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Peds Exam 1
Intro to Caring for Children
| Question | Answer |
|---|---|
| pediatric nursing | Infancy – adolescence 72.5 million children – 22% of population Declining percentage Goal- maintain optimal health, recognizing family influences Health promotion, disease and injury prevention, care during illness |
| mortality in infants | infants (first 12 months) number of infant deaths/1000 live births |
| leading cause in mortality in infants | congenital anomalies |
| significant predictors of infant mortality | low birth weight and prematurity |
| mortality in childhood | (1-14 years) number of deaths/100,000 |
| ages 1-4 | unintentional injuries - drowning, MVA, suffocation congenital malformations |
| ages 5-14 | unintentional injuries - MVA, poison, falls cancer |
| other causes of death in childhood | suicide, homicide, diseases of the heart, influenza, and pneumonia |
| childhood morbidity high risks | Low birth weight Attending childcare centers - inc exposure to sicknesses Living in poverty, homelessness Foreign- born adoptions With chronic medical and psychiatric illness and disabilities Limited access to care |
| contributing issues to childhood morbidity | Obesity - T2D now in peds Environmental toxins Allergies Child abuse and neglect Mental health issues |
| role of pediatric nurse | Therapeutic relationship Family advocacy and caring Disease prevention and health promotion Health teaching Injury prevention Support and counseling Coordination and collaboration Ethical decision making |
| informed consent for children under 18 | parent or legal guardians |
| exceptions for informed consent | emergencies, assume all measures |
| informed consent for emancipated minors | if <18, if petitioned in court, living on own, military, pregnant |
| informed consent for mature minors | children 14-18 can see care without getting consent for STI, mental health, substance abuse, contraception exception is self harm |
| religion/cultures issues | if religion/culture says no to something, if hospital has ethical concerns, can get taken to court |
| assent vs dissent | 7 y/o or older can volunteer consent for care and research or say no I don't want to |
| advanced directives | DNR or DNAR, parents often change their mind at the time |
| family centered care | Collaborative relationship between families, nurses, providers Recognizes family as expert in child’s care/needs Empowerment and enabling - new info to take care of kid at home Respect for uniqueness and diversity |
| comprehensive care | Collaborative Care Continuum of care - across all settings Preventive care Culturally congruent care Complementary and Alternative Medicine (CAM) |
| Preventive care | Anticipatory guidance |
| Well Child-Care and Health Promotion | Promotion of health and well-being Assessment of development and behavior Anticipatory guidance Disease detection and prevention Optimizing family function |
| Atraumatic Care | Utilizing interventions to eliminate/minimize psychologic and physical distress |
| if pt has positive first experience then | they will have a positive second experience |
| atraumatic care means | do no harm! Prevent or minimize physical stressors Prevent or minimize separation from family - parents can stay in room Promote sense of self control |
| Factors affecting child health | Genetics Health status and lifestyle Access to care Family |
| Types of families | Traditional nuclear Nuclear Blended (reconstituted) Extended Single parent Binuclear Lesbian, Gay, Bisexual, Transgender Polygamous Communal |
| Family Theories components | Family systems Family stress Developmental |
| family theories help | understand how parents respond |
| Family systems | family viewed as whole system, not individuals - one thing affects the whole family so our goal is to help families remain balance |
| family stress | inevitable, their resilience and resources will determine how they will respond |
| developmental | theory that family is changing |
| positive family relationships | mutual respect, shared sense of responsibility, communication! |
| Types Parenting Styles | Authoritarian or Dictatorial Authoritative or Democratic Permissive Uninvolved, Rejecting or Neglecting |
| Authoritarian or Dictatorial | my way or the high way, high control and low warmth |
| Authoritative or Democratic | IDEAL!!! there is give and take rules change based on circumstances high control and high warmth |
| Permissive | parents want to be friends, involve kids in decision making high warmth and low control |
| Uninvolved, Rejecting or Neglecting | low warmth, low control |
| Discipline | Setting rules, expectation |
| Punishment | Consequence |
| Limit Setting and Discipline | Clear and realistic limits and expectations Role model and reinforce appropriate behavior Explain consequences Timely Validate child’s feelings Focus on behavior, not the child |
| Clear and realistic limits and expectations | give warnings and intervene right then |
| Biologic, Physical growth | objective and measurable!! Height, weight, bone, organ, teeth changes |
| domains of development | Physical development - gross and fine motor skills Cognitive Language Emotional / psychosocial |
| Principles of Motor/Physical Developmental | Systematic and hierarchical, there is an expected sequence builds of previously mastered skills |
| Principles of Motor/Physical Developmental are | Predictable and individual, happen at their own timing but the sequence is predictable |
| there are rapid changes in | first year of life |
| gross motor skills | cephalo-caudal, head to toe |
| fine motor skills | proximal-distal, trunk and core then arms then hands then fingers |
| Theoretical Foundations | Cognitive Development- Jean Piaget Psychosocial Development- Erik Erikson Moral Development- Lawrence Kohlberg |
| Cognitive Development - Piaget | Predictable stages of reasoning towards mature, logical thinking Mechanisms of development- adaptation |
| Predictable stages of reasoning towards mature, logical thinking | Biological potential - what they're born with Environmental interaction - how they'll maximize the potential they were born with |
| Mechanisms of development- adaptation | Assimilation Accommodation |
| Piaget Stages- Cognitive Development | 4 stages: sensorimotor, preoperational, concrete operational, formal operational |
| sensorimotor | birth to 2 years (infancy, beginner toddler) |
| preoperational | 2-7 years (early childhood) |
| concrete operational | 7-11 years (middle childhood) |
| formal operational | 11-15 years (later childhood) |
| Psychosocial Development: Erikson | Series of critical stages Core conflict/task - master to progress to next stage Core conflicts recur throughout life |
| Psychosocial Development: Erikson determines if | something has negative or positive impact on life |
| Erikson’s Stages - Psychosocial Development | 5 stages arise during childhood: trust vs mistrust, autonomy vs shame & doubt, initiative vs guilt, industry vs inferiority, identity vs role confusion |
| trust vs mistrust | birth to 1 years- infancy |
| autonomy vs shame & doubt | 1 to 3 years- toddler |
| initiative vs guilt | 3 to 6 years- preschooler |
| Industry vs. Inferiority | 6 to 12years- middle childhood |
| Identity vs. Role confusion | 12 to 18 years- later childhood |
| Moral Development: Kohlberg | Parallels cognitive development Evolves from externally driven rules into individual and abstract - based on are they allowed (good) or not allowed (bad) 3 levels |
| 3 levels of Moral Development: Kohlberg | young child preconventional conventional |
| young child | based on freedom or restrictions |
| Preconventional 3-7 years | Based on reward and punishment |
| Conventional 8-13 years | Based on external ethics |
| Role of Play in Development | Universal language of children Allows children to express feelings and fears Facilitates development Teaches socially acceptable behavior Provides protection from everyday stressors |
| Social Character of Play | Onlooker play Solitary play Parallel play Associative play Cooperative or Team Play |
| Therapeutic Play | structured play uses dolls and stuffed animals teaches coping strategies cooperation for medical treatment |
| structured play encourages | expression of feelings, helps child work through things |
Created by:
leh195