Pedi Module 1

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hoving22
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132867
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Pedi Module 1
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2012-02-05 22:05:23
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3614 Pedi Module
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  1. measurements of the prevalence of a specific illness in the population at a particular time, generally presented as rates per 1,000, may denote acute illness, chronic disease, or disability, increasing morbidity occurs in homeless children, children living in poverty, LBW children, children with chronic illness, foreign-born adopted children, and children in daycare centers
    morbidity
  2. the incidence or number of individuals who have died over a specific period, generally presented as rates per 100,000
    mortality
  3. the number of deaths during the first year of life per 1,000 live births
    infant mortality rate
  4. the number of deaths during the first 28 days or less of life
    Neonatal mortality
  5. the number of deaths during 28 days to 11 months of life
    Postneonatal mortality
  6. caring, well-defined boundaries separate the nurse from the child and family, boundaries are positive and professional and promote the family’s control over the child’s health care, open communication is maintained
    Therapeutic relationship
  7. recognizes the family as the constant in a child’s life, health care personnel must support, respect, encourage, and enhance the strength and competence of the family by developing a partnership with parents
    family-centered care
  8. professionals enable families by creating opportunities and means for all family members to display their current abilities and competencies and to acquire new ones to meet the needs of the child and family
    enable family centered care
  9. describes the interaction of professionals with families in such a way that families maintain or acquire a sense of control over their family lives and acknowledge positive changes that result from helping behaviors that foster their own strengths, abilities, and actions
    empowerment of family centered care
  10. -attachment to parent
    -stranger anxiety
    -sensorimotor phase of learning
    -increased m. control
    -imatation of gestures
    expected behavior of an infant during procedure
  11. -egocentric thought (explain procedure from tactile perspective)
    -negative behavior-animism (keep frightning objects out of view)
    -limited language skills
    -limited concept of time
    -striving for independence
    expected behavior of a toddler during procedure
  12. -egocentric thought
    -increased language skills
    -limited concept of time and frustration tolerance
    -illness and hopsitalization viewed as punishment
    -animism-fears of bodily harm
    -striving for initiative
    expected behavior of a preschooler during procedure
  13. -concrete thought
    -interest in acquiring knowledge
    -improved concept of time
    -increased self control
    -desires participation
    -developing relationships with peers
    expected behavior of a school age during procedure
  14. -abstract thought, want explanations
    -conscious of appearance
    -concerned with present rather than future
    -striving for independence
    -developing peer relationships
    expected behavior of an adolescent during procedure
  15. interval scale that includes five categories of behavior

    what are the five? and how are they scored?
    FLACC pain assessment tool

    For ages 2 months - 7 years

    • Facial expression
    • Leg movement
    • Activity
    • Cry
    • Consolability

    each valued 0-2 for a possible total of 10
  16. Reaction of parents to child's illness
    • -seriousness of the threat to the child
    • -previous experience with hospitalization
    • -procedures involved in dx and tx
    • -available support system
    • -personal ego strengths
    • -coping abilities
    • -additional stresses on family
    • -cultural and religious beliefs
    • -communication patterns among family
  17. Infants during assessment
    • -quiet when cuddled, patted, and other physical contact
    • -respond to gentle handling, quiet, calm speech
    • -more at ease upright than horizontal and with parents visable
    • -gain cooperation using distraction
  18. early childhood children during assessment
    • -let them touch and examine equipment
    • -keep unfamiliar equipment out of view until needed
    • -let them play with BP bulb
  19. school aged children during assessment
    • -prefer child to sit
    • -explain purpose of equipment and significance of procedure, teach about body function and care
  20. Adolescence aged children during assessment
    • -give the option of parent being in room
    • -sitting position
    • -respect privacy, explain findings, emphasize what is found and what is normal
  21. Physical development

    weight changes the first six months
    gain 5-7 ounces weekly until 5-6 months

    weight gain slows second 6 months
  22. Physical development

    1 month
    gain 1 inch monthly first 6 months

    head circumference increases 1.5 cm monthly first 6 months

    reflexes present and strong, obligatory nose breathing
  23. Physical development

    2 months
    posterior fontanel closed

    crawling reflex disappears
  24. Physical development

    3 months
    primitive reflex fading
  25. Physical development

    4 months
    drooling begins

    moro, tonic and rooting reflexes disappeared
  26. Physical development

    5 months
    begining signs of tooth eruption

    birth weight doubles
  27. Physical development

    6 months
    growth rate declines

    weight gain 3-5 ounces weekly for next 6 months

    teething may begin

    chewing and biting occur
  28. Physical development

    7 months
    eruption of upper incisors
  29. Physical development

    8 months
    begins to show regular patterns in bladder and bowel elimination
  30. Physical development

    9 months
    eruption of upper lateral incisor
  31. Physical development

    10 months
    able to raise head
  32. Physical development

    11 months
    eruption of lower lateral incisor
  33. Physical development

    12 months
    birth weight triples

    length increased by 50%

    head and chest circumfrence is equal

    has 6-8 teeth

    anterior fontanel almost closed
  34. Physical development

    15 months
    steady growth in ht and wt

    head circumfrence 48 cm

    wt 11 kg

    ht 78.7 cm
  35. Physical development

    18 months
    picky eaters

    anterior fontanel closed

    able to control sphincters
  36. Physical development

    24 months
    head circumference 49-50 cm

    chest circumference exceeds head

    gain 4-6 lbs per year

    grow 4-5 in per year

    beginning daytime control of elimination
  37. Physical development

    30 months
    birth weight quadrupled

    primary dentition of 20 teeth completed
  38. Physical development

    Pre-schoolers

    (avg wt of 3,4,5 yr olds)
    rate of growth slows

    • avg wt:
    • 3 yrs- 14.5
    • 4 yrs- 16.7
    • 5 yrs- 18.7
  39. Physical development

    accomplishments of a 3 yr old
    grow about 3 in a yr

    ride a tricycle

    catch a ball

    build towers of 6-9 blocks

    stand on one foot, walk on tip toes, jump horizontally

    paint in circular and horizontal motions
  40. Physical development

    accomplishments of a 4 yr old
    run on tip toes, gallop, pump on a swing, hop on one foot, begin to skip

    throw a ball overhand, small m. control

    can make representational pictures

    can dress and undress themselves

    cut a line with scissors

    active and aggressive in their play
  41. Physical development

    School aged child
    gain 4-7 lbs per year

    baby teeth begin to be lost

    girls develop secondary sex characteristics and begin menstruation
  42. Physical development

    School Aged child

    6 years old
    ht and wt gain slowly

    loses first tooth

    constantly active

    hand as a tool

    vision reaches maturity
  43. Physical development

    School Aged child

    7 years old
    grow at least 2 in

    weight 17.7-30 kg

    more cautious

    jaw expands to accomodate permanent teeth
  44. Physical development

    School Aged child

    8-9 years old
    grow 2 in per year

    weight 19.5-39.5 kg

    uses cursive writing

    dresses self completely
  45. Physical development

    School Aged child

    10-12 years old
    weight 24.5-58 kg

    height 127-162.5 cm

    remainder of teeth will erupt

    • girls: puberty changes may occur
    • boys: slow growth in height, rapid wt gain
  46. Physical development

    Adolescents
    development of secondary sex characteristics

    fluctuations of wt

    all teeth are perminent

    heightened emotions, puberty
  47. Weight measurement accuracy for growth assessment
    infants: nearest 10g

    children: nearest 100g
  48. general growth should be between __ and __ percentile for ht, wt, and head circumference
    5th and 95th
  49. 6 month old average weight is ___
    7.3 kg
  50. 1 year old average weight is ___
    9.75 kg
  51. 6 month old average ht is ___
    65 cm
  52. 1 year old average height is ___
    74 cm
  53. average head circumference at 6 months age is ___
    46 cm
  54. averages for a 2 year old:

    ht-___
    wt-___
    ht-86..6 cm

    wt-12kg
  55. average for a 6 year old

    wt-__
    ht-__
    wt-21kg

    ht-116cm
  56. averages for a 12 year old

    wt-__
    ht-__
    wt- 40kg

    ht- 150cm
  57. age of even head molding, occipital prominence, systemic facial features and a fused suture
    18 months
  58. Freud's 5 stages of growth and development in order:
    -Anal

    -Phallic

    -Latency

    -Genital
  59. Erikson's 5 stages of growth and development in order:
    1.trust vs. mistrust

    2.autonomy vs. shame and doubt

    3.initiative vs. guilt

    4.industry vs. inferiority

    5.identity vs. role confusion
  60. Piaget's 5 stages of growth and development in order:
    1.sensorimotor (birth-2yrs)

    2.peroperational thought, preconceptual phase (transudctive reasoning) (2-4 years)

    3.preoperational thought, intuitive phase (transductive reasoning) (4-7 years)

    4.concrete operations (inductive reasoning and beginning logic) (7-11 years)

    5.formal operations (deductive and abstract reasoning) (11-15 years)
  61. age when stranger anxiety is greatest
    6-8 months
  62. walk alone using a wide stance for extra balance
    12-13 months
  63. try to run but fall easily
    18 months
  64. refinement of upright position to improve coordination and equilibrium
    2-3 years
  65. walk up and down stairs
    2 years
  66. jump using two feet
    2.5 years
  67. climb stairs with alternate foot
    2
  68. walking, climbing, jumping
    36 months
  69. skips and hops on one foot and catches ball reliably
    4 years
  70. skips on alternate fee and jumps rope

    begins to skate and swim
    5 years
  71. primary form of dehydration in children, occurs when e- and water deficits are present in near balanced proportions, no osmotic force between ICF and ECF. Na level remains between 130-150mEq/L
    isotonic (isosmotic or isonatremic)
  72. occurs when e- deficit needs exceeds the water deficit, leaving serum hypotonic. ICF is more concentrated than ECF and water moves from ECF to ICF to establish equilibrium. tends to be more severe Na level is less than 130mEq/L
    hypotonic (hyposmotic or hyponatremic)
  73. results from water loss in excess of e- loss and is usually caused by proportionately larger loss of water or larger intake of e-. most dangerous and requires more specific fluid. Na is greater than 150mEq/L
    hypertonic (hyperosmotic or hypernatremic)
  74. three principles in providing atraumatic care
    -prevent childs seperation from family

    -promote sense of control

    -prevent bodily injury and pain
  75. considered to be the leading cause of neonatal death in the US
    LBW
  76. the leading cause of death in children over 1 year (mostly MV)
    injuries
  77. ____ and ____ are important determinants in the prevalence of injuries at a given age
    developmental stage and environment
  78. follows light to midline at ____mo
    1 month
  79. posterior fontanel closes and crawling reflex disappears at ___ mo
    2 months
  80. at 2 mo, infants need ___ to help prevent ricketts and vit d deficiency
    200 units of vit d
  81. at 2-3 mo it is common for a child to have ___ ___ as a result of hematopoetic changes
    physiologic anemia
  82. primitive reflexes begin to fade at ____ mo
    3 months
  83. visual acuity- binoculr (fusion) develops at ___, and well est at ___
    develops at 6 weeks

    est at 4 months
  84. drooling begins, moro, tonic neck and rooting reflexes have disappeared at ___ mo
    4 months
  85. ___ begins at 4 mo b/c of poorly coordinated swallow refelx

    digestive process begins
    drooling
  86. the infant should be transitioned to solid foods around ___ mo
    4-6 months
  87. which of the following characteristics best describes fine motor skills of a 5 mo old infant
    able to grasp object voluntarily
  88. maternal iron stores are present in the newborn for ___ mo
    5-6 months
  89. at __ mo able to roll; back to abd.

    at __ mo able to roll; abd to back
    5 months

    6 months
  90. age which chewing and biting occur
    6 months
  91. any child who displays head lag at __ mo should have a dev. and neuro eval
    6 months
  92. teething may begin w/ eruption of lower central incisors at ___ mo
    6 months
  93. infants gain __ oz weekly until approx 6 mo
    5-7 oz
  94. seperation anxiety becomes prominent when attachtment has happend around __ mo
    6-8 months
  95. depth perception of an infant develops at __ mo
    7-9 months
  96. reg patterns in bladder and bowel elim and parachute reflex appears
    8 months
  97. at ___ mo old, the infant is able to comprehend meaning of "no" and obey simple commands
    9-10 months
  98. anterior fontanels almost closed, lumbar curve develops and babinski reflex disappears at ___ mo
    12 months
  99. at 1 yr, infants wt has ___
    tripled
  100. voluntary control of the anal and urethral sphincters is achieved by age ___
    2 years
  101. potty training should begin b/w ___ and ___ mo

    girls are ready ___ to ___ mo before boys
    1.5-2 years

    2-5 months
  102. primary dentition complete at ___ mo
    30 months

    20 teeth
  103. the measurement of ht, wt, head circumference, proportions, skinfold thickness, and arm circumference in young children
    anthropometry
  104. fever in infants less than 3 months is ___
    100.4
  105. fever in infants 3 to 36 months of age is ___
    102
  106. fever in children older than 3 years old is ___
    104

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