Exam 1

What is family considered as?

basic social unit

What is the definition of “nuclear family”?

outdated dominant family structure involving the husband, wide, and children living in the same household

What definition of family should healthcare workers abide to?

whatever the child or family says it is

What are the 4 parental roles?

nurturer, decision maker, financial manager, educator

What are the 4 parental styles?

authoritarian, authoritative, permissive, neglectful

What is authoritarian parenting style like?

expects child to be obedient; discourages child from questioning family rules; low support/high control; low nurture/affection from parents to child

What is authoritative parenting style like?

“democratic”; some respect for child’s opinion; child is seen as an individual; fair and consistent

What is permissive parenting style like?

little control over child’s behavior; rules are inconsistent/unclear; child determines own standards and rules for behaviors

What is neglectful parenting style like?

caregivers are uninvolved/disconnected; no rules or standards

What is temperment?

manner in which a child interacts with environment (easy, difficult, slow to warm up)

What are the 4 special situations for informed consent?

children under 18 years of age, emergencies, verbal consent, and emancipated minors

What are emancipated minors?

a minor who is declared separate from parents and is deemed to make medical decisions for self regardless of being < 18 years old

What is assent?

a child’s participation/agreement in decision-making (e.g., if parent agreed to allow child to participate in allergy testing study but child refused, healthcare providers would abide to child’s wish over parents)

What is atraumatic care?

therapeutic care that minimizes or eliminates psychological and physical distress experienced by children and their families in the health care system

What are examples of preventing physical stressors?

inserting medication locks on a pt who is expected to get multiple blood draws; anesthetics for insertion of medication lock; pain medication

What are ways to prevent psychological stressors?

allow caregiver to stay with child during care provided by healthcare team; allowing caregiver to hold child’s hand; grouping together care to minimize sleep interruptions

What is a technique used with pediatric patients to enhance therapeutic communication?

therapeutic play where children uses play to provide an emotional outlet and relieve stress

How can a nurse prepare for a physical exam on newborns and infants?

do quiet non-invasive things first, have parent hold child, use soft gently voice

How can a nurse prepare for a physical exam on toddlers?

incorporate play as appropriate, introduce equipment slowly, can sit in parent’s lap, remove one piece of clothing at a time; don’t ask for permission (will likely say no to everything) so compromise like reward with snack after assessment

How can a nurse prepare for a physical exam on a preschooler?

allow them to help by holding equipment, may withdraw from procedures they see as intrusive

How may a nurse prepare for a physical exam on school-age children?

use words the child can understand, use gown and undergarments, respect privacy, be truthful and use simple explanations

How can a nurse prepare for a physical exam on an adolescent?

provide privacy, be respectful, expose only area needing to be examined, encourage child to ask any questions

What age is a tympanic temperature recommended for?

children 3 months and older (reads in seconds)

What age is actemporal temperature recommended for?

3 months and older taken over temporal artery on exposed side of head

What age is an oral temperature recommended for?

5 y/o and is highly reliable

What is the normal HR and RR of an infant?

HR: 80-150

RR: 25-55

What is the normal HR and RR of a toddler?

HR: 70-120

RR: 20-30

What is the normal HR and RR of a preschooler?

HR: 65-110

RR: 20-25

What is the normal HR and RR of a school-aged child?

HR: 60-100

RR: 14-26

What is the normal HR and RR of an adolescent?

HR: 55-95

RR: 12-20

What age can you typically switch from apical pulse to radial pulse?

10 y/o

What type of breathing do infants < 1 y/o do?

diaphragmatic breathing

At what age does BP start to get taken during welfare health checks?

3 y/o

What ages is length measured?

0-24 months (measurement laying down)

What ages does height get measured?

24+ months (standing up)

How is weight taken for infants?

naked weight including diapers

For what ages are weight for height used?

0-24 months

For what ages are BMI’s used?

>2 y/o (below 5th percentile means underweight, 90th percentile means risk for overweight, 95th percentile means overweight)

What ages are head circumference measurement used for?

0-24 months

What age group experience more anxiety?

toddlers

How can nurses manage reactions to hospitalization?

utilize family-centered care, understand developmental stages and milestones pt reach, work as team especially with child life, comfort items

What age range are newborns?

0-28 days

What age range are infants?

28 days-1 year

What is Erikson’s developmental theory for infants?

trust vs. mistrust- caregiver responding to infant needs creates a sense of trust

What is Piaget’s developmental theory for infants?

sensorimotor- infant uses senses and motor skills to lear about the world

What is Freud’s developmental theory for infants?

oral stage- pleasure is focused on oral activities of feeding and sucking

How does an infants weight change at 4 months and one year?

weight doubles by 4 months, triples by one year

How does the body compensate for the increased brain growth?

rapid growth of head circumference during 6 months

What age does the anterior fontanelle remain open until?

12-18 months

What is the Moro reflex?

when arms abduct and move upward while hands form a “c” when there is a sudden extension of the head and feel like they are falling

What is the Rooting reflex?

cheek gets stroked and infant turns to the side and “searched” with their mouth

What is the Sucking reflex?

when nipple or finger is in mouth

What is the Asymmetric Tonic Neck/Fencing reflex?

infant is lying supine with arms extended at side and head is turned while opposite side is flexed

What is the Plantar/Palmar grasp relfex?

palm of hands or bottom of feet are touched and reflex is to grasp

What is the Step reflex?

When infant is standing and while one foot is flat on the surface the other foot is aiming to take the next step

What is the Babinski reflex?

when foot gets stroked along the sole, a fanning and hyperextension of the toes occur

What is the Parachute reflex?

protection of self by extending arms when leaned sideways, forward, or backwards

How should a 1 month old demonstrate age appropriate gross motor skills?

lift and turn head to sit in prone position, head lag when pulled to sit, rounded back in sitting

How should a 2 month old demonstrate age appropriate gross motor skills?

raises head and chest and holds position, improvement in head control

How should a 3 month old demonstrate age appropriate gross motor skills?

raises head to 45 degrees in prone, slight head lag in pull-to-sit

How should a 4 month old demonstrate age appropriate gross motor skills?

lifts head and looks around, rolls from prone to supine, head leads body when pulled to sit

How should a 5 month old demonstrate age appropriate gross motor skills?

rolls from supine to prone and back again, sits with back upright when supported

How should a 6 month old demonstrate age appropriate gross motor skills?

tripod sits

How should a 7 month old demonstrate age appropriate gross motor skills?

sits alone with some use of hands for support

How should a 8 month old demonstrate age appropriate gross motor skills?

sits unsupported

How should a 9 month old demonstrate age appropriate gross motor skills?

crawls, abdomen off floor

How should a 10 month old demonstrate age appropriate gross motor skills?

pulls to stand, cruises

How should a 12 month old demonstrate age appropriate gross motor skills?

sits from standing position, walks independently

What are signs of motor development issues?

arms and legs still floppy, no support of head at 3-4 months, only reaches with one hand, cannot sit w/ assistance at 6 months, does not crawl at 12 months, cannot stand supported at 12 months

How should a 1 month old demonstrate age appropriate fine motor skills?

first mostly clenched

How should a 3 month old demonstrate age appropriate fine motor skills?

holds hands in front of face

How should a 4 month old demonstrate age appropriate fine motor skills?

bats at objects

How should a 5 month old demonstrate age appropriate fine motor skills?

grasps at rattle

How should a 6 month old demonstrate age appropriate fine motor skills?

release objects in hand to take another

How should a 7 month old demonstrate age appropriate fine motor skills?

hand to hand object transfer

How should a 8 month old demonstrate age appropriate fine motor skills?

finger feeding (raking) and pincer grasp

How should a 9 month old demonstrate age appropriate fine motor skills?

bangs objects together

How should a 10 month old demonstrate age appropriate fine motor skills?

puts objects in containers and takes them out; fine pincer grasp

How should a 11 month old demonstrate age appropriate fine motor skills?

offers objects to others and releases them

How should a 12 month old demonstrate age appropriate fine motor skills?

feeds self with cup and spoon

How should a newborn demonstrate age appropriate language development?

responds to sound

How should a 1-3 month old demonstrate age appropriate language development?

coos and smiles

How should a 4-5 month old demonstrate age appropriate language development?

laughs, expresses delight

How should a 7 month old demonstrate age appropriate language development?

babbles

How should a 7-10 month old demonstrate age appropriate language development?

dada and mama

How should a 8-9 month old demonstrate age appropriate language development?

waves “bye-bye”

How should a 9-10 month old demonstrate age appropriate language development?

understands “no”

How should a 11-12 month old demonstrate age appropriate language development?

2 words other than mama/dada

How should a 12-13 month old demonstrate age appropriate language development?

jabbering

When does the emergence of fearing strangers begin?

6-9 months

When does the emotional development (accompanied with cognitive milestone of object permanency) occur?

as infant distinguished mother from stranger

When does separation anxiety begin and peak?

begins around 8-9 months; peaks around 14 months

What are signs of language development problems?

no sounds at 4 months, no laugh or squeal at 6 months, no babble at 8 months, does not use single words w/ meaning (mama, dada) at 12 months

What is a newborns vision like?

can focus on objects between 8-15 inches preferring human face; have a preference for black and white stripes

When does visual ability to fuse two ocular into one cerebral picture (combining images captured by the two eyes into single image) begin and when is it established?

6 weeks; 4 months

At what age does full color vision, distance vision, and ability to track develop by>

7 months

When does tooth eruption begin?

6 months

What if an infant is not on public water?

will need fluoride by 6 months of age

What should be done to an infant’s mouth after feedings?

clean gums with wet washcloth

When should a infant have their first dental appointment

12 months