct sexual activity Sexually Transmitted Infections (STIs)
What is the nursing care/teaching for STIs? Emotional support, privacy, assess the person's level of knowledge and provide information at an understandable level. Assess person's emotional reasoning for sex and provide options for that person. Teach to finish all medications, and condom use
What are signs and symptoms of dysmenorrhea? Pain in lower abdomen and back, may have diarrhea, nausea, and vomiting
What is nursing care/teaching for dysmenorrhea? Educate that low fat and vegetarian diets reduce estrogen levels and can relieve menstrual pain for some women
Shoulders widen, pectoral muscles enlarge, voice deepens, and hair begins to grow on face, chest, axillae, and pubic areas Characteristics of boys physical growth
Onset of menses, fate is deposited on hips, thighs, and breast, causing them to enlarge; wear a bra; complete BSE, and hair growth on axillae and pubic area Characteristics of girls physical growth
What is Erikson's major developmental task for the adolescent? Identity vs. Role Confusion
Who refers to adolescents stage of life as the "genital stage"? Sigmund Freud
Motor vehicle accidents, homicide, and drowning's Leading causes of death among adolescents
Who serves as the initial separation from family for the adolescent? Peer groups
What occurs in rooms/class that is considered harmless if child continues toward normal pursuits? Daydreaming
How do you help a child adjust to hospitalization? Explain all procedures, be honest, encourage parents to room in and bring familiar objects from home, always perform invasive procedures in treatment room away from child's room (keeping their room a "safe place")
Separation is most common is what age group? Toddlers
Protest, Despair, Denial/Attachment Three stages of separation anxiety
Sense of abandonment expressed loudly Protest
Crying stops, child appears sad and depressed Despair
Deny need for patent and becomes detached or disinterested in their visits Denial/Detachment
What is the best policy when it comes to pain in a child? Be honest! Don't lie about whether or not something is going to hurt
Distraction, drawing, relaxation/cognitive strategies Non-pharmalogical techniques
Child chooses a word that describes pain Descriptive word pain scale
Child points to face that best describes how they are feeling FACES pain scale
Child points to where pain falls on the scale Visual analogue scale
Child uses number of chips to relay how much they are hurting Poker chip scale
What is the nursing care/teaching for procedures/surgery? Involve parents, offer simple (age appropriate) explanations, show equipment, allow child to touch if appropriate, allow choices when possible, tour surgical area if possible, offer small reward afterward
What age group is appropriate to use the mummy restraint on? 6 years and younger
Short term restraint that may be necessary for examination or treatments; effectively controls the child's movement and can be modified to expose an arm, leg, or chest Mummy restraint
How often are restraints checked? Q1-2 hours
How often are restraints removed? Q 2 hours; so skin may be assessed and toileting offered
Used to restrict movement of arm that has IV in it to reduced risk of accidental dislodgement? Arm boards
How often are IV patency checked on a child? Q hour
Cradle position, football position, upright position, colic carry Acceptable safe ways to hold a child
What is the weight conversion when weighing a diaper for I/O? 1 gram = 1 mL of urine
Combustible materials, infection prevention & control, prolonged exposure, and termination of O2 therapy gradually Safety concerns in relation to O2 therapy specific to children
Decreased restlessness, improved breathing, vital signs, and color Goals of oxygen therapy
What are the methods of administration for O2? Neonates & infants may require an isolette or hood; other age groups may require mask, NC, tent, or trach
What are signs and symptoms of respiratory distress? Retractions, nasal flaring, and restlessness
How do you collect urine specimen on infant? Wee bag; use tongue depressor to obtain stool specimen from diaper
What two identifies do you use before administering medication to a child? Name and DOB (if child is too young, may ask parent)
Location, size of catheter, number of attempts, any fluids running, and arm board or other reinforcement is used to stabilize IV What you document for IV
Prevents accidental fluid overload in child Syringe pump
What are steps when calculating medications for children? Calculate lowest safe dose, highest safe dose, verify calculated ordered dose with another nurse
What do you do if dose ordered is above highest safe dose? Clarify with physician and document that ordered dose was confirmed with physician
What is nursing teaching for parents/guardians at discharge for medication administration? Administer all medications as ordered
What is the max volume dosage for an infant IM vastus lateralis? 0.5 mL
What is the max volume dosage for a toddler IM vastus lateralis? 1 mL
What is the max volume dosage for preschool, school age, and adolescent child IM in the deltoid and vastus lateralis? Deltoid 1 mL; vastus lateralis 2 mL
How do you secure a toddler for medication administration? Hug position
What age group do you avoid prolonged reasoning with during medication administration? Preschool
What must you show toward families with hospitalized children to decrease anxiety? Cultural sensitivity
What should nursing care plans include for a hospitalized child? Measures to minimize negative impact on growth and development and to recognize play as an important role
Separation, pain, and fear of bodily harm Three major causes of stress in hospitalized child
Why must nurses maintain a high level of suspicion for pain? Child is often unable to verbalize discomfort
Occurs in infants 6 months or older Separation anxiety
Intrusive procedures are ______ provoking, they disrupt the child's trust level and threaten self-esteem and self-control Fear
Loss of an achieved level of functioning to a past level of behavior that was successful during earlier stages of development Regression
Which age group is preoccupied with self? Adolescents
What two conditions may complicate or exacerbate problems with body image? Anorexia nervosa and bulimia
What age group is most affected by dehydration? Infants
When does discharge planning begin? Day of admission
Created by: tandkhopkins