Peds chapter one review

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Peds chapter one review
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  1. Who was Lillian Wald
    a nurse who was interested in the welfare of children, and is credited with suggesting the establishment of a Federal Childrens Bureau. (est. 1912)
  2. Who is credited with first suggesting the establishment of a federal childrens bureau?
    Lillian Wald
  3. The Children's Bureau was established in the year ______and focused its attention on the problem of  _________.  This program was followed by one focused on ___________. these programs eventually led to the ____________ in _________.
    • 1912
    • infant mortality
    • maternal mortality
    • birth registration in all states.
  4. in the 1930's the Childrens Bureau investigations led to what
    the development of hot lunch programs in many schools.
  5. Today the Childrens Bureau is administered under the auspices of who
    the depaartment of health, and human services.
  6. Define Culture
    a body of socially inhereted characteristics that one generation hands down to the next. ((consists of values, beliefs, and practices shared by members of the group))
  7. Define Culture awareness
    a consious awareness of the cultural values, beliefs, and preseptions of one's self and others.
  8. Define cultural sensativity
    an understanding of and sensativity to cultural practices that differ from ones own.
  9. Define cultural conpetence
    a quality, attained by cultural awarness and sensativity, that enables health care providers to adapt practices to meet the  needs of patients from various cultures
  10. One way in which a nurse can gain imporntant information about  an individuals culture is to ask the pregnant woman
    what she considers normal practice
  11. there were 6 sample questions in the book about what a nurse could ask a pregnant mother in order to collect data about her culture. what were they
    • 1 - how does the woman view her preganancy? (as an illness, a vulnerable time, or a healthy time )
    • 2 - Does she view the birth process as dangerous?
    • 3 - in what position does she expect to deliver? (squating, lothotomy, or some other position?)
    • 4 - What type of help doed she need before, and after delivery?
    • 5 - What role does her immediate, and extended family play in relation to the pregnancy, and birth?
  12. T or F
    Culture and society have a weak influence on family and child care
    F - strong
  13. the cultural background play an imporntant role in its members ______________________________.
    adaptation to the birth experience.
  14. What is the nursing process? when was is developed?
    developed in 1963 The nursing process refers to the searies of steps describing the process nurses use to identify, prevent or treat actual or potential health problems.
  15. whar are the standards ( Steps ) to the nursing process?
    • 1 - assessment: Collection of patient data, both subjective, and objective.
    • 2 - Diagnosis: Analisis of data in terms of NANDA nursing diagnosis.
    • 3 - Planning: Preperation of a plan of care designed to achieve stated outcomes
    •    Outcomes identification: Identification of individualized expected patient outcomes.
    • 4 - implamentation: Carrying out of interventions identified in the care plan.
    • 5 - Evaluation: of outcome process and redesigning of the plan if nessisary.
  16. What is the nursing care plan?
    developed as a result of the nursing process It is a written insturment of communication among staff members that focusses on individualized patient care
  17. define Clinical Pathways -
    collabpritive guidelines that define multidissiplinary care in terms of outcomes within a timeline (Aka. Critical pathways, mare maps, or multidisiplinary action plans)
  18. Fundimentally what does a clinical pathaway do?
    it identifies expected process within a set timelline, and benchmarks by which to recognize this progress.......Clinical Pathways improve the quality of care and reduce unnessisary hospitialization time.
  19. What is a variance in a clinical pathway?
    when a daily goal for progress is not met, it is called a deviation or variance. these variances. if a goal is not achieved and time is lost it is known as a negative variance. negative varainces can delay discharge from hospitals.
  20. What is Critical thinking?
    purpodefull,goal-directed thinking based on scientific evedence rather than assumption or memorization. Critical thinking entails applying creativity, and ingenuity to solve a problem.
  21. What is the seven step process of critical thinking?
    • 1 - Identify the problem
    • 2 - Differentiate fact from assumption
    • 3 - Check reliability and accuracy of data
    • 4 - Determine relevent from irrevelant data
    • 5 - Identify possible conclusions or outcomes
    • 6 - Set prioritys and goals
    • 7 - Evaluate response of patient
  22. what is NIC?
    Nursing intervention classification specifies actions that nurses perform to help patients toward a specafied goal or outcome.
  23. What is NOC?
    Nursing outcomes classification Develpoed to identify outcomed of nursing care that are directly influenced by nursing actions
  24. What is Erikson's theory for the infancy stage?
    • Trust/Mistrust
    • Getting needs met
    • Tolerating frustration in small doses
    • Recognizing mother as distinct from others and self
  25. What is Piaget's developmental theory for Infancy?
    • Sensorimotor Stage (birth to 2 years) –
    • at birth, responses are limited to reflexes; begins to relate to outside
    • events; concerned with sensations and actions that affect self directly
  26. What is Kohlbergs developmentat theroy for the infancy stage?
    • Preconventional/premoral
    • – cannot distinguish
    • right from wrong
  27. What is Eriksons stage for the toddler stage?
    • Autonomy/Shame and doubt
    • Trying
    • out own powers of speech
    • Beginning acceptance
    • of reality versus pleasure
  28. What is Piaget's Thteory for the Toddler stage?
    • Preoperational (2 to 7 years) –
    • child is still egocentric; thinks everyone sees world as self does
  29. What is Kohlberg's developmental theory for the toddler stage?
    • Punishment/obedience – performance based
    • on fear of punishment
  30. What is Erikson's theory for the preschooler stage?
    • Initiative/guilt Questioning
    • Exploring
    • own body and environment
    • Differentiation of
    • sexes
  31. What is piaget's theory fot the preschooler stage?
    • Perceptual (4 to 7 years) –
    • capable of some reasoning but can concentrate on only one aspect of a situation
    • at a time
  32. What is Kholbergs' theory fot the preschooler stage?
    • Morality –
    • rules are absolute; breaking rules results in punishment; behavior based on rewards
  33. What is Kholbergs' theory fot the School-age stage?
    Conventional morality – rules are created for the benefit of all; adhering to rules is the right thing to do (7 to 11 years)
  34. What is Piaget's' theory fot the School-age stage?
    Concrete operations (7 to 11 years) – capable of some reasoning but can concentrate on only one aspect of a situation at a time
  35. What is Erikson's' theory fot the School-age stage?
    Industry/inferiority  Learning to win recognition by producing things Exploring, collection Learning to relate to own sex
  36. What is Erikson's' theory for the Adolescence stage?
    • Identity/role diffusion
    • Moving toward Heterosexuality. Selecting vocation. Beginning separation from family. Integrating personality
  37. What is Kohlberg's' theory for the Adolescence stage?
    • Principled morality (autonomous stage)
    • (12 years on) – acceptance of right or wrong on basis of own perceptions of world and personal conscience
  38. What is Piaget's' theory for the Adolescence stage?
    • Formal Operations (11 to 16 years) –
    • acquires ability to develop abstract concepts for self; oriented to problem solving
  39. Cephalocaudal development
    proceeds from head to toe. The infant is able to raise the head before being able to sit, and he or she gains control of the trunk before walking
  40. Proximodistal development
     – proceeds from midline to the periphery. Development proceeds from the center of the body to the periphery. These patterns occur bilaterally.
  41. Height v.s Length
    • Height – refers to standing measurement, whereas length
    • refers to measurement while the infant is in recumbent position.
  42. Average newborn birth length
    50cm (20 inches).
  43. How does an infant grow (length)
    The length of the infant usually increases about 2.5 cm (1inch) per month for the 6 months. By age 1 year, the birth length increases by 50%
  44. how does babies' weight change in the first few days of life?
  45. The length of the infant usually increases about 2.5 cm (1inch) per month for the 6 months. By age 1 year, the birth length increases by 50% 
    The infant usually regains his or her birth weight by age 10 to 12 days.
  46. How does babies weight change for the first year?
    Birth weight usually doubles by age 5 to 6 months and triples by age 1 year.
  47. How does babies weight change after the first year?
    • After the first year, weight gain levels off to approximately
    • 1.81 to 2.72 kg (4 to 6lbs) per year, until the pubertal growth spurt begins
  48. What are Growth standerds?
    • Growth is measured in dimensions such as height,
    • weight, volume, and thickness of tissues. 
    • A number of standards have been developed to make it possible to compare
    • 1. The measurement of a child to others of the same age and sex, and
    • 2. The child’s present measurements with the former rate of growth and pattern of progress.     
    • Length refers to horizontal measurement; it is used before achild can stand, usually from birth to 2 years.
    • Height is measured with the child standing, usually between 2 and 18 years.
    • Some pointers in reading and interpreting growth charts are as follows:
    • Children who are in good health tend to follow a consistent pattern of growth
    • At any age there are wide individual differences in measured values
  49. Deciduous teeth
    • Development of the 20 deciduous, or baby, teeth begins at about the first month of intrauterine life. The health and diet of the expectant mother affect their soundness. Primary teeth erupt during the first 2.5 years of life. It is a normal process and is generally accompanied by little or no discomfort. 1st tooth generally appears at about the sixth or seventh month. The 1 year old has about 6 teeth four about and two
    • below.
  50. Permanent teeth
    • The 32 permanent teeth develop just before birth
    • and during the first year of life. They do not erupt through the gums, however
    • until the sixth year. Nutrition and general health during the first year of life affect the
    • formation on permanent teeth. This process is completed until the wisdom teeth
    • appear at about age 18 to 25 years.
  51. Formula to asess the number of in a child under 2 years of age
    age in minths - 6
  52. What is Explore, imitate play?
    • found in infants
    • Provide visual stimuli for newborns; touch
    • stimuli for infants, and toys involving manipulations for 1-year-olds
  53. What is Parallel play?
    • occurs in 1 to 2 year olds
    • Children play next to each other but with each
    • other. Provide each child with toys that reflect activities of daily living
  54. What is Cooperative play and Creative play?
    • Occures in 3 to 5 year olds
    • Children play with each other, each taking a specific roll: You be the mommy and I’ll be the daddy.”
    • A simple box can
    • become a train to a 3-year-old
  55. What is Symbolic group play; secret clubs
    • Occures in 5 to 7 year olds
    • Secret codes, “Knock-Knock” jokes, and rhymes
    • are popular at the age
  56. What is Competative play?
    • Occurs in 7 to 10 year olds
    • Children at this age start to accept competition
    • with structured rules and highly interactive physical activity
  57. What is Group sports and explorative. Internet activities or computer games
    occures in 10 to 13 year olds ------ internet should be supervised
  58. What is fantacy play; cliques
    • 13 to 18 year olds
    • Leadership activities such as baby-sitting or tutoring are popular.
    • Daydreaming occurs.
    • Board games are popular.
    • Interactive social activities
    • in “cliques” occur at and after school
  59. When i sit recomended that children are started on solid foods? and why
    6 months is recommended because this is when the tongue extrusion reflex has completely disappeared and the gastrointestinal tract is mature enough to digest foods. Parents should be instructed to read the labels on the jars to obtain nutrition information
  60. how should solid food be offered at first?
    Offer only small amounts at first (1 teaspoonful). A small amount of food is placed on the back of the tongue
  61. Guidelines to adding new foods
    • Only one new food isoffered in a 4-day to 1-week period to determine tolerance.
    • IF the infant refuses a certain food, it is temporarily omitted. Mealtime is kept pleasant
    • New foods should not be introduced when the
    • infant is ill because adverse responses may not be effectively assessed.
    • Offer new foods BEFORE milk feedings
  62. Which foods are consdered allergenic to new eaters
    • Highly allergenic foods that may be delayed
    • include orange juice, fish, nuts, strawberries, chocolate, and egg whites *honey should also be ommited for the first year -- not because of allergy issues but to prevent the development of botulism.
  63. Extrusion reflex
    • (protrusion of the tongue), which pushes food out of the
    • mouth to prevent intake of inappropriate food, disappears. after about the fourth month.
  64. guidelines for determineing adequate feeding:
    • 1 - the infant has gained 4 to 7 oz per week for the first 6 months
    • 2 - the infant has at least six wet diapers per day.
    • 3 - the infant sleeps peacfully for several hours after feedings.
  65. lengths between feedings bottle feeding vs. breastfeeding
    bottle feedings 3 - 4 hour intervals, breast feeding, 2 - 3 hour intervals.
  66. babies stomach capacity
    10 to 20 mL at birth, 200 mL by twelve months.
  67. By 6 months, the digestive system can handle more _______________ and it is less susceptible to food __________.
    complex nutrients , allergens
  68. prevention of SIDS
    infants should be positioned for sleep on their backs and on a firm mattress, both for their safety and to prevent sudden infant death syndrome (SIDS).....((((comforters, pillows, quilts, loose bedding, thick pillow like crib bumpers can endanger a child in a crib)))))
  69. Benchmarks of locomotion, 1 - 15 months
    • 1 month  :Chin up
    • 2 months :Chest up - Elevates self with arms
    • 4 months :Rolls over at will
    • 5 months :Sits alone, momentarily
    • 6 months :Sits alone steadily with hands forward for support
    • 8 months :Sits with  support. Pulls to standing positon
    • 9 months :Creeps
    • 10 months :Walks whenled
    • 11 months :stands alone from standind position
    • 12 months :Walks 3 steps
    • 15 monthd :Can walk up stairs with support
  70. Voluntary control of anal and urethral
    sphincters begins at about __________ months
    18 to 24
  71. The child’s ____________ in the morning or from
    naptime is an indication of ________.
    waking up dry, maturity
  72. A ___________ may make the toddler feel more
    secure because it is small
    potty-chair
  73. two indications that it may be a good time to potty train
    • 1 - when the toddler stays dry for about 2 hours at
    • a time
    • 2 - when the parrent discover that the toddler has gone the entire night without wetting
  74. Most children continue to have occasional
    accidents until ___________.
    age 4 years
  75. If the toddler has a mishap.....
    parents should accept it matter-or-factly and merely change the clothes. Children benefit when adults show continuous affection to them and accept both bad and good days.
  76. IN Erikson’s stage of autonomy versus shame and
    doubt, (toddler years) there are tasks to be mastered, name a few
    • including toilet training, self feeding, self
    • dressing and speech development.
  77. two major challanges for parents of toddlers who are learning atonomy vs. shame and doubt are..
    • 1 - One major parental responsibility is to maintain safety whileallowing the toddler the opportunity for social and physical independence.
    • 2- Another major parental responsibility is to maintain a positive self-image andbody image in the child whose behavior is inconsistent and often frustrating.
  78. reasons a toddler may experience inability to seporate;
    • 1- Inadequate establishment of self - concept, leading to lack of confidence, even in unfamiliar environments
    • 2 - Uses protest of seporation as a manulipitive control device.
    • 3 - fear of being abandoned
  79. parental guidence for parents of chiildren who experience inability to seporate
    • 1- prepare toddler for anticipated seporation
    • 2 - refer to toime using concrete terms, like "I will be home after lunch" instead of " I will be home at one"
    • 3 - Avoid radiating personal anxiety, at planned seporation
    • 4 - Spend time with toddler in a new inviorment, or with a new caregiver before leaving.
  80. Language benchmarks 3 years
    • Has vocabulary of approximately 300 – 800 words.
    • Uses plurals
    • Forms three-word sentences
    • Can repeat three numbers
    • Understanding occurs
    • before expressive ability
  81. Language benchmarks 4 years
    • Has vocabulary of 1500 words.
    • Uses four to five word sentences
    • Experiments with language and words
    • May use offensive words without understanding the meaning
  82. Language benchmarks, 5 years
    • Has vocabulary of 2000 words
    • Can name four colors
    • Uses six to eight
    • word sentences with pronouns
  83. Play Benchmarks 3 years
    • Kohlberg: beginning moral development.
    • Identifies with same-sex parent.
    • Develops understanding of good/bad.
    • Explains different emotions in pretend play
    • Starts to engage in group play
    • Is highly imaginative
  84. Play benchmarks 4 years
    • Engages in rough and tumble play.
    • Learns how much he or she can control.
    • Demonstrates sibling rivalry
  85. Play benchmarks 5 years
    • Wants to play by rules but cannot accept losing
    • Can copy sample shapes and print first name.
    • Establishes preference for hand use
  86. Pre  - adolescence 10 year olds - stuff
    • 10yrs marks the beginnning of pre adolescence
    • - girls are phisically more mature thatn boys
    • - the child begins to show self direction, is curtious to adults, and thinks clearly about social problems and predijuces.
    • - resents being told what to do, but is receptive to sudjestions
    • - the ideas of the group are more imporntatnt than that of the individual.
    • - interest in sex, and sexual curiosity continues
    • - they can wright  fo rlong periods of time, mantaning a good writing speed, uses fractons and knows abstract numbers
    • - begin to identify themselves with skills that pertain to their sex role.
    • - intollerent of oppasit sex
    • - take more interst in personal appearence
  87. 11 and 12 year olds
    • - intense, obervant, all-knowing, energetic, meddlesome, and arguementative. a period of complete disorginization.
    • - Before the end of this period, the hormones in the body start to influence physical growth.
    • - 24 to 26 perminant teeth.
    • - preoccupied, drop in grades
    • - cant bear the though tof dependance yet cant quite stand alone.
    • - boys and girls tend to "ignore the oppasit sex, but are verry much aware of them
  88. Latchkey Children
    Children who are left unsupervised after school because parents are away from home, or at work, an d extendes family is not avaliable to care for them. --Higher rate of accidents, and at high risk for feeling isolated and alone.
  89. Puberty
    The stage in which the reproductive organs becomefunctional, and secondary sex charecteristics develop.
  90. Growth Spurt
    period of growth during adolescence whenthe final 20% of height occures
  91. asynchrony
    different body parts mature at different rates ...think gaingley
  92. Body Image
    • - Imagionary audience they believe that everyone is lookong at them....which accounts for thir constant combing, and fixing of makeup seen among adolesence.
    • - some young adolesence may try to hide their changing body, or may try to advertize it.
    • - early adolesence try to be like their peers, late adolesences enjoy their individual skills.
  93. parenting teens effective approaches to problems.
    • - Reflective Listening - i.e the restate
    • - "i" message - communicating your feelings about adolesent behavior by telling hem how it effects you. " "when ..... I fell...."
    • - Exploring alternatives - helping them solve problems on their own
    • - Natural and logical consiquences - Permiting (within limits) the adolesent to decide how they will behave and allowing them to experience the cosiquences.
  94. what is the nursing roll for homosexual adolesents?
    not to change homosexual behaviors, but to help the child cope with the reaction of others
  95. what is the risk for dential caries in adolesence
    increased, because of inadequate dental mantinence, and frequent snacking on candies.
  96. When dential hygene is neglected the period of greatest tooth decay in the perminant teeth is from ages_____________.
    12 to 18 years.
  97. young people with un attractive teeth may suffer from ________
    low self esteem
  98. Temper
    tantrums norms
    • Tantrums peak at age 2 years, decreasing in frequency and intensity until they rarely occur by about 4 years of age
    • Tantrums usually occur in response to the frustrated desires of a child, such as wanting a toy that cannot be purchased.
  99. Factors that contribute to tempertantrums
    • Used as a manipulative device to gain
    • control of parental behavior.
    • Insufficient positive interaction with adults, leading
    • to use of tantrums to gain attention
  100. Parential guidence for temper tantrums
    • Use simple explanations of behavior
    • expectations.
    • Use “time-out” responses (1 minute per
    • year of age)
    • Maintain consistency of expectations
    • from both parents

    Reward good behavior

    • Use simple explanations of behavior
    • expectations.
    • Use “time-out” responses (1 minute per
    • year of age)
    • Maintain consistency of expectations
    • from both parents
    • Reward good behavior
  101. Toilet training norms
    • Child has full physiological capacity
    • for day control by age 3 years, night control by age 4 years.
    • Daytime and nighttime “accidents” occur
    • throughout early childhood, decreasing in frequency by age 4 years.
    • Regression occurs with environmental or social
    • changes, such as arrival of sibling, moving or divorce.
  102. Factors contributing to problems with toilet traing, and bed wetting
    • Fears and anxiety in response to
    • negative toilet training.
    • Used as an attention-getting device if
    • positive means of gaining attention are lacking
    • May use constipation as a control
    • mechanism
    • Excessive fluid intake before bedtime
  103. parental guigence for  problems with toilet traing, and bed wetting
    • Use positive rewards for successful
    • toileting and ignore accidents.
    • Recognize signals of need to use
    • toilet.
    • Restrict fluids before bedtime.
    • Use clothing that toddler can easily remove for
    • self-toileting.
  104. norms of Aggressive
    or quarrelsome behavior, sibling rivalry
    • Ability to play cooperatively begins to
    • emerge at 3-5 years.
    • Before this age, the child is seldom
    • able to share toys and often wants toys that another child has.
    • There is a predominant use of physical hitting and
    • shoving to express displeasure; verbal abilities begin to emerge
  105. contributing factors for problems related to Aggressive
    or quarrelsome behavior, sibling rivalry
    • Insufficient positive adult attention,
    • leading to deliberate use of aggression to gain adult attention.
    • May arise from actual or perceived adult preference
    • for sibling or playmate
  106. parenting guidence for Aggressive
    or quarrelsome behavior, sibling rivalry
    • Prepare toddler for the separation and
    • change involved in the arrival of a new sibling.
    • Provided for any changes involved 1-2
    • months before arrival of sibling
    • Provide toddler with doll to imitate parental
    • behaviors. Provide for special individual time with toddler each day
  107. norms about Inability
    to separate, excessive shyness
    • Child can separate easily by age 3
    • years if surroundings are consistent, predictable and positive.
    • Child continues to protest separation
    • if environment changes or if confronted by total strangers.
    • Child is shy in new and strange surroundings but
    • relaxed and spontaneous in familiar surroundings
  108. contributing factors to problems with Inability
    to separate, excessive shyness
    • Inadequate establishment of
    • self-concept, leading to lack of confidence, even in familiar surroundings.
    • Uses protest of separation as a
    • manipulative control device
    • Fear of being abandoned
  109. parental guidence for problems related to Inability
    to separate, excessive shyness
    • Prepare toddler for anticipated separation.
    • Refer to time using concrete terms
    • Avoid radiating parental anxiety at the
    • planned separation.
    • Spend time with toddler and in new environment or with
    • new caregiver before leaving

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