Pediatric Nursing

95 flashcards by MentisLibrary

Nursing care of infants, children and adolescents: growth and development, pediatric respiratory and cardiac conditions, infectious disease, fluids and GI, neurologic care, injury prevention, oncology and safe pediatric medication.

When does a healthy infant double and triple the birth weight?
Birth weight roughly doubles by about 6 months and triples by about 12 months.
When do the fontanels close?
The posterior fontanel closes by about 2 to 3 months and the anterior fontanel by about 12 to 18 months.
Name the major gross motor milestones of the first year.
Head control by about 4 months, sitting without support by about 6 to 8 months, crawling around 9 months, and walking around 12 to 15 months.
What are Erikson's stages from infancy through adolescence?
Trust versus mistrust in infancy, autonomy versus shame and doubt in toddlerhood, initiative versus guilt in the preschool years, industry versus inferiority in school age, and identity versus role confusion in adolescence.
What are Piaget's stages of cognitive development?
Sensorimotor from birth to about 2 years, preoperational from about 2 to 7, concrete operational from about 7 to 11, and formal operational from about 11 onward.
Why is a toddler's negativism developmentally normal?
Saying no and resisting help are expressions of the drive for autonomy, which is the central task of toddlerhood.
What is magical thinking and how does it affect a preschooler in the hospital?
Preschoolers believe thoughts can cause events, so a child may conclude that illness or a procedure is punishment for something they did or wished.
What matters most to a school age child during hospitalization?
Competence and mastery, so involving the child in care and preserving schoolwork and peer contact supports the industry stage.
What are the priorities when caring for a hospitalized adolescent?
Privacy, peer contact, honest information, and as much control over decisions as their development and the law allow.
What are the three phases of separation anxiety in a hospitalized young child?
Protest with crying and clinging, despair with withdrawal and sadness, and detachment where the child appears to have settled but is disengaged.
How does play change with age?
Solitary play in infancy, parallel play alongside others in toddlerhood, associative play in the preschool years, and cooperative play with rules in school age.
What are the expected language milestones of early childhood?
Babbling by around 6 months, a few words around 12 months, two word phrases around 2 years, and speech that strangers can mostly understand by about 3 years.
How is a child prepared for a procedure at different ages?
Infants and toddlers are prepared just before, with a parent present; preschoolers a short time ahead with simple concrete words and play; school age children a day or so ahead with explanations of what they will feel; adolescents further ahead with full information.
When do the first teeth usually appear and how are they cared for?
The first teeth typically erupt around 6 months, and the first dental visit is recommended by about the first birthday.
Why do young children develop airway obstruction more easily than adults?
Their airways are shorter and narrower, the tongue is relatively large, cartilage is softer, and the same amount of swelling narrows a small airway far more.
How does croup present and how is it managed?
Viral laryngotracheobronchitis causes a barking cough, inspiratory stridor and hoarseness, usually worse at night, and is treated with corticosteroids and, when severe, nebulized epinephrine.
What must never be done when epiglottitis is suspected?
Do not inspect the throat or insert anything into the mouth, because that can trigger complete airway obstruction.
How is bronchiolitis from respiratory syncytial virus managed?
With supportive care: nasal suctioning, hydration, oxygen for hypoxemia, and contact precautions; bronchodilators and steroids are not routinely effective.
What do the asthma action plan zones mean?
Green means good control at roughly 80 to 100 percent of personal best peak flow, yellow means caution at about 50 to 79 percent, and red means a medical alert below about 50 percent.
What are the nursing priorities in cystic fibrosis?
Airway clearance, pancreatic enzyme replacement with all meals and snacks, and a high calorie high protein diet with added salt.
What are the signs of foreign body aspiration in a child?
Sudden coughing, choking or gagging in a previously well child, sometimes followed by wheeze, stridor or decreased breath sounds on one side.
What are the postoperative bleeding signs after a tonsillectomy?
Frequent swallowing, restlessness, pallor, tachycardia and vomiting bright red blood.
What does grunting indicate in an infant?
The infant is generating their own positive end expiratory pressure against a closed glottis, which signals significant respiratory distress.
What are the safe sleep recommendations for infants?
Place the infant on the back on a firm flat surface with no pillows, bumpers or loose bedding, share a room but not a bed, and avoid smoke exposure.
How does acute otitis media present in a young child?
Ear pain with pulling at the ear, fever, irritability and poor feeding or sleep, with a bulging red tympanic membrane on examination.
Acyanotic vs cyanotic congenital heart defects
Acyanotic defects shunt blood from the left side to the right and cause pulmonary overcirculation and heart failure; cyanotic defects allow deoxygenated blood to reach the systemic circulation and cause hypoxemia.
How does a ventricular septal defect affect the infant?
Blood shunts from the left ventricle to the right, increasing pulmonary flow and causing a loud murmur, tachypnea, poor feeding and slow weight gain; many small defects close on their own.
What is a tet spell and what is the first nursing action?
A hypercyanotic episode in tetralogy of Fallot with sudden deep cyanosis and irritability; the first action is to place the infant in a knee to chest position, then give oxygen and calm the child.
What examination finding suggests coarctation of the aorta?
Blood pressure higher in the arms than the legs, with bounding upper extremity pulses and weak or absent femoral pulses.
How is a patent ductus arteriosus managed in a preterm infant?
With fluid management and a prostaglandin inhibitor such as indomethacin or ibuprofen to promote closure, and surgical or catheter closure if that fails.