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Peds Ch 4

Test 1

empathy capacity to understand what another person is experiencing from w/i that person's frame of reference
sympathy having feelings or emotions similar to those of another person, rather than understanding those feelings
anticipatory guidance preventative measure, focused on providing families info on normal growth and development and nurturing childrearing practices.
nurse's implementation of anticipatory guidance *base interventions on needs identified by family not professional *view family as competent or able to be competent *provide opportunities for family to achieve competence
info overload too much info, demonstrate signs of increased anxiety or decreased attention
nursing blocks to communication *socializing *unsought advise *inappropriate reassurance *over-ready encouragement *defending situation or opinion *using cliches *closed-ended questions *finishing sentences *talking more than interviewee *prejudging *changing focus
signs of info overload *long periods of silence *wide eyes, fixed expression *fidgeting, nervous habits *sudden interruptions *looking around *yawning *frequently looking at watch *attempting to change topic
egocentric only see things in relation to themselves and from their point of view. children under 5.
direct history taking nurse asks for info via direct interview with informant
indirect history taking informant supplies the info by completing some type of questionnaire
chief complaint specific reason for the child's visit to the clinic or hospital
history of present illness narrative of the chief complaint from its earliest onset thru progression to the present
birth history includes all data concerning 1. mothers health during pregnancy 2. labor and delivery 3. infant's condition immediately after birth
past history includes *birth history *previous illness, injuries, surgeries *allergies *current meds *immunizations *growth and development *habits
family history *family composition *home and community environment *occupation and education of family members *cultural and religious traditions *family function and relationships
growth and development *measurements if weight, length, and head circumference *patterns of growth on the growth chart and any significant deviations from previous percentiles *concerns about growth from family or child
estimated average requirement (EAR) estimated to meet the nutrient requirement of half of healthy individuals for a specific age and gender group
recommended dietary allowance (RDA) sufficient to meet the nutrient requirement of nearly all healthy individuals for a specific age and gender group
adequate intake (AI) based on estimates of nutrient intake by healthy individuals
tolerable upper intake level (UL) highest nutrient intake level likely ti pose no risk of adverse health effects
anthropometry an essential parameter of nutritional status, is the measurement of height, weight, head circumference, proportions, skinfold thickness, and arm circumference
reflect past nutrition height and head circumference
reflect present nutrition weight, skinfold thickness, arm circumference
length measure taken supine using a length board and two measurers. hold head midline, grasp knees together gently, push down on knees until legs are fully extended and flat against table.
height measurement taken while child is standing upright
stadiometer wall-mounted height unit, most accurate
head circumference measured in children up to 36 months and any child whose head size is questionable. measure to nearest 1mm or 1/16 in.
normotensive BP below 90th percentile
facies child's facial expression and appearance
strabismus cross-eye, one eye deviates from the point of fixation.
amblyopia caused by strabismus, blindness from disuse if not corrected by 4 to 6 yo.
corneal light reflex test (Hirschberg) light shined into eye from distance of 16in. light falls symmetrically in each pupil if normal (orthophoric).
fluorosis excessive fluoride ingestion, causes chalky white to yellow or brown areas on the enamel
pectus excavatum sternum is depressed
pectus carinatum sternum protrudes outward
evaluate respirations for *rate *rhythm *depth *quality
vesicular breath sounds heard over the entire surface of the lungs with the exception of the upper intrascapular area and area beneath the manubrium. inspiration is louder, longer, and higher pitched than expiration. sound is soft and swishing.
bronchovesicular breath sounds heard over the manubrium and in the upper intrascapular regions where the trachea and bronchi bifurcate. inspiration is louder and higher pitched that in vesicular breathing.
bronchial breath sounds heard only over trachea near suprasternal notch. inspiratory phase is short, expiratory phase is long.
Kussmaul respirations hyperventilation, gasping and labored respiration, usually seen in diabetic coma or other states of respiratory acidosis
Cheyne-Stokes respiration gradually increasing rate and depth with periods of apnea
Biot respirations periods of hyperpnea alternating with apnea (similar to cheyne-stokes only depth remains constant)
Seesaw (paradoxic) respirations chest falls on inspiration and rises on expiration
agonal last gasping breaths before death
innocent murmur no anatomic or physiologic abnormality exists
functional murmur no anatomic cardiac defect exists, but physiologic abnormality (such as anemia) is present
organic murmur a cardiac defect with or without a physiologic abnormality exists
sinus arrhythmia HR increases with inspiration and decreases with expiration
opisthotonos hyperextension of the neck and spine accompanied by pain when head is flexed. needs immediate medical evaluation
genu varum bowleg, lateral bowing of the tibia. should not be present beyond 2-3 yro.
genu valgum knock knee, knees close together while feet are spread apart. normally present in children from 2 to 7 yro.
Created by: tkulwicki