PNU 135 Pediatric Nursing: Growth, Development, Immunizations, and Mandated Reporting

Flashcards covering growth and development stages, physical/motor milestones, pediatric nutrition, injury prevention, immunization types and storage, and mandated reporting responsibilities for nurses.

Family-Centered Nursing Care

An agreed-upon partnership between families, nurses, and healthcare providers that respects cultural diversity, considers children's opinions, treats families as experts in their children's care, and defines family as whatever the child considers it to be.

Traditional Nuclear Family

A family structure composed of a married couple and their biological children, consisting only of full brothers and sisters.

Blended Family

Also called a reconstituted family; a family structure that includes at least one stepparent, stepsibling, or half-sibling.

Binuclear Family

A family arrangement in which parents have terminated their spousal roles through divorce or separation but continue their joint parenting roles.

Communal Family

A group of individuals who share common ownership of property and goods, and exchange services without monetary consideration.

Childhood Stages by Age

The official age divisions of childhood: Infants ($1$ to $12$ months), Toddlers ($1$ to $2$ years), Preschool ($3$ to $5$ years), School-age ($6$ to $11$ years), and Adolescents ($12$ to $19$ years).

Erikson's Psychosocial Stages of Childhood

The five developmental crises across childhood: Trust vs. Mistrust (Infant), Autonomy vs. Shame and Doubt (Toddler), Initiative vs. Guilt (Preschool), Industry vs. Inferiority (School-age), and Identity vs. Role Confusion (Adolescent).

Infant Physical Growth Norms

Physical growth expectations during the first year of life where birth weight doubles by $6$ months and triples by $1$ year, height increases by $50\%$ by $1$ year, and head growth occurs rapidly.

Infant Fine and Gross Motor Milestones

Key motor developments in the first year: head control ($4$ months), two-handed grasp ($5$ months), rolling back to abdomen and holding bottle ($6$ months), sitting alone ($8$ months), standing while holding furniture ($9$ months), crawling and pincer grasp ($10$ months), creeping and cruising ($11$ months), and walking with one hand held ($12$ months).

Infant Dietary Progression

Nutritional intake progressing from exclusive breast milk or iron-fortified formula for the first $12$ months; introduction of iron-fortified cereal at $4$ to $6$ months; fruits, fruit juice, and vegetables at $6$ to $8$ months; finger foods (no eggs or meat) at $8$ to $9$ months; and chopped cooked table food (eggs and meat permitted, no honey) at $12$ months.

Toddler Physical Growth Norms

Growth patterns in toddlers characterized by slowed weight gain, reaching $4 \times$ birth weight at $2.5$ years, and achieving approximately $50\%$ of adult height by $2$ years of age.

Toddler Motor Milestones

Motor skill progression including independent walking, cup usage, and building block towers ($15$ months); jumping, throwing a ball, and turning pages ($18$ months); running and climbing stairs with two feet per step ($24$ months); and standing on tiptoe and drawing a circle ($36$ months).

Preschooler Growth and Vital Signs

An average annual physical gain of $3\text{ inches}$ in height and $4\text{ pounds}$ in weight. Normal blood pressure range for ages $3$ to $5$ years is a systolic of $82$ to $100\text{ mmHg}$ and a diastolic of $50$ to $78\text{ mmHg}$.

Preschool Visual Acuity Screening

Visual acuity testing performed $10\text{ feet}$ from an eye-level chart screening one eye at a time, where normal visual acuity is $20/40$ for age $3$ and $20/30$ for age $4$.

Magical Thinking

A cognitive characteristic of preschool-age children in which they believe their personal thoughts, wishes, or actions directly influence external events in the world around them.

Associative Play

A form of play characteristic of preschoolers centered around group interaction, sharing with peers and adults, and imaginative or pretend activities without strict formal rules.

Concrete Operational Thought

Cognitive stage characteristic of school-age children who are limited to understanding concepts they can see or touch; patient education requires concrete objects (e.g., allowing them to handle a syringe) rather than abstract verbal explanations.

Formal Operational Thought

Cognitive stage achieved during adolescence enabling individuals to think in abstract terms, manipulate hypothetical concepts, and use rational thinking to reach conclusions.

Pediatric Car Safety Standards

Restraint requirements by age: Rear-facing seat in back seat for infants; forward-facing harness seat then booster seat for toddlers/preschoolers; booster seat for school-age children under $4\text{ ft } 9\text{ in}$ (typically ages $8$ to $12$); and sitting in the front seat with lap/shoulder belt permitted at age $13$.

Combination Vaccine

A single formulation combining multiple vaccines to protect against different diseases, reducing the total number of required injections and improving adherence (e.g., MMRV vaccine).

Conjugate Vaccine

A vaccine type that covalently links a polysaccharide antigen to a protein carrier to enhance immune response against encapsulated bacterial pathogens (e.g., Haemophilus influenzae type b [Hib] vaccine).

Monovalent Vaccine

A vaccine designed to target a single specific pathogen or a single strain of a microorganism (e.g., targeted SARS-CoV-2 vaccine).

Polyvalent Vaccine

A vaccine formulated to provide broad immune protection against multiple strains or serotypes of the same pathogen (e.g., seasonal influenza vaccine).

Vaccine Contraindication vs. Precaution

A contraindication permanently excludes a child from receiving further doses due to risk of severe harm (a severe allergic reaction is the only standard contraindication); a precaution indicates elevated risk for an adverse reaction. Current moderate or severe illness warrants temporary delay, but mild illness (e.g., ear infection) does not.

Live Vaccine Storage Requirements

Vaccines containing live attenuated virus pathogens, specifically Varicella and MMR vaccines, which must be maintained inside a monitored vaccine freezer rather than a standard refrigerator.

Mandatory Reporting

The legal obligation imposed on all healthcare providers to report any suspected cases of child maltreatment or abuse based on clinical assessment findings, carrying legal penalties for failure to report and not requiring the provider to prove or validate the abuse prior to reporting.

Physical Indicators of Child Abuse (Skin and Burns)

Objective assessment findings suggesting non-accidental trauma, including unusual bruising on the abdomen, back, or buttocks; bruises at different stages of healing; object-shaped welts (belt buckle); glove- or stocking-like immersion burns on hands or feet; and small round burns caused by lit cigarettes.

Physical Indicators of Child Abuse (Fractures and Head Trauma)

Clinical indicators of intentional injury including multiple fractures, unusual fracture configurations such as forearm spiral fractures caused by forceful twisting, and head trauma marked by altered consciousness, unequal or unreactive pupils, or unexplained nausea and vomiting.