NURS 403 - Pediatrics Unit 2

2nd

from birth to 24 months, below the _____ percentile is considered underweight

98th

from birth to 24 months, above the _____ percentile is considered overweight

5th

after 24 months, below the _____ percentile is considered underweight

85th and 95th

after 24 months, between the _____ percentile are at risk for overweight

95th

after 24 months, above the _____ percentile is considered overweight

corrected gestational age

when documenting growth, use a _____ for infants that were born prematurely until they are 3 years old

3

when documenting growth, use a corrected gestational age for infants that were born prematurely until they are _____ years old

3

head circumference is measured on infants until age _____ at each well visit

fever

crying

medications

activity

factors that can increase a child's heart rate

> 20

apnea in infants is no respirations for _____ seconds

lanugo

fine downy hair of an infant

lanugo

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acrocyanosis

blueness of the extremities

acrocyanosis

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mongolian spots

hyperpigmented nevi common in dark-skinned infants

mongolian spots

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9-18 months

when does the anterior fontanel close?

2 months

when does the posterior fontanel close?

milia

small white papules on the face of an infant

milia

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positional plagiocephaly

a flattened occiput in an infant may be due to _____

plagiocephaly

develops when an infant's soft skull becomes flattened in one area, due to repeated pressure on one part of the head

plagiocephaly

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polydactyly

increased number of digits

polydactyly

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syndactyly

webbed digits

syndactyly

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cradle cap

seborrheic dermatitis in infants

cradle cap

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4-6 months

intermittent strabismus is normal in infants until _____

genetic syndromes

low set ears in infants may indicate _____

3-6 months

infants are obligate nose breathers until _____

3 months

in infants, salivation begins at _____

6 months

in infants, the tongue extrusion reflex lasts up to _____

5-6 months

infants have no teeth until _____

4 months

head control in infants is expected by _____

umbilical hernia

type of hernia in infants that usually goes away on it's own and doesn't require surgical intervention

30 months

toddlers should have 20 teeth by _____

pectus excavatum

depressed sternum

pectus excavatum

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pectus carinatum

protuberant sternum

pectus carinatum

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internal tibial torsion

pigeon toes

large

_____ tonsils are normal in toddlers

flat

_____ feet are normal in toddlers

paronychia

inflammation of the nail fold

paronychia

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chronic hypoxia

clubbing of nails indicates _____

clubbing of nails (chronic hypoxia)

this picture indicates:

koilonychia

spoon shaped nails

koilonychia (iron-deficiency anemia)

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iron-deficiency anemia

koilonychia indicates _____

8 years

female breast development may begin as early as _____

tanner staging

sexual maturity rating scale for breasts, genitalia, and pubic hair

13

female breast development begins at age _____ in most girls

facial expressions (brow contracting, quivering chin)

the most common response to pain in infants

CRIES scale

pain scale used for newborns and infants

crying

requires O2 for an SpO2 > 95%

increased vital signs

expression

sleeplessness

categories of the CRIES scale:

Wong-Baker FACES scale

pain scale used for ages 3-8 on average

FLACC scale

pain scale used for children who can't verbalize the FACES pain scale (children younger than 3, those with developmental issues, those who are nonverbal)

face

legs

activity

cry

consolability

categories of the FLACC scale:

therapeutic hugging

relaxation

distraction

guided imagery

biofeedback

thought stopping, positive self-talk

cognitive-behavioral strategies for pain management:

massage, acupressure

cold therapy, ice

heat therapy

nonnutrive sucking with sucrose (sweet-ease)

biophysical interventions for pain management:

nonopioids

analgesics indicated for mild (0-3) to moderate (4-6) pain

ibuprofen

ketorolac (toradol)

acetaminophen

nonopioids for pain management:

ibuprofen

nonopioid that should not be given to children under 6 months of age due to gastrointestinal issues and problems that can occur with the kidneys

aspirin

nonopioid that should not be given to children due to the risk for Reye syndrome, which causes brain and liver swelling, neurological impairment, and death

opioids

analgesics indicated for severe pain (>7)

hydrocodone

morphine

opioids for pain management:

morphine

the gold standard for severe pain

meperidine (demerol)

opioid that should be avoided because it has been known to cause seizures and CNS toxicity

codeine and tramadol

opioids that should not be given to children younger than 12

diazepam (anxiety)

midazolam (amnesia)

benzodiazepines for pain management:

gabapentin (neuropathic pain)

anticonvulsants for pain management:

EMLA cream

vapocoolants

local anesthetics for pain management:

strained healthcare funding

shorter hospital stays

cost containment

acute care is not a good environment for children

reasons for early transitions of care from hospitals to communities:

teaching

communicating

care coordination

resource allocation

primary functions of the community health nurse for the pediatric population

protest phase

despair phase

detachment or denial phase

three phases of separation anxiety:

protest phase

phase of separation anxiety: crying, clinging to parents

protest phase

phase of separation anxiety: expressing agitation and aggression toward strangers

protest phase

phase of separation anxiety: rejecting others who attempt to offer comfort

despair phase

phase of separation anxiety: hopelessness

despair phase

phase of separation anxiety: withdrawal, decreased communication, quiet, depressed, apathetic, sad

despair phase

phase of separation anxiety: lack of interest

detachment or denial phase

phase of separation anxiety: long-term separations

detachment or denial phase

phase of separation anxiety: coping skills developed

detachment or denial phase

phase of separation anxiety: superficial relationships formed

detachment or denial phase

phase of separation anxiety: parents are ignored if they return

detachment or denial phase

phase of separation anxiety: delays may occur (developmental regression)

trust and bonding

a developmentally delayed infant may fail to develop sense of _____

autonomy

a developmentally delayed toddler may have difficulty developing _____

initiative

a developmentally delayed preschooler may have difficulty achieving a sense of _____

industry

a developmentally delayed school-age child may have difficulty achieving _____

self-identity relative to peers

a developmentally delayed adolescent may have difficulty forming a sense of _____

vulnerable child syndrome

describes a phenomenon in which a child is perceived as being at higher risk for medical, behavioral, or developmental problems than is warranted by the child's current health

vulnerable child syndrome

occurs when a parent continues to exhibit unwarranted concerns as a reaction to a serious event in the child's past

preterm birth

congenital anomaly

newborn jaundice

handicapping condition

an accident or illness that the child was not expected to recover from

crying or feeding problems in the first 5 years of life

risk factors for vulnerable child syndrome:

failure to thrive

a condition of inadequate growth in infants and children

developmental issues

a child with failure to thrive may develop _____ due to the poor nutritional intake

observe parent-child interactions

develop and maintain appropriate feeding schedule

weigh child daily and record strict I&O

educate parents on feeding techniques and amounts

provide consistent nursing care and support

nursing interventions for failure to thrive: