peds exam 1 notes

Health Promotion

Health Promotion

Focuses on maintaining or enhancing the physical and mental health of children

Partnership Development

Key strategy for success in health promotion activities

Principles of Health Supervision

Providing services proactively, optimizing child's functioning, ensuring appropriate growth and development, promoting best health, preventing injury and illness

Three Components of Health Supervision

Developmental surveillance, injury and disease prevention, health promotion

Growth

Increase in physical size

Development

Sequential process of gaining skills and functions

Maturation

Increase in functionality of body systems or skills

Denver II Developmental Screening Test

Screens developmental milestones in gross motor, fine motor, language, and social skills

Adjusted Age

Used for premature infants to assess growth and development milestones

Newborn Reflexes

Sucking, Rooting, Grasp, Babinski, Moro, Tonic neck, Dance/step

Infant Milestones

Fine pincer grasp, social smile, head turns, steady head control, rolling, peek-a-boo, object transfer, sitting unsupported, crawling, waving, walking with assistance, first words

Toddler Safety

Focus on safety education, car seats, pool fences, prevention of accidental poisoning

Puberty

Maturational changes in girls and boys, sequence of physical changes

School Age/Adolescent Safety

Focus on preventing unintentional injuries, seatbelt use, swimming lessons, avoiding distractions while driving, recognizing signs of depression

Growth Milestones

Doubling and tripling of birth weight, doubling of birth length, milestones like using scissors and tying shoes

Erikson's Developmental Theories

Trust vs mistrust, Autonomy vs shame and doubt, Initiative vs guilt, Industry vs inferiority, Identity vs role confusion

Stressors in Hospitalized Children

Separation anxiety, loss of control, ways to minimize stress

Autism

Neurodevelopmental disorder with deficits in social communication, diagnostic evaluation, prognosis, nursing care management

Hearing Impairment

Complex disorder affecting social, language, and behavioral aspects, diagnostic evaluation, nursing care strategies.

Hearing Impairment

When caring for a child who is hearing impaired, encourage the use of hearing aids, maintain eye contact, speak clearly, eliminate background noise, and use visual aids for communication.

Visual Impairment

When working with a child who has a visual impairment, orient them to the environment, explain actions before touching, use familiar terms, keep items in consistent places, allow control, and supervise as needed.

Nursing Assessment of Child w/ Disability

Assess intellectual skills, social interaction, ADLs, and communication, use simple language, involve the child in providing information, and follow a non-invasive assessment order.

Emancipated Minor

A minor who has legal independence from parents through marriage, pregnancy, service in the armed forces, or court order, capable of giving informed consent.

IV Access

Involves site selection, atraumatic care, peripheral IV placement, securement, use of infusion pumps, safety measures, maintenance, and complication assessment.

Pain Management

Includes assessment scales like NIPS, FLACC, FACES, and numeric scale, opioid and non-opioid analgesics, and guidelines for pediatric pain management.

Respiratory Dysfunctions

Assess respiratory function, including breathing patterns, cough characteristics, cyanosis, and auscultation techniques for lung sounds.

Acute Laryngotracheobronchitis

The most common form of croup caused by a viral infection, leading to inflammation of the larynx, trachea, and bronchi.

Viral Croup

Inflammation of the upper airway.

Pathophysiology of Acute Laryngotracheobronchitis

Includes Parainfluenza, RSV, and Influenza.

Characteristics of Croup

Night-time cough and Barky cough.

Signs and Symptoms of Acute Laryngotracheobronchitis

Include Inspiratory stridor, Suprasternal retractions, Nasal flaring, and Decreased pulse-ox.

Nursing Interventions for Acute Laryngotracheobronchitis

Home Management with cool mist vaporizer, Elevate Head of Bed, Shower steam, Keep comfortable, and Increase PO fluids.

Hospital Management for Acute Laryngotracheobronchitis

Monitor for respiratory distress, Provide cool mist humidified oxygen, Elevate HOB, and Administer medications like Oxygen, epinephrine nebulizer, and corticosteroids.

Acute Spasmodic Laryngitis

Recurring night laryngeal obstruction that subsides in a few hours, often allergic-related.

Pathophysiology of Acute Spasmodic Laryngitis

Involves RSV, Adenovirus, and Parainfluenza.

Signs and Symptoms of Bronchiolitis

Tachypnea, Wheezing, Cough, Rhinorrhea, Sneezing, and Difficulty feeding.

Nursing Interventions for Bronchiolitis

Include Nasal and/or nasopharyngeal suctioning, Frequent respiratory assessments, Positioning, and Monitoring pulse oximeter.

Prevention of RSV Bronchiolitis

Palivizumab (Synagis) for high-risk infants.

Pneumonia

Inflammation/infection of the alveoli and the pulmonary parenchyma.

Signs and Symptoms of Pneumonia

Fever, Cough, Tachypnea, Decreased breath sounds, Crackles, and Difficulty feeding.

Nursing Interventions for Pneumonia

Administer Oxygen and Antibiotics as ordered, Chest PT, Monitor Pulse Ox, and Lay on affected side.

Foreign Body Obstruction

Occlusion to lungs due to an offending object, leading to symptoms like Cough, Gagging, Wheezing, and Stridor.

Nursing Interventions for Foreign Body Obstruction

Prevention through education on dangers of certain foods/toys, Emergency measures like Heimlich maneuver, and preparing for endoscopy.

Asthma

Chronic airway inflammation with heightened reactivity, leading to airway obstruction and recurring symptoms.

Status Asthmaticus

Severe asthma attack requiring immediate medical attention.

Nursing Interventions for Asthma

Avoid triggers, Monitor pulse ox, Administer medications like Albuterol and corticosteroids, and Educate on asthma action plan and trigger avoidance.

Cystic Fibrosis

Multisystem autosomal recessive disorder characterized by thick mucous production affecting respiratory, GI, and reproductive systems.

Signs and Symptoms of Cystic Fibrosis

Include Cough, Recurrent URI, Clubbing, Barrel chest, Intestinal obstruction, and Failure to thrive.

Nursing Interventions for Cystic Fibrosis

Diagnose with sweat chloride test, Manage with Chest PT, Oxygen, and Pancreatic enzymes, and Provide a high-calorie, high-protein diet.