care of the hospitalized child

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

>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

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