Pedi/OB Exam 3

Osteogenesis Imperfecta (assessment)

THINK BLUEEEEE

-blue sclera

-small, discolored teeth (blue)

-early hearing loss

-bone fractures and deformities

cerebral palsy assessment

-Gagging or choking with feeding

-Poor sucking

-Consistent tongue thrusting

-Asymmetric crawl

-Early hand preference

-Toe walking

-Persistent primitive reflexes (moro or tonic neck)

-Hyperreflexia

-Rigid posture and extremities

-Scissoring and extension of legs

-Arching back

-Difficulty diapering child

-Stiff postures

-Vision, speech, or hearing impairments

-Seizures

-cognitive/intellect impairment

-Impaired social relationships

-Parents report difficulty meeting developmental milestones

cerebral palsy reduction of risk/analyze

-airway & aspiration

-mobility (falls/injury) (skin breakdown)

-difficulty feeding

types of casting/harnesses used in developmental dysplasia of hip

-pavlik harness

-hip spica cast

what age uses a pavlik harness

newborn-6 months

what age uses a hip spica cast

6 months-2 years

nursing interventions for pavlik harness

-Manage dislocation or persistent instability

-Maintain harness placement for to 12 weeks

-Harness typically worn 23 hours per day until the hip is stabilized

-Straps may need readjustment by the provider at least every week

-Check straps frequently at least 2 times each day

-Perform neurovascular and skin integrity checks

-Removing the harness is dependent on the parents

nursing interventions for hip spica cast

-Changed frequently by the provider

-Assess and maintain the cast

-Perform frequent neurovascular checks

-Perform range of motion with the unaffected extremities

-Perform frequent assessment of skin integrity, especially in the diaper area

-Assess for pain control using an age-appropriate pain tool. -Intervene as indicated

-Evaluate hydration status frequently

-Assess elimination status daily

birth-3 yrs concept of death

-little to no concept

-mirrors parents

-may regress

3-6 yrs (preschool) concept of death

-egocentric

-seperation is a punishment

-death is temporary

6-12 (school-age) concept of death

-some concept

-can be curious

12-20 (adolescents) concept of death

-adult-like concept

-relys on peers more than guardians

-stressed

-guilt and shame

WHAT IS SUPER IMPORTANT TO KNOW FOR THE CONCEPT OF DEATH IN 3-6 OR PRE-SCHOOL CHILD

they think it is temporary