what should pediatric care be focused on
atraumatic care and anticipatory guidance
who is important in obtaining the health history of a child
parents
until what age is head circumference measured
2 years
when do lead screening questionnaires begin
6 months
when do we start taking BP
3 years
if BMI is less than 5% what is indicated
failure to thrive
what is the purpose of the Denver developmental screening tool
screens for developmental delays in the first 5 years of life for children considered at risk
what factors does the denver developmental screening look at
communication, gross motor, fine motor, problem solving, personal-social
for infants <3 months, when should a fever be reported to physician
100.4
what kind of breathing is seen in infants-early childhood
diaphragmatic
how can you communicate with a young child to gain trust
play, story telling, use toys and familiar objects, allow time
tips for assessing an infant
let baby sleep, auscultate heart and lungs while baby is quiet, undress baby
tips for assessing a toddler
make it a game, use minimal physical contact initially, painful procedures last, give choices, allow them to explore instruments
normal or abnormal for child assessment: able to feel small non-tender single lymphnodes
normal
when do typical new infant health visits occur
2 weeks, 2 months, 4 months, 6 months, 9 months
when are infants first screened for hearing
birth
average head circumference of a newborn
33-35cm (2-3cm greater than chest circumference)
what is the safest way to use a carseat
rear-facing in the back seat until they reach max weight/height
how can we prevent falls in infants
never leave alone on high surface, keep crib rails up, put gates on stairs
what is SIDS
unexplained death of an infant <1 year of age
how to prevent SIDS
safe sleep- on the back, avoid pillows, blankets, and toys in bed, pacifier is protective
what should be an infants nutrition birth to 6 months
breast milk or formula only
when is a baby ready for solid foods
6 months and when they show interest and are able to hold head up
when should cows milk or plant-based milk be introduced
1 year
what does nutrition look like 6-12 months
introduce veggies first (one at a time), water in a cup
what supplement do infants often need
vitamin d
what should parents be informed to do if they call about their child ingesting chemicals or poison substance
call poison control
how do toddlers often view bedtime
resistance due to night terrors and fear of missing out
at what age does vision mature to 20/20
6 years
what should be assessed in school aged children
HEEDASSS- home, education, eating, drugs, activities, sexuality, suicide, safety
what are typical parent reactions to a hospitalized child
fear, guilt, stress over finances/work/other children, lack of knowledge
how to support a toddler in the hospital
maintain home routine, expect regression, minimize separation from parents, allow mobility
how do preschoolers view hospitilization
may feel punished or concern with bodily mutilation
how to assist a hospitalized pre-schooler
allow choices, get child involved in care, incorporate play, allow them to handle equipment, provide praise
how to assist a hospitalized school age child
encourage expression of feelings, respect privacy, explain procedures with factual info
where should non-emergent procedures and treatment be performed
in the treatment room, not the child’s room as this should be a safe space
what is the nurses role and initial action if child abuse is suspected
call DCFS as a mandated reporter
what is the primary trigger for shaking a baby
inconsolable crying
what are the red flags of muchausen by proxy
frequent moves of caregiver/child, siblings who have died or have unusual illness, seeking care at multiple facilities, reluctance to accept severe diagnosis
what places children at greater risk for child abuse
behavioral difficulties, chronic illness, physical or developmental disabilities, unplanned pregnancy
what places a parent at greater risk for becoming an abuser
substance abuse, young age, mental illness, poor impulse control, lack of knowledge on child development, overexpectations
what are the characteristic of accidental burns
splash burn to the chest, back, lateral face, or shoulder that come from scalding liquids such as hot water from the stove
what are the characteristics of non-accidental burns
stocking/glove, flexion, immersion
what is a stocking/glove burn (non-accidental)
child uses hands to prevent immersion into hot water
what is a flexion burn (non-accidental)
z pattern occurs from the child flexing body part during immersion
what is an immersion burn (non-accidental)
buttocks or genital involved