Pediatrics Developmental Stages and Common Health Issues: A Comprehensive Study Guide, Exams of Nursing

Download Pediatrics Developmental Stages and Common Health Issues: A Comprehensive Study Guide and more Exams Nursing in PDF only on Docsity! Pediatrics Final Exam Study Guide For each developmental stage: (Infant, Toddler, Preschool, School age, & Adolescent)  The concept of death: - SCHOOL AGE: By age 10 = view death as inevitable, universal and permanent  Anticipatory guidance education for parents School Age: - Involved in sports, they are out playing – SAFETY! Helmets & knee pads - They are trying to do more, want to do everything, concerned about success - They are going to start to go through puberty – don’t go into detail, just give basic information! Adolescent: - Normal for them to be distant, parent will not understand - Good time to talk is in the car b/c they can’t go anywhere (uninterrupted) - Be non-judgmental (any strategy to increase communication) - Be calm before responding - Allow friends to come to hospital - Talk about driving with adolescent (texting & driving, seatbelts) - Water safety is important!  Care of Hospitalized Patient: Hospitalized School Age Child - Understands the reason for hospitalization & what will happen - Worried about pain or changes that may occur to his or her body - Be open & honest with school-age child . LEWIS PEDS FINAL SG . Pediatrics Final Exam Study Guide - May regress to behaviors of a younger child (needing comfort toys or demanding attention from parents) - Nurse must provide opportunities for the school-age child to MAINTAIN INDEPENDENCE, GAIN CONTROL, & increase self-esteem! - Bring their homework to them when they are in the hospital  will develop inferiority if they are not passing their classes/missing school Hospitalized Adolescent: - Adolescent is concerned about how the illness or injury will affect his or her body image - They are fearful b/c they understand what is going on - Fears pain & loss of privacy - May experience anxiety about being separated from friends & loss of control - Nurse: provide opportunities for independence, participation in decisions, & encourage socialization with friends through phone, e-mail, & visits when possible - Infant (1 month-1 yr.)  “Trust vs. Mistrust” ▪ Parent has significant impact on infant’s sense of trust. When infant’s needs are consistently met, infant develops sense of trust. If parent is inconsistent in meeting needs in a timely manner, infant develops mistrust. - Toddler (2-3 yrs)  “Autonomy vs. Shame & Doubt” ▪ Learning to do things for themselves (autonomy) ▪ Feelings of doubt about independence ▪ Favorite response = “NO” • “negativism” = normal part of health development; result of asserting independence - Preschool (4-6 yrs)  “Initiative vs. Guilt” ▪ Magical thinking – take everything literally  Erikson’s Developmental Stages: Pediatrics Final Exam Study Guide controlled is finding of infection - Measure the head circumference daily Pediatrics Final Exam Study Guide Tonsillectomy post- op: - Excessive swallowing = sign of hemorrhage - Don’t give them anything red! No red popsicles!! - Review the common illnesses discussed in each age group such as:  Meningitis  Diabetes  Glomerulonephritis  Seizures/epilepsy  IBD  Musculoskeletal issues: *Scoliosis: lateral curvature of the spine that exceeds 10 degrees TX varies based on severity: - Mild = curve <15-20 degrees  monitor every 3-6 months until musculoskeletal maturity; in mild cases, bracing is only considered if the patient is symptomatic (function is affected) - Moderate = b/w 24-40 degrees (<40)  Milwaukee brace! ▪ Worn 23 hours a day to prevent curve progression ▪ Compliance issues w/ many adolescents – d/t discomfort, pain, heat, poor fit, & teens are concerned with body image - Severe = curve > 40 degrees  requires SX correction; involves rod placement and bone grafting (spinal fusion)  JRA: Juvenile Rheumatoid Arthritis (JRA): - autoantibodies mainly target the joints (some forms affect the eyes & other organs) - Joint pain, redness, warmth, stiffness & swelling Pediatrics Final Exam Study Guide - Stiffness usually occurs after inactivity (in the morning, after sleep) - Chronic disease – child may have healthy periods & flare ups - Rarely demonstrates positive rheumatoid factor - TX focused on = inflammation control, pain relief, & maintenance of mobility ▪ NSAIDs, corticosteroids, & anti-rheumatic drugs such as methotrexate & etanercept are prescribed depending on severity ▪ NSAIDS = helpful w/ pain relief ▪ Anti-rheumatics = necessary to prevent disease progression ▪ ROM exercises & exercise! (SWIMMING is a particularly useful exercise to maintain joint stability without placing pressure on the joints) - first sign in infant/young child = HX of irritability or fussiness - mold-moderate anemia and elevated sedimentation rate are common - some may have a positive ANA - encourage regular eye exams & vision screening to allow for early TX of visual changes & to prevent blindness - JIA results in chronic pain and affects growth & development as well as school performance Basic Growth & Development issues (both physical & psychosocial): INFANTS: 1 month – 1 year - Assessment  do painful things last! ▪ What order to do vital signsS Respirations, pulse, temperature ▪ Measure head circumference each visit • Average full-term newborn = 13-14 in. (33-35 cm) • Increase in head circumference indicates brain growth Pediatrics Final Exam Study Guide - Cryptorchidism = undescended testicle/s Pediatrics Final Exam Study Guide ▪ If they do not drop by 1 year ➔ SX “orchiopexy” indicated to preserve fertility - DDH : TX = Pavlik harness (under 6 months old) = ensures hip flexion & abduction. Does NOT allow hip extension or adduction. Worn for 3-6 months. ▪ DDH assessment • Asymmetry of thigh & gluteal folds • Alli’s sign = unequal knee height • Ortolani’s maneuver = distinctive “clunk” or clicking sound heard • Positive Barlow’s sign = “clunk” = feeling of femoral head slipping out of the acetabulum - RSV = most common cause of bronchiolitis ▪ Problem = airway partially obstructed allows air to come in but mucus & swelling of the airway block expulsion of air (Air can get in, but can’t get back out)  creates wheezing & crackles! ▪ The noisier the lungs, the better the air exchange! ▪ RSV can live on inanimate objects up to 72 hours & 30 min on skin ▪ Once the lower airway is involved = more severe infection…symptoms = tachypnea (>70 breaths/min); severe distress= nasal flaring - Otitis media: middle ear infection; related to Eustachian tube dysfunction ▪ often preceded by URI. ▪ Risk factors = day care, second-hand smoke, using pacifiers for several hours a day, & recurrent URIs ▪ Breastfeeding provides some protection (prevention) Pediatrics Final Exam Study Guide - Neural tube defects : spina bifida, Meningocele, myelomeningocele Pediatrics Final Exam Study Guide Pediatrics Final Exam Study Guide TOF = cyanotic; 4 defects: 1. D = defect (VSD) 2. R = right ventricular hypertrophy 3. O = overriding aorta 4. P = pulmonic stenosis - Clubbing - TET SPELLS! Put them in knee-chest position or squatting! (pressure changes gives them an O2 boost) & calm the child down! - Lifelong infective endocarditis prophylaxis required TGA: transposition of the great arteries - LIFE THREATENING condition; cannot survive w/o SX - significant cyanosis w/o murmur* - prostaglandin E1 used to keep a PDA until a palliative procedure can be done; SX (atrial switch) usually done before 1 week old ~ TODDLER: 1-3 years old - Potty training - Age 2 = voluntary sphincter control - Favorite word = NO - Average weight @ 2 years? 26 lbs - Average height @ 2 years? 34 in. - Increased ability to maintain body temp. - Produces antibodies - Voluntary control - Anterior fontanel closes = 12-18 months - Potbelly appearance - Urine output should = 1 mL/kg/hr Routines are important to them! Parallel play = playing next to others ~ PRESCHOOL: 3 - 6 years old - Fantasy play is dramatic & imaginative - Associative play = playing w/ others - Interactive play - - Pediatrics Final Exam Study Guide - Counting - “Magical thinking” - Imaginary friends (abandoned by school age) = provide reassuring feedback to them! - ~ SCHOOL AGE: 6-12 years old - Play = cooperative play, team play - Loses first primary teeth at about 6 years - All of their senses are mature - Develop interest for collecting objects - Develop concrete operational thinking  understanding of the “principle of conservation” = that matter does not change when its form changes (for ex. pouring the same amount of water into a wide glass vs. a tall thin glass, same amount of water) - Pre-pubescence = development of secondary sex characteristics - Sexual development in both boys & girls can lead to a negative perception of physical appearance & lowered self-esteem o Early development in girls can lead to embarrassment, low self- esteem; late development in boys can lead to negative self-concept - By age 10 can view death as inevitable, universal and permanent - Psychological: o Morality develops o Before age 9 = things are right or wrong o After age 9 = recognizes differing points of view; Sees “gray” areas o Self-esteem & worth relies on feedback from others (authority figures, etc) o They want to be good & please their parents/those around them - develop interest in religion but still guided by family beliefs & values - More active, playing outside, sports, rollerblading, etc.  SAFETY = important! Wear a helmet! - Important for school-agers to feel accepted by peers - compare themselves to peers & self-esteem is a central issue - Cooperative play (team sports) & solitary play (board, video games) - Rules are important to them! They can understand & obey rules. -Initiative vs. guilt Pediatrics Final Exam Study Guide o Need Ý calcium for skeletal growth, iron for muscle mass and blood cell development, zinc for skeletal and muscle tissue and sexual maturity Pediatrics Final Exam Study Guide - Safety  Accidents #1 cause of death